For living well, behaviors and circumstances matter just as much as psychological traits.

In 2004 through 2016, three studies in the national Midlife in the United States (MIDUS) project asked participants the open-ended question "What do you do to make life go well?". We use verbatim responses to this question to evaluate the relative importance of psychological traits and circumstances for predicting self-reported, subjective well-being. The use of an open-ended question allows us to test the hypothesis that psychological traits are more strongly associated with self-reported well-being than objective circumstances because psychological traits and well-being are similarly self-rated-meaning that they both ask respondents to decide how to place themselves on provided and unfamiliar survey scales. For this, we use automated zero-shot classification to score statements about well-being without training on existing survey measures, and we evaluate this scoring through subsequent hand-labeling. We then assess associations of this measure and closed-ended measures for health behaviors, socioeconomic circumstances, biomarkers for inflammation and glycemic control, and mortality risk over follow-up. Although the closed-ended measures were far more strongly associated with other multiple-choice self-ratings, including Big 5 personality traits, the closed- and open-ended measures were similarly associated with relatively objective indicators of health, wealth, and social connectedness. The findings suggest that psychological traits, when collected through self-ratings, predict subjective reports of well-being so strongly because of a measurement advantage-and that circumstance matters just as much when assessed using a fairer comparison.

COVID-19 increased censorship circumvention and access to sensitive topics in China.

Crisis motivates people to track news closely, and this increased engagement can expose individuals to politically sensitive information unrelated to the initial crisis. We use the case of the COVID-19 outbreak in China to examine how crisis affects information seeking in countries that normally exert significant control over access to media. The crisis spurred censorship circumvention and access to international news and political content on websites blocked in China. Once individuals circumvented censorship, they not only received more information about the crisis itself but also accessed unrelated information that the regime has long censored. Using comparisons to democratic and other authoritarian countries also affected by early outbreaks, the findings suggest that people blocked from accessing information most of the time might disproportionately and collectively access that long-hidden information during a crisis. Evaluations resulting from this access, negative or positive for a government, might draw on both current events and censored history.

Online social integration is associated with reduced mortality risk.

Social interactions increasingly take place online. Friendships and other offline social ties have been repeatedly associated with human longevity, but online interactions might have different properties. Here, we reference 12 million social media profiles against California Department of Public Health vital records and use longitudinal statistical models to assess whether social media use is associated with longer life. The results show that receiving requests to connect as friends online is associated with reduced mortality but initiating friendships is not. Additionally, online behaviors that indicate face-to-face social activity (like posting photos) are associated with reduced mortality, but online-only behaviors (like sending messages) have a nonlinear relationship, where moderate use is associated with the lowest mortality. These results suggest that online social integration is linked to lower risk for a wide variety of critical health problems. Although this is an associational study, it may be an important step in understanding how, on a global scale, online social networks might be adapted to improve modern populations' social and physical health.

Prediction of mortality using on-line, self-reported health data: empirical test of the RealAge score.

OBJECTIVE: We validate an online, personalized mortality risk measure called "RealAge" assigned to 30 million individuals over the past 10 years. METHODS: 188,698 RealAge survey respondents were linked to California Department of Public Health death records using a one-way cryptographic hash of first name, last name, and date of birth. 1,046 were identified as deceased. We used Cox proportional hazards models and receiver operating characteristic (ROC) curves to estimate the relative scales and predictive accuracies of chronological age, the RealAge score, and the Framingham ATP-III score for hard coronary heart disease (HCHD) in this data. To address concerns about selection and to examine possible heterogeneity, we compared the results by time to death at registration, underlying cause of death, and relative health among users. RESULTS: THE REALAGE SCORE IS ACCURATELY SCALED (HAZARD RATIOS: age 1.076; RealAge-age 1.084) and more accurate than chronological age (age c-statistic: 0.748; RealAge c-statistic: 0.847) in predicting mortality from hard coronary heart disease following survey completion. The score is more accurate than the Framingham ATP-III score for hard coronary heart disease (c-statistic: 0.814), perhaps because self-reported cholesterol levels are relatively uninformative in the RealAge user sample. RealAge predicts deaths from malignant neoplasms, heart disease, and external causes. The score does not predict malignant neoplasm deaths when restricted to users with no smoking history, no prior cancer diagnosis, and no indicated health interest in cancer (p-value 0.820). CONCLUSION: The RealAge score is a valid measure of mortality risk in its user population.

Antimicrobial-induced mania (antibiomania): a review of spontaneous reports.

The authors reviewed reported cases of antibiotic-induced manic episodes by means of a MEDLINE and PsychLit search for reports of antibiotic-induced mania. Unpublished reports were requested from the World Health Organization (WHO) and the Food and Drug Administration (FDA). Twenty-one reports of antimicrobial-induced mania were found in the literature. There were 6 cases implicating clarithromycin, 13 implicating isoniazid, and 1 case each implicating erythromycin and amoxicillin. The WHO reported 82 cases. Of these, clarithromycin was implicated in 23 (27.6%) cases, ciprofloxacin in 12 (14.4%) cases, and ofloxacin in 10 (12%) cases. Cotrimoxazole, metronidazole, and erythromycin were involved in 15 reported manic episodes. Cases reported by the FDA showed clarithromycin and ciprofloxacin to be the most frequently associated with the development of mania. Statistical analysis of the data would not have demonstrated a significant statistical correlative risk and was therefore not undertaken. Patients have an increased risk of developing mania while being treated with antimicrobials. Although this is not a statistically significant risk, physicians must be aware of the effect and reversibility. Further research clearly is required to determine the incidence of antimicrobial-induced mania, the relative risk factors of developing an antimicrobial-induced manic episode among various demographic populations, and the incidence of patients who continue to have persistent affective disorders once the initial episode, which occurs while the patient is taking antibiotics, subsides. The authors elected to name this syndrome "antibiomania."