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Resilience and adaptation to stress in later life: empirical perspectives and conceptual implications
- Authors:
- ONG Anthony D., BERGEMAN C.S.
- Journal article citation:
- Ageing International, 29(3), 2004, pp.219-246.
- Publisher:
- Springer
- Place of publication:
- New York
As it has become more widely recognized that increasing numbers of people are living to progressively older ages, it is important to understand the nature of individual traits that promote resilience and well-being in later life, to describe how these traits develop, to identify the factors that threaten and undermine their maintenance, and to elucidate the mechanisms that support and promote their growth. To have a knowledge base upon which to build intervention programs to improve and maintain well-being in later life, it is necessary to build understanding of what the multiple pathways are that lead to resilience, how these pathways may change, and what can be done to stop or forestall maladjustment and decline. In this article, the authors highlight theoretical areas of research on resilience and well-being that have received relatively little attention in previous work with older adults. They also identify unresolved methodological challenges associated with the measurement and analysis of within-person phenomena and elaborate on the implications of these challenges for process research in aging populations. Finally, future intervention directions to advance knowledge of resilience and positive health in later adulthood are discussed.
A model predicting suicidal ideation and hopelessness in depressed older adults: the impact of emotion inhibition and affect intensity
- Authors:
- LYNCH T.R., et al
- Journal article citation:
- Aging and Mental Health, 8(6), November 2004, pp.486-497.
- Publisher:
- Taylor and Francis
This study begins a preliminary examination of constructs theorized to be related to suicidal behavior by testing a model of the influence of both temperament and emotion regulation on suicidal ideation and hopelessness in a sample of depressed older adults. The model was evaluated using structural equation modeling procedures in a sample of depressed, older adults. Findings supported a temporally predictive model in which negative affect intensity and reactivity lead to emotion inhibition, operationalized as ambivalence over emotional expression and thought suppression, which in turn lead to increased presence of suicidal predictors, operationalized as hopelessness and suicidal ideation. These results suggest that suicide prevention efforts in older adults may be improved by targeting emotion inhibition in treatment, especially among affectively intense and reactive older adults.
Prevalence of major and minor depression in elderly persons with mild cognitive impairment - MADRS factor analysis
- Authors:
- GABRYELEWICZ T., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 19(12), December 2004, pp.1168-1172.
- Publisher:
- Wiley
The aim of the study was to detect the prevalence of depressive syndromes and symptoms in the sample of elderly persons with Mild Cognitive Impairment (MCI), and to analyse Montgomery-Asberg Depression Rating (MADRS) item scores. The subjects of the study were 102 consecutive out-patients with MCI. All subjects were assessed by an experienced psychiatrist and MADRS was applied. Major and minor depressive episodes were defined according to DSM-IV criteria. Factor analysis was used to analyse baseline MADRS item scores. Three patient groups emerged according to the depressive symptoms distribution and severity scores basis: those with major depression constituted 19.6% (n = 20), with minor depression 26.5% (n = 27), and with very few depressive symptoms 53.9% (n = 55). Three interpretable MADRS factors were identified, using the factor analysis with Varimax rotation: the first consisting of apparent and reported sadness, inability to feel, pessimistic thoughts, the second consisting of inner tension, reduced sleep, reduced appetite, suicidal thoughts, and the third with concentration difficulties and lassitude. It was concluded that both major and minor depression is common in MCI. Three MADRS factors were identified and labelled as anhedonia-pessimism, anxiety-vegetative, and cognitive-inhibition.
Lifetime trauma, emotional support, and life satisfaction among older adults
- Author:
- KRAUSE Neal
- Journal article citation:
- Gerontologist, 44(5), October 2004, pp.615-623.
- Publisher:
- Oxford University Press
The purpose of this study is to examine the relationships among lifetime exposure to traumatic events, emotional support, and life satisfaction in three cohorts of older adults. Face-to-face interviews were conducted with a nationwide sample of 1,518 older people in 2003. Approximately 500 elders were interviewed in each of the following age cohorts: Young–old (age 65–74), old–old (75–84), and oldest–old (85 and older). The findings suggest that exposure to lifetime trauma is associated with less life satisfaction in all three age cohorts. The data further reveal that emotional support offsets the effects of trauma on feelings of life satisfaction in the old-old and the oldest–old. The stress buffering properties of emotional support were especially evident in the oldest–old cohort. The findings underscore the need to develop interventions that help older people deal more effectively with lifetime trauma. Moreover, the results suggest that interventions providing emotional support may be especially helpful for the oldest–old.
In a strange land: people with dementia and the local church
- Author:
- GOLDSMITH Malcolm
- Publisher:
- 4M Publications
- Publication year:
- 2004
- Pagination:
- 239p.
- Place of publication:
- Southwell
The special aims of this book span a consideration of the relationship between an individual’s spiritual being and the progress of the disease, how this may affect their faith and how their faith and the faith community may influence the experience of life with dementia. The author follows the school of ‘personhood’ in dementia.
The relationship between gender and the psychological impact of urinary incontinence on older people in Hong Kong: an exploratory analysis
- Author:
- LEE Jik-Joen
- Journal article citation:
- Ageing and Society, 24(4), July 2004, pp.553-566.
- Publisher:
- Cambridge University Press
Adult incontinence violates social norms and values and undermines the personal expectation of being independent, dry and clean. Urinary incontinence is widely known to have a psychological impact on elderly people. This paper reports the findings of a study of the impact of incontinence on a convenience sample of older people in Hong Kong. Several of the results concur with those of studies in western countries. It was found that the prevalence of urinary incontinence increased with adult age, and that the condition affected women more than men. Over half of both men and women respondents had suffered for less than three years. It appeared that the period of suffering was not strongly associated with the level of incontinence. There were no significant differences between the duration and the level of incontinence, or between health status and years of suffering. About 80 per cent of the incontinent respondents had negative psychological impacts. There were significant differences between the sexes in the impact of urinary incontinence as indicated by the following items: elderly men found incontinence more stressful than their women counterparts; and elderly men more often strove to hide their incontinence from their friends. In summary, older men reported more negative psychological effects than older women. This study is not able to conclude that the psychological suffering of those who reported more negative effects is greater than that of those who reported fewer.
Neurosis and mortality in persons aged 65 and over living in the community: a systematic review of the literature
- Authors:
- DEWEY Michael E., CHEN Chih-Mei
- Journal article citation:
- International Journal of Geriatric Psychiatry, 19(6), June 2004, pp.554-557.
- Publisher:
- Wiley
No previous attempt has been made to synthesise information on mortality and neurosis in older people. Our objective was to estimate the influence on mortality of various types of neurosis in the older population. Data sources were: Medline; Embase; and personal files. Studies were considered if they included a majority of persons aged 65 and over at baseline either drawn from a total community sample or drawn from a random sample from the community. Studies which sampled from a larger age range were also included if it was possible to retrieve results about those aged 65 and over. Samples from health care facilities were excluded. Effect sizes were extracted from the papers and if they were not included in the published papers effect sizes were calculated if possible. No attempt was made to contact authors for missing data. We found seven reports (six of which used a neurosis diagnosis and one which used a symptom scale). Using Fisher's method we found an increase in mortality which was not significant (p = 0.08). There have been few studies, and the evidence is weakly in favour of an increased mortality risk.
Behavioural and psychological syndromes in Alzheimer's disease
- Authors:
- MIRAKHUR A., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 19(11), November 2004, pp.1035-1039.
- Publisher:
- Wiley
The origins of behavioural and psychological symptoms of dementia (BPSD) are still poorly understood. By focusing on piecemeal behaviours as opposed to more robust syndrome change valid biological correlates may be overlooked. Our understanding of BPSD via the identification of neuropsychiatric syndromes. The researchers recruited 435 subjects from old age psychiatry and elderly care memory outpatient clinics fulfilling the criteria for diagnosis of probable Alzheimer's disease. Behavioural and psychological symptoms were assessed using the Neuropsychiatric Inventory. Principal components factor analysis was carried out on the composite scores of the 12 symptom domains to identify behavioural syndromes (factors). Results were confirmed by performing three different rotations: Varimax, Equamax and Quartimax. Four factors were identified (which accounted for 57% of the variance): affect factor - depression/dysphoria, anxiety, irritability/lability and agitation/aggression; physical behaviour factor - apathy, aberrant motor behaviour, sleep disturbance and appetite/eating disturbance; psychosis factor - delusions and hallucinations; hypomania factor - disinhibition and elation/euphoria. These groups were unchanged when different methods of rotation were used. The authors report novel observations that agitation/aggression/irritability cluster within a depressive symptom factor and apathy is found within a physical behaviour factor.
Understanding older Americans' attitudes, knowledge and fears about vision loss and aging
- Authors:
- BRENNAN Mark, HOROWITZ Amy, REINHARDT Joann P.
- Journal article citation:
- Journal of Social Work in Disability and Rehabilitation, 3(3), 2004, pp.17-37.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
The purpose of the present study was to identify factors associated with attitudes, knowledge, and fear of age-related vision impairment in a representative sample of US adults age 55 and older. Data were obtained from a national telephone survey. Attitudes toward vision impairment and aging were positive, but fears were extensive and knowledge was lacking. Higher socioeconomic status and experience with nonrelated persons who were visually impaired predicted better attitudes and greater knowledge. Being a women and having experience with persons who were visually impaired predicted lower fear. Findings emphasize the importance of accurate knowledge and training about visual impairment for practitioners working with this population. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580)
A preliminary investigation of self-reported personality disorders in late life: prevalence, predictors of depressive severity, and clinical correlates
- Authors:
- MORSE J. Q., LYNCH T.R.
- Journal article citation:
- Aging and Mental Health, 9(4), July 2004, pp.307-315.
- Publisher:
- Taylor and Francis
Previous research suggests that personality disorders, particularly in clusters A and C, persist into late life, are particularly prevalent in late-life depressed samples, and negatively impact treatment of late-life depression. The present study examined the self-reported personality disorder traits of a sample of 65 depressed elders using the Wisconsin Personality Disorder Inventory IV (WISPI IV). As expected, clusters A and C were most prevalent and the presence of a personality disorder predicted the maintenance or re-emergence of depressive symptoms, as did hopelessness and ambivalence regarding emotional expression. No specific personality disorder traits were associated with clinical features of late-life depression (age of onset, number of previous episodes) while some personality disorder traits were associated with psychological correlates of depression (hopelessness, ambivalence regarding emotional expression, thought suppression). A theoretical explanation for the cluster prevalence based on self-verification is discussed along with a profile of elderly patients who may have poor depression treatment course if they exhibit personality disorder traits, particularly interpersonal rigidity or avoidance, chronic hopelessness, and emotional inhibition.