Adult Development and Aging Ch (9-14) Exam

Clarifications and Expansions of Erikson's Theory

Some dismiss the theory as untestable and incomplete Some ideas are leading researchers to reassess the usefulness of Erikson's theory as a guide for research on adult personality development Can be considered a cycle that repeats Achievement is theme throughout the theory Last stage is a struggle between pride and embarrassment, responsibility etc. There is a possibility of an additional stage in emerging adulthood - Some call it incarnation vs. impudence - Resolved through experimental sexuality, temporal and spatial social and intimate relationships, interdependence and self sufficient and dependence and helplessness and relativist and absolutist ideological experimentation Some argue the 7th stage is too broad, and suggest 5 types of generativity 1) Biological and parental generativity - raising children 2) Technical generativity - passing on of specific skills 3) Cultural generativity - being a mentor 4) Agentic generativity - desire to do something that transcends death 5) Communal generativity - participation in a mutual interpersonal reality

Other research on self-concept

Some look at how people organize the various facets of their self concept Older adults compartmentalize the different aspects of self concept more than either younger or middle aged Related to a wide variety of variables such as health and longevity

Religiosity and Spiritual Support

Some use it more that family and friends as support Evidence linking spirituality and health Older adults who are more involved and committed to their faith have better physical and mental health Spiritual Support: seek pastoral care, participate in organized and nonorganized religious activities and express faith in a God who cares for people - as a key factor for understanding how older adults cope Krause found it was a 3 step process of turning to God over problems 1) Differentiating between things that can and cannot be changed 2) Focusing on ones own efforts on the parts of the problem that can be changed 3) Emotionally disconnecting from those aspects of the problem that cannot be changed by focusing on the belief that God provides the best outcome possible for those Appears to be especially important for many African Americans Connection between certain practices and brain activity - Practice meditation show more organized attention systems and less activity in areas of the brain that focus on the self Health care and social service provides should keep in mind the self-reported importance of spirituality in the lives of older adults

The Changing Nature of Work

Start of global competition- workers in Canada are competing for jobs with workers in other countries Globalization has resulted in extensive changes in number and types of jobs available Full-time work has been replaced by part-time work, manufacturing jobs have been lost Layoffs occur mostly because of o competition o productivity o relocation of operations o mergers o acquisitions o infusion of new technology or plant obsolescence Traditional organizational careers consisted of meeting organizational needs A fundamental re -definition of the nature of work is occurring - not the emphasis is on occupational flexibility and learning - everyone must stay current with the latest technology and newest skills With mandatory retirement being eliminated in most provinces, workers 55 and over are becoming a predominant segment of the workforce

What aging-relevant factors might you consider when choosing an occupation?

+ Ability to work into old age. - Consider a construction worker vs. professor. + Retirement benefits. + Prospects for re-training as initial education becomes obsolete. - Imagine someone who was trained as an engineer 40 years ago

What has been identified as a serious obstacle to maintaining high quality of life in older adulthood?

+ Bieman-Copland et al. (2002): the "social facilitation of the nonuse of competence." - Older adults fail to perform at their maximum potential because of social stereotypes. - **In other words, they accept that they are suppose to be docile, inactive, weak, etc. and so they don't try to be otherwise.

What did Otto von Bismark have to do with retirement?

+ Bismark created an early pension system in Germany in the late 1800's. + Established 65 as retirement age. - In 1900, people spent only 1.2 years in retirement, so it was relative easy to pay for compared to the amount of time people spend in retirement today. + US social security act passed in 1935 creating pension for those over 65

Are older adults more or less satisfied with their jobs than young adults?

+ Most older workers look forward to retirement, but they are also more satisfied. - Probably because Older Adults have found their niche

What are the neurophysiological correlates of Alzheimer's disease?

+ Neuritic or Amyloid plaques. + Neurofibrillary tangles. + Tau. + Neuronal death.

What kind of relationship do you think people have for the longest amount of time?

+ Sibling relationships. + 80% of OAs have a living sibling. + Divorce, widowhood, illness, loss of family member may strengthen relationship. + Presence of children may decrease it.

What is social support? Who provides it? Describe two distinct types of social support.

+ Social Support is assistance provided by or given to those in our social network. + The Social Network is the group of family and friends that we consider to be close to us. + Two types of support: - Instrumental: money, food, etc. - Emotional: visit after a loss. + Concentric Circle Diagram to characterize social support.

Depression:

+ is a kind of pervasive disorder of affect + Most older adults are depressed, the rate of severe depression declines from young adulthood to old age for healthy people- this downward age trend does not hold in all cultures United states, the average age at diagnosis is 32 Being female, unmarried, widowed, or recently bereaved (experiencing stressful life events), and lacking an adequate social support network are more common among older adults with depression than younger adults Less than 5% of older adults living in the community show signs of depression, but the percentage rises to over 13% among those who require home health care Subgroups of older adults who are at greater risk include those with chronic illness, nursing home residents, and family care providers Rates of depression tend to be higher in Latino older adults Older African Americans have lower rates of depression than European Americans General Symptoms and Characteristics of People with Depression: o Dysphoria: the most prominent feature of clinical depression which is feeling down or blue o Older adults may not talk about their feelings at all, have feelings that flow from life events such as bereavement that mimic depression, or label their down feelings as depression but rather pessimism or helplessness o Older adults are more likely to show signs of apathy, subdued self-deprecation, expressionlessness, and changes in arousal than are younger people o Second major component of clinical depression is the accompanying physical symptoms - including insomnia, changes in appetite, diffuse pain, troubled breathing, headaches, fatigue, and sensory loss o Physical symptoms may reflect an underlying physical disease including vitamin deficiencies, thyroid disease, certain viruses, and medication interactions and side effects o The third primary diagnostic characteristic us the symptoms must last at least 2 weeks o The forth is that other causes for the observed symptoms must be ruled out o Finally, the clinician must determine how patients symptoms affecting their daily lives ******* Assessment Scales: o The Beck Depression Inventory contains items that focus on feelings and physical symptoms o Geriatric Depression Scale aimed specifically at older adults where physical symptoms are omitted, and the response format is easier for older adults to follow This reduces the age-related symptom bias and scale response problems with other self-report scales measuring depressive symptoms Center for Epidemiologic Studies-Depression Scale is also frequently used in research ****** Causes of Depression: o Biological theories focus most on genetic predisposition, brain changes, and changes in neurotransmitters o Genetic evidence is based on two sets of data: Several studies that show higher rates of depression in relatives of depressed people than would be expected given base rates in the population Genetically-driven-age-related changes in brain structures o There is substantial research evidence that severe depression is linked to imbalance in neurotransmitters such as low levels of serotonin and the action of brain-deprived neurotropic factor o Brain-derived neurotropic factor (BDNF) is a compound found in blood serum, and its level is negatively correlated with the severity of depression o Low levels of norepinephrine, that regulates arousal and alertness, may be responsible for the feelings of fatigue associated with depression o Psychological effects of loss is the most common basis for psychosocial theories of depression - bereavement has received the most attention ***** Treatment of Depression: o Treatment falls into two categories: medical treatment and psychotherapy o Medical treatments are used in cases of severe depression and involve mainly medication, but in some cases of long-term severe depression, these treatments include electroconvulsive therapy o Most common first-line medication used to treat depression is selective serotonin reuptake inhibitors (SSRIs) They have the lowest overall rate of side effects of all antidepressants They work by boosting the level of serotonin o Other types of first-line medications include: Serotonin and norepinephrine reuptake inhibitors (SNRIs) Norepinephrine and dopamine reuptake inhibitors (NDRIs) Combined reuptake inhibitors and receptor blockers - Tetracyclic antidepressants o If the first-line medications do not work, the next most popular medications are the tricyclic antidepressants o If none of these medications are effective, the monoamine oxidase (MAO) inhibitors are used They are generally less effective than the tricyclic's and can produce deadly side effects They are used with extreme caution, usually only after SSRIs and HCAs have proved ineffective o Bipolar disorder is characterized by unpredictable, often explosive mood swings as the person cycles between extreme depression and extreme activity Treated with Lithium o Electroconvulsive therapy (ECT) is an effective treatment for severe depression - especially those where it has lasted a long time, who are suicidal, have serious physical problems caused by their depression, and who do not respond to medications o Vagus nerve stimulation (VNS) and repetitive transcranial magnetic stimulation (rTMS) are other brain stimulation therapies o Two general approaches seem to work best for depression: Behavior therapy: focuses on attempts to alter current behavior without necessarily addressing underlying causes Goal is to get them to increase the good things that happen to them Seeks to get people to decrease the number of negative thoughts they have Cognitive behavior therapy: attempts to alter the ways people think Based on the idea that depression results from maladaptive beliefs or cognitions about oneself The person is taught how to recognize the thoughts that become so automatic and ingrained that other perspectives are not seen

Durable Power of Attorney

a document that appoints someone to act in one's favor

vocational maturity

degree of congruence between people's occupational behavior and what is expected of them at different ages

job satisfaction

positive feeling that results from an appraisal of ones work

Kubler Ross's Theory

there are 5 reactions/ways of how people approach their own death 1. denial 2. anger 3. bargaining 4. depression 5. acceptance

Picasso example (1881-1973)

• First: 1891 (blue period) • Best: 1937 (classicism and surrealism, guernica) • Last: 1973 (mixture of styles

Subjective well-being (Class notes)

• Individuals overall sense of happiness (emotional and cognitive) • Positive affect -Attentive, interested, alert, excited, enthusiastic, inspired, proud, determined, string, active • Negative affect -Distressed, upset, hostile, irritable, angry, scared, afraid, fearful, etc. • Life satisfaction -Cognitive evaluation of life circumstances

Well-being and emotion

Subjective Well Being: - An evolution of ones life associated with positive feelings - Assessed by measures of life satisfaction, happiness and self esteem Young-older are characterized by improved subjective well being compared to earlier in adulthood Age related changes in how the amygdala functions may play a role in understanding emotional regulation in older adults - Amygdala and emotional arousal are lower in older adults - Experience less negative emotion, lower rates of depression and better well being Changes in cognitive processing in prefrontal cortex also associated with emotional regulation in older adults Possible Selves:*** Represent what we could become, what we would like to become, and what we are afraid of becoming + What we could become, what we don't want to become, and what we do want to become. + Whether we see change depends on the question asked. - All adults focus on physical health to some extent. + Although OAs view themselves as declining (in contrast to YAs), they also view their pasts more favorably and believe that they are closer to being the person that they want to be than YAs. - They are motivators, how we behave is largely an effort to achieve or avoid these possible selves and protect the current view of the self Hoped for selves - Young adults listed family concerns - Adults in 30s listed family concerns last; main issue was personal - By 40-50 family issues were most common again - Over 60, personal issues most prominent; especially health

Holland's Theory of Occupational Choice

"people choose occupations to optimize the fit between their individual traits (personality, intelligence, skills and abilities) and their occupational interests Occupation categorized in two ways: 1. Interpersonal settings in which people must function 2. By their associated lif estyle o 6 work environments in which people can express their personalities have been identified: • Realistic = individuals enjoy physical labour and working with their hands, like to solve concrete problems • Investigative = individuals are task-oriented and enjoy thinking about abstract relations • Social = individuals are skilled verbally and interpersonally, enjoy solving problems using these skills • Conventional - individuals have verbal and qualitative skills that they like to apply to structured, well-defined tasks assigned to them by others • Enterprising = individuals enjoy using their verbal skills in positions of power, status and leadership • Artistic = individuals enjoy expressing themselves through unstructured tasks + Theory exists at level of interest not level of performance + Having a good match between personality and occupation maximizes occupational satisfaction + When people have jobs that match their personality, research shows that employees are more productive and have more stable career paths Limitations to Holland's theory = how the match between personality type and occupation may change in adulthood has been ignored, also interactions between personal, ethnic, gender and economic factors have not been conside red

Violence in Relationships

** Abusive Relationships - One person has become aggressive toward the partner ** Battered Women Syndrome - When a women believes she cannot leave the abusive situation and may even go so far as to kill her abuser Being female, Latina, African American, having atypical family structure, having more romantic partners, early onset of sexual activity and being a victim of child abuse - Predicts victimization Has declined 60% since 1990s Acquaintance rape and date rape still a problem - College women 4x higher to be victim and any other age group, with 40% experience abuse in a dating relationship There is a continuum of aggressive behaviours toward a partner, and a progresses as follows: - Verbally aggressive, physically aggressive, sever physically aggressive and murder Causes of abuse also vary with the type of abuse behaviour being expressed Two points about the continuum should be noted 1) There are many fundamental difference in the types of aggression independent of level of severity 2) Suspected underlying causes differ as they type of aggressive behaviour changes Men are also victims, about 1/3 of that of women Heterosexual couples report more incidents than homosexual Culture is also a factor in understanding the abuse - Rates of abuse higher in cultures that emphasized female purity, male status and family honor

Dispositional Traits across Adulthood

+ 3 assumptions are made about traits 1) Traits are based on comparisons of individuals, behave there are no absolute quantitative standards for concepts 2) The qualities or behaviours making up a trait must be distinctive enough to avoid confusion 3) Traits attributed to a specific person are assumed to be stable characteristic + Trait: any distinguishable, relatively enduring way that one individual differs from others + Trait Theories: assume little change in personality across adulthood Trait vs. States Trait: Eduring (e.g. shyness) State: Transient (E.g. feeling "down in the dumps")

What is a bridge job?

+ A job that one has after ending one's primary career, but before becoming fully retired. - e.g. working as a consultant for the engineering firm that one used to work for full time. - e.g. more likely: working as a waiter after having been an engineer. + These jobs are usually lower paying, lower status, and part-time. - High demand for these jobs, which can drive down wages. + Nonetheless, ideal for people near retirement as it "weans" them off work. + Most professionals enjoy bridge job more than career job.

Friendships

+ A mutual relationship in which those involved influence one another's behaviours and beliefs and define friendship quality as the satisfaction derived from the relationship + Source of support throughout adulthood Predominantly based on feelings and grounded in reciprocity and choice + Less emotionally intense than love relationships and do not involve sex + Good friendship boosts self esteem and happiness + Helps us become socialized into new roles

What is a trait theory of personality? What should these theories predict about personality and aging if personality is largely innate?

+ A trait theory, like Costa and McCrae's, assumes that personality is primarily biologically based, and therefore, stable. - Evidence for this exists in the fact that the temperaments of babies predict later behavioral patterns, like shyness. - Also, twin studies show that MZ twins are more similar in personality than DZ twins. + We should not see age-related change in traits, except to the extent that we see changes in relevant neurological function.

Why might employers discriminate against older workers?

+ ADEA (age discrimination in employment act) made age discrimination illegal, but has lost its teeth. - Courts favor corporations. Why? Ignorance? Corruption? - Corps turn it into a monetary issue. + When Older Adults are let go, they have a harder time finding a job. Lower salaries when they do. - This is might sometimes be because they truly do have outdated skills and/or resumes. + Employers will often not hire someone or will fire someone simply due to age. + Often, employers base decisions on stereotypes (health, training, performance). + More often, the decision is based on finances. - Older Adults tend to make more because of their experience. + Older Adults are forced out, or given incentives to leave. + Sometimes, they are actually brought back in to train young adults

Do married couples stay happy? Most people get married

+ About half get divorced. + Factors of long-lasting marriages: - Marital satisfaction. ** -Curvilinear pattern due to children, finances. - Carstensen et al. (1995) study: ** Longer marriages showed high levels of affection. ** Problems approached with humor. ** Not critical of one another. + Even for those who do stay together, strain increases for women + The beliefs people bring into the marriage will influence how satisfied they will be + But some feelings do change, stronger or weaker Overall martial satisfaction is highest at the beginning of the marriage, falls until the children begin to leave home, and rise again later in life - Same for cohabiting couples For some, satisfaction never rebounds, and remains low, in essence they have become emotionally divorced When dependence is mutual and about equal and both people hold similar values that form the basis for their commitment to ach other, the marriage is strong and close When dependence of one partner is much higher the marriage is characterized by stress and conflict Vulnerability - Stress - Adaptation Model - Sees marital quality as a dynamic process resulting from the couples ability to handle stressful events in the context of their particular vulnerabilities and resources - As the couples ability to adapt to stressful situations gets better over time, the quality of the marriage will probably improve

Where do people go when they retire?

+ Aging in place. By far, most people do NOT move after retirement. + If they do move, Florida, Arizona, Texas, and North Carolina are popular destinations, but again, most age in place. + Typically, a move away from home is the result of declining health. (e.g. nursing homes)

When do people typically retire?

+ An increasing proportion are retiring before age 65. - Although, they try to hold out until 62. ** Perhaps due to health, but this keeps them from working, not living. + Length of retirement estimated based on life expectancy at age of retirement. - e.g. retired at 65 in 2000, expect to live another 18 years. + Implications for Social Security system (e.g. potential to spend 40 years in retirement). + Full benefits at 67 for those born after 1960.

McAdams's Life Story Model

+ Argues a persons sense of identity cannot be understood using the language of dispositional traits or personal concerns + Instead, we have to look at what he calls a person's life story. + Imaging reading a novel, and how we can follow the development of a character. +These life-stories contain plots, characters, settings, and themes. + Thus, McAdam's focuses more on the role of experience than traits. + Life-stories work much the same way, but we are creating our own character development which is uniquely determined by how we reconstruct our past and evaluate our possible future. + Identity is not just a collection of traits and goals, but it is based on a story of how the person came into being, where the person has been, where they are going, and who they will become People create a life story with a beginning, middle and end People in westerns societies begin forming their life story in late adolescence, but is rooted in attachments from infancy Generativity marks the attempt to create an appealing story ending There are changing personal identities that are reflected in the emotions conveyed in the story Motivations change and are reflected in the person trying to attain goals - Two most common goal themes are agency (reflecting power, achievement, autonomy) and communion (reflecting love, intimacy, belonging) Examine the development of life stories through autobiographical memory Believe that the model for change in identity over time is a process of fashioning and refashioning ones life story - strongly influenced by culture Reformulation may be at a conscious level, or unconscious

What considerations must be made when assessing the mental health of older adults, and why?

+ Biopsychsocial framework again: - biological influences: chronic illnesses, etc. can contribute to or cause a mental illness. - psychological: Are the cognitive changes normal (look for abrupt changes)? Did someone die? - sociocultural: Is the behavior normal given a person's cultural background? - Life-cycle factors: Does the behavior fit with where the person is at in his or her life? example: an older adult not sharing personal information. + On the part of the clinician, biases must be overcome. - A Clinician might be too willing to diagnose DAT, or unwilling because it is "just normal aging". - Clinicians need to avoid idea that they are too old to treat. - They need to understand issues like cohort differences in willingness to share deeply personal information. - They shouldn't ignore mental illness just because a physical illness is present. ***Although sometimes treating the physical illness will address the mental illness.

Describe the major symptoms of dementia.

+ Cognitive dysfunction: - Memory loss (minimal, then extreme). - Language deficits. - Impaired judgment and reasoning. - Agitation, paranoia, confusion, wandering, insomnia. - Impaired emotionality. + Loss of control over bodily functions. + * One must be sure that these changes aren't due to depression, or delirium (psuedodementia).

What is comorbidity?

+ Comorbidity is having multiple illnesses at once. - Can make diagnosis and treatment difficult. + Sometimes diseases have a tendency to go together (e.g. depression and substance abuse). + Sometimes the illnesses can have a kind of interactive effect.

The Case for Stability: The 5 Factor Model

+ Consists of 5 independent dimensions of personality + Neuroticism, extraversion, openness, agreeableness, conscientiousness Neuroticism:*** + 6 facets are anxiety, hostility, self-consciousness, depression, impulsiveness, vulnerability + Anxiety and Hostility underlie traits for anger and fear - High anxiety - nervous, high strung, tense, worried - Hostile - irritable + Self-consciousness and depression related to shame and sorrow - Self-consciousness - sensitive to criticism, teasing, and inferiority - Depression - sadness, hopelessness, loneliness, guilt + Impulsiveness and Vulnerability come out in behaviour - Impulsiveness - give into temptation and desires because of lack of will power - Vulnerability - lower capability to deal effectively with stress + People high in neuroticism tend to be high in all of these traits involved + Typically results in violent and negative emotions Extraversion:*** + 3 interpersonal traits: warmth, gregariousness, assertiveness - Warmth - friendly, compassionate, intimately involved style of interaction - Warmth and gregariousness - sociability - Assertive - take change, make up mind, express thoughts and feelings + 3 temperamental traits: activity, excitement seeking, positive emptions - Activity - Want to keep busy, talk fast, endless energy - Excitement Seeking - Prefer stimulating and exciting environments - Positive emotions - zestful, delightful, fun + Tend to have people oriented jobs, + Value humanitarian goals and persona oriented use of power Openness to Experience:*** + 6 facets represent 6 different areas - Fantasy - vivid imagination and active dream life - Aesthetics - appreciation of art, sensitivity to pure experience for its own sake - Action - willingness to try something new - Ideas - curious and value knowledge - Values - open minded - Strong feelings - see them as a major source of meaning in life + Likely to be in occupations that place a high value on thinking theoretically or philosophically + Typically intelligent and tend to subject themselves to stressful situations Agreeableness:**** + Opposite of antagonism + Trustful, sympathetic, nice + Tend to be overly dependent and self effacing Conscientiousness:*** + Hardworking, ambitious, energetic, scrupulous, persevering + Strong desire to make something of themselves + Opposite - lazy, disorganized, late, aimless

Describe the five factor model

+ Costa and McCrae identified 5 commonly occurring traits: 1. Neuroticism: Worried vs. Calm; Insecure vs. Secure; Self-pitying vs. Self-satisfied. 2. Extraversion: Social vs. retiring; fun-loving vs. sober; Affectionate vs. reserved. 3. Openness: Imaginative vs. down-to-earth; Likes variety vs. likes routine; Independent vs. conforming. 4. Agreeableness: Kind hearted vs. ruthless; Trusting vs. suspicious; helpful vs. uncooperative. 5. Conscientiousness: Organized vs. disorganized; careful vs. careless; self-disciplined vs. weak willed + N,E,O,A,C + The NEO PI (Personality Inventory) measures these traits. + People vary on a continuum for each factor.

Who is most likely to provide care for elderly family members?

+ Daughters and Daughters-in-law. + Sisters also frequently provide support. + Caring for elderly family members can result in depression, anxiety, and other health problems. + However, providing care can be rewarding as well.

Singlehood

+ Defined as not living with an intimate partner Pressure to marry is especially strong for women + Men remain single longer in young adulthood because they marry at a later age + Fewer men than women remain unmarried throughout adulthood - have more options + Ethnic differences in singlehood reflect differences in age at marriage, as well as social factors - Twice as many African Americas are single during young adulthood, and more are choosing to remain so - Increasing among Latinos Meanings and implications of staying single are often tied to strongly held cultural and religious beliefs An important distinction is between those who are temporarily single, and those who remain single For most singles, the decision to remain single is a gradual one - This transition is represented by a change in self attributed status that occurs over time and is associated with a cultural timetable for marriage - Individual identifies more with singlehood than marriage

What are the 5 phases of retirement?

+ Defined by Atchley + Not all will go through all stages. 1. Preretirment - Remote: saving now, find jobs with good pension plans. - Near: Actually begin the process. Let the boss know. File for Social Security. 2. Honeymoon: soon after retirement. Elevated mood, because you can do anything. No structure. - Often ends when out of money, when health declines, or boredom sets in. 3. Retirement Routine: Basically, how our lives are now, but without work. Chores at certain times, meetings, etc. 4. Disenchantment: Unhappy because hopes and dreams of retirement can't be realized (*Money, loss of spouse). - Not many say they are disenchanted. 5. Termination: Go back to work due to boredom or necessity.

Describe frequent causes of acute cognitive disorder (sometimes also referred to as delirium, although these aren't always the same thing).

+ Drugs and other toxins. Polypharmacy can be a cause. + Stroke. + Cardiovascular disease. + metabolic disorders. Vitamin B deficiency or electrolyte imbalance can be a cause. + Injury or illness (fever, constipation) + Usually fairly easy to distinguish from dementia, because of its rapid onset. + It is often reversible.

What is the DSM-IV-R?

+ Emil Kraepelin: no serious attempt to distinguish between disorders before him. + Diagnositic and Statistical Manual of Mental Disorders: Guidelines, based on a classification system, used to identify and diagnose mental illness. 1952 (American Psychiatric Association) +DSM uses a multiaxial system or areas of assessment: - Clinical disorders, mental retardation and personality, general medical conditions, psychological and environmental complications (unemployment, divorce), global assessment of function.

How might work-related issues pertaining to gender and ethnicity have implications for financial independence and retirement in old age?

+ Ethnic and gender differences in the types of jobs people have. - Non-white workers more likely to have "blue-collar" jobs. *** Blue-collar jobs can be harder on the body forcing people out of the work force early. *** Blue-collar jobs tend to have fewer retirement benefits. + Both women and minorities tend to make less over the course of a career, allowing less money to be saved for retirement. - Women more likely to put careers on hold to raise a family

What increases your risk of developing Alzheimer's?

+ Genes: Apo (Apolipoprotein) E4 increases, E2 decreases. + Advanced age. + Being female (are men just not living long enough?) + African American. + Hispanic American. + Down's syndrome. + High blood pressure. + Obesity.

What decreases your risk of developing Alzheimer's?

+ Higher ed + complex interactions with people at work. + mental activity. + NSAIDS + eating fish + Physical activity + Good nutrition

Social support is important for maintaining health in old age, but the kind of support matters.

+ In one study, depression, disability, received support, and perceived support were measured. - Relationship between depression & disability mediated by perceived support, not received support.

What have recent attempts to treat Alzheimer's disease focused on?

+ Increasing levels of Acetylcholine. + Experimental: prevent build up of beta amyloid. + Perhaps estrogen for women. Those on HRT seem to be protected. + Ginko biloba may work, but side effects in the doses used in studies. + Applied Behavior Analysis for symptoms.

What is the difference between formal and informal retirement planning?

+ Informal planning: family discussions about finances, travel, residence, etc. + Formal planning: Participation in formal planning program and/or meeting with someone specializing in retirement (usually a financial expert). + Most use informal planning. +Those that use formal planning tend to be of higher SES. + Regardless of type, finances are almost always the focus.

What do you think the primary question is with respect to personality and aging?

+ Is it stable, or does it change? + What we find depends on the level of analysis and how we ask the question (e.g. mean levels of change vs. intraindividual change).

What is meant by "dependency-ratio"?

+ It is the number of people providing financial support for every person receiving financial support. - * I alluded to this in a previous set of slides in the context of retirement programs like social security. - In most countries, this ratio is decreasing, which is a very worrisome trend.

What are the two ways that Jung believed personality changes with age?

+ Jung said that OAs become more introverted because of a desire or need to think more about aging and death. + He also thought that the distinction between masculine and feminine aspects of personality becomes more blurred with age. - People suppress the opposite sex characteristics when young to conform to gender stereotypes.

How do health and life satisfaction change after retirement?

+ Life satisfaction is higher for those who choose to retire. + Not much evidence that retirement causes decline in health, but health issues may cause a person to retire

Cohabitation. What different reasons do you think younger and older couples might have for cohabitating?

+ Living with someone you are in a relationship with while not married. + Usually ends in marriage. + Young: afraid to get married, or precursor to marriage (premarital cohabitation). + Older may be more likely to cohabitate for support, or may want to get married, but don't for fear of losing Social Security. + Also, older couples have "been there done that" and may be afraid of loss. + People in committed, intimate, sexual relationships but are not married + Becoming increasingly popular + People with lower education cohabit more, and do so in more relationships + Couples cohabit for 3 main reasons; testing their relationship in potential for marriage, convince, or alternative to marriage It is extremely uncommon in Netherlands, Norway, Sweden, where lifestyle is part of the culture It does not make marriages any better Two issues; couples who have children while cohabiting, and couples who are using it to test their relationship Many countries extend the same rights and benefits to cohabitating couples as they do for married couples

The Role of Mentors

+ Mentors are likely to be older, more experienced employees who have learned the "tricks of the trade" and the inner workings of a particular business. + Mentors can help finish a new employee's training (when initial education is not adequate). + New employees can learn the unspoken rules and procedures that may be in place. + Research has shown that women and minorities seem to benefit from mentors. + A mentor is a co-worker who teaches a new employee the unwritten rules and fosters occupational development + Mentor-protégé relationships develop over time, through stages, like other relationships + Being a mentor helps middle-aged workers achieve generativity Kram suggests that a four-stage sequence occurs in mentor-protégé relationships o Initiation - 6 to 12 month period during which the protégé selects a mentor and they begin to develop their relationship o Cultivation - lasts 2 to 5 years and is the most active phase of the mentoring relationship; period when mentor provides occupational assistance and serves as a confidant o Separation - most difficult stage; begins when protégé receives a promotion, often to the level of the mentor; protégé must emerge from protection of mentor to demonstrate his or her own competence o Redefinition - protégé and mentor redefine their relationship but with a new set of rules based on friendship between peers

In search of the Midlife Crisis

+ Middle aged adults experience a personal crisis that results in major changes in how they view themselves + Difficult issues are thought to be faced, and intense internal struggles + Far more research fails to document the existence In fact, those who actually experience a crisis may be suffering from general problems of psychopathology The major dynamic that drives such changes may not be age dependent but follow general cognitive changes Midlife Correction: re-evaluating ones roles and dreams and making the necessary corrections Changes people perceive in midlife can be seen as representing both gains and losses, which emphasises two things - The exact timing of change is not fixed but occurs over an extended period of time - Change can be both positive and negative at the same time Some suggest it is a cultural invention In other cultures, transitions and crises are linked to role relations like marriage and relocation

Why do People Retire? What factors motivate people to retire?

+ Most people retire because they choose to o although some people are forced to retire because of financial status or serious health problems + Finances - Negative relationship between SES and retirement age (more money, more able to retire). ** So, the poor keep on working. Poverty (or worse poverty) and depression may result if poor are forced into retirement + Health - Minorities are often forced to retire due to poor health. ** More physically demanding jobs (wear and tear). **** Wet conditions, vibrating equipment, heavy loads, chemical exposure. + Sometimes it is the health of a family member that forces one to retire. (e.g. ill parent.) - Women more likely to care for family members than men. o The most important factor in determining early retirement and satisfaction Gender differences o Married women's decision to retire is predicted most by her husband's health status or number of dependents, the opposite is true for men o Having a retired spouse will also increase the likelihood of retiring Ethnic differences o In Canada, almost no attention has been paid to retirement decisions as a function of ethnicity

Are older workers injured more often than young workers? Do they miss more work?

+ Older Adults are not injured more (protected by experience?) but when they are injured, it does take them longer to recover. + Type of injury associated w/ age. - OAs tend to get repetitive strain injuries. *** Likely due to physical changes in musculature

What kinds of new job skills might older workers have the most difficult time learning?

+ Older Adults can learn to perform new job tasks, but more slowly and with more errors. + Learning can be improved by reducing WM demands, and teaching memory strategies. + Regardless of whether they can, Older Adults may fear learning new tasks. Employers offer fewer training opportunities for Older Adults. Why? - Stereotypes? Investment (about to retire anyway). Have to pay them more. Already experienced

Do older adults feel more or less lonely than young adults?

+ Older Adults have as many close friends as YAs (even though YAs have more total friends). + Not as many acquaintances. + Older adults feel less lonely than young adults.

What did Costa and McCrae's find with respect to the stability of traits?

+ Primarily, research suggests that personality does not change with age. + A grumpy old man was probably a grumpy young man. + Some studies have reported change. - but it is not clear whether situational factors were adequately considered. - Related to that, how long can a state last? +Much of the discrepancy may come from various researchers understanding and definition of personality. + By some definitions, traits should not change, so finding stability with age is really just confirming the construct. + For those studies that do report change: - They tent to examine intraindividual change, not mean levels of change. - Neuroticism tends to decrease (Cross-sectional studies?). - Agreeableness and Conscientiousness increase. - Openness to new experience decreases. + CONCLUSION: As with most things, the truth is probably somewhere in between. - Probably, our biology gives us a starting point and range within which we can vary. - Experience then determines the trajectory of change.

What is meant by "quality of life"?

+ Quality of life refers to a person's subjective assessment of his or her well-being and life satisfaction. + One goal of successful aging should be to maintain a high quality of life.

What Happens to Dispositional Traits Across Adulthood

+ Research suggests personality traits stop changing by age 30 + Some changes did occur in the very old - suspiciousness and sensitivity + But evidence suggests that stability and change can be detected in personality trait development across the adult life span + Extraversion and openness decrease with age + Agreeableness increases with age + Conscientiousness appears to peak in the idle age + Neuroticism often disappears or is much less apparent in late life + Suggest that personality takes on two forms: adjustment and growth + Personality Adjustment:*** - Developmental changes in terms of their adaptive value and functionality, such as functioning effectively within society, and how personality contributes to everyday life running smoothly + Personality Growth:*** - Ideal end states. Such as increased self transcendence, wisdom, and integrity + Growth cannot occur without adjustment + Stability and change in the big five: - With increasing age there is absence of neuroticism and presence of agreeableness and conscientiousness - These are associated with adjustment. Allowing older adults to maintain and regain levels of well being in the face of loss, threats and challenges - Also decrease in openness to new experiences with increasing age - related to personal maturity - Personal growth in adulthood appears to be rare rather than normative + The most likely answer is personality growth or change across adulthood does not normally occur unless there are special circumstances and with an environmental push for it to occur

What is meant by "the three-legged stool"?

+ Retirement income comes from three sources: Social Security, Pensions, and Savings. + Deficiencies in one leg must be supplemented by increases in the others. + Social Security: partial @62, full @67. Incentives for working longer. - Not funded by how much you contributed, but by those working now. ** Think about implications of life expectancy at retirement. ****- 1970: 4.1 workers for every 1 retiree, now: 2 for every 1. ** How do we save it? **** Increase taxes, Privatization, Raise tax cap, increase age. **** Ultimately, compression of morbidity and changes in attitudes about being entitled to retirement may be the only real solutions + Pensions: benefits provided by employers for a certain number of years of service. Usually government. - Many do not claim benefits because they lose track of them. - Women and Minorities receive less from pensions. + Savings: Money in the bank, home, other assets. -Tend to make up a small part of retirement resources. - The largest asset for retirees is their home. *Reverse mortgages can be helpful.

How would you define retirement?

+ Retirement: Leaving the workforce either because one chooses to, or because one is unable to find a new job. + What is the difference between retirement and simply being unemployed? - Permanence of situation. = Expectations (i.e. no intentions of rejoining the workforce). - Choice + Retirement was not seen drastically across people until AFTER World War II

7. How does social support change after retirement?

+ Social Support is important for well-being during retirement. + Retirees may lose contact with former co-workers.

Is there such a thing as a "midlife crisis"?

+ Some theories focus on transitions and assume that we experience periods of stability that are punctuated by periods of change and conflict. One period of change is the midlife crisis (MLC). + Midlife crisis is not real if you base it solely on stereotypes. Older men buy the Porsche because they can finally afford to, not because of crisis. + Most research has failed to support the idea. + Some have argued that the stereotype is the result of the media. Who knows? Perhaps a newspaper editor was jealous of his slightly older neighbor's nice new car.

What is meant by successful aging?

+ Successful aging can be contrasted with "normal" aging, which is often accompanied by disease and disability. - Rowe and Kahn (1998): 1. Avoidance of disease and disability. 2. Maintenance of cognitive and physical function. 3. Sustained engagement with life. + Note that not all experts agree with this notion of successful aging as it is seen by some as relying too much on good health and adequate income

How can Alzheimer's disease be diagnosed? Why is it so difficult to diagnose Alzheimer's disease?

+ Technically, it can only be diagnosed conclusively with an autopsy. + Thus, it is difficult to diagnose, especially given that so many different types of dementia can produce similar symptoms. + This is why DAT is always a diagnosis of exclusion. + Neuropsychological batteries can help, but never definitive. + Also, is DAT really just one disease? Perhaps several different diseases look like DAT, even at autopsy.

What is the relationship between frequency of depression and age?

+ The frequency of clinically diagnosed depression decreases with age, but... - ...that fact refers to community dwelling OAs. The prevalence of depression is fairly high in nursing home residents. + Also, if we just look at symptoms, those over 75 do seem to show more signs of the disease than the middle aged and the Young-Old (but not Younger Adults). + Remember comorbidity? Depression tends to be higher for Older Adults with diabetes. Why?

Describe the manner in which parent-child relationships have been changing and how those changes can influence the lives of older adults.

+ The number of children living with parents has been increasing, and they live there longer. + Financial strain is increasing as a result. + Feeling of failure as a parent, but this depends on personality and microculture. + Parents sometimes move in with children. + Regardless of the living arrangement, strain can develop. - Parents will always be parents. - Relationship better if parent is healthy and if child is married, child is working.

Describe the manner in which grandparent-grandchild relationships have been changing and how those changes can influence the lives of older adults.

+ This relationship is important for transmission of culture and preserving history. + Tend to be closer to grandmothers. + Usually rewarding unless under 51 or over 79. Why might that be? + Custodial grand-parenting is becoming more frequent. Perhaps because of delayed independence.

Describe Erikson's theory of psychosocial development.

+ We go through different stages as we develop. + Each stage is characterized by a psychosocial crisis. + How our personality develops depends on how we deal with each of these crises. + So, all are important to understanding personality in old age, but the crises that are addressed by middle-aged adults and older adults are: - Generativity versus stagnation: Are we being useful to society? Are we sharing and contributing? If not, we are stagnate. - Integrity versus despair: Reflect on accomplishments and experiences and ask, has my life been meaningful? ** Personal observations of Eriskson's (and Loevinger's) theories. + His theory is not necessarily applicable to different cultures, and more research definitely needs to be done to evaluate its validity. Too fluffy (speculative and anecdotal)? + It seems kind of problematic and perhaps even unscientific to me to suggest that the evolution of a person's personality is guided by universal goals. - Goals are determined in part by morals and values, and we definitely do not all share the same morals and values.

Does job performance decline with age?

+ Whether or not performance declines depends on the abilities required for the job. - Decline may be expected if abilities related to fluid intelligence are required. + However, experience can be a protective factor, and can often compensate for intellectual and physical loss.

Are people working longer now than they use to?

+ Yes. At least, this is suggested by the fact that the median age of the workforce is increasing (41.4 years as of 2012). - Partly because they have to (can't afford to retire), partly because they can (older workers have better health now than in years past). + Type of job influenced by cohort, age, gender. - young - more dangerous and more diverse jobs. - older women - more clerical jobs.

Are older or younger couples more likely to get divorced? Do you think divorce is more difficult for men or women?

+ Young are more likely to divorce. + More difficult for women: Money, custody, implications for growing old as a woman.

A Multidimensional Life-Span Approach to Psychopathology:

+ most effective + Some models of psychopathology assume the same underlying cause is responsible for maladaptive behavior regardless of age and symptoms of the mental disease are fairly constant across age o Although these models are used in clinical diagnosis, they are inadequate for understanding psychopathology in old age Biological Forces: o Various neurological changes, chronic diseases, functional limitations, and other ailments can change behavior o Because health problems increase with age we must be more sensitive to them when dealing with older adults o Some forms of Alzheimer's disease have a clear genetic component o Extreme irritability can be caused by thyroid problems, and memory loss can result from certain vitamin deficiencies Psychological Forces: o Several important changes in memory, intelligence, social cognition, and personality must be considered carefully in interpreting behavior o Normative changes with age in these arenas can mimic certain mental disorders o These changes make it more difficult to tell when an older adult has a given type of psychopathology o The nature of a person's relationships with other people is a basic dimension in understanding how psychopathology is manifested in adults of different ages o Young adults are more likely to be expanding their network of friends, whereas older adults are more likely to be experiencing losses Sociocultural Forces: o Social norms and cultural factors we all experience also play a key role in helping define psychopathology - they influence people's behaviors and affect our interpretation of them o Behaviors that may be normative in one culture may be viewed as indicating problems in another Older women living in a high-crime area may be highly suspicious of other people and to label her behavior "paranoid" may be inappropriate o Must ask whether the behavior we see is appropriate for a person in a particular setting Life-Cycle Factors: o How people behave at any point in adulthood is strongly affected by their past experiences and the issues they face o Middle-aged women who wants to go back to school may not have an adjustment disorder; she may simply want to develop a new aspect of herself o The meaning of particular symptoms change with age

Like any psychological measure, assessment instruments must have the psychometric properties of __________ and __________ to be useful.

+ validity and reliability. - validity: does it measure what it is suppose to? - reliability: will you get the same result again?

Giving back; Middle Aged Adults and Their Aging Parents

+ ¼ of people have middle aged parents who need care + Job of taking care of a parent usually falls to daughter or daughter - in- law, who also tend to coordinate care provided by multiple siblings + Filial Obligation - a sense of responsibility to care for their parents if necessary

The Big Three: Depression, Delirium, and Dementia

- Both depression and delirium are treatable; the most common form of dementia, Alzheimer's disease is not - The three conditions are connected by overlapping symptoms and the possibility that they may coexist - Although these aren't typical, they are the most frequently occurring, and perhaps most worried about mental illnesses.

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- Conscientious appears to peak in middle age. - most interestingly, neuroticism often disappears or is much less apparent in late life. - such changes are found in studies that examine larger populations across a larger range (e.g. 16 to mid 80's) and greater geographical regions (e.g. United states to Great Britain)

Integrity vs. Despair

- Growing awareness of the nearness of the end of life, but it is actually completed by only a small number of people - Older adults try to understand their lives in terms of the future of their family and community - Thoughts of a persons own death are balanced by the realization they live on through children, grandchildren etc. - To have integrity, the person must come to terms with the choices and events that made their life unique - Acceptance that ones life is drawing to a close

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- Over the years of adulthood, people create a life story or narrative view of the past in which they express their identity over the course of time o Older adults seem to benefit from a life story that emphasizes achievements and experiences that reflect favorable on their identity, altering the way they interpret events that might otherwisedetract from their self-esteem o Emerging adults seem to benefit from exploring alternatives as they arrive at identity commitments, as long as this exploration does not involve a high degree of rumination or self-criticism o For older adults, identity processes may provide a means of maintaining high levels of well-being in the face of less than satisfactory circumstances. Identity assimilation allows them to place a positive interpretation on what might otherwise cause them to feel that they are not accomplishing their desired objectives

SUCCESSFUL AGING: FINAL PERSPECTIVES

- People later in life appear not only to manage to feel saisied with their life but also to be able to achieve new forms of creaive expression - Many older adults have produced notable contribuions in their later adults years. The accomplishments of these unusual individuals add to the literature on subjecive well-being as well as the "vital involvement" framework proposed by Erikson, adding support to the concept of successful aging

Generativity vs. Stagnation

- Struggle between feelings that people must maintain and perpetuate society, and a sense of feeling self-absorbent - If generativity is accepted, the development of trust in the next generation is facilitated

Delirium:

- is characterized by altered consciousness and declines in cognition, which occur over a relatively short period of time + Characterized by a disturbance of consciousness and a change in cognition that develop over a short period of time Changes in cognition can include difficulties with attention, memory, orientation, and language Can be caused by: o Any of a number of medical conditions (stroke, cardiovascular disease, and metabolic condition) o Medication side effects o Substance intoxication or withdrawal, o Exposure to toxins o Any combinations of factors It is often undiagnosed or misdiagnosed and symptoms are ascribed to other causes Assessment and treatment of delirium focus on the physiological causes - differentiating it from depression and dementia Severity is related to the level of the underlying physiological problem

How would you define psychopathology?

- mental illness. - abnormal thoughts or behaviors. - impaired cognition. - All these things exist on a continuum and it can be difficult to decide when a behavior or condition is too extreme, especially when working with older adults. + Criteria: - Is the behavior deviant? ***Behavior must be identified in context. (does it deviate from cultural norms?) ***Consider an actor practicing on the street, or doing research for a role. ****If you didn't know the person was an actor, you might think the person was mentally ill. + Does it cause personal harm or harm to others? + Is it maladaptive? + Does it cause the person distress?

Dementia:

- refers to a family of disorders that involve damage to the brain, usually through various disease processes, and the resulting cognitive deficits + There are many types of dementia + Sometimes normal age-related decline is mistaken for dementia. - Remember, determining whether declines in cognition is due to normal (inevitable) processes or disease is one of the more difficult tasks in cognitive aging. + Also, delirium can be mistaken for dementia. + Individuals can literally lose their mind, being reduced from a complex, thinking, feeling human being to a confused, vegetative victim unable even to recognize one's spouse and children Affects nearly 37 million people globally The Family of Dementias: o Not a specific disease but rather a family of diseases characterized by cognitive and behavioral deficits involving some form of permanent damage to the brain o Most common and widely known is Alzheimer's disease o Others are important: vascular dementia, Parkinson's disease, Huntington's disease, alcoholic dementia, and AIDS dementia complex + Alzheimer's Disease is the most common form of progressive, degenerative, and fatal dementia, accounting for 70% of all cases of dementia + Neurological Changes in Alzheimer's Disease: o The microscopic changes that define Alzheimer's disease are rapid cell death, neurofibrillary tangles, and neuritic plaques o Rapid cell death occurs in the hippocampus, the cortex, and the basal forebrain o Neurofibrillary tangles are accumulations of pairs of filaments in the neuron that become wrapped around each other They occur in several areas of the brain, and the number of tangles is directly related to the severity of symptoms, specifically the severity of memory impairment o Neurotic or amyloid plaques are spherical structures consisting of a core of betaamyloid: a protein surrounded by degenerated fragments of dying or dead neurons Degeneration of neurons in some areas of the brain results in the formation of vacuoles, or space that become filled with fluid and granular material o Another protein that has been the focus of much research is tau protein which acts within a neuron and may provide a key to understanding how neurons die o Increased levels of plasma homocysteine have been associated with the level of cognitive impairment observed in Alzheimer's disease + Symptoms and Diagnosis: o Major symptoms are gradual changes in cognitive functioning: - Declines in memory beginning with loss of recent memory and progressing to loss of remote memory, learning, attention, and judgment - Disorientation in time and space - Difficulties in word finding and communication - Declines in personal hygiene and self-care skills - Inappropriate social behavior Changes in personality o Sundowning: the symptoms associated with Alzheimer's disease are worse in the evening than in the morning o Has an average duration of 9 years o Early stage is marked by memory loss, disorientation to time and space, poor judgment, and personality changes o Middle stage is characterized by increased memory problems, increased difficulties with speech, restlessness, irritability, and loss of impulse control o Late stage is characterized by the experience of incontinence of urine and feces, loss of motor skills, decreased appetite, having a great difficulty with speech and language, may not recognize family members or oneself in the mirror, lose most if not all self-care abilities, and decreased ability to fight off infections o The number and severity of neurological and behavioral changes allow clinicians to make increasingly accurate early diagnoses o The clinical diagnosis consists of: Carefully nothing the history of the symptoms Documenting the cognitive impairments Conducting a general physical exam and neurological exam Performing laboratory tests to rule out other diseases Obtaining a psychiatric evaluation Performing neuropsychological tests Assessing functional abilities Searching for a Cause: o Certain forms are caused by autosomal dominant genes related to beta-amyloid protein production o Autosomal dominant inheritance patterns: those that involve only one gene from either one's mother or father in order to cause a trait or condition to develop Usually involves mutations in the presenillion 1 (PSEN1) and amyloid beta (A4) precursor protein (APP) genes o Several sites on various chromosomes have been tentatively identified as being involved in the transmission of Alzheimer's disease - chromosomes 12, 14, 19, and 21 o Beta-amyloid cascade hypothesis: refers to the process by which beta-amyloid deposits create neuritic plaques, that in turn lead to neurofibrillary tangles, that cause neuronal death and, when this occurs severely enough, Alzheimer's disease o Other research is focusing on the role of changes in the vascular system in the brain o Beason-Held and colleagues discovered increased blood flow in the frontal cortex, combined with decreased blood flow in the parietal and temporal lobes, resulting in significant cognitive impairments o De la Monte argues that it is caused at least in part by impairment in the brains ability to use glucose and produce energy Intervention Strategies: Medications o Two groups of medications approved by the Food and Drug Administration: Cholinesterase inhibitors that affect the levels of neurotransmitter acetylcholine (dopenpezil and galantamin) Memantine that works on other neurotransmitters and sets of neurons Intervention Strategies: Behavioral o Key steps to be taken once a diagnosis is made include: Obtaining accurate information about the disease Involving the patient as much as possible in decisions about his or her care Identifying the primary care provider Assessing the patients living situation Setting realistic goals Making realistic financial plans Identifying a source of regular medical care Maximizing the patients opportunity to function at his or her optimal level Making realistic demands of the patient Using outside services as needed o One of the most difficult issues care providers face concerns taking things away from the affected person and restricting activity o Traveling alone is another difficult issue o Differential reinforcement of incompatible behavior (DRI): is one of the successful approach for dealing with difficult behavior Care providers reduce the incidence of difficult behavior by rewarding the person with Alzheimer's disease for engaging in appropriate behaviors that cannot be done at the same time as the problem behaviors o Spaced retrieval: a behavioral, implicit-internal memory intervention used in early and middle-stage dementia Combing spaced retrieval with additional memory encoding aids helps even more Also works in training non-memory behaviors; used with residents with dementia who have trouble swallowing to help to relearn how to swallow o Behavioral intervention strategies are powerful tools to assist care providers in helping people deal with Alzheimer's disease

the grief process

-acknowledge the reality of the loss -work through the emotional turmoil -adjust to environment where the deceased is absent -loosen ties with the deceased *this process/length varies*

What is related to higher death anxiety?

-lower ego integrity -physical problems -psychological problems

Family Dynamics and the Life Course

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Life Narratives, Identity, and the Self

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Adult Developmental Aspects of Greif:

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Karen Hooker added 2 processes that act in tandem with ^:

1) State Processes - Act with dispositional traits - Crease transient, short-term changes in emotion, mood, hunger, anxiety etc. 2) Personal Concerns - Act with self regulatory processes - Include primary and secondary control 3) Cognitive Processes - Act with life narratives - Create natural interaction that occur between a storyteller and listener, processes central in organizing life stories

What strategies are mentioned in your book for maximizing the likelihood of successful aging?

1. Adopt a healthy lifestyle, and make it part of your daily routine. 2. Stay active cognitively, and maintain an interest in things. 3. Maintain a social network and stay engaged with others. 4. Maintain good economic habits.

What are the key features (symptoms) of depression? How might a person's age affect the diagnosis of depression?

1. Dysphoria: feeling down. 2. Physical symptoms: fatigue, sleep disturbances, headaches, changes in appetite, etc. 3. Duration: The dysphoria lasts at least two weeks. 4. Other causes of the symptoms, like substance abuse, must be ruled out, as the treatment would be different. 5. Global functioning (e.g. shopping, socializing, ability to work) should be impaired. + It may be difficult to distinguish between symptoms of depression and normal age-related changes. + It is important to use assessment instruments that are not age biased. + To make matters worse, the OlderAdults may not recognize the symptoms themselves. I am speculating, but this may partially explain depletion syndrome of the elderly.

List and briefly describe 8 different kinds of dementia

1. NeuroAIDS: HIV destroys dopaminergic areas of the brain. 2. Korsakoff's syndrome: Alcoholism leads to vitamin b deficiency. 3. Family of frontotemporal dementias, like Pick's disease. 4. Huntington's disease: results in shortage of GABA, especially in caudate nucleus. 5. Creutzfeldt-Jakob: mad cow disease. Involves a small infectious protein or prion. 6. Vascular dementia: mini-strokes. 7. Parkinson's disease. Initially a movement disorder. 65% chance of cognitive decline by age 85. 8. Alzheimer's disease.

Describe the six primary assessment methods.

1. self-report - "I can't keep my balance all of a sudden." 2. report of others - "Dad keeps telling the same story over and over again." 3. psychophysiological assessment - EEG, perhaps fMRI. Interview - Structured: Certain questions are asked about specific aspects of functioning. - Unstructured: Questions based largely on patient's comments. - Semi-structured. Certain aspects of functioning and symptoms may be addressed, but not in any order and not necessarily everything will be covered. 5. direct observation - Notice that patient neglects half of the environment. 6. performance-based assessment - Neuropsych batteries. - Cognitive tasks.

Step, Foster, Adoptive and Same Sex Couple Parenting

1/3 become stepparents, foster or adoptive parents In general there are few differences between them and biological parents But a big issue is how the child will bond - Infants less than 1 year bond really well - Children old enough to have formed attachments with biological parents may have competing loyalties Adopted children may want to locate biological parents, which puts a strain on the relationship between all involved Adopted from another culture has challenges of how to establish and maintain connection with culture of origin Foster parents have the most tenuous relationship because the bond can be broken for a number of reasons having nothing to do with quality of care provided - May not have children long enough to develop attachments - Child may be unable to form any attachments Gay and lesbian parents often experience resistance to their having children Child of day and lesbian parents do not experience any more problems and are just as psychologically healthy Gay and lesbian parents have more egalitarian sharing of child rearing

Love Relationships

3 basic components 1) Passion - intense physiological desire fro someone 2) Intimacy - feeling that you can share all thoughts and actions 3) Commitment - willingness to stay with the person

Assessment Methods:

6 primary methods: interview, self-report, report by others, psychophysiological assessment, direct observation, and performance-based assessment + Clinical interviews are the most widely used because they provide both direct information in response to the questions and nonverbal information such as emotions Can be used to: o Obtain historical information o Determine appropriate follow-up procedures o Build rapport with the client o Obtain the client's informed consent to participate in assessment o Evaluate the effects of treatment Information can be obtained through interviews or self-reports o Discrepancies between the clients and others' description of the problem can be diagnostic - these sources are valuable if the client is unlikely or unable to tell the whole story Psychophysiological assessment examines the relation between physical and psychological functioning o Electroencephalogram (EEG) which measures brain wave activity is a common measure o Other measures include heart rate, muscle activity, and skin temperature Direct observation is especially useful when the problem involves specific behaviors, as in eating disorders Performance-based assessment involves giving clients a specific task to perform o Underlies much cognitive and neuropsychological assessment o Person's memory is assessed by giving him or her a list of items to remember and then testing retention

In search of the midlife crisis

A key idea in life transition theories is the midlife crisis o The idea that at middle age we take a good look at ourselves in the hopes of achieving a better understanding of who we are - Many adults face difficult issues and make behavioral changes Very little data supports the claim that all people inevitably experience a crisis in middle age o Most middle-aged people do point to both gains and losses, positives and negatives in their lives This transition may be better characterized as a midlife correction o Reevaluating one's roles and dreams and making the necessary corrections

persistent vegetative state

A state resulting from loss of cortical functioning -the person is unconscious and displays no voluntary movements, but continued functioning in the brain stem

Stresses and Rewards of Providing Care

Adult children and other family caregivers are vulnerable to two main sources of stress 1) Adult children may have trouble coping with declines in their parents functioning, especially those involving cognitive abilities and problematic behaviour and with work overload, burnout and loss of the previous relationship with a parents 2) If the care situation is perceived as confining or seriously infringes on the adult child's other responsibilities than the situation is likely to be perceived negatively Many middle ages care provides are hard pressed financially, especially when caring for those with chronic conditions The caregiver should monitor their own health, to avoid burnout But it can also bring children and parents closer together and provide a way for adult children to feel they are giving back Independence and autonomy are important values in some ethnic groups, and their loss is not taken lightly by the ill individual - More likely to express desire to pay professional for assistance Hard to determine whether older parents are satisfied with help their children give Newson proposes a model of how certain aspects of care can produce negative perceptions of care directly or by affecting the interactions (figure 11.7) - Even under the best circumstances there is no guarantee the help adult children provide will be well received

Friendship in Adulthood

Adult friendships can be viewed as having identifiable stages - Acquaintanceship, Build-up, Continuation, Deterioration and Ending - ABCDE model - Describes stages of friendship and how they change Life transitions usually result in fewer friends and less contact with the friends you keep More friends and acquaintances during young adulthood than any other period People who have friendships across ethnic groups have more positive attitudes toward people with different backgrounds Provides a buffer against losses or roles and status that accompany old age Being faced with threatening situations results in different brain processing if faced with alone or with a close fiend Patterns of friendship among older adults tend to mirror those in young adulthood Older women have more numerous and intimate friendships than older men + 3 broad themes characterize both traditional and new forms of adult friendships 1) The affective or emotional basis o Self disclosure and expression of intimacy, appreciation, affection, and support an all are based on trust, loyalty and commitment 2) Shared or communal nature o How friend participate in or support activities of mutual interest 3) Sociability and compatibility o How friend keep us entertained and are sources of amusement, run and recreation Online friendships, trust develops on the basis of 4 sources - 1)Reputation, 2) performance or what users do online, 3) precommitment, through personal self-disclosure; and 4) situational factors, especially the premium placed on intimacy and the relationship - Develop much like face to face ones in that the more time people spend online with friends the more likely thy are to self disclose - More conducive to people who are lonely

Substance Abuse:

Alcoholism includes 4 symptoms: craving, impaired control, physical dependence, and tolerance Two patterns of onset are evident with older people with alcohol dependency: o Early-onset in young adulthood or middle-age lifelong problem drinking o Late-onset problem drinking Treatment for substance abuse in all age groups focuses on three goals: 1. Stabilization and reduction of substance consumption 2. Treatment of coexisting problems 3. Arrangement of appropriate social interventions Older adults respond better to education programs rather than direct confrontation to reduce their denial of their problem and to make sure they understand the age-related changes in alcohol metabolism

Alienation and Burnout

Alienation: feeling that what one is doing is meaningless Burnout o Too much stress in one's occupation and can lead to o Loss of energy and motivation o Loss of occupational idealism o Feeling that one is being exploited Making sure workers feel that they are important to the organization by involving them in decisions, keeping expectations realistic, ensuring good communication, promoting teamwork and co -worker support may help employees avoid alienation and burnout

Interpersonal Ties

All aspects of a person's life and interpersonal relationships are affected by retirement - Marital relationships o May undergo considerable stress until new role definitions are reached o Readjusting to being home rather than at work is difficult for men in traditional marriages o Sometimes marriages are disrupted, but marri ed men are generally happier in retirement than men who are not married

Theories based on life transitions:

Among the most popular theories of adult personality development Based on the idea that adults go through a series of life transitions, or passages o Few of these theories have substantial databases, and none are based on representative samples Life transitions tend to overestimate the commonality of age-linked transitions

Living Will

An advance directive document that specifies an individual's wishes regarding the use of specific end-of-life procedures intended to sustain or prolong life.

Other Mental Disorders and Concerns

Anxiety Disorders: Include problems such as: o Feelings of severe anxiety for no apparent reason o Phobias with regard to specific things or places o Obsessive-compulsive disorders, when thoughts or actions are repeatedly performed Symptoms and Diagnosis: o Physical changes include dry mouth, sweating, dizziness, upset stomach, diarrhea, insomnia, hyperventilation, chest pain, chocking, frequent urination, headaches, and a sensation of a lump in the throat o There usually is nothing specific a person can point to as the specific trigger or cause Treating Anxiety Disorders: o Can be treated with medication - benzodiazepine, paroxetine, buspirone, and betablockers o Can be treated with psychotherapy - specifically cognitive behavior or relaxation therapy, especially when anxiety disorders first occur in later life

Occupational Insecurity and Job Loss

Anxiety about one's job may result in negative attitudes about one's employer or work in general, which in turn may result in a diminished desire to be successful Occupational insecurity is a growing problem - fear that one may lose one's job is a better predictor of anxiety than the actual likelihood of job loss Losing one's job can have serious negative effects on every aspect of a person's life - may result in mental health problems, including o Low self-esteem o Depression o Anxiety o Suicide These effects are related to the degree of financial stress one is under and the timing of the job loss Effects of losing one's job emphasize the central role of occupations in forming a sense of identify in adulthood - how one perceives a loss plays a major role in determining what the long -term effects will be

separation distress

Anxiety experienced when the attachment figure leaves or is absent

Whitbourne's Identity Theory:

Argues that people build conceptions of how their lives should proceed They create a unified sense of their past, present, and future o The life-span construct People's identity changes over time via Piaget's concepts of assimilation and accommodation The life-span construct has two parts o A scenario: this includes future expectations or a game plan for one's life; it is strongly related to age norms o A life story: a personal narrative history that organizes past events into a coherent sequence

McAdam's Life-Story Model:

Argues that people create a life story o That is, an internalized narrative with a beginning, middle, and an anticipated ending There are 7 essential features of a life story o Narrative tone o Image o Theme o Ideological setting o Nuclear episodes o Character o An ending Adults are said to reformulate their life stories throughout adulthood both at the conscious and unconscious levels o The goal is to have a life story that is Coherent Credible Open to new possibilities Richly differentiated Reconciling of opposite aspects of oneself Integrated within one's sociocultural context

Areas of Multidimensional Assessment: Imagine an older adult visits her doctor because she suspects her memory is declining unusually rapidly. What assessment instrument might the doctor administer during that initial visit? + MMSE: Mini Mental Status Examination + This might then be followed by a more in depthneuropsychological assessment, if necessary.

Assessment is a formal process of measuring, understanding, and predicting behavior Involves gathering medical, psychological, and sociocultural information about people through various means, such as interviews, observation, tests, and clinical examinations Many physical conditions can create mental problems, so it is important to identify any underlying issues Mental status exams: are especially useful as quick screening measures of mental competence used to screen for cognitive impairment o Mini Mental Status Exam (MMSE) - commonly used instrument Psychological functioning is typically assessed through interviews, observation, and tests or questionnaires

Kegans Theory of Self Concept

Attempted to integrate the development of self-concept and cognitive development Made 6 stages of the development of self corresponding to stages of cognitive development First 3 stages: incorporative, impulsive, imperial - Correspond to sensorimotor, preoperational and concrete operational stages - During this time, children move from knowing themselves on the basis of reflexes to knowing themselves through needs and interests Interpersonal stage - Beginning of formal operational thought, where you being to develop a sense of interpersonal mutuality Institutional stage - When people move to a mature sense of identity based on taking control of their own life and developing an ideology - Late adolescence Interindividual stage - Acquisition of post formal thought, comes the understanding that the self is a complex system that takes into account other people A person is a complex integrated whole

A Life-Span View of Loss Through Death:

Bereavement is the state or condition caused by loss through death o Greif is the sorrow, hurt, anger, guilt, confusion, or other feelings that arise after a loss o Mourning is the way we express our grief (heavily influenced by cultural norms) Society assigns different values on the death of people of different ages o E.g. the older the person is at death, the less tragic it is perceived to be

Critiques of the Five-Factor Model:

Block (1995) takes issue with the methodology that uses laypeople to specify personality descriptors that were used to create the terms of the Five-Factor Model McAdams (1996-1999) points out that any model of dispositional traits says nothing about the core or essential aspects of human nature A major criticism is directed to the notion of stability and change in personalit

Ethical Issues:

Bioethics is the study of the interface between human values and technological advances in health and life science o The most important bioethical issue is euthanasia o Grew from two bases: respect for individual freedom and the impossibility of establishing any single version of morality by rational argument or common sense o Requires people to weigh how much the patient will benefit from a treatment relative to the amount of suffering he/she will endure as a result of the treatment Euthanasia is the practice of ending life for reasons of mercy o Active euthanasia involves the deliberate ending of someone's life May be based on someone's clear statement of their wishes or be a decision made by someone else who has the legal authority to do so o Passive euthanasia involves allowing a person to die by withholding available treatment o Globally opinions about euthanasia vary o Analyses show opinions are often related to religious or political beliefs Physician-Assisted Suicide occurs when physicians provide dying patients with a fatal dose of medication that the patient self-administers o 70% of all adults respondents (62% over 65) agreed people who are terminally ill, in great pain and have no chance for recovery should have the right to choose to end their lives o Allowed in several countries (Netherlands, Belgium) and states: Oregon, Vermont, Washington State, (Montana, and New Mexico...kinda) o Debated in Canada, mostly in BC due to the Sue Rodriguez case. Some movement in Quebec in June 2014, may go into law 2015 o The Dutch Supreme Court eliminated prosecution of physicians if 5 criteria are met: 1. The patient's condition is intolerable with no hope for improvement 2. No relief is available 3. The patient is competent 4. The patient makes a request repeatedly over time 5. Two physicians review the case and agree with the patients request o Laws require physicians to inform the person he/she is terminally ill and describe alternative options (hospice care, pain control) o Studies examining the impact of the Oregon law: The numbers of patients who received prescriptions and died between 1998 and 2012 - figure 13.1 Over the period, a total of 525 patients died under the terms of the law Concluded all safeguards working and such things as depression, coercion, and misunderstanding of the law were carefully screened + Although U.S. Supreme Court ruled in two cases in 1997 (Vacco V. Quill and Washington V. Gluucksberg) there is no right to assisted suicide, the Court decided in 1998 no to overturn the Oregon L,aw

Falling in Love

Can give you great ecstasy, so also can cause you great pain ** Assorative Mating: - States that people find partners based on their similarity to one another - Religion, physical traits, education, SES, intelligence, political - Non-random mating - Occurs most in western countries that have control over own dating - Common activities are one basis for identifying mates Meeting in school was most likely to result in the most forms of homogamy: the degree to which people are similar Pool of available people to meet is shaped by the opportunities available 1/5 couples meet online Increasing trend among emerging adult of 'hook up culture' of casual sex often without even knowing the name of the sexual partner - Men and women do it, but are both still interested in long term relationship Secure romantic attachment was the norm in nearly 80% of cultures "Preoccupied" romantic attachment was common in East Asian cultures There are global patterns in mate selection and romantic relationships Culture is a powerful force in shaping mate selection choices - Good health, good education, and resources permits young adults to choose their own mates and tend to develop more secure romantic attachments than do people from cultures with out these characteristics - Cultural norms are sometimes highly resistant to change - Loyalty to the family is sometimes important - like in India where 95% of marriages arranged, and Islamic societies use matchmaking

Character summary:

Character factors could be improved through modification Little evidence for higher-order Character factor The Character model is different for men and women

The case for stability - The Five-Factor Model:

Consists of five independent dimensions of personality: Neuroticism - high scorers tend to be nervous, high-strung, insecure, worrying; low scorers tend to be calm, relaxed, secure, hardy) Extraversion - high scorers tend to be sociable, friendly, fun loving, talkative; low scorers tend to be introverted, reserved, inhibited, quiet) Openness to experience - high scorers tend to be original, creative, curious, complex; low scorers tend to be conventional Agreeableness - high scorers tend to be good natured, sympathetic, forgiving, courteous; low scorers tend to be critical, rude, harsh, callous Conscientiousness - high scorers tend to be reliable, well-organized, self-disciplined, careful; low scorers tend to be disorganized, undependable, negligent

Dispositional traits across adulthood

Costa and McCrae found: o Over a 12 year period, 10 personality traits measured by GZTS (a temporary survey) remained stable o Other studies similar to the GZTS found equivalent o Results - however, in the very old, suspiciousness and sensitivity increased What happens to dispositional traits? o Other studies have shown increasing evidence for personality changes as we grow older: = Ursula Staudinger and colleagues found that personality takes on two forms = Personality adjustment: developmental changes in terms of their adaptive value and functionality = Personality growth: ideal end states such as increased self-transcendence, wisdom, and integrity Conclusions about dispositional traits: o Personality traits tend to be stable when data are averaged over large groups of people o But, looking at specific aspects of personality in specific kinds of people, there may be less stability and more change

Possible Selves:

Created by projecting yourself into the future and thinking about what you would like to become, and what you are afraid of becoming Age difference have been observed in both hoped-for and feared selves o Young adults and middle-aged adults report family issues as most important o Middle-aged and older adults report personal issues to be most important However, all groups included physical aspects as part of their most feared selves o Interestingly, young and middle-aged adults see themselves as improving in the future, while older adults do not Ryff identified 6 aspects of psychological well-being: o Self-acceptance o Positive relationships with others o Autonomy o Environmental mastery o Purpose in life o Personal growth

Levels of analysis and personality research:

Dispositional traits: o Aspects of personality that are consistent across different contexts and can be compared across a group along a continuum representing high and low degrees of the characteristic (vs.) o Qualitative methods: Personal concerns Life narrative

Dual-Earner Couple

Dual-earner couples with children experience both benefits and costs - there are many stresses living in this arrangement, gender differences are also clear, especially in the division of household chores

Love Through Adulthood

Early romantic relationships - passion is high, intimacy and commitment low - This is infatuation: an intense, physically based relationship when two people have a high risk of misunderstanding and jealousy - Relationship either acquires emotional intimacy or is likely to end - People who select a partner during this are more likely to end in divorce As relationship lasts, intimacy and passion decrease but commitment increases

Jung's Theory:

Emphasizes that each aspect of a person's personality must be in balance with all the others (e.g. introversionextroversion and masculinity-femininity) Jung was the first theorist to discuss personality development during adulthood o He invented the notion of midlife crisis Jung argues that people move toward integrating these dimensions as they age, with midlife being an especially important period

Erikson's Stages of Psychosocial Development:

Erikson was the first theorist to develop a lifespan theory of personality development His 8 stages represent the 8 great struggles that he believed people must undergo Each struggle has a certain time of ascendancy o The epigenetic principle - each struggle must be resolved to continue development (but stages may be revisited) The sequence of Erikson's stages are: o Trust vs. mistrust o Autonomy vs. shame and doubt o Initiative vs. guilt o Industry vs. inferiority o Identity vs. identity confusion o Intimacy vs. isolation o Generativity vs. Stagnation o Ego vs. despair

Ethnic Diversity and Parenting

Ethnic background matters a great deal in terms of family structure and parent child relationship African American husbands more likely to help with chores, and parents provide a cohesive, loving environment that often exists within a context of strong religion, heritage, self respect and cooperation with family Many Native American parents have lot traditional cultural parenting skills - Children were valued, women scared and honoured and men cared for and provided Mexican American parents adopt authoritative behaviours Latino families demonstrate familism and extended family Familism - the idea the well being of the family takes precedence over the concerns of individual family members - Valued by Latino families; Brazilian and Mexican - Also Asian Americans with: good grades, discipline, conformity Raising multi ethnic children presents challenges not experience by same race children - Parents report feeling discrimination - Worry children may be rejected

Planning for Retirement

Financial planning and realistic expectations toward retirement ar e important predictors of future satisfaction o people who plan for retirement tend to be more successful in adapting to this major life change Pre-retirement education programs cover a variety of topics, including finances, attitudes, health, and expectations

loss oriented stressors

Focus on the deceased individual (can include grief work and both positive and negative reppraisal of the loss)

Marriage at Midlife

For most, satisfaction improves when children leave - empty nest Married Singles - grown apart but continue to live together Martial dissatisfaction in mid life is gradual, not spontaneous

Types of Leisure Activates

Four categories are usually used to help organize leisure activities: o Cultural - attending sporting events concerts, church services and meetings o Physical - basketball, hiking, aerobics and gardening o Social - visiting friends and going to parties o Solitary - reading, listening to music, and watching tv Leisure activities can also be considered in terms of the degree of cognitive, emotional, or physical involvement - they can also vary in degree o intensity of sport or activity Leisure activities are distinguished by preoccupations and interests o Preoccupations are much like daydreaming - sometimes they become more focused and become interests o Interests are ideas and feelings about things one would like to do, is curious about or is attracted to Any specific activity has different meaning and value, depending on a person involved How do we pick our leisure activities? o Each of us has a leisure repertoire - personal library of intrinsically motivated activates that we do regularly o These activities are determined by two things 1. Perceived competence - how good we think we are at an activity compared to people of the same age as us 2. Psychological comfort - how well we meet our personal goals for performance Other factors are also import ant - income, health, abilities, transportation, education and social characteristics

Developmental Aspects of Friendships and Socio-emotional Selectivity

Friends are important to older adults, who don't want to become burdens on family Help foster independence Older adults tend to have fewer relationships with people in general and develop fewer newer relationships ** Socioemotional Selectivity: - Life span theory that argues social contact is motivated by a variety of goals, including information seeking, self-concept and emotional regulation - Each of these goals id differentially salient at different points of the adult life span and results in different social behaviours Information seeking - exploring the world, trying to figure out how you fit in, what others are like, meeting new people is essential - Goal of young adults Emotional regulation - highly selective and prefer familiar people - Goal for older people People become increasingly selective in who they choose to have contact with

Normal Grief Reactions:

Grief work is the psychological side of coming to terms with bereavement American society does not support long periods of grieving, and pressures bereaved individuals to come to "closure" as quickly as possible

Patient Self-Determination and Competency Evaluation:

Health care facilities must provide information in writing about patients rights o Make their own health care decisions o Accept or refuse medical treatment o Make an advance health care directive Two types of determination about whether a person can make decisions: 1. Capacity to make decisions (clinical) 2. Competency (legal) With capacity determinations, the issues is whether the individual is able to make a decisions about specific tasks, and the abilities necessary are subject to measurement With competency determinations, the individual is being judged either with respect to a specific task or in general, and the determination can be made subjectively by the court Surrogate decision-makers are often wrong about what patients really want

Work-Family Conflict: The feeling of being pulled in multiple directions by incompatible demands from one's job and one's family

How to deal with work-family conflict successfully: o Women must be clear in their commitment to their careers, marriage, and children o Couples equally share housework and emotional work, and combine their roles without high levels of stress How did they do it? o Age of children is not a factor, but number of children is o Stress is lower if men have a flexible work schedule that allow them to care for sick children and other matters o Stress is higher during the peak parenting years, then is reduced

Whitbourne's Identity Theory

Idea that people build their own conceptions of how their lives should proceed Life-span Construct: the persons unified sense of the past, present, and future Many influences: identity, values and social context Has two structural components that in turn are the ways it is manifested 1) The scenario o Consisting of expectations about the future o Translates aspects of our identity that are important at a time into a plan for the future o Influenced by age norms defining key transition points o Game plan for how we want our lives to go 2) The life story o Narrative organizing past events into coherent sequence o Gives events meaning and sense of continuity o Distortions occur with time and retelling There is a continuous feedback between identity and experience; this explains why we evaluate ourselves positively at one point, yet defensive and protective at others Based on piagets concepts of assimilation and accommodation - Assimilation involves using already existing aspects of identity to handle present situations - overreliance makes you resistant to change - Accommodation reflects willingness to let the situation determine what you'll do - often when you don't have well developed identity around the situation Most list family as most important aspect, another was work She found people go through transitions when they feel they needed to, and do so on their own time Assimilation higher in older adulthood and accommodation higher in younger adulthood Assimilation associated with maintaining and enhancing positive self regard thought the minimization of negativity Changing identity through accommodation was associated with poor psychological health

Personal Concerns and Qualitative Stages in Adulthood What's Different about Personal Concerns?

Importance about sociocultural influences on development that shape peoples wants and behaviours Personal concerns take into account a persons developmental context and distinguish between having traits and doing everyday behaviours Personal concerns entail descriptions of what people are trying to accomplish and the goals they create

Divorce

In US it is 50-50 change In japan, Italy, Africa, Asia and Spain the rate is a lot lower - but is in nearly every country African American and Asian American couples tended to be married longer at time of divorce, and ethnically mixed marriages are at greater risk Higher level of education have lower rates Gorrman and Levenson developed two models that predicated divorce early (7 years of marriage) and later (first child reaches 14) - Negative emotions displayed during conflict predicted early divorce, but not later - Reflects a pattern of wide-demand husband-withdraw - Lack of positive emotions in discussion of day events and during conflict predicted later divorce but not early - Shows how couples emotions are critical to marriage success - Doesn't apply to all couples For older, long term married couples, the perception of spousal support is the most important predictor of remaining married Covenant marriage - approach to keeping couples together

Traditional and Non-Traditional Occupations

In the past, women who were employed entered traditionally female - dominated occupations Women who end up in non-traditional occupations is often related to personal feelings and experiences as well as expectations of occupation Many women have difficulties in finding occupations that match their skills Women who choose non-traditional occupations still are viewed with disapproval by their peers of either sex, even though they have high job satisfaction themselves

Labouvie-Vief's Dynamic Integration Theory

Integration of cognitive and personality development Argues the self is a product of the integration of emotion and cognition The integration of the optimization of happiness and the ability to tolerate tension and negativity to maintain objectivity that creates a healthy self concept in adulthood The accomplishment of this integration increases from young though middle adulthood but decreases in late life Mature adults move from representations of the self in young adulthood that are relatively poor differentiated from others, or from social conventions and expectations, to highly differentiated representations in middle age, to less differentiated representations in old age The degree of differentiation in self representation was related to the level of cognitive development

Active Euthanasia

Intentionally engaging in direct actions to shorten a patient's life.

Death Anxiety

Is a multidimensional construct involving many death-related fears, including fear of the dying process, moment of death, situation of the body and spirit after death and the unknown, both for one's self and for others.

Grandparenthood

It is your children's decisions and actions that determine if you experience it, making this role different from others we experience Most people become grandparents in 40s or 50s It is a peak experience There are societal needs and expectations of what grandparents are to do Grandchildren keep grandparents in touch with youth and latest trends Most grandparents derive multiple meanings, and they are linked with generativity Grandchildren highly value the relationship, even when young Intergenerational relationships are especially important for African American and Latino Families - African American grandfathers tend to perceive it as a central role to a greater degree - Latino American are more likely to participate in child rearing owing to a cultural core value of family Native American provide grandchildren with a way to connect with cultural heritage, and are likely to provide a great deal of care - The grandmothers take a more active role than grandfathers Asian American grandparents serve as primary source of traditional culture, and become heavily involved in caring for grandchildren It is tougher today than it use to be, families are more mobile, and often separated The biggest change is the increasing number of grandparents serving as primary caregivers, or parents - Parents may be deceased, addicted, incarcerated, or behavioural problems of child - Lack of legal recognition poses a problem - Social service workers often assist graparents in the policies they face - Financial stresses, cramped living space, and social isolation are some issues

Job Satisfaction: the positive feelings that results from an appraisal of one's work

Job satisfactions tends to show low to moderate increases with age o Older workers report higher job satisfaction than younger workers This may be partly because of self-selection o Unhappy workers may quit Other reasons include intrinsic satisfaction, good fit, lower importance of work, finding non-work diversions, and life -cycle factors

Midlife Issue: adult children and caring for aging parents

Kin keeper - the person who gathers family members together for celebrations and keeps them in touch with each other - Usually middle age mothers + Sandwich Generation - those between the competing demands of two generations; their parents and their children *** Due to an increase in life expectancy and an increase in the time it takes for children to become independent many middle aged individuals find themselves supporting adult children and parents at the same time. *** Sometimes, a person may be faced with supporting grandchildren, children, and elderly parents simultaneously. OUCH!

Consequences of Leisure Activities

Leisure activities promote well-being and can enhance all aspects of people's lives Importantly, it is the amount of satisfaction you derive from your leisure activities; not your level of participation Quality rather than quantity of leisure activities

Leisure Activities

Leisure consist o activities not related to work According to University of Waterloo (2001), women may experience "family leisure" as just one more added burden required of good mothers

Gay and Lesbian Couples

Less is known about the developmental course For most part, it is very similar to that of heterosexual couples Do differ in the degree to which both partners are similar on demographic characteristics: like race, age and education - Tend to be more dissimilar Gay mean, like heterosexual men, separate love and sex and have more short term relationships Lesbian and heterosexual women, are more likely to connect sex and emotional intimacy in fewer, longer lasting relationships - Lesbians tend to make commitment and cohabit faster than heterosexual couples Report less support from family members Still lack or legal recognition for gay and lesbian couples, and not provided with same rights

Developmental Changes in Leisure

Longitudinal research shows that leisure preferences in adulthood reflect those in earlier life However, as people grow older they tend t o engage in leisure activities that are less strenuous and more family-oriented

Occupational Choice and Development

Main purpose of work is to earn a living Meaning of work = money we exchange for life's necessities/luxuries and the possibility of personal growt h Although most people work for money, other reasons are highly variable - They include, prestige, recognition, and a sense of worth Occupational priorities: what people want from their employment reflect the culture and times in which people live, as well as the characteristics of the job and the quality of the workplace Study on job strain (balance between psychological demands of a job and the amount of control the worker has in that job ) - was the amount of job strain related to the decision to retire? - findings: o Job strain affected the retirement decision in those in managerial, technical or professional jobs but not in those in service and blue-collar occupations Impact of work cuts through all aspects of life; work is a major social role and influence on adult life

Single Parents

Many divorced single parents report complex feelings like frustration, failure, guilt, and need to be overindulgent Loneliness can be especially difficult to deal with Separation anxiety is a common and strong feeling among military parents Financially less well off than those who are married Single mothers are hit hardest One particular obstacle is dating

The Dependent Care Dilemma

Many employed adults must also provide care for dependent children and/or parents Whether a women returns to work after having a child depends largely on how attached she is to her work o This can lead to inter-role conflict Conflicts between work and family responsibilities Giving up a career means that the aspect's of one's identity that come from work must be re -defined and based on being a stay-at-home mom Inter-role conflict: results in a clash between competing sets of roles, in this case between work and family responsibilities Flexible work schedules and number of children are important factors in role conflict o Employed mothers are significantly less distressed than employed non-mothers When a woman's partner provides good support and women have average or high control over their jobs The mere availability of a workplace childcare centre does not always result in higher job satisfaction o Sympathetic supervisors are essential to lowering the stress of how child care issues can be resolved

What is a successful marriage, and what predicts it?

Marital Success - An umbrella term, referring to any marital outcome (such as divorce rate) Marital Quality - a subjective evaluation of the relationship on number of dimensions Marital Adjustment - degree spouses accommodate each other over a period of time Marital Satisfaction - a global assessment of ones own marriage Some important predictors of future success can be identified Younger the partners are, the lower the odds it will last - especially for teens/early 20s Financial security and pregnancy are other reasons Homogamy - similarity of values and interests a couple shares - Similarity increases the likelihood it will succeed Exchange Theory - Marriage is based on each partner contributing something to the relationship the other would be hard pressed to provide - Satisfying and happy marriages results when both partners perceive there is a fair exchange in all dimensions - Problems arise when competing demands of work, family etc. are an issue

Caring for a spouse/partner

Marital satisfaction much lower than for healthy couples Caregivers report loss of companionship and intimacy The better the perceived quality of the marriage, the fewer symptoms caregivers report Most adopt caregiver role out of necessity Situations that improve functional level of the ill partner improve the caregivers situations The important of feeling competent as a partner caregiver fits with the docility component of the competence - environmental press model (chapter 5) - Caregivers attempts to balance their perceived competence with the environmental demands of caregiving - Perceived competence allows them to proactive rather than merely reactive that gives them a better change to optimize the situations

Research on Generativity:

McAdam's model shows how generativity results from: o Complex interconnections between societal and inner forces, thus, creating a concern for the next generation and a belief in the goodness of the human enterprise

Gender Differences in Occupational Choice

Men have been groomed from birth for future employment Currently, more than 81% of women between ages of 25 and 54 worked outside of the home in 2005 (versus 91% of men, Statistics Canada, 2006) Many women have difficulty finding occupation that match their level of skill o Women in non-traditional occupations are viewed more poorly by both men and women o Women in traditional female occupations changed jobs less often

Men's, Women's and Cross Sex Friendships

Men's and women's friendships tend to differ in adulthood, reflecting continuity in the learned behaviours from childhood Women based their friendships more on intimate and emotional sharing, and use friendship as a means to confide in others Getting together for women often involves discussing personal matters Men base friendships on shared activities These friendships have a beneficial effect - Especially for men Cross sex friendship helps men have lower levels of dating anxiety and higher capacity for intimacy Cross sex friendships can have problems because of misperception - Men overestimate their friends sexual interest in them - Can result in partners feeling jealous

Marriage

Most adults want their love to end in marriage U.S residents less in a hurry to achieve this goal, as the medial age has been rising

Setting the Stage: Early Years of Marriage

Most intense Discussing financial matters is key since many newly married couples experience first serious martial stresses around money issues Must learn to adjust to different perceptions and expectations each person has Learn to handle confrontation and resolve conflicts For wives, more accurate specific perceptions of what their spouses are really like were associated with more supportive behaviours, feelings of control in marriage, and decrease risk of divorce Couples who are happiest focus on the good things As time goes on, stress increases Primary reason for drop in satisfaction is children - Temperament of child plays a role - Less time to devote to marriage But child free couples also experience this drop Research indicates disillusionment - decline in feeling in love, demonstrations of affection, responsiveness, increase ambivalence - key predictor of dissatisfaction In early marriage, many may experience time apart for long periods of time (e.g. military) Spouses that serve in combat areas may suffer from PTSD - More likely for other spouse directed aggression - If the non deployed spouse believes the deployment will have negative effects on the marriage, the problems are much more likely - Effects may be greater on wives

Research on Generativity

Multidimensional model shows how generativity results from interconnections among societal and inner forces (figure 9.1) The tension between creating a product or outcome that outlives oneself and selflessly bestowing ones efforts as a gift to the next generation results in a concern for the next generation and a belief in the goodness of the human enterprise Positive resolution finds middle age adults developing a generative commitment that produces generative actions Generative concern relates to life satisfaction, generative action does not Can be expressed by adults of all ages Middle aged adults are more concerned with it

Ethnicity, Gender, Aging, And Mental Health:

Neither positive mental health nor psychopathology has been adequately defined in any group in a way that takes social context into account so as to be sensitive to contextual differences in ethnic communities People in different ethnic groups have different ways of describing how they feel, so they may describe symptoms of mental disorders differently Researchers should adopt an ethnic research matrix that takes as its defining elements: o Ethnicity, national origin, racial group membership, gender, social and economic statuses, age, acculturation, coping reactions, and mental health outcomes Being female increases the risk of depressive symptoms and males who are depressed are more likely to commit suicide than women

Ethnicity and Occupational Development

Not much research has been conducted from a developmental perspective Statistics Canada (1991, 1996, 2001) one in four recent universitytrained immigrants obtained a job that required no more than a high school diploma Members of this group were most likely women from South or Southeast Asia who had a mother tongue other than English or French Whether an organization is responsive to the needs of ethnic minorities makes a big difference for employees Having an identifiable role model has a positive effect for ethnic minority employees, even if they are not active mentors

Temperament summary:

Novelty Seeking and Harm Avoidance may be useful measures Reward Dependence and Persistence are suspect Little evidence for a second-order Temperament factor Temperament Model worked equally well for men and women

The Parental Role

Nuclear Family - consisting only of parent(s) and children Extended Family - grandparents and other relatives live with parents and children

Gender, Ethnicity, Bias and Discrimination

Occupational choice and development are not equally available to all

Religiosity and Spiritual Support:

Older adults use religion more often than any other strategy to help them cope with problems in life o Spiritual support provides a strong influence on identity o Among Aboriginal Canadians, spiritual elders are wisdom keepers and repositories of sacred ways

Which demographic has the highest risk for suicide?

Older white men over the age of 75

Jung's Theory

One of the first theorists to believe in personality development in adulthood, Freudians thought it stopped in adolescence Emphasizes each aspect of a persons personality must be in balance with all the others This means each part of the personality will be expressed in some way, whether through normal means, neurotic symptoms, or in dreams Jung asserts the parts of the personality are organized in such a way as to produce two basic orientations of the ego - One is concerned with the external work; Jung labels it extraversion - The inner world of subjective experiences - labeled introversion - Individuals must deal with the external world effectively and also be able to evaluate their inner feelings and values - When people emphasise one orientation over the other, they are classified as extraverts or introverts Jung advocates two important age-related trends in personality development 1) Relates to introversion-extraversion distinction o Young adults re more extraverted than older, perhaps because they need to find a mate, a career etc. o With increasing age, the need for balance creates a need to focus inward and explore personal feelings about aging and mortality, thus comes with increase introversion 2) Involves the feminine and masculine aspects of our personalities o Each of us has elements of both masculinity and femininity o In young adulthood most of us express only one while working to suppress the other o As they grow older, people begin to let out the suppressed parts of their personality o Allows people to deal more effectively with their individual needs than ones defined socially

Occupational Choice

Our work life is a major source of our identity influences our lifestyle and social interactions More adults changing occupations than ever before or have to rethink about the kinds of jobs that they want to hold - can happen in middle a older adulthood as well, not only limited to young adults

Theories Based on Life Transitions

People go through predictable age related crisis Some crises are followed by periods of relative stability Thus, adulthood consists of a series of alternating periods of stability and change But research methods used to study life transitions are questionable They typically present stages as if everyone does through them

Occupational Expectations

People have expectations about what they want to become and when they hope to get there Expectations change as the result of o Realizing that one's interests have changed or the dream was not a good fit o But also due to age, race, or sexual discrimination, lack of opportunity, and obsolescence of skills Reality Shock: the realization that one's expectations about an occupation are different from the reality one experiences o Reality shock is common among young workers o This happens most to young adults and people with little relevant experience prior to assuming a new job o The outcome of reality shock is often a revision of o personal priorities in life

Gender-Role Identity:

People's beliefs about the appropriate characteristics for men and women o They reflect shared cultural beliefs and stereotypes about masculinity and femininity There is some evidence that gender role identity converges in middle age o Men and women are more likely to endorse similar self-descriptions However, these similar descriptions do not necessarily translate into similar behavior Also, older men and women tend to endorse similar statements about masculinity and femininity

What's different about personal concerns?

Personal concerns: o Are contextual in contrast to dispositional traits o Are narrative descriptions that rely on life circumstances o Change over time One "has" personality traits, but "does" behaviors that are important in everyday life

McAdams described 3 parallel levels of personality structure and function: What is personality?

Personality is an individual's typical pattern of behavior and thought that is relatively stable across time and situations. 1) Dispositional Traits - What people usually think of; Consist of aspects of personality consistent across different contexts and can be compared across a group along a continuum representing high and low degrees of the characteristic (e.g. shyness, gregariousness, etc.) - The level of personality most people think of first, and include commonly used descriptors like shy, talkative, 2) Personal Concerns what does a person think about often regarding goals, worries, etc.? this changes with life stage (e.g. retirement) a person is in - Consist of things important to people, their goals, and their major concerns in life - Usually described in motivational, developmental or strategic terms; they reflect the stage of life a person is in 3) Life Narrative - A person's identity as created by a combination of factors like past experiences. - Consist of the aspects of personality pulling everything together, those integrative aspects that give a person an identity or sense of self - The creation of ones identity is the goal of this level

Elder Abuse, Neglect and Exploitation

Physical abuse - The use of physical force that may result in bodily injury, physical pain or impairment Sexual abuse - Non-consensual sexual contact of any kind Emotional/psychological abuse - Infliction of anguish, pain or distress Abandonment - Desertion of an older adult by an individual who had physical custody or other wise assumed responsibility for providing care for the older adult Financial or material exploitation - Illegal or improper use of an older adults funds, property or assets Self neglect - Behaviour of an older person that threaten their own health or safety, excluding those conscious and voluntary decisions by mentally competent and health adult Neglect - Refusal or failure to fulfil any part of a persons obligation or duties to an older adult ¼ vulnerable older adults are at risk

Deciding whether to have Children

Potential parents actually don't think deliberately or deeply about when to have a child Those who are career oriented or like freedom no not often deliberately postpone it Children add affection, improve family ties, and sense of accomplishment Children bring happiness to parents Finances are of great concern Social attitudes are improving toward child free couples - Advantages: higher marital satisfaction, more freedom and higher standards of living Today, typically have fewer children and have first child later than in the past - Many women postpone because they are marrying later, want to have career - 41% of mothers are unmarried Being older at birth of first child is advantageous - Women more ease being parents, spend time with them, more affectionate, sensitive and supportive - Those who father in 30s are more invested, spend 3x more time caring for child

Describe the different types of prevention interventions*.

Primary: Prevent disease/disability from occurring in the first place. Secondary: Prevent significant impairment after a disease/disability is present, but perhaps before disease/disability has been diagnosed (e.g. cancer screening). Tertiary: Prevent the development of secondary conditions (e.g. bed sores). Quaternary: Improve functioning in people with established chronic conditions. * Not to be confused with Primary, Secondary, and Tertiary Aging

Occupational Development

Promotion is a measure of how well one is doing in one's career People who want to advance learn rather quickly how long to stay at one level and how to seize opportunities as they occur How a person advances in a career depen ds on professional socialization, expectations, support from co -workers, priorities and job satisfaction

Retraining Workers

Rapid changes in the nature of work have resulted in the displacement of older workers Career plateauing: occurs when there is a lack of promotional opportunities in the organization or when a person decides not to seek advancement Very difficult for older workers to maintain their job or land new jobs when they are forced into retirement, displaced or downsized unless they keep skills up-to-date If corporations are to meet the challenges of a global economy, they must include retraining in their employee development programs Effective training and development are often predicted by self-efficiency

Physician-Assisted Suicide

Refers to the circumstance in which a physician in some way, usually through prescription for a lethal drug, aids a patient in ending his or her own life.

Mourning

Refers to the displaying of behaviors expected by one's cultural and/or religious tradition following the death of another person.

Temperament & Character Inventory

Research questions:*** Can we replicate Cloninger's TCI model? What are the implications with regard to group comparisons or examining TCI over time? Since the TCI has been used in 1000s of studies it should work, right?

Defining Mental Health and Psychopathology:

Researchers and practitioners refer to Birren and Renner's classic argument that mentally healthy people have the following characteristics: o A positive attitude toward self o An accurate perception of reality o A mastery of the environment o Autonomy o Personality balance o Growth and self-actualization Some behaviors considered abnormal under this definition may actually be adaptive under some circumstances for many older people (isolation, passivity, or aggressiveness) An approach to defining abnormal behavior that emphasizes considering behaviors in isolation and from the perspective of younger or middle-aged adults is inadequate for defining abnormal behaviors in older adults Analyses of data from national surveys reveals older European Americans and Caribbean Blacks have a higher lifetime prevalence of major depressive disorder than do African Americans We must consider what else is happening and how the behavior fits the situation in addition to such factors as age and other personal characteristics

Adjustment to Retirement

Retirement is an important life transition and can be stressful o However, the degree of stress is related to attitudes toward retirement and whether retirement is voluntary Most people are satisfied with their retirement, as long as people o Have financial security o Have their health o Have a supportive network of relatives and friends High satisfaction in early retirement includes - For men: o Being in good health o Having enough income o Having retired voluntarily - For women: o No one role was associated with satisfaction For both men and women high personal competence was associated with higher retirement satisfaction over the long run

Older Couples

Satisfaction fairly high Describe partner in more positive terms than in midlife In general increases shortly after retirement, but then decreases with health problems and advancing age - Directly related to the perceived support each partner receives Past or present sexual activity is unrelated, but is related to social activity Many develop detached, contented styles Many couples show several specific characteristics - Selective memory regarding the occurrence of negative events and perceptions of their partner - Reduced potential for martial conflict - Greater potential for pleasure - Likely to be similar in mental and physical health - Fewer gender differences in sources of pleasure Overall, develop adaptive ways to avoid conflict and grow more alike Satisfaction remains high until health problems Being married in late life has several benefits - Deal with chronic illness, functional problems, disabilities

Erikson's Stages of Psychosocial Development

Says personality is determined by the interaction between an inner maturational plan and external societal demands Each stage is marked by a struggle between two opposing tendencies and both are experienced by the person The struggles are resolved through an interactive process involving both the inner psychological and the outer social influences Successful resolutions establish the basic areas of psychosocial strength Unsuccessful resolutions impair ego development in a particular area and adversely affect the resolution of the future struggles Epigenetic Principle:*** - What the sequence of stages are based on - Each psychosocial strength has its own special time of ascendancy, or period of particular importance - It takes a lifetime to acquire all of the psychosocial strengths - Later stages build on the foundation laid in previous ones 1) Trust vs. Mistrust - A conflict an infant faces in developing trust in a world it knows little about - Security and comfort 2) Autonomy vs. Shame and Doubt - Child budding understanding they are in charge of their own actions - Understanding changes them from totally reactive beings to ones who can act intentionally - Autonomy is threatened by their inclinations to avoid responsibility for their actions 3) Initiative vs. Guilt - They begin to discover who they are - Take advantage of wider experience to explore the environment on their own, ask questions and imagine possibilities about themselves 4) Industry vs. Inferiority - Increasing interests in interacting with peers, their need for acceptance, and need to develop competencies - Manifested behaviourally by desire to accomplish tasks by working hard - Failure to succeed developing self perceived competencies results in feelings of inferiority 5) Identity vs. Identity Confusion - Struggle is choosing from among a multitude of possible selves the one we will become - Confusion results when we are torn over the possibilities - Trying to balance our need to choose a possible elf and the desire to try out many possible selves 6) Intimacy vs. Isolation - Establishing a fully intimate relationship with another - Intimacy is sharing all aspects of oneself without fearing the loss of identity - If not achieved isolation results

Self-Concept and Well Being

Self Concept: the organized, coherent, integrated pattern of self perceptions; how we view ouselves. what we think we are? + There isn't much inter-individual change. - Mortimer et al. (1982): They identified several elements of SC (much like C&M's traits), and these did not seem to differ over the years. - However, within a person, SC will change based on experiences. ***Imaging how your SC would change if you consistently failed at something. - Includes notions of self esteem and self image

Bias and Discrimination

Sex discrimination: denying a job to someone solely on the basis of whether the person is a man or a women o sex discrimination is a major issue, in terms of getting jobs, occupational development, and also in pay Glass ceiling: the level to which women may rise in a company, but not go beyond o This is a barrier to promotion women and ethnic minorities often experience o Study on wage gap - women who delayed motherhood, presumably until skills and seniority were acquired, achieved higher rates of pay o Evidence of glass ceiling found in private co -operations, government agencies and non -profit organizations Glass elevator: in traditionally female occupations, men may rise much faster than female counterparts o Women paid 84 cents for every dollar that a man is paid; wage gap widens as women's working years increase o Solutions to problem have been promoted, one of which is the comparable worth: equalizing pay in occupations that are determined to be equivalent in importance but differ in the gender disposition of the people doing the job ; this can be carried out by gender-neutral job evaluations, which examine all positions within an organization to establish fair pay policies Sexual Harassment o 70% of women have experienced or heard offensive slurs or jokes or remarks about women o 40% of women have been sexually harassed o Less than 5% of victims report their experiences to anyone in authority o 40% of women report having been sexually harassed in the workplace at least once; victims are often single/divorced women under the age of 35 o The reasonable woman (person) standard is used to decide whether an act constitutes harassment o - If a reasonable women would view a behaviour as offensive then it is offensive even if the man did not conceive it as so o Train people in gender awareness to help minimize sexual harassment in work places Age Discrimination: denying a job or promotion to someone solely on the basis of age o Making employment decisions only on the basis of age or denying employment or promotion if the worker is over the age of 40 o Age discrimination occurs in many ways, such as differential layoff patterns and stereotypical views about older worker

Occupational Transitions

The average North American changes jobs multiple times during adulthood Changing occupations may be one way to guarantee challenging and satisfying work Factors influencing occupational change include o Dislike - which results in quitting or seeking other employment o Worker obsolescence - for example, technological developments that eliminate jobs o Economic factors which result in layoffs or downsizing - for example, recessions

Psychotic Disorders:

The behavior present in psychotic disorders are commonly manifested as secondary problems caused by other disorders, or as side effects from medications Schizophrenia: o Characterized by the severe impairment of thought processes including: The content and style of thinking Distorted perceptions Loss of touch with reality Distorted sense of self Abnormal motor behavior o May show these abnormal behaviors in several ways: Loose associations Hearing voices that tell them what to do Believing they can read other peoples minds Believing their body is changing into something else Sometimes having bizarre delusions Treating Schizophrenia: o Drug therapy consists of antipsychotics - haloperidol, chlorpromazine o A comprehensive and integrated social rehabilitation program combined with health care management intervention can be effective

Conclusions about Dispositional Traits

The bulk of evidence suggests dispositional traits are relatively stable across adulthood Criticisms of the research point to the need for better statistical analyses and a determination of the role of life experiences Stability in personality traits may be more evident later in the life span

Widowhood

The death of spouse increases the likelihood of dying, for about 10 years But most widowed manage to cope reasonably well Women are more likely to be widowed than men - More than half over age 65, only 15% of men - Women have longer life expectancies and marry older Loneliness is a major problem In general the spouse who was more dependent on their partners report the highest increase in self esteem because they learned to do the tasks formerly done by deceased + May recover slowly unless they have strong social support systems + Some cohabit or remarry "Living alone together" - arrangement where two older adults form a romantic relationship but have separate living arrangements

Conclusions about Dispositional Traits:

The idea that personality traits stop changing at age 30 does not have uniform support It could be that, generally speaking, personality traits tend to be stable when data are averaged over large groups of people But looking at specific aspects of personality in specific kinds of people, there may be less stability and more change

Super's Theory - occupational development theory based on self-concept

The initial two phases occur during late adolescence: 1. Crystallization - identity development as a source of career ideas 2. Specification - focusing on and training in specific lines of work Super describes five stages in adulthood, based on self-concept and adaptation to an occupational role o Implementation - begins in late adolescence or early 20's; people take a series of temporary jobs to learn about work roles and try out possible career choices o Establishment - begins by selecting a specific occupation during young adulthood; continues as person advances up the career ladder in the same occupation o Maintenance - transition phase during middle age; as workers max. Their efficiency, they begin to reduce the amount of time they spend fulfilling work roles o Deceleration - workers begin planning in earnest for their upcoming retirement and separating themselves from their work o Retirement - begins when people stop working full-time The more congruent a person's occupational behaviours are with what is expected of them at different ages, the more vocationally mature they are Super believes that people's occupations evolve in response to changes in their self-concept Limitations to Super's Theory - in recent times, people do not stay in the same occupation for all their worki ng lives, does not agree with women's work experience

death ethos

The philosophy of death can be inferred from funeral rituals, treatment of those who ware dying, belief in the presence of ghost, belief in an afterlife, the extent to which death topics are taboo

What Does Being Retired Mean?

The way in which people withdraw from full-time employment Changing conceptions of work are resulting in changing conceptions of retirement Retirement can be crisp or blurred o Crisp: making a clean break from employment by stopping work entirely o Blurred: repeatedly leaving and returning to work, with some periods of unemployment

Conclusions about Personal Concerns

Theory and research both provide support for change in the personal concerns people report at various times in adulthood

Developmental Issues in Therapy:

Therapy for mental disorders generally involves two approaches: medical treatment and psychotherapy Medical treatment most often involves the use of various medications based on the underlying physiological causes of the disorder Psychotherapy usually involves talking to a clinician or participating in a group The ways medications work change with age Clinicians must adapt techniques to the unique needs of older adults Lead some to purpose a new positive approach to geriatric psychiatry and geropsychology by adopted This positive approach focuses "on recovery, promotion of successful ageing, neuroplasticity, prevention, and interventions to enhance positive psychological traits such as resilience, social engagement, and wisdom" Another major issue in psychotherapy is establishing whether a particular therapeutic approach is effective, based on research and clinical evidence

Describe how gender, ethnicity, and SES affect the structure of a person's social network.

There are gender differences in the structure of social networks. Women have larger networks. Women place more in inner circle; men only include wives. There are race & ethnic differences. African Americans and Latin/Hispanic Americans include more family members than European Americans. + SES is also a factor. - Outer circles are larger for those with greater SES/Education, but inner circles are not affected. + Of course, even within these major groups, individuals differ. - Correlation between network support and health. - Sometimes disability can affect the amount of support received +People have the most friends when they are young adults

The process of the life story

Through which people develop a narrative view of the past that emphasizes the positive, is an example of identity assimilation as it alters the way that people interpret events that might otherwise detract from self esteem.

Factors Influencing Assessment:

Two areas of concern are biases (negative or positive) and environmental conditions (where the assessment occurs, sensory or mobility problems, and health of the client) Negative biases: racial, ethnic, and age stereotypes o Older adults may be "diagnosed" with untreatable problems such as Alzheimer's disease rather than treatable problems such as depression Clinicians do not always have the option of selecting and ideal environment; assessment sometimes occur in hallways, or in a noisy emergency room Physical health in older adults can create a negative bias so mental health issues may be overlooked when a health problem is discovered

Remarriage

Typically wait around 3.5 years to remarry African Americans tend to remarry slower than other ethnic groups Women are less likely to remarry, unless they are poor Women generally benefit more than men, especially if they have children No evidence that remarrying sooner has less successfulness Options are more constrained for older adults, also after a death Widows are constrained in their options and typically must depend on others Effects of remarriage on children is often positive, especially for young adult children who report a positive effect on their own intimate relationships

Effects of Divorce on the Couple

Unlike when spouse dies, it means that the persons ex-spouse is present to provide a reminder of the failure As a result, they are typically unhappy for a while Financial effects can trace to future generations Suffer negative health consequences "Divorce hangover" - reflects inability to let go, develop new friendships, orient themselves as single parents Forgiveness is important for adjustment, as well as low preoccupation Divorce in middle age or late life has special characteristics - If women initiate it, they report self focused growth and optimism, if they did not initiate it they tend to ruminate and feel vulnerable - Also face significant financial challenges - especially women

Letting go: Middle Aged Adults and Their Children

Usually children now see their parents in a new light, and are starting to move away - two positive developments The extent parents approve of their child leaving matters Mothers of all ethnic groups report feeling sad, but positive about potential for growth of their relationship Children are regarded as successes when they meet parents culturally based developmental expectations and are seen as good kids ½ of young adults return home - boomerang kids

Describe the convoy model.

We tend to take the individuals in our social networks along with us as we age. Our social networks don't change much, especially the inner circle. *outer circle more likely to change. This idea is known as the convoy model.

Mental Health and the Adult Life Course

What distinguishes the study of mental disorders, or psychopathology, in adulthood and aging is not so much the content of the behavior as its context: whether it interferes with daily functioning

Personality

What it is and what it isn't: When you think of "personality" what comes to mind? How is it measured and are they really measuring "whatever it is" properly... Assorted personality tests and links

Developmental Issues in Assessment and Therapy:

Whether the person is 25 or 85, it is important to be able to determine whether memory problems, energy loss, social withdrawal, or other areas of concern really indicate an underlying problem

Juggling Multiple Roles

Women still perform the greater amount of housework regardless of employment status - greater likelihood of gender parity if wife's income is high or has a university education o This causes women to feel more time -stressed than men Working mothers spend about twice as many hours per week as their husbands in family work and bear the greatest responsibility for household tasks Unequal division of labour is a major cause for arguments and unhappiness Men are often most satisfied with an equitable division based on number of hours spent, especially if the amount of time is small Women are most satisfied when men are willing to perform women's traditional chores

Women and Occupational Development

Women who leave well-paid occupations do so for many reasons, including o Family obligations - for women working part-time o Workplace issues - for women working full-time Women who continue to work full-time o Have adequate child care o Look for ways to further their occupational development Most important workplace issues are gender-related o Unsupportive or insensitive work environments o organizational politics o lack of occupational development opportunities

gender discrimination

act of denying a job to someone solely on the basis of whether the person is a men or women

meaning mission fit

alignment between an executive's personal intentions and his or her firm's mission

anniversary reaction

changes in behavior related to feelings of sadness on the date of a loss

acceptance

depends on ability to talk openly about death and express one's emotions

burnout

depletion of a person's energy and motivation the loss of occupation idealism and the feeling that one is begin exploited

Leisure

discrectionary activity that includes simple relaxation activates for fun and creative pursuits

Backup plan

emergency care for dependent children to adults so that an employee does not need to lose a day at work

work family conflict

feeling of being pulled in multiple directions by incompatible demands from ones job and ones family

Hospice Care

focused on keeping patients as alert, engaged and comfortable as possible during last few months of life. -emphasis on pain management rather than treatment -"death with dignity" -requires family involvement

boomerang employees

individuals who terminate employment at one point in time but return to work in the same organization at a future time

age discrimination

involves denying a job to someone because of their age

higher brain standard of death

lack of consciousness=death Individuals are dead when the higher brain functions responsible for consciousness permanently close down

Glass ceiling

level to which women may rise in an organization but beyond which they may not go

final scenario

making one's choices known about how they do and do not want their lives to end -choices about end of life issues known to others

psychological capital theory

notion that having a positive outlook improves processes and outcomes

AIDS Dementia Complex

o ADC or HIV-associated encephalopathy, occurs primarily in persons with more advanced HIV infection o Inflammation may damage the brain and spinal cord and cause symptoms such as: Confusion and forgetfulness Behavioral changes Severe headaches Progressive weakness Loss of sensation in the arms and legs Stroke o HIV infection can significantly alter the size of certain brain structures involved in learning and information processing Encephalitis (inflammation of the brain) Behavioral changes Gradual decline in cognitive function

Huntington's Disease:

o An autosomal dominant disorder that usually begins between ages 30 and 45 o Generally manifests itself through: Involuntary flicking movements of the arms and legs The inability to sustain a motor act Prominent psychiatric disturbances Clear personality changes o Changes in the brain thought to underlie the behavioral losses include degeneration of the caudate nucleus and the small-cell population, as well as substantial decreases in the neurotransmitters g-aminobutyric acid (GABA) and substance P

Vascular Dementia:

o Cerebrovascular accident (CVA) results from a distribution of the blood flow, called an infarct that may be caused by a blockage or hemorrhage o If a person experiences numerous small cerebral vascular accidents, a disease termed vascular dementia may result o It may have a sudden onset after a CVA, and its progression is described as stepwise and highly variable across people, especially early in the disease o Most people who have vascular dementia have a history of cerebrovascular or cardiovascular disease Typical symptoms include hypertension, specific and extensive alterations on an MRI, and differential impairment on neuropsychological tests

Alcohol-Related Dementia:

o Chronic alcohol abuse or dependence may result in cognitive decline, ranging from limited forms of amnesia or mild cognitive impairment to dementia o Causes of these memory problems include deficiency of nutritional factors that cause Wernicke-Korsakoff's syndrome, and/or other problems such as cerebrovascular disease o One key symptom is confabulation, when the person makes up what sounds believable, but completely fictitious, stories that cover the gaps in memory o Other symptoms: personality changes, loss of problem-solving skills, communication problems, and disorientation to time and place o Thiamine, that limits some of the toxic effects of alcohol is an important supplement for heavy drinkers

Parkinson's Disease:

o Known primarily for its characteristic motor symptoms that are easily seen: very slow walking, difficulty getting into and out of chairs, and slow hand tremor o These problems are caused by a deterioration of neurons that produce the neurotransmitter dopamine o One prominent theory is the earliest indications of Parkinson's are found in a different part of the brain, the medulla and the olfactory bulb, which controls the sense of smell o Treated by several medications - most popular are levodopa, which raises the functional level of dopamine in the brain; Sinemet that gets more levodopa to the brain, and Stalveo that extends the effective dosage time of Sinemet o Neurostimulator device that acts like a brain pacemaker by regulating brain activity when implanted deep inside the brain, may prove effective in significantly reducing the tremors, shaking, rigidity, stiffness, and walking problems when medications fail

Caring for Patients with Dementia at Home:

o Women average about $324,000 and men average about $290,00 in losses from taking time off to care for a loved one o Caregiving career begins with the onset of the illness and continues through the bereavement and social adjustment period o Two options available to provide some relief for care providers are: Respite care: which is designed to allow family members to get away from the caregiving situation for a time Adult day care: provides placement and programing for frail older adults during the day - goal is to delay institutionalization, enhance self-esteem, and encourage socialization

mentor or developmental coach

persons who is part teacher, part sponsor, part model. helps a new hire do the work required in his or her present role and to prepare for the future roles

reality shock

situation in which what you learn in the classroom does not always transfer directly to the real world and does not represent all that you need to know

glass cliff

situation in which woman's leadership position precarious

career plateuing

situation that occurs when there is a lack of challenge on one's job, promotional opportunity in the organization or when a person decides not to seek advancement

Passion

strong inclination an activity that people like ( love) and in which they invest time and energy

grief work

the psychological side of coming to terms with bereavement

career construction theory

theory that posits that people build careers through their own actions results from the interface of their personal characteristics and social context

social cognitive career

theory that proposes that career choice is a result of the application of social cognitive thory,

Alienation

when workers believe that what they are doing is meaningless and that their efforts are devalued or what they do not see the connection between what they are doing and the final product

Age & productivity (Dennis)

• Dennis (1966) - Evaluated total output, regardless of quality - Sample included only 80+ • Scholarship peaked in the 40s and remained pretty high until the 70s • There was either Maintenance or decline depending on the discipline • This study is just looking at the quantity of work not the quality of work *Ultimately, creative productivity is unlikely to be a component of successful aging according the the research done by Dennis and Lehman.

Paradox of well-being

• Despite objective difficulties, older adults feel good about themselves and their situations *Even if they are living in less than ideal physical settings or experience negative life events, people in later life report that they feel good about themselves and their situations.

factors affecting the grief process

-mode of death (sudden or expected) -strength of attachment to the deceased person -social support -gender differences -relationship to the diseased

Sociocultural variations

1) Certain sectors of the population, particularly minorities from low income backgrounds, do not have the opportunity to achieve good health and full expression of their innate abilities 2) Definition of eminence as used in studies of aging and creativity -Women are far less likely than would be expected on the basis of chance to appear in lists of creative and productive at any age -Only within the area of children's literature that Lehman listed women as constituting anywhere near 50% of the notable contributors. -Little if any mention is made of Blacks. *Certain areas of accomplishment within Black culture were not recognized within the majority reference works, including law, education, religion, classical music, and the sciences. -Those who are likely to manage to break through cultural barriers are likely to receive considerable recognition within their own as well as the majority culture.

Are grief reactions more severe after an unexpected death or after an expected death? What is anticipatory grief and how might it explain this?

Although the findings are mixed, it is believed that some people experience anticipatory grief when they know a loved-one is near death. This anticipatory grief is thought to prepare a person for someone's death.

Sky Burial

In Old Tibetan Buddhism, a human corpse was cut into pieces at specific locations and left for birds of prey to eat. This is because the soul has already reincarnated, so its old body is merely an empty shell.

Which age group shows the lowest levels of death anxiety?

Older adults

Quantitative Research Methods

Research design that emphasizes researchers' *precise measurement* of psychological variables and the statistical analysis of those measurements.

Qualitative Research Methods

Research philosophy or method that emphasizes the participants' *expression* of psychological variables, often through narratives and summarizing of data into themes.

The Dual Process Model (DPM):

o Considers two broad types of stressors: Loss-oriented stressors concern the loss itself, such as the grief work that needs to be done Restoration-oriented stressors are those that involve adapting to the survivor's new life situations, such as building new relationships and finding new activities o The DPM captures well the process bereaved people themselves report - at times they are nearly overcome with grief, while at other times they handle life well o Helps us understand how, over time, people come to balance between the long-term effects of bereavement and the need to live life

Age & productivity (Lehman)

* Lehman: Age and Achievement (1953) - Evaluated number and quality, focusing on significant impact in field • Peak of productivity: 30-35 • Creative peak: varies by discipline - Earlier peaks: sciences, intellectual imagination, physical ability - Later peaks: experience and diplomacy - In the middle: literature

Swan Song Phenomenon

*A brief renewal of creativity that can stimulate the creation of new works and a new style of work. -Strong, evocative, and easy to remember -"Lachrymosa" from Mozarts last work *The resurgence of creativity that stimulates the swan song may come about with the composer's awareness of increased closeness to death.

Set point perspective

*Biologically determined temperament (personality) sets the boundaries for levels of well-being experiences throughout life • We have a biologically determined temperament that sets the boundaries of our levels well-being experiences throughout life • Extraversion and life satisfaction • Optimistic perceptions despite reality • Successful interpersonal relationships • We have this set point that we fluctuate around • Trough our adaptation processes we always come back to our set point • Psychological factors • We tend to feel better about ourself when we achieve our goals • The kind of goals we set for ourselves reflect our subjective well being • One of the ways we habituation is through coping • We want to try and match our coping strategy to our stressor • Emotion focused for a problem that may not be able to be solved • We can use our social support network for problem focused or emotion focused problem solving and support • Relates to socio emotional selective theory because we hold on to relationships that are emotionally fulfilling and satisfying which benefits us in the long run. • We also tend to enhance our sense of belongingness which boosts or feelings of self esteem and self worth

Creativity with a little "c"

*Characterizes the work by people who in their daily lives express themselves through cooking, crafts, gardening, or story-telling. *Can also be thought of as personality development -develop a completely open mind to new experiences and are able to enjoy and appreciate the finer nuances of life. *Ordinary individual: -construct personal narrative. *Part of a successful life narrative may involve coming to grips with the recognition of how cultural constraints have affected your ability to realize your hopes and dreams.

Productivity and creativeity

*Creativity: ability to produce a notable or extraordinary piece of work - Judged by a group of experts relative to a particular time period for: • Novelty • Impact on society • Element of surprise

Social indicator model

*Demographic and social structure variables account for individual differences in levels of well-being • Older adults are disadvantaged - Physical illness - Widowhood - Low income - Age - Gender • Success = exceptional

Relative deprivation

*In which people compare themselves to others within their own social class and it is only when they perceive themselves to be disadvantaged compared to them their well being suffers.

Successful aging

*Involves the additional quality of enhancing the healthy spirit and sense of joy in life seen in older adults who seem to transcend whatever physical limitations they encounter. *Synonymous with mental health

Carrer age

*Key aspect of Simonton's model *Which is the age at which an individual begins to embark on his or her career.

Simonton's (1997) model

*Mathematical model 1) Relates creative productivity to creative potential, age, nature of field/endeavor 2) Productivity = f(m, a, b) - Initial creative potential (m) - Ideation (a) - Elaboration (b) 3) "Career age" -Defines productivity -Based on first, best, and last contribution *Mathematical model • Related creative productivity to creative potential, age, nature of field/endeavor • Productivity = f (m, a, b) 1) Assumptions • Individuals vary in "initial creative potential" (m) • Creative potential is translated into concrete products through • Ideation (a) • Refers to the number of specific ideas that comes from that creative potential • Elaboration (b) • The number of works that actually get tuned into output • Elaborated from those creative ideation in order become a product • A little bit of discrepancy here • Abilities to turn that potential into something concrete in the end is different for all of us. • Those with higher creative potential should produce more work and more high quality work because of the fact that they are creating more. • They have more ideas and elaborate more on those ideas • This suggests that the more output you have the more likely you are to have something of worth • "Career age" defines productivity • Based in first, best, and last contribution • First: marks the beginning of career, first work of high quality, what signifies the beginning of the individual's career. • Best: as judged by critical review/ acclaim, received the greatest acclaim • Last: last work of high quality and value. *On average, according to this model, productivity in later life will be higher among people who begin their careers at a later age and so with the age of best works.

MacArthur Foundation Study of Aging in America

*Most popular model of successful aging based on this research. 1) Absence of disease and disability associated with disease, 2) Maintaing high cognitive & physical functioning (Active and competent) 3) "Engagement with life" (Being involved in productive activity and maintaining relationships with and concern for other people, in ways that contribute to their well being) *All three components reinforce each other.

Adaptation

*Or habituation is one of these theorized psychological mechanisms that people may use to maintain high well-being in the face of objectively negative circumstances. *learn to adjust their daily lives to fit the constraints presented to them. 1) Goal setting 2) Coping -problem focused vs. emotion focused 3) Self efficacy 4) Religion

The neuroscience of creativity

*Prefrontal cortex: new ideas/creativity • Flexibility + experience = ~20 years into career; midlife *People can enhance their creativity by exercising these areas of the brain through mental activity. *Working memory, attention, the ability to shift mental focus, necessary operations for creativity, are also associated with the anterior cingulate cortex. *For men, higher openness scores were related to activation of the anterior cingulate cortex (Involved in monitoring process) *For women, prefrontal activation (reflecting flexibility) *For both sexes, openness was also related to frontal lobe activation.

Social comparison

*Process through which examine other People's lives and circumstances and compare them to our own lives and circumstances 1) Downward: • Less fortunate than us • Outcome is comfort 2) Upward • More fortunate than us • Outcome is defeat

Subjective well-being (Book notes)

*Referes to an individual's overall sense of happiness. *Concept is divided into three components: 1) Positive affect 2) Negative affect 3) Life satisfaction

Equal Odds Rule

*There is a positive relationship between quality of work and quantity of work. *Those who produce more output are more likely to score a hit or success than those who produce fewer works. -"If you don't shoot you can't score" *An implication of this theory is is the notion that people are most likely to produce their best work during their peak period of productivity on the basis of probability alone. *Simonton's model allows for the existence of older individuals who retain high levels of productivity and creativity.

The Hospice Option:

+ A program of healthcare that seeks to allow a person to die with dignity and with as little pain as possible. + Hospice is an approach to assist dying people emphasizing pain management (palliative care) and death with dignity + Typically, a physician must declare that a person isn't expected to live for more than 6 months. + The family is often included in the process and can be beneficial to them as well as the patient. + Outpatient: person taken care of at home, often by family and a visiting nurse. + Inpatient: all care is provided by healthcare professionals. + Hospice care emphasizes quality of life rather than quantity of life o The goal is a de-emphasis on the prolongation of death for terminally ill patients o Both inpatient and outpatient hospices exist Outpatient is becoming more popular - more clients served at a lower cost The approach to care in hospice is called palliative care and is focused on providing relief from pain and other symptoms of disease at any point during the disease process

The Price of Life-Sustaining Care

+ Affordable Care Act passed in 2010, concerns the financial, personal, and moral costs of keeping people alive on life support machines and continuing aggressive care when people have terminal conditions + Data indicates less than 7% of people who received hospital care die each year, but account for nearly 25% of all Medicare expenditures + expenditures are typically less for those having advance directives

What is an advance directive? What are the different types?

+ An advance directive is a legal document that specifies what a person's wishes are with respect to healthcare and/or financial concerns in the event that they become incapable of making decisions for themselves. + Sometimes a health care proxy is specified. - Durable power of attorney for healthcare. - Durable power of attorney for finances. + Advanced directives are not always followed. + These may be very specific: water but no food. Food and water, but not CPR, etc. - Psychiatric AD: what should happen in the event that one becomes mentally incapacitated? - Do not resuscitate: No CPR during medical crisis. - Do not hospitalize: Do not transfer to hospital for medical care during a crisis.

Legal and Medical Definitions:

+ Clinical death: lack of heart beat and respiration + Whole-Brain death is the most widely accepted today o Includes 8 specific criteria, all of which must be met: 1. No spontaneous responses to any stimuli 2. No spontaneous respiration for at least 1 hour 3. Total lack of responsiveness to even the most painful stimuli 4. No eye movement, blinking, or pupil responsiveness 5. No postural activity, swallowing, yawning, or vocalizing 6. No motor reflexes 7. A flat EEG for at least 10 minutes 8. No change in any of these when tested again 24 hours later Persistent vegetative state occurs when cortical functioning ceases; the person does not recover This condition can occur following disrupting of the blood flow to the brain, a severe head injury, or a drug overdose Other conditions that mimic death - such as deep coma, hypothermia, or drug overdose - must be ruled out The whole-brain standard does not permit a declaration of death for someone who is in a persistent vegetative state

What is euthanasia? What are the different forms of euthanasia?

+ Terminating someone's life for reasons of mercy, such as alleviating extreme unabated pain. + Active euthanasia: deliberately ending someone's life. - Suicide - Physician assisted suicide. + Passive euthanasia: Allowing a person to die by withholding available treatment. + * Arguments for? Alleviate suffering. Not our bodies or lives. Alleviate unnecessary financial strain. + * Arguments against? Does the person really want to die? What if a treatment becomes available? Could be murder.

Factors that Promote Successful Aging.

- After controlling the effects of cohort, time of measurement, and number of test occasions, it was concluded that the course of life satisfaction across adulthood was nearly stable until the very older ages, dropping slightly after the age of 70 and them more steadily in the 80s. Another research found a different pattern, life satisfaction decreasing early in adulthood, increasing from mid-to late adulthood, and then declined at the very end of life o Both cases showed results that contradict predictions from socioemotional selectivity theory of a general upturn in satisfaction among the oldest-old o Furthermore, they make the paradox of well-being a little less paradoxical. It appears that at the end of life, individuals may be influenced by objective life circumstances and, on average, show a gradual decline in their overall well-being - The set point perspective proposes that people's personalities influence their level of well-being throughout life o Using the MIDUS data, found that people higher on positive poles of the five factor model traits had higher levels of well-being. Over time, positive changes in these traits correlated with further increases in well-being. The study's findings suggest that personality acts as more than a set "point", in that its relationship to changes in well-being continues to evolve

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- However, connecions between objecive social indicators and subjecive well-being were found. Studies of older adults show posiive associaions between feelings of well-being and personal resources, including physical funcioning and adequacy of inancial support. Physical funcioning as well as paricipaion in physical acivity contributes to subjecive well-being of older adults. Educaion level, in turn, predicts high levels of physical and cogniive funcioning, which also predict high levels of subjecive well-being - There are advantages to having higher educaional levels and income in terms of health status - money and status can help to resolve many of the challenges that people at the lower end of the income spectrum experience. Even ater adjusing for medical condiions, lower SES is related to depression and poorer healthrelated status - Data suggested that when people arrive at their sense of overall well-being, they do so by combining all the speciic domains (health, income, housing, spouse, job, social life). Life saisfacion in older adults will be high if the posiives outweigh the negaives, but will be low if the adults experience themselves more negaively in the sub-domains that contributes to overall well-being - Saisfacion with health was one of the domains to show an accelerated decline in the oldest groups. However, individuals may be poor in health objecively but sill feel they are aging successfully. Self-rated health may difer from the objecive measure of physical funcioning - Researchers believe that older adults derive their self-rated health raing through social comparison, the process that occurs when people rate themselves relaive to their primary reference group. If people in an older adult's reference group are in poorer health, then the individual's self-rated health will be higher than if the comparison group is in beter health - Found that physical funcioning had a decreasing relaionship to self-rated health as individuals grew older. However, there were diferences within the older groups in the physical funcioning-heaolth raings relaionship o White Americans were more likely to have their actually physical funcioning afect their self-rated health, as with older adults with advanced educaional degrees o However, the relaionship between physical funcioning and self-rated health was weaker among older adults from non-white racial or ethnic groups, those with less educaion, and those whose health is disadvantaged o It may be that social comparison inluences this relaionship and that these groups are more likely to compare themselves with members of a group that, like theirs, is in poor health

Successful Cognitive Aging? ...

- In contrast of popular belief, most older people do not become depressed, and personality development in middle to later adulthood appears to in the positive direction of greater adaptiveness. Most older adults preserve their cognitive abilities to a very large degree o Study of centenarians show that those who live to these advanced ages are sturdy both cognitively and physiologically - One reason why the successful ager is thought of the as the miraculous exception rather than the rule is that many theorists, researchers, and lay people believe in the social indicator model. According to this model, demographic and social structural variables, such as age, gender, marital status, and income, account for individual differences in the levels of well-being. Because by demographic standards older individuals are in a disadvantaged position, they should be less happy than the young. An older adult who is able to avoid becoming depressed by the potentially disturbing circumstances of poor health, widowhood, and low income seems deserving of some kind of recognition this is all under the social indicator model beliefs, it is not true - Of a population 75 years and older, 81% said they were "very" or "pretty" happy and only 19% rated themselves as "not too" happy - The Canadian Community Health Survey found that 88.5% of those aged over 65 reported being satisfied with their lives

Factors that Promote Successful Aging

- Interest in successful aging its generally within the larger field of positive psychology, which seeks to provide a greater understanding of the strengths and virtues that enable individuals and communities to thrive. Within this tradition, life satisfaction is the overall assessment of an individual's feelings and attitudes about his/her life at a particular point in time. Subjective well-being is the individual's overall sense of happiness o Life satisfaction may be more of a cognitive evaluation, while subjective well-being is more affect ive. Together, they represent a complete picture of a person's well-being - One of the puzzles for researchers who study successful aging is why so many adults are able to remain positive in their approach to life despite their accumulating chronic health conditions, normal age-related changes, and alterations in their social roles and financial security. The paradox of well-being refers to the well-established finding that older adults maintain high subjective well-being despite facing challenges from their objective circumstances o May be because older adults have developed a set of coping skills over their lifetime that allows them to frame events that younger adults would consider detrimental to their own well-being o Cohort effects may have lead current generations of older adults to feel higher levels of subjective well being because they grew up with expectations about what their life would be like o Another possibility is that the paradox of well-being reflects a survival effect, and that the older adults who are sill alive and are available to be tested are hardier and more optimistic than those who are either no longer in the population or unwilling to be sampled. Perhaps these individuals were always inclined to view the world in a positive way

Successful Cogniive Aging

- Many older adults regard cognitive functioning as central to their identity - In keeping with this focus then, successful cognitive aging can be defined as cognitive performance that is above the average for an individual's age group as objectively measured - "SuperAgers", defined as individuals 80 years and older with superior episodic memory (comparable to middle aged adults), were found to have thicker cerebral cortex. Their memory performance, in turn, was correlated positively with cortical thickness. They also showed greater volume of the cingulate cortex, an area that may be involved in preventing episodic memory loss - Researchers looked for relationships between successful brain aging and successful cognitive aging, but results were far from clear-cut: 61% of studies showed a mixed relationship, a negative, relationship, or no relationship at all o It is possible that successful brain agers are most likely to show brain plasticity - Cognitive aging may be best understood as maintaining relative superiority to a person's age peers, not to standards based on the performance of young adults - The factors that predict successful cognitive functioning in older adults may be different from those which predict better functioning in young adults. (Higher CRP related to less risk of dementia)

Overview of Successful Aging

- The Rowe and Kahn definition of successful aging is the absence of disease and disability, high cognitive and physical functioning, and engagement with life o Criticized for being unclear, overly focused on physical and cognitive health, and lacking psychological traits such as spirituality and well-being - A model that focuses on a broader range of influences is in the WHO definition of active aging: the process of optimizing opportunities for health, participation, and security in order to enhance quality of life as people age o Specifies a role for social, health care, and economic determinants, as well as pointing to the importance of the physical environment o WHO makes explicit the role of autonomy and independence, placing greater emphasis on the individual's ability to get around in the environment than on whether the individual needs physical accommodations because of disability - To overcome the limitation identified in the Rowe and Kahn model, researchers administered a study in an attempt to predict self-rated successful aging o They found that the women highest in subjectively rated successful aging had high scores in what they called psychological protective factors of resilience, self-efficacy, and optimism; were high in positive emotional functioning, and rated themselves low in physical symptoms o These findings support the contention that the Rowe and Kahn definition of successful aging is overly narrow, and that psychological resilience and optimism are more important contributors to the older individual's own sense of aging well. - Sexuality is another component of successful aging that is known to play a role in overall health and well-being in the mid-life and later years. The overall scores of the women of the successful aging measures were related to sexual satisfaction, but not related to actual sexual activity - Actual physical health, then, appears to be less important in predicting successful aging, even in an area of functioning as important to overall well-being as sexuality - In a research study, health behaviors, particularly physical exercise, predicted successful aging to an even greater extent than did social support or social contact - As indicated by WHO model, the physical environment is an important determinant in the ability to age successfully o Given the demonstrated relationship between physical exercise and successful aging, designing walk-able neighborhoods should be a priority for supporting well-being in late life

Characteristics of last works

1) Ability to criticize own work -Those who are older tend to have a greater ability to take an objective view of their own work, potentially because they have all this experience 2) "Old age style": -approach to art that eliminates fine detail and presents the "essence" of the works intended. -choice of theme related to aging or death (Reality of artist's life) -"Swan song": brief renewal of creativity that can stimulate creation of new works or new style of work (simple, strong, evocative, and easily remembered) 4) Shift away from innovation and discovery toward synthesis and integration -Sometimes inspired by age related changes, health problems, etc -Sue whitebourne is an example of a successful agers

Old age style

1) Eliminates the fine details and instead presents the essence of the work's intended meaning. *The work becomes less objective and focused on on formal perfection and instead more subjective. -Michael angelo, Renior, Matisse, Degas, Picasso..etc. *Critics have also noted that older adults paint with a larger brushstroke, so that each packs a larger emotional punch 2) A choice of theme related to aging or death (Relative of artists life) -not necessarily morbid or depressing. *A preface to this style, creativity may be expressed in midlife as "pairing down life to the essentials" *Midlife may bring with it a heighten sense of urgency to create a lasting legacy. 3) Swan Song Phenomenon 4) Shift their creative products away from innovation and discovery and instead become oriented toward integration and synthesis of existing knowledge. -observed primarily among among scientists and academicians. *This style may be stimulated by proximity to death, a desire to leave behind a legacy, or perhaps age-related changes or health problems.

Where does creative potential come from>

1) Neurological basis 2) Personality -openness -flexibility -tolerance -psychological-mindedness -trait of flexibility or plasticity and, rather than dwell on their accomplishments of the past, looked forward to new goals and new creative enterprises.

Successful aging: Final Perspectives

1) People in later life appear not only to manage to feel satisfied with their lives but also to be able to achieve new forms of creative expression 2) Analysis od Simonton's model shows creative productivity, people who begin their careers with a high degree of creative potential are likely to maintain higher creative output well into their 60s, 70s, and beyond.

Subjective well-being influences

1) Personality -We have a biologically determined temperament that sets the boundaries of our levels well-being experiences throughout life -Extraversion and life satisfaction *Optimistic perceptions despite reality *Successful interpersonal relationships -We have this set point that we fluctuate around 2) Goals 3) Coping 4) Social relationships 5) Affect regulation/SST 6) Social comparisons 7) Identity process

Passive Euthanasia

Allowing a disease process and related complications to proceed, either as a result of withholding treatments or ceasing those that have already been place, resulting in a patient's death.

Advance Directives

Documents that indicate a patient's wishes in the event that the patient becomes incapacitated and unable to make decisions regarding medical care.

Creating a Final Scenario:

End-of-life issues o Managing the final aspects of life o After-death disposition of the body and memorial services o Distribution of assets People want to manage the final part of their lives by thinking through the choices between traditional care and alternatives, completing advance directives, resolving key personal relationships, and perhaps choosing the alternative of ending one's life prematurely through euthanasia Making such choices known about how people do and do not want their lives to end: o A crucial aspect of the final scenario is the process of separation from family and friends - bringing closure to relationships o One's final scenario helps family and friends interpret one's death, especially when the scenario is constructed jointly o Any given final scenario reflects the individual's personal past, that is unique combination of the development forces the person experienced

Sociocultural Definitions of Death:

In Western Culture, several meanings have developed: o An image o A statistic o An event o A state of being o An analogy o A mystery o A boundary o A thief of meaning o A basis for fear and anxiety o A reward or punishment All cultures have their own views Mourning rituals and states of bereavement also vary in different cultures There is great variability across cultures in the meaning of death and whether there are rituals of other behaviors to express grief Some cultures have formalized periods of time during which certain prayers or rituals are performed Death can be a truly cross-cultural experience, such as when major tragedies occur Variations in the customs surrounding death are reflected in some of the most iconic structures on earth, such as the pyramids in Egypt

Dealing with One's Own Death:

Kubler-Ross's theory includes five stages o 200 interviews with terminally ill people convinced her most people experienced several emotional reactions when dealing with death o Denial, Anger, Bargaining, Depression, and Acceptance o The first reaction is likely to be shock and disbelief Denial is a normal part of getting ready to die o At some point people express anger as hostility, resentment, frustration, and envy o It is important to note that Some people do not progress through all of these stages, and some people move through them at different rates People may be in more than one stage at a time and do not necessarily go through them in order

Learning to Deal with Death Anxiety:

Living life to the fullest is one way to cope with death anxiety - fewer regrets o Teenagers (especially males) engage in risky behavior that is correlated with low death anxiety Koestenbaum proposes exercises to increase one's death awareness o Writing your own obituary o Plan your own death and funeral services o Consider that death could happen now An increasingly popular way to reduce anxiety is death education o Death education programs help primarily by increasing our awareness of the complex emotions felt and expressed by dying people and their families

Making Your End-of-Life Intentions Known:

Living will: a person simply states his/her wishes about life support and other treatments Durable power of authority: an individual appoints someone to act as his/her agent for health care decisions The purpose of both is to make one's wishes about the use of life support known in the event one is unconscious or otherwise incapable of expressing them These can also serve as the basis for Do Not Resuscitate (DNR) medical order which is used when cardiopulmonary resuscitation (CPR) is needed

Risk Factors in Grief:

Mode of death, personal factors, income, and interpersonal context can make bereavement more difficult Grief is equally intense in both the expected and unexpected death o May begin before the actual death when the patient as a terminal illness It is believed that when death is anticipated, people go through a period of anticipatory grief before the death that supposedly serves to buffer the impact of loss when it does come and to facilitate recovery When the deceased person was one whom the survivor had a strong and close attachment and the loss was sudden, greater grief is experienced Such secure attachment styles tend to result in less depression after the loss because of less guilt over unresolved issues (because there are fewer of them), things not provided (because more were likely provided), and so on Expected death does not mean that people do not grieve o In a study of widows whose husbands had been ill for at least 1 month before their death grieved just as intensely as did widows whose husbands died unexpectedly

Coping with Grief:

Numerous theories have been proposed to account for the grieving process: The Four Component Model: o Understanding grief is based on 4 things: 1. The context of the loss 2. Continuation of subjective meaning associated with loss 3. Changing representations of the loss relations over time 4. The role of coping and emotion-regulation process o Dealing with grief is a complicated process only understood as a complex outcome that unfolds over time o Grief work as rumination hypothesis not only rejects the necessity of grief processing for recovery from loss but views extensive grief processing as a form of rumination that may actually increase distress Rumination is actually considered a form of avoidance because the person is not dealing with their real feelings and moving on Assumes resilient individuals are able to minimize processing of a loss through relatively automated processes, such as distraction or shifting attention toward more positive emotional experiences Argues the deliberate avoidance or suppression of grief represents a less effective form of coping o Individuals who engage in minimal grief processing will show a relatively favorable grief outcome o Individuals who are predisposed to more extensive grief processing tend toward ruminative preoccupation and, to a more prolonged grief

Grief

Refers to an individual's emotional reaction to another person's death. -sorrow, hurt, anger, confusion, guilt, and other feelings that may arise after suffering loss

Death Anxiety:

Refers to people's anxiety or even fear of death and dying Terror Management Theory: addresses why people engage in certain behaviors to achieve particular psychological states based on their deeply rooted concerns about mortality o Proposes ensuring the continuation of one's life is the primary motive underlying behavior and all other motives can be traced to this basic one o Neuroimaging research shows that it provides a useful framework for studying brain activity related to death anxiety Brain activity in the right amygdala, left rostral anterior cingulate cortex, and right caudate nucleus was greater when male participants were answering questions about fear of death and dying than when they were asked about dental pain Electrical activity indicated that people defend themselves against emotions related to death Death anxiety consists of several components that can be accessed at the public, private and nonconscious levels o What we admit feeling about death in public may differ greatly from what we feel when we are alone with out own thoughts Older adults tend to have lower death anxiety than younger adults, perhaps because of their tendency to engage in life review, have a different perspective about time, and their higher level of religious motivation Men show greater fear of the unknown than women, but women report more specific fear of the dying process Death anxiety may have a beneficial side o Being afraid to die means we often go to great lengths to make sure we stay alive o Fear of deaths serves as a motivation to have children and raise them properly

Respite Care

Refers to the vacation time away needed by primary caregivers who are caring for an ill loved one on a full-time basis.

Bereavement

Refers to time between the death of someone close to you and full adjustment to new routines and return to everyday life. (state or condition caused by loss through death)

The Grief Process:

The grieving process is often described as reflecting many themes and issues people confront that may be expressed through rituals Grief is a process that involves choices in coping, from confronting the reality and emotions to using religion to ease one's pain Grief is an active process in which a person must o Acknowledge the reality of the loss o Work through the emotional turmoil o Adjust to the environment where the deceased is absent o Loosen ties to the deceased How these are accomplished is an individual matter The amount of time to deal with death is highly individual (most agree at least 1 year is necessary) "Recovery" may be a misleading term - better to say we learn to live with our loss rather than we recover from it

Complicated or Prolonged Grief Disorder:

What distinguishes prolonged grief is: o Symptoms of separation distress Preoccupation with the deceased to the point that it interferes with everyday functioning o Symptoms of traumatic distress Feeling disbelief about the death Mistrust, anger, and detachment from others as a result of the death The experience of physical presence of the deceased Complicated grief forms a separate set of symptoms from depression o Report high levels of separation distress, along with specific cognitive, emotional, or behavioral indicators, as well as increased morbidity, increased smoking and substance abuse, and difficulties with family and other social relationships

When does grief tend to peak?

Within the first six months; then gradually subsides

A Life-Course Approach to Dying:

Young adults report a sense of being cheated by death o The shift from formal operational thinking to post-formal thinking is accompanied by a lessening of the feeling of immortality in adolescence to one that integrates personal feelings and emotions with their thinking Middle-aged adults begin to confront their own mortality and undergo a change in their sense of time lived and time until death o Occurs usually when their parents die Older adults are less anxious and more accepting of death o The greater overall acceptance of death results from the achievement of ego integrity o Best understood from the perspective of attachment theory - a person's reactions are a natural consequence of forming attachments and then losing them

prolonged grief reaction

an inability to move on after the death of a loved one -includes separation distress and traumatic distress symptoms

Principles that underlie hospice care:

o Clients and their families are viewed as a unit, clients should be kept free of pain, emotional and social impoverishment must be minimal o Clients must be encouraged to maintain competencies, conflict resolution and fulfillment of realistic desires must be assisted o Clients must be free to begin or end relationships, an interdisciplinary team approach is used, and staff members must seek to alleviate pain and fear Hospice and hospital patients differ in many ways o Hospice are more mobile, less anxious, and less depressed; spouses visit more often and participate more in their care Most people who select hospice suffer from cancer, AIDS, cardio-vascular disease, pulmonary disease, or a progressive neurological condition such as dementia

Muller and Thompson 5 themes of grief involves:

o Coping: concerns what people do to deal with their loss in terms of what helps them o Affect: refers to people's emotional reactions to the death of their loved ones o Change: involves the way survivor's lives change as a result of the loss; personal growth is a common experience o Narrative: relates to the stories survivors tell about their deceased loved ones, that sometimes included details about the process of the death o Relationship: reflects who the deceased person was and the nature of the ties between that person and the survivor How people show grief varies across ethnic groups o In many cultures the bereaved construct a relationship with the person who died, but how this happens differs widely, from "ghosts" to appearances in dreams to connection through prayer Physical health may decline while grieving o Depression, sleep disturbances, neurological and circulatory problems Anniversary reaction refers to the changes in behavior related to feelings of sadness on the anniversary of the death Grief Over Time o Grief work tends to peak within the first six months o People can grieve many years after the loss

A Contextual Theory of Dying:

o Emphasizes the tasks and issues that a dying person must face, and although there may be no right way to die, there are better or worse ways of coping with death o Corr identified four dimensions of tasks that must be faced Bodily needs, psychological security, interpersonal attachments, and spiritual energy and hope o Kastenbaum and Thuell (1995) point out that theories must be able to handle people who have a wide variety of terminal illnesses and be sensitive to dying people's own perspectives and values related to death

How do people decide to explore the hospice option? Several considerations:

o Is the person completely informed about the nature and prognosis of his/her condition? o What options are available at this point in the progress of the person's disease? o What are the person's expectations, fears, and hopes? o How well do the people in the person's social network communicate with each other? o Are family members available to participate actively in terminal care? o Is a high-quality hospice care program available? o Is hospice covered by insurance?

Deaths of One's Child:

o Loss of a child has profound, lifelong effects o Loss before birth hurts deeply, as well o The loss of a young adult child is different but equally devastating o Young parents report high anxiety, a more negative view of the world, and much guilt

Death of One's Parents:

o Perceived as very significant regardless of age of parent o For young-adult women transitioning into motherhood, losing their own mother during adolescence raises many feelings, such as a deep lose at not being able to share their pregnancy with their mother o Middle-aged women report having intense emotional feelings of both loss and freedom, they remember both positive and negative aspects of their parent, and they experience shifts in their own sense of self o Feelings after the loss of an older parent reflect a sense of letting go, loss of a buffer against death, better acceptance one's own eventual death, and a sense of relief the parent's suffering is over

Complicated grief is common in young adulthood:

o Young adult widows report level of grief does not diminish significantly until 5-10 years after the loss o Report strong sense those who die at this point in their lives would be cheated out of their future o One of the most difficult aspects for young widows is they must deal with both their own and their young children's grief

restoration oriented stressors

re-engage the mourner with the outer world by overcoming loneliness, mastering skills, and roles once performed by the deceased person, establishing an identity, and facing many practicial details of life

dual process model

those bereaved deal with two clinical stressors -loss oriented stressors and restoration oriented stressors

the life course approach to dying

young adults tend to have more intense feelings about death; middle-aged adults change focus of time (focus to time *left* rather than time already *lived*; older adults are less anxious about death and more accepting of it than any other age group

Theoretical perspectives on successful aging

• Absence of disease • High physical and cognitive functioning • Engagement with life • Social support and involvement with others. • These all also reinforce each other because if we are happy in one domain we are also happy in the other domains.

Take home messages

• Later career start: higher productivity in later life • Higher creative potential: higher productivity in early and later life. *Possible to have 1 hit wonder.

Expectations vs. experiences

• People's expectations are typically more pessimistic than their actual experiences of getting old. • This reflects the idea that successful aging should not actually be that unusual