Social relationships, social support, and patterns of cognitive aging in healthy, high-functioning older adults: MacArthur Studies of Successful Aging.

This study examines the relationship of social ties and support to patterns of cognitive aging in the MacArthur Studies of Successful Aging (see L. F. Berkman et al., 1993), a cohort study of 1,189 initially high-functioning older adults. Baseline and longitudinal data provide information on initial levels as well as changes in cognitive performance over a 7.5-year period. Linear regression analyses revealed that participants receiving more emotional support had better baseline performance, as did those who were unmarried and those reporting greater conflict with network members. Greater baseline emotional support was also a significant predictor of better cognitive function at the 7.5-year follow-up, controlling for baseline cognitive function and known sociodemographic, behavioral, psychological, and health status predictors of cognitive aging. The findings suggest the potential value of further research on the role of the social environment in protecting against cognitive declines at older ages. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Accounting for changes in social support among married older adults: Insights from the MacArthur Studies of Successful Aging.

Using longitudinal, community-based data from the MacArthur Studies of Successful Aging, the authors examined determinants of changes in social support receipt among 439 married older adults. In general, social support increased over time, especially for those with many preexisting social ties, but those experiencing more psychological distress and cognitive dysfunction reported more negative encounters with others. Gender affected social support receipt: Men received emotional support primarily from their spouses, whereas women drew more heavily on their friends and relatives and children for emotional support. Discussion centers on the importance of social support provision to those with the greatest needs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Dealing with negative social exchanges in later life: Coping responses, goals, and effectiveness.

Negative exchanges have been shown to detract from psychological well-being in later life, but little research has investigated how older adults respond to such exchanges. The authors examined older adults' coping responses, goals, and effectiveness following a specific negative social exchange. The findings revealed that participants' coping responses and the effectiveness of these responses varied as a function of their coping goals. The results underscore the importance of considering older adults' coping responses and goals when evaluating factors that affect the impact of negative social exchanges on well-being in later life. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Older adults' recovery from surgery for osteoarthritis of the knee: Psychosocial resources and constraints as predictors of outcomes.

The authors investigated psychosocial resources (positive support, active coping) and psychosocial constraints (negative support, avoidant coping) as predictors of improvement in the health of 63 older adults undergoing surgery for osteoarthritis of the knee. Following surgery, patients and social partners are motivated both to strive for the appetitive goal of recovery (approach), and to protect themselves from pain and impairment (avoidance). The authors assessed resources and constraints 6 weeks after surgery as predictors of outcomes (improvement in knee pain, knee functioning, and psychological well-being) 6 months after surgery. The constraints patients encountered early in recovery were strong predictors of poor recovery. Although resources were associated with some improvement, these effects were largely accounted for by constraints. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Assessment of depression in aging contexts: General considerations when working with older adults.

Popular assertions portray depression as an inevitable outcome of aging, a widespread image embraced by many health professionals. Although epidemiological data contradict the prevalent image that depressive syndromes increase with age, the prognosis becomes more negative as one grows older. An early thorough assessment is vital to identify depressive symptoms in older adults, thus promoting the development of tailored interventions and improved recovery rates. The main problems associated with the assessment of depressive symptoms in older adults include a lack of knowledge about changes in the pattern of symptoms, the inadequacy of techniques developed for other age cohorts, the misuse of psychometric instruments, and deficits in additional areas of assessment. The underlying goal of this article is to analyze the obstacles to a successful assessment of depression symptoms in older adults, suggesting strategies to overcome them. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Growth trajectories of exercise self-efficacy in older adults: Influence of measures and initial status.

Objective: This study examined differential trajectories of exercise-related self-efficacy beliefs across a 12-month randomized controlled exercise trial. Method: Previously inactive older adults (N = 144; M age = 66.5) were randomly assigned to one of two exercise conditions (walking, flexibility-toning-balance) and completed measures of barriers self-efficacy (BARSE), exercise self-efficacy (EXSE), and self-efficacy for walking (SEW) across a 12-month period. Changes in efficacy were examined according to efficacy type and interindividual differences. Latent growth curve modeling was employed to (a) examine average levels and change in each type of efficacy for the collapsed sample and by intervention condition and (b) explore subpopulations (i.e., latent classes) within the sample that differ in their baseline efficacy and trajectory. Results: Analyses revealed two negative trends in BARSE and EXSE at predicted transition points, in addition to a positive linear trend in SEW. Two subgroups with unique baseline efficacy and trajectory profiles were also identified. Conclusion: These results shed new light on the relationship between exercise and self-efficacy in older adults. They also highlight the need for strategies for increasing and maintaining efficacy within interventions, namely targeting participants who start with a disadvantage (lower efficacy) and integrating efficacy-boosting strategies for all participants prior to program end. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Retrospective analysis of social factors and nonsuicidal self-injury among young adults.

Retrospective reports of social influences in nonsuicidal self-injury (NSSI) with regard to initiation, disclosure, methods, and motivations for engaging in the behaviour were examined in 23 (2 male, 21 female) self-injuring university students. Parent and peer social support was compared between the NSSI group and a comparison group that did not engage in NSSI. Lifetime frequency of NSSI and social support were evaluated. NSSI behaviours were found to be highly socially influenced in several ways, with 65% reporting that they talk to their friends about self-injury, 58.8% indicating that a friend had been the first to engage in self-injury, and 17.4% had self-injured in front of friends. Almost all participants endorsed emotional motivations for engaging in NSSI (91%); however, social motivations were also common (65.2%). Social support from peers was less for the NSSI group than the non-NSSI group, although social support was not found to be related to lifetime frequency of NSSI. The implications for understanding NSSI as a socially influenced behaviour are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Depression as a predictor of perceived social support and demand: A componential approach using a prospective sample of older adults.

This study examined the relationship of the cognitive, mood, and somatic components of depression on perceptions of social support and social demand among older adults (n = 851) over two years. Factor-analyses confirmed the factor structure of our multicomponential model of depression. Results supported our proposal that interpersonal specificity, as measured by depressive cognition about self and others, is important to predicting changes in perceived support and demand over time. Each component of depression was related to social support and social demand cross-sectionally, whereas only the cognitive component of depression predicted changes in support and demand prospectively. Future research should consider the pathways linking depressive cognition to perceived support and demand. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Regulating partners in intimate relationships: The costs and benefits of different communication strategies.

This study tested the success of communication strategies used by relationship partners (N = 61 romantic couples) who were videotaped while trying to produce desired changes in each other. Strategies varying in valence (positive vs. negative) and directness (direct vs. indirect) were differentially associated with postdiscussion perceptions of success as well as ratings of demonstrated change in targeted features gathered at 3-month intervals during the following year. Direct strategies (positive and negative) were initially perceived as relatively unsuccessful but predicted increased change over the next 12 months as reported by the targeted partners and (for positive-direct strategies) as perceived by female agents. Positive-indirect strategies, in contrast, were associated with higher concurrent perceived success but did not predict later change. Increases in problem severity also forecasted lower relationship quality over time. These findings indicate that one mechanism through which regulation strategies impact relationship outcomes is the extent to which engaged strategies are successful at producing desired change. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Health-related quality of life in bereaved HIV-positive adults: Relationships between HIV symptoms, grief, social support, and Axis II indication.

Objective: This study evaluated a model of the impact of borderline and antisocial personality disorder indications on HIV symptoms and health-related quality of life (HRQoL) in AIDS-bereaved adults, accounting for grief severity, social support, and years since HIV diagnosis. Design: Structural equation modeling was used to test the proposed model in a sample of 268 HIV-seropositive adults enrolled in an intervention for coping with AIDS-related bereavement. Main Outcome Measures: Functional assessment of HIV infection, HIV symptoms. Results: The proposed model demonstrated excellent fit with study data and all hypothesized paths were supported. Personality disorder indication was directly related to HIV symptoms and HRQoL and indirectly related through both social support and grief severity. Social support was negatively related to HIV symptoms and positively related to HRQoL, while grief severity was positively related to HIV symptoms and negatively related to HRQoL. Finally, HIV symptoms had a direct negative relationship with HRQoL. Conclusion: Personality disorders have a direct negative effect on HIV symptoms and HRQoL and indirect effects through grief severity and social support. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The benefits and costs of repeated memory tests for young and older adults.

Repeated and prolonged searches of memory can lead to an increase in how much is recalled, but they can also lead to memory errors. These 3 experiments addressed the costs and benefits of repeated and prolonged memory tests for both young and older adults. Participants saw and imagined pictures of objects, some of which were physically or conceptually similar, and then took a series of repeated or prolonged recall tests. Both young and older adults recalled more on later tests than on earlier ones, though the increase was less marked for older adults. In addition, despite recalling less than did young adults, older adults made more similarity-based source misattributions (i.e., claiming an imagined item was seen if it was physically or conceptually similar to a seen item). Similar patterns of fewer benefits and more costs for older adults were seen on both free and forced recall tests and on timed and self-paced tests. Findings are interpreted in terms of age-related differences in binding processes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The treatment of depression in older adults in the primary care setting: An evidence-based review.

The objective of this study was to conduct an evidence-based review of treatments for depression in older adults in the primary care setting. A literature search was conducted using PsycINFO and Medline to identify relevant, English language studies published from January 1994 to April 2004 with samples aged 55 and older. Studies were required to be randomized controlled trials that compared psychosocial interventions conducted within the primary care setting with "usual care" conditions. Eight studies with older adult samples met inclusion criteria and were included in the review. Two treatment models were evident: Geriatric Evaluation Management (GEM) clinics and an approach labeled integrated health care models. Support was found for each model, with improvement in depressive symptoms and better outcomes than usual care; however, findings varied by depression severity, and interventions were difficult to compare. Further efforts to improve research and clinical care of depression in the primary care setting for older adults are needed. The authors recommend the use of interdisciplinary teams and more implementation of psychosocial treatments shown to be effective for older adults. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Object- and location-based inhibition of return in younger and older adults.

When a cued object moves to new spatial coordinates, inhibition of return (IOR) with younger adults is found at the original cued location (location-based IOR) and at the current location of the object (object-based IOR). Older adults, however, show only location-based IOR. To determine whether this pattern of results represents a general age-related deficit in object-based IOR, the authors used static displays in which the placeholders (i.e., objects) were either present (location-based IOR + object-based IOR) or absent (location-based IOR only). Both age groups showed location-based IOR, but the older adults failed to show object-based IOR, consistent with age-related differences in visual pathways. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Loneliness, attachment, and the perception and use of social support in university students.

This study examined factors related to family, social, and romantic loneliness in 173 undergraduate students (66 males, 107 females). Participants completed measures of attachment style, perceived availability of social support, use of social support coping, and loneliness. Results indicated that participants with greater attachment security reported lower levels of all types of loneliness compared to those with less attachment security, and this was partially mediated by perceived social support but not the use of social support coping. When examining underlying attachment constructs, a more positive model of others was related to less family and social loneliness, and these associations were mediated by greater perceived social support. Model of others also was associated with less romantic loneliness and model of self was associated with less loneliness in all domains, and these relations were partially mediated by perceived social support. Findings are discussed with respect to possible interventions to increase students' perceptions of available social support and to decrease overall loneliness levels. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Aging and symptoms of anxiety and depression: Structural invariance of the tripartite model.

Negative affect measures were evaluated in a cross-sectional community sample of adults aged 18-93 (N = 335) to examine the structure of neuroticism, anxiety, and depressive symptoms in young, middle, and older adult cohorts. Structural equation modeling was used to contrast 3 nested models: a 1-factor general distress model; a 2-factor high negative-low positive affect model; and a 3-factor "tripartite model" reflecting a higher order Negative Affect factor that is common to depression and anxiety problems and 2 lower order factors, Low Positive Affect (mostly specific to depression) and Arousal (specific to anxiety/panic). As expected, the tripartite model fit best for all age groups. Further, multigroup analyses indicated age invariance for the tripartite model, suggesting the model can be effectively applied with older populations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of social support visibility on adjustment to stress: Experimental evidence.

Previous fieldwork has suggested that visible social support can entail an emotional cost and that a supportive act is most effective when it is accomplished either (a) outside of recipients' awareness or (b) within their awareness but with sufficient subtlety that they do not interpret it as support. To investigate the latter phenomenon, the authors conducted 3 experiments in which female participants were led to expect a stressful speech task and a confederate peer provided support in such a way that it was either visible or invisible (N=257). Invisible support (practical and emotional) reduced emotional reactivity relative to visible and no support. Visible support was either ineffective or it exacerbated reactivity. Explanatory analyses indicated that support was effective when it avoided communicating a sense of inefficacy to recipients. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The role of optimism in social network development, coping, and psychological adjustment during a life transition.

The authors investigated the extent to which social support and coping account for the association between greater optimism and better adjustment to stressful life events. College students of both genders completed measures of perceived stress, depression, friendship network size, and perceived social support at the beginning and end of their 1st semester of college. Coping was assessed at the end of the 1st semester. Greater optimism, assessed at the beginning of the 1st semester of college, was prospectively associated with smaller increases in stress and depression and greater increases in perceived social support (but not in friendship network size) over the course of the 1st semester of college. Mediational analyses were consistent with a model in which increases in social support and greater use of positive reinterpretation and growth contributed to the superior adjustment that optimists experienced. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relational regulation theory: A new approach to explain the link between perceived social support and mental health.

Perceived support is consistently linked to good mental health, which is typically explained as resulting from objectively supportive actions that buffer stress. Yet this explanation has difficulty accounting for the often-observed main effects between support and mental health. Relational regulation theory (RRT) hypothesizes that main effects occur when people regulate their affect, thought, and action through ordinary yet affectively consequential conversations and shared activities, rather than through conversations about how to cope with stress. This regulation is primarily relational in that the types of people and social interactions that regulate recipients are mostly a matter of personal taste. RRT operationally defines relationships quantitatively, permitting the clean distinction between relationships and recipient personality. RRT makes a number of new predictions about social support, including new approaches to intervention. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Being the best bearer of bad tidings.

Giving bad news is an unpleasant task, and the medical literature provides numerous guidelines for giving bad news well. However, what people mean by "giving bad news well" is less clear. What should be the goal when communicating bad news? The authors suggest that the goal of news-givers should be to guide recipients toward a desired response and the authors propose a theoretical framework, the Bad News Response Model, for delivering bad news that draws from research in health and social psychology. The model is applicable to all forms of bad news and specifies that three characteristics of the news (controllability, likelihood, and severity) influence which response (Watchful Waiting, Active Change, or Acceptance) will most often lead to the best quality of life for the recipient. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Changing network support for drinking: Initial findings from the Network Support Project.

The aim of this study was to determine whether a socially focused treatment can effect change in the patient's social network from one that reinforces drinking to one that reinforces sobriety. Alcohol dependent men and women (N = 210) recruited from the community were randomly assigned to 1 of 3 outpatient treatment conditions: network support (NS), network support + contingency management (NS + CM), or case management (CaseM; a control condition). Analysis of drinking rates for 186 participants at 15 months indicated a significant interaction effect of Treatment × Time, with both NS conditions yielding better outcomes than the CaseM condition. Analyses of social network variables at posttreatment indicated that the NS conditions did not reduce social support for drinking relative to the CaseM condition but did increase behavioral and attitudinal support for abstinence as well as Alcoholics Anonymous (AA) involvement. Both the NS variables and AA involvement variables were significantly correlated with drinking outcomes. These findings indicate that drinkers' social networks can be changed by a treatment that is specifically designed to do so, and that these changes contribute to improved drinking outcomes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)