Monitor on Psychology - November 2011 - (Page 69)

the losses associated with aging — such as bereavement or the development of a chronic illness — may activate negative age stereotypes, thereby generating unhelpful self-fulfilling prophecies that may be harmful to the individual (Levy, 2009). As a result, the older client may mistakenly attribute the cause of his or her problems to aging rather than depression and may become hopeless about the possibility for change. Unless psychotherapists are able to recognize that these beliefs are cognitive errors associated with the negative age stereotype, progress in treatment may be impeded. Depression and anxiety are major causes of mental health problems in later life. However, while depression rates may increase with age, rates of depression and anxiety in later life are lower than rates reported for working-age adults (Blazer & Hybels, 2005). Echoing this finding, Sadavoy (2009) found that depression is surprisingly uncommon among older people considering the challenges some face as they age. The Centers for Disease Control and Prevention (2008) note that, contrary to popular belief, older people do not report experiencing frequent mental distress. In addition, their lifetime histories of depression and anxiety are low (10.5 percent and 7.6 percent, respectively) and lower than those reported for adults age 50 to 64 years (19.3 percent and 12.7 percent respectively). Of course, medical conditions increase people’s chances of being depressed later in life, with a greater burden of illness resulting in an increased risk of depression (Alexopoulos, 2005). The good news is that most older adults who develop physical problems do not develop depression (Blazer & Hybels, 2005). Nevertheless, medical illnesses complicate the recognition and treatment of depression and anxiety (Krishnan et al., 2002). It is estimated that 80 percent of older Americans have at least one chronic health problem and up to 50 percent have two (Wan et al., 2005). As a consequence of demographic change, therapists may be confronted with more medical issues with a complexity and chronicity attached to them that is rarely seen currently. Older people are also more likely to die because of noncommunicable diseases, such as cancer, heart disease and stroke, rather than injury or infection. Thus, older people may be more likely to have lived with a number of chronic diseases for many years before their eventual demise. This is another complicating factor that psychologists may need to reconcile with new or existing models of psychotherapy. A model for optimal aging Selective optimization with compensation (SOC) is a useful model (or meta-theory) that promotes optimal aging in the face of realistic challenges (Freund and Baltes, 1998). Research suggests that using SOC as a life-management strategy may buffer people against aging’s effects in later life (Jopp and Smith, 2006). In this model, selection (usually “loss-based selection”) is a process in which people are encouraged to maintain their highly valued roles and goals in the face of loss (Jopp & Smith, 2006). Optimization requires that people focus their resources n ov e M b e r 2 0 1 1 • M o n i to r o n p s yc h o l o g y on achieving goals through practicing or relearning activities. It must be done in an intentional manner. Compensation requires that people seek other ways of achieving the highest possible level of functioning, thereby taking account of the reality of a person’s capacity and physical integrity. Baltes (1997) illustrates SOC in action when he cites the example of the acclaimed pianist Arthur Rubinstein, who at age 80 was interviewed about his skill. (Rubinstein retired from performing at age 89 due to deteriorating eyesight.) He attributed his enduring level of prowess to restricting his repertoire (selection), which allowed him to practice more frequently (optimization) and, “He suggested that to counteract his loss in mechanical speed, he now used a kind of impression management, such as introducing slower play before fast segments, so as to make the latter appear faster” (compensation) (Baltes, 1997, p. 371). SOC can be incorporated into psychotherapy, especially cognitive behavioral therapy (CBT), since its active selfdirected, problem-solving orientation fits well with an aim of symptom reduction, enhanced resilience and positive affect. the importance of support networks Social capital is the amount of emotional and practical support one can draw upon from families and friends — and viewed in this way, social support is an outcome of social capital (Gray, 2009). Consistent with socioemotional selectivity theory, which suggests that emotional regulation and emotional investment in close relationships become more important as people age (Carstensen, Isaacowitz, & Charles, 1999), people’s social support networks may become smaller in size and diversity as they age. This may be intentional as familial and other emotionally nurturing relationships are preferentially selected (Charles & Carstensen, 2009). As a result, when psychologists work with depressed or anxious older people, it may be important to assess whether their accessible social capital has diminished. In addition, as a result of people’s increased longevity, psychologists should examine whether older couples’ relationships have become strained after retirement as they face more years together. For many couples, retirement can require a period of adjustment and it is more helpful to view this time as a process rather than a state (Kim & Moen, 2002). Women appear to find the adjustment more difficult as retirees and as partners (van Solinge & Henken, 2005). Further complicating relationships for older people is the fact that families are becoming smaller and divorce rates, family break-ups and reconstitutions are increasing, all of which affect the potential pool of informal caregivers (Ajrouch et al., 2005). When working with couples, the therapist is wise to remember that quantity is not equivalent to quality when it comes to relationships, and the longevity of a relationship does not mean that the partnership is supportive and nurturing. Meanwhile, future cohorts of older people (the baby 69

Table of Contents for the Digital Edition of Monitor on Psychology - November 2011

Monitor on Psychology - November 2011
Letters
President’s Column
Contents
Guest Column
‘Grand Challenges’ offers blueprint for mental health research
Documentary seeks to reach parents of LGBT kids
Treating veterans will cost at least $5 billion by 2020
Selfless volunteering might lengthen your life
Combat and stress up among U.S. military in Afghanistan
South Africa to host international psychology conference
Study uncovers a reason behind sex differences in mental illness
Navy psychologist gives a voice to combat trauma
In Brief
Psychologist suicide
On Your Behalf
Journey back to Heart Mountain
Psychology is key to pain management, report finds
ACT goes international
Judicial Notebook
Random Sample
Time Capsule
Questionnaire
Science Watch
Behavior change in 15-minute sessions?
Health-care reform 2.0
Perspective on Practice
Giving a heads up on concussion
Practice Profile
Searching for meaning
Inspiring young researchers
Aging, with grace
Public Interest
Thank you!
APA News
Division Spotlight
American Psychological Foundation
The man who gave Head Start a start
Personalities

Monitor on Psychology - November 2011