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Chapter 12: Mental Health, Coping, and Adjustment to Aging One’s mental health depends on creating a meaningful existence in the social and environmental contexts of life. Success depends on achieving a balance between inner strengths and external resources and continuing the self-development process. Adjusting to the aging years requires similar growth. Four models of coping are presented to explain how thinking and behavior reduce stress. Environmental models, the behavioral model, coping style model and cognitive-appraisal model. The behavioral model places responsibility on the individual to learn coping strategies or to experience a consequence of learned helplessness. (see more info on learned helplessness further down in notes) The coping-style models categorize approaches to coping as mature, neurotic, immature, or psychotic adaptive strategies. The cognitive-appraisal model describes coping as dependent on an individual’s interpretation of a situation in relation to personal resources and environmental constraints. (more on this model later in the notes) Atchley’s continuity theory proposes that people require a balance between stability and change. Whitbourne explains the need to reach acceptable levels of assimilation and accommodation. Laypeople emphasize the importance of social contact, continued growth, and acceptance as characteristics of successful aging. Stress, Coping and Adaptation Stress: Stress is a physiological response to threatening or challengingevents in the environment. Stress prepares body for “fight” or “flight” coping. Events can be internal (thoughts) or external (environmental occurrences). Stress can trigger disease and illness due to the effect on the body. Environmental models look at external events using a quantitative approach and illness as a measure of ability to cope. Stress is defined in terms of the degree of environmental demand the person is experiencing. Social readjustment scale (SRRS) consists of life-change events that require adaptation . An environmental inventory to identify events that cause emotional stress helps predict when someone at higher risk for physical and mental health problems. Holmes and Rahe believe life events can be ranked in terms of the magnitude of the stress they produce. A significant but modest relationship has been found between degree of stress and physical illness. The Life Events approach is not very useful since individuals react in different ways to the same event. There is too much emphasis on change and it largely ignores mediating processes, such as context, subjective interpretation, and cognitive emotional impact. Sometimes people reinterpret events over time to be beneficial. The importance of timing: Stressful events are coped with better when occurring at expected times in lifespan. Neugarten found when events fit social clock or timetable, people are better prepared and can cope better. The behavioral model places responsibility on the individual to learn coping strategies or to experience a consequence of learned helplessness. learned helplessness: A state in which people conclude that unpleasant or aversive stimuli cannot be controlled—a view of the world that becomes so ingrained that they cease trying to remedy the aversive circumstances, even if they actually can exert some influence Original experiment---dogs placed in harness where exposed to electric shocks. Later dogs placed in shuttle-box where experienced more shocks. Dogs exhibited learned helplessness failed to escape shocks in shuttle-box. People said to experience learned helplessness when generalize the inability to control one aversive event to a situation they might be able to exert control. Learned helplessness model---has been associated with depression. Depression begins when people experience an inability to control important events in their lives—one way to treat depression is to give depressed person successful experience at controlling an important event Personal Control : A sense of personal control serves as a buffer against the impact of stress. The coping-style models categorize approaches to coping as mature, neurotic, immature, or psychotic adaptive strategies. The cognitive-appraisal model describes coping as dependent on an individual’s interpretation of a situation in relation to personal resources and environmental constraints. The Cognitive Appraisal Model of Adaptation and Coping Importance of Subjective Perception: Primary appraisal determines if an event is stressful. Secondary appraisal chooses how to deal with the stress. In general, older people maintain coping abilities developed earlier. Prolonged stress can suppress the immune system and render the body susceptible to many diseases; from colds and flu to cancer and cardiovascular disorders. COPING WITH STRESS - The efforts to control, reduce, or learn to tolerate the threats that lead to stress Two major forms of coping with stress: Emotion-Focused Forms of Coping - emotional or cognitive strategies that change how we view stressful situations, such as reappraising or reinterpreting situation, and the use of defense mechanisms. characterized by the conscious regulation of emotions Problem-Focused Forms of Coping - This approach to coping with stress deals directly with the situation or causative factors to decrease or eliminate the problems. characterized by attempts to manage the stressful problem or stimulus Resources for Effective Coping - The ability to cope with a stressor also depends on the resources available to a person: includes health and energy, positive beliefs, social skills, material resources personal control, and social support( mutual network of caring, interested others) The Search for Meaning: Cognitive Distortion, Social Comparison, and Mastery People want to create meaning from challenging and stressful situations. A study on women with breast cancer showed they derived a new sense of personal meaning; other emerging themes are "magical mastery," regaining feelings of self- esteem. Women who coped with breast cancer the most successfully tried to master their dilemma and take charge of their lives by using problem-focused coping. In trying to regain self-esteem, these women used downward social comparisons which compared them and their situation to others who were worse off. Social Support and Social Integration Social support is linked with improved physical and mental health in older adults. Social integration plays an important role. Friends play an important role in the support systems of older adults. Being lonely and socially isolated is a significant health risk factor in older adults. Older adults who participate in more organizations live longer than their counterparts who have low participation rates. Older adults often have fewer peripheral social ties but a strong motivation for spending time in relationships with close friends and family members that are rewarding. Researchers have found that many older adults are quite effective in maintaining a sense of control and have a positive view of themselves. Social support is affect, affirmation, and aid received from others. A person's perception of the adequacy of his or her social contacts and emotional support is more strongly related to physical and emotional health than are more objective measures. Adults with adequate social support have lower risk of disease, death, and depression than do adults with weaker social networks and less supportive relationships. Social support has a buffering effect in the face of high stress. Social networks can also be source of stress. SUCCESSFUL AGING Increasingly, the positive aspects of older adults are being studied. Factors linked to successful aging include an active lifestyle, positive coping skills, good social relationships and support, and self-efficacy. Successful aging also involves perceived control over the environment and a sense of self-efficacy Self-efficacy has often been used to describe perceived control over the environment and the ability to produce positive outcomes. Successful aging may be defined as meeting the changing demands of adulthood. Disengagement theory explains a gradual reduction in social involvement as normal; Disengagement theory states that to cope effectively older adults should gradually withdraw from society. older adults develop increasing self-preoccupation, decreasing emotional ties with others, and decreasing interest in society’s affairs which leads to enhanced life satisfaction. This theory is no longer viable. Activity theory proposes that continued involvement is crucial to life satisfaction. Activity theory states that the more active and involved older adults are, the more likely they will be satisfied with their lives. Researchers have found strong support for this theory. Activity theory suggests that many individuals will achieve greater life satisfaction in they continue their middle adulthood roles into late adulthood. Peck suggests seven types of personality adjustment, four in middle age (valuing wisdom, socializing, emotional flexibility, and mental flexibility) and three in old age (broader self-definition, transcendence of the body, and transcendence of the ego). Successful Aging Peck attempted to identify factors related to successful aging. Peck (1955) expanded upon Erikson’s psychosocial development in middle and late adulthood. Peck identified seven psychological developments that he considered crucial for a healthy adaptation to aging. Given that aging is a gradual process, psychological developments in middle adulthood affect whether one experiences successful aging. The first four adjustments focus on middle adulthood. Valuing wisdom versus valuing physical powers. Wisdom compensates for diminished physical abilities and loss of youthful appearance. Socializing versus sexualizing in human relationships. Middle-aged adults recognize men and women as companions or friends rather than primarily as sex objects. Individuals are valued for their attributes and unique characteristics. Emotional flexibility versus emotional impoverishment. Emotional flexibility involves the shifting of emotional investment between people and between activities. This is an important ability as people age and change roles (child to adult, parents die, or one’s spouse dies). Mental flexibility versus mental rigidity. It is important to remain mentally flexible and open to new ideas. The following three life adjustments occur during late adulthood. Broader, self-definition versus preoccupation with work roles. This adjustment focuses on the transition from defining oneself as a worker to defining oneself as a nonworking person. The retiree needs to broaden his/her interests and restructure his/her life around the new interests and the nonemployed self. Transcendence of the body versus preoccupation with the body. This adjustment involves compensation for physical decline that accompanies aging. Adjustment to late adulthood is facilitated by focusing on relationships and activities that do not demand perfect health. Activities that stress social and mental abilities should be emphasized. Transcendence of the ego versus preoccupation with the ego. Peck considers the acceptance of death a crucial part of successful aging. Part of this acceptance involves reflecting back upon one’s achievements and accomplishments. Concern shifts from one’s own needs and accomplishments to the contribution that these have on the well-being of others. Religion and Adult Lives In a recent longitudinal study of individuals from their early thirties through their late sixties/early seventies, a significant increase in spirituality occurred between late middle (mid fifties/early sixties) and late adulthood. Religion is an important dimension of many peoples’ lives worldwide. Females show a stronger interest in religion than males do. Americans are becoming less committed to particular religious denominations. They are more tolerant of other faiths and more focused on their own spiritual journeys. It is important to consider individual differences in religious interest. Religion and Physical Health In some cases, religion can be negatively linked to physical health, as when cults or religious sects restrict individuals from obtaining medical care. In mainstream religion, religion usually shows either a positive association or no association with physical health. Religion may promote physical health for several reasons including lifestyle issues, social networks, and coping with stress. Religion and late adulthood Many elderly are spiritual leaders in their church and community. Religious interest increases in old age (put faith into practice, and attend services). For some, religious practice is associated with sense of well-being. Religion and religious organizations can meet important psychological needs in older adults, offering social support and an opportunity to assume leadership roles Coping Psychologists disagree as to the effectiveness of religious commitment as a coping strategy. Various dimensions of religiousness can help some individuals cope more effectively with their lives. Happiness Happy people tend to have a meaningful religious faith, but it is important to remember that the link is correctional, not causal. Meaning in Life Frankl believes that examining the finiteness of our existence leads to exploration of meaning in life. Faced with death of older relatives and less time to live themselves, many middle-aged individuals increasingly examine life’s meaning. Religion and spirituality and how they relate to the experience of stress and stress management: Research on the use of transcendental meditation indicated that meditation with a mantra induces a relaxation response (i.e., lower metabolic rate, slower heart rate, lower blood pressure, slower breathing). The researchers looked at the effects of short prayers from the Christian and Jewish traditions as well (e.g., “Hail Mary, full of grace,” “Shalom,” “The Lord is my Shepherd”). These phrases also brought about the relaxation responses. Using traditional Western prayers worked better than meditation using the word “one” because subjects stuck with the meditation longer using prayers. When using longer prayers, the researchers found subjects reporting a “praying high.” People high in spirituality (i.e., the feeling that there is a higher being) score higher on psychological health and have fewer stress-related symptoms.
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