Adult Development and Aging

Susan Krauss Whitbourne, Ph.D., professor of psychology at the University of Massachusetts Amherst, received her Ph.D. in developmental psychology from Columbia University in 1974 and completed a postdoctoral training program in clinical psychology at the University of Massachusetts at Amherst, having joined the faculty there in 1984. Her previous positions were as associate professor of education and psychology at the University of Rochester (1975–1984) and assistant professor of psychology at SUNY College at Geneseo. Formerly the Psychology Departmental honors coordinator at the University of Massachusetts Amherst, she is director of the Office of National Scholarship Advisement where she advises students who apply for the Rhodes, Marshall, Fulbright, Truman, and Goldwater Scholarships, among others. In addition, she is faculty advisor to the University of Massachusetts Chapter of Psi Chi, a position for which she was recognized as the Eastern Regional Outstanding Advisor for the year 2001 and as the Florence Denmark National Faculty Advisor in 2002. She served as eastern region vice president of Psi Chi in 2006–07 and as chair of the program committee for the National Leadership Conference in 2009. Her teaching has been recognized with the College Outstanding Teacher Award in 1995 and the University Distinguished Teaching Award in 2001. Her work as an advisor was recognized with the Outstanding Academic Advisor Award in 2006. In 2003, she received the American Psychological Association (APA) Division 20 (Adult Development and Aging) Master Mentor Award and the Gerontological Society of America (GSA) Behavioral and Social Sciences Distinguished Mentorship Award. Her publications include 17 published books, many in multiple editions, and more than 160 journal articles and chapters. Stacey B. Whitbourne, Ph.D., received her Ph.D. in social and developmental psychology from Brandeis University in 2005 where she was funded by a National Institute on Aging training fellowship. She completed her post-doctoral fellowship at the Boston University School of Public Health, Department of Epidemiology, funded by a National Institute on Aging Grant and a Department of Veterans Affairs Rehabilitation Research and Development Service Grant. Currently, she is a research health scientist at the Massachusetts Veterans Epidemiology and Research Information Center (MAVERIC), an independent research center housed within the VA Boston Healthcare System. She also serves as program director for the Million Veteran Program, a longitudinal health and genomic cohort funded by the Department of Veteran’s Affairs Office of Research and Development. In addition, she is an instructor of medicine at Harvard Medical School and an associate epidemiologist at the Division of Aging at Brigham and Women’s Hospital. The author of several published articles, she is also a coauthor on a chapter for the Sage Series on Aging in America. She is a member of the American Psychological Association Division 20 and the Gerontological Society of America. A member of the Membership Committee of Division 20, she has also given more than 30 presentations at national conferences. As an undergraduate, she received the Psi Chi National Student Research Award. In graduate school, she was awarded the Verna Regan Teaching Award and an APA Student Travel Award. She has taught courses on adult development and aging at Brandeis University and the University of Massachusetts Boston.

Preface v

Chapter 1 Themes and Issues in Adult Development and Aging 1

The Biopsychosocial Perspective 3

Four Principles of Adult Development and Aging 4

Principle 1: Changes are Continuous Over the Life Span 4

Principle 2: Only the Survivors Grow Old 5

Principle 3: Individuality Matters 6

Principle 4: ‘‘Normal’’ Aging is Different From Disease 7

The Meaning of Age 8

Using Age to Define ‘‘Adult’’ 9

Divisions by Age of the Over-65 Population 10

Functional Age 10

Personal Versus Social Aging 12

Key Social Factors in Adult Development and Aging 14

Sex and Gender 14

Race 14

Ethnicity 14

Socioeconomic Status 15

Religion 16

The Baby Boomers Grow Up: Changes in the Middle-Aged and Older Populations in the United States and the World 16

United States 17

Aging Around the World 18

Summary 20

Chapter 2 Models of Development: Nature and Nurture in Adulthood 21

Models of Individual–Environment Interactions 23

Reciprocity in Development 25

Sociocultural Models of Development 26

Ecological Perspective 26

The Life Course Perspective 27

Ageism as a Social Factor in the Aging Process 29

Psychological Models of Development in Adulthood 31

Erikson’s Psychosocial Theory 31

Piaget’s Cognitive-Developmental Theory 34

Identity Process Theory 35

The Selective Compensation with Optimization Model 38

Biological Approaches to Aging in Adulthood 39

Genes and DNA 39

Programmed Aging Theories 41

Random Error Theories 43

Summary 46

Chapter 3 The Study of Adult Development and Aging: Research Methods 48

Variables in Developmental Research 49

Descriptive (Single-Factor) Research Designs 49

Age, Cohort, and Time of Measurement 50

Longitudinal Designs 50

Cross-Sectional Designs 54

Sequential Research Designs 56

The Most Efficient Design 56

Correlational Designs 57

Simple Correlational Designs 59

Multivariate Correlational Designs 59

Types of Research Methods 61

Laboratory Studies 61

Qualitative Studies 61

Archival Research 61

Surveys 62

Epidemiological Studies 62

Case Reports 62

Focus Groups 63

Daily Diaries 63

Observational Methods 63

Meta-Analysis 63

Measurement Issues in Adult Development and Aging 64

Ethical Issues in Research 65

Summary 66

Chapter 4 Physical Changes 68

Appearance 69

Skin 69

Hair 71

Body Build 72

Mobility 74

Muscles 74

Bones 75

Joints 76

Vital Bodily Functions 77

Cardiovascular System 77

Respiratory System 79

Urinary System 79

Digestive System 81

Bodily Control Systems 81

Endocrine System 81

Immune System 85

Nervous System 86

Central Nervous System 86

Sleep 88

Temperature Control 89

Sensation and Perception 89

Vision 89

Hearing 91

Balance 93

Smell and Taste 94

Somatosensory System 94

Summary 95

Chapter 5 Health and Prevention 97

Key Concepts in Health and Prevention 98

Diseases of the Cardiovascular System 98

Cardiac and Cerebrovascular Conditions 99

Incidence 100

Behavioral Risk Factors 100

Prevention of Heart Disease and Stroke 102

Cancer 102

Risk Factors and Prevention 103

Treatments 105

Disorders of the Musculoskeletal System 106

Osteoarthritis 106

Osteoporosis 107

Diabetes 108

Characteristics of Diabetes 108

Incidence and Risk Factors 108

Prevention and Treatment 109

Respiratory Diseases 109

Neurocognitive Disorders 110

Alzheimer’s Disease 110

Other Forms of Neurocognitive Disorder 115

Summary 117

Chapter 6 Basic Cognitive Functions: Information Processing, Attention, and Memory 118

Processing Speed and Attention 119

Reaction Time 119

Attention 120

Video Games and Attention 122

Driving and Aging 124

Memory 126

Working Memory 126

Effects of Aging on Long-Term Memory in Adulthood 127

Psychosocial Influences on Memory 130

Memory and Health-Related Behaviors 131

Memory Training Studies 133

Summary 134

Chapter 7 Higher-Order Cognitive Functions 136

Executive Functioning and Its Measurement 138

Intelligence Tests 138

Neuropsychological Assessment 139

Aging and Executive Functioning 141

Language 142

Cognitive Aspects of Language 142

Social Aspects of Language 143

Bilingualism and Aging 145

Everyday Problem-Solving 145

Characteristics of Problem-Solving 146

Problem-Solving in Adulthood 146

Adult Learners 149

Intelligence 151

Theoretical Perspectives on Adult Intelligence 151

Research on Adult Intelligence 152

Training Studies 155

The Psychology of Wisdom 156

Summary 157

Chapter 8 Personality 159

Psychodynamic Perspective 161

Ego Psychology 161

Vaillant’s Theory of Defense Mechanisms 165

Adult Attachment Theory 167

Trait Approaches 168

Research on Aging and the Five-Factor Model 168

Health and Personality Traits 170

Social Cognitive Approaches 171

Cognitive Perspective 172

Possible Selves Theory 172

Coping and Control 173

Identity Process Theory 174

Midlife Crisis Theories and Findings 175

Theory of the Midlife Crisis 175

Critiques and Research on the Midlife Crisis 176

Summary 178

Chapter 9 Relationships 180

Marriage and Intimate Relationships 181

Marriage 181

Cohabitation 182

Same-Sex Couples 184

Divorce and Remarriage 184

Widowhood 186

Psychological Perspectives on Long-Term Relationships 186

Families 189

Parenthood 189

The Empty Nest 191

Parent–Adult Child Relationships 193

Siblings 196

Grandparents 196

Friendships 198

Theoretical Perspectives 198

Patterns of Friendships 198

Summary 199

Chapter 10 Work, Retirement, and Leisure Patterns 201

Work Patterns in Adulthood 203

Vocational Development 205

Holland’s Vocational Development Theory 206

Super’s Life-Span Life-Stage Theory 207

Occupation as Calling 209

Variations in Vocational Development 209

Vocational Satisfaction 210

Intrinsic and Extrinsic Factors 210

Positive and Negative Moods 211

Person–Environment Correspondence 213

Work Stress 213

Relationships Between Work and Family Roles 214

Age and Vocational Satisfaction 215

Age and Vocational Performance 216

Retirement 217

Definitions of Retirement 217

Facts About Retirement 218

The Effects of Retirement on the Individual 220

Leisure Pursuits in Later Adulthood 222

Summary 223

Chapter 11 Mental Health Issues and Treatment 225

Psychological Disorders in Adulthood 226

Major Depressive Disorder 227

Bipolar Disorder 228

Anxiety Disorders 228

Obsessive-Compulsive and Related Disorders 229

Trauma and Stress-Related Disorders 229

Schizophrenia and Other Psychotic Disorders 230

Substance-Related Disorders 231

Personality Disorders 232

Elder Abuse 235

Suicide 236

Treatment Issues in Mental Health Care 237

Assessment 237

Treatment 238

Serious Mental Illness 241

Summary 241

Chapter 12 Long-Term Care 243

Institutional Facilities for Long-Term Care 244

Nursing Homes 245

Residential Care Facilities 246

Community-Based Facilities and Services 247

Home Health Services 248

Day Treatment Services 249

Community Housing Alternatives 249

The Financing of Long-Term Care 249

Medicare 250

Medicaid 252

Legislative Landmarks in the Long-Term Care of Older Adults 254

1987 Nursing Home Reform Act (NHRA) 254

1998 Nursing Home Initiative 255

2002 National Nursing Home Quality Initiative 255

2008 (to Present) CMS Five-Star Quality Ratings 255

The Quality of Long-Term Care 256

Psychological Issues in Long-Term Care 258

Suggestions for Improving Long-Term Care 259

Summary 261

Chapter 13 Death and Dying 263

What Do We Know About Death? 264

Medical Aspects of Death 264

Death by the Numbers 265

Sociocultural Perspectives on Death and Dying 270

Psychological Perspectives on Death and Dying 271

Issues in End-of-Life Care 272

Advance Directives 272

Physician-Assisted Suicide and Euthanasia 274

Hospice Care 274

Improving Health Care and Mental Health Services to Dying Patients 275

Bereavement 275

Summary 278

Chapter 14 Successful Aging 279

What is Successful Aging? 281

An Overview of Successful Aging 281

Successful Cognitive Aging 282

Factors That Promote Successful Aging 283

Creativity and Aging 287

What is Creativity? 287

Creative Older Adults 288

Characteristics of Last Works 289

Biopsychosocial Perspectives on Creativity and Aging 291

Successful Aging: Final Perspectives 293

Summary 293

Glossary G-1

References R-1

Author Index I-1

Subject Index I-16