PSYB32H3 Chapter 16: Study Guide of Chapter 16 for PSYB32
Chapter 16 – Aging and Psychological Disorders
- most segments of North American society tend to have certain assumptions about old age
- in contrast to the esteem in which they are held in most Asian countries, older adults are generally not
treated very well in North America, and numerous myths abound
- the general public endorses many mistaken beliefs about the elderly; for instance, considerably
mythology has surrounded sexuality and aging, the principal assumption being that at the age of 65 sex
becomes improper, unsatisfying, and even impossible; however, older people, well into their 80s and
beyond, are capable of deriving enjoyment from sexual intercourse and other kinds of lovemaking
- the social problems of aging may be especially severe for women
- although grey hair at the temples and even a bald head are often considered distinguished in a man,
signs of aging in women are not valued in society
ageism – discrimination against someone because of his/her age
- the physical realities of aging are complicated by ageism, which can be defined as discrimination
against any person, young or old, based on chronological age
- like any prejudice, ageism ignores the diversity among people in favor of employing stereotypes
- in any discussion of the differences between the old and the not yet old, the old are usually defined as
those over the age of 65; the decision to use this age was set largely by social policies
- to have some rough demarcation (separation) points, gerontologists usually divide people over 65 into 3
groups; the young-old, those aged 65-74; the old-old, those aged 75-84; and the oldest-old, those over
age 85; the health of these groups differs in important ways
Issues, Concepts, and Methods in the Study of Older Adults
Diversity in Older Adults
- the word “diversity” is well suited to the older population
- not only are older people different from one another, but they’re more different from one another than
are individuals in any other age group
- people tend to become less alike as they grow older
Age, Cohort, and Time-of-Measurement Effects
- in the field of aging, as in studies of earlier development, a distinction is made among 3 kinds of effects:
! age effects – are the consequences of being a given chronological age
eg: Jewish boys are bar mitzvahed at age 13
! cohort effects – are the consequences of having been born in a given year and having grown
up during a particular time period with its own unique pressures, problems, challenges, and
opportunities
eg: people who invested money in the stock market in the late 1990’s view investments in
equities as a reasonably safe and very lucrative place to put their money – unlike people
who lost a lot of money in the bear markets of the 1930’s or late 1960’s
! time-of-measurement effects – are confounds that arise because events at an exact point in
time can have a specific effect on a variable being studied over time
eg: time of measurement could affect the results of studies assessing PTSD in Holocaust
survivors if one of the assessments occurs shortly after 9/11
- the 2 major research designs used to assess developmental change are the cross-sectional and the
longitudinal
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- in cross-sectional studies, the investigator compares different age groups at the same moment in time
on the variable of interest
cross-sectional studies – studies in which different age groups are compared at the same time
- cross-sectional studies do not examine the same people over time; consequently, they allow us to make
statements only about age effects in a particular study or experiment, not about changes over time
- in longitudinal studies, the researcher selects one cohort – say, the graduating class of 2002 – and
periodically retests it using the same measure over a number of years
longitudinal studies – investigation that collects information on the same individuals repeatedly over
time, perhaps over many years, in an effort to determine how phenomena change
- longitudinal studies allows researchers to trace individual patterns of consistency or change over time –
cohort effects – and to analyze how behavior early in life relates to behavior in old age
- however, because each cohort is unique, conclusions drawn from longitudinal studies are restricted to
the cohort chosen
- an additional problem with longitudinal studies is that participants often drop out as the studies proceed,
creating a bias commonly called selective mortality
selective mortality – a possible confound in longitudinal studies, whereby the less healthy people in a
sample are more likely to drop out of the study over time
- the least-able people are the most likely to drop out, leaving a nonrepresentative group of people who
are usually healthier than the general population
- thus, findings based on longitudinal studies may be overly optimistic about the rate of decline of a
variable such as sexual activity over the lifespan
Diagnosing and Assessing Psychopathology in Later Life
- the DSM-IV-TR criteria for older adults are basically the same as those for younger adults
- the nature and manifestations of mental disorders are usually assumed to be the same in adulthood and
old age, even though little research supports this assumption
- a measure of cognitive functioning is often included as standard practice in research to determine
whether the elderly respondent has experienced declines in cognitive ability
- researchers often assess cognitive functioning with the Mini-Mental State Examination (MMSE) in its
original or modified form (i.e., the Modified Mini-Mental State Exam)
- the MMSE is a brief measure of an individual’s cognitive state, assessing “orientation, memory, and
attention,.. ability to name, follow verbal and written commands, write a sentence spontaneously, and
copy a complex polygon”
- because some elderly people will have diminished attention spans, one goal is to develop short but
reliable measures suitable for screening purposes
- one relatively simple measure used to detect dementia and Alzheimer’s disease is the clock drawing
subtest of the Clock Test
- in this test, respondents are presented with a previously drawn circle (7cm in diameter) and are asked to
imagine that the circle is the face of a clock and to put the numbers on the clock and then draw the hand
placement for the time of 11:10; up to 25 different types of errors can occur ; this test has been found to
be reliable and valid
- another assessment goal is to create measures whose item content is tailored directly to the concerns
and symptoms reported by elderly people, not to those of younger respondents
- one well-known measure crafted for the elderly is the Geriatric Depression Scale (GDS), a true-false
self-report measure
- the GDS has acceptable psychometric characteristics and is regarded as the standard measure for
assessing depression in the elderly
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- the Geriatric Suicide Ideation Scale (GSIS) is a new 31 item measure that is the 1st measure of suicide
ideation created specifically for the elderly; the GSIS has a 10-item suicide ideation scale, as well as 3
other subscales tapping death ideation, loss of personal and social work, and the perceived meaning in
life
Range of Problems
- as a group, no other people have more of these problems than the aged
- they have them all: physical decline and disabilities, sensory and neurological deficits, loss of loved one,
the cumulative effects of a lifetime of many unfortunate experiences, and social stresses such as ageism
- one concern from the WHO is that elderly people with a mental disorder may suffer from “double
jeopardy”; that is, they suffer the stigmas associated with being older and being mentally ill
Old Age and Brain Disorders
Dementia
dementia – deterioration of mental faculties – memory, judgments, abstract thought, control of impulses,
intellectual ability – that impairs social and occupational functioning and eventually changes the
personality
- dementia – what laypeople called senility – is a general descriptive term for gradual deterioration of
intellectual abilities to the point that social and occupational functions are impaired
- difficulty remembering things, especially recent events, is the most prominent symptom, and reported
memory problems in people who objectively have normal cognition predict subsequent dementia
- people with dementia may leave tasks unfinished because they forget to return to them after an
interruption; judgments may become faulty, and the person may have difficulty comprehending situations
and making plans or decisions; the ability to deal with abstract ideas deteriorates, and disturbances in
emotions are common, including symptoms of depression, flatness of effect, and sporadic emotional
outbursts; they could also show language disturbances; also, they may have trouble recognizing familiar
surroundings or naming common objects
- many people with progressive dementia eventually become withdrawn and apathetic
- in the terminal phase of the illness, the personality loses its sparkle and integrity; relatives and friends
say that the person is just not himself/herself anymore; social involvement with others keeps narrowing;
finally, the person is oblivious to his/her surroundings
- prevalence of dementia increase with advancing age
- the Alzheimer’s Society of Canada estimates that more than 750,000 Canadians will develop
Alzheimer’s and other dementias in the next 30 years
Causes of Dementia
- dementias are typically classified into 3 types
- Alzheimer’s disease is the most common; then there are the frontal-temporal and frontal-subcortical
dementias, which are defined by the areas of the brain that are most affected
Alzheimer’s Disease
Alzheimer’s disease – a dementia involving a progressive atrophy of cortical tissue and marked
by memory impairment, involuntary movements of limbs, occasional convulsions, intellectual
deterioration, and psychotic behavior
- Alzheimer’s disease accounts for about 50% of the dementia in older people; about 1/13
Canadians over the age of 65 has Alzheimer’s disease or a related dementia
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