Study Guide of Chapter 16 for PSYB32

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19 Jul 2010
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
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 1930s or late 1960s
! 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
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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
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 deterioration of mental faculties memory, judgments, abstract thought, control of impulses,
intellectual ability that impairs social and occupational functioning and eventually changes the
- 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
Alzheimers 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
Alzheimers Disease
Alzheimers 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 Alzheimers disease or a related dementia
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