Markers of Resilience and Risk: Adult Lives in a Vulnerable Population

In this report, we drew on data from an ongoing longitudinal study that began in 1978 (Hauser, Powers, Noam, Jacobson, Weiss, & Folansbee, 1984). Focusing on late, young-adult life among individuals who were psychiatrically hospitalized during adolescence, we examined markers of resilience empirically defined in terms of adult success and well-being. The study includes a demographically similar group recruited from a public high school. Major goals were to (a) develop preliminary models of adaptive functioning among adults in their 30s, (b) examine the extent to which adults with histories of serious mental disorders can be characterized by these models, and (c) explore predictors of successful adult lives from indicators of individuals' psychosocial adjustment at age 25.Results showed significant cohort effects on indexes of adaptive functioning, especially for men. Findings suggest that social relations as well as self-views of competence and relatedness play important roles in characterizing adjustment during the adult years. In addition, indexes of psychosocial adjustment as well as symptoms of psychiatric distress and hard drug use at age 25 made a difference in adult social functioning and well-being, providing hints of possible mechanisms likely to facilitate the ability to "bounce back" after a difficult adolescence.     

History of Religious Delusions and Psychosocial Functioning Among Mexican Patients with Paranoid Schizophrenia

The association between global functionality and religiosity among patients from developing and predominantly Catholic countries warrants attention. To compare religiosity and psychosocial functioning in Mexican schizophrenia patients with and without a history of religious delusions, seventy-four patients with paranoid schizophrenia were recruited. Patients with a history of religious delusions had more psychiatric hospitalizations and poorer psychosocial functioning compared with those without a history of religious delusions. No differences emerged between groups in the total scores of religiosity scales. A history of religious delusions rather than religiosity itself may have an influence on psychosocial functioning among Mexican patients with schizophrenia.     

Markers of Resilience and Risk: Adult Lives in a Vulnerable Population

In this report, we drew on data from an ongoing longitudinal study that began in 1978 (Hauser, Powers, Noam, Jacobson, Weiss, & Folansbee, 1984). Focusing on late, young-adult life among individuals who were psychiatrically hospitalized during adolescence, we examined markers of resilience empirically defined in terms of adult success and well-being. The study includes a demographically similar group recruited from a public high school. Major goals were to (a) develop preliminary models of adaptive functioning among adults in their 30s, (b) examine the extent to which adults with histories of serious mental disorders can be characterized by these models, and (c) explore predictors of successful adult lives from indicators of individuals' psychosocial adjustment at age 25. Results showed significant cohort effects on indexes of adaptive functioning, especially for men. Findings suggest that social relations as well as self-views of competence and relatedness play important roles in characterizing adjustment during the adult years. In addition, indexes of psychosocial adjustment as well as symptoms of psychiatric distress and hard drug use at age 25 made a difference in adult social functioning and well-being, providing hints of possible mechanisms likely to facilitate the ability to "bounce back" after a difficult adolescence.     

Androgyny,ego development,and psychosocial crisis resolution

The present study examined the relationship of psychological androgyny with ego development in the context of Loevinger's theory and with psychosocial crisis resolution from the perspective of Erikson's theory. A sample of 30 male and 30 female adults completed the Bem Sex-role Inventory, the Washington University Sentence Completion Test, and the Inventory of Psychosocial Development (IPD). The androgynous individuals were predominate in the higher stages of Loevinger's hierarchical model of ego development, with the masculine sex-typed orientation falling between the androgynous and feminine sex-typed groups. The highest scores on psychosocial personality development, as assessed by the IPD, were obtained by those with an androgynous sex-role orientation, followed by those with masculine, feminine, and undifferentiated orientations, in that order. These results support the view that psychological androgyny represents an added adaptive capacity that can be developed in association with the development of higher ego functioning. These findings applied equally to both sexes and all age groups.     

Overcoming Adversity in Adolescence: Narratives of Resilience

Our overarching goal is to understand the unfolding of resilient development. Our person-based approach is based on a follow-back design, enabling us to examine previously recorded adolescent clinical and adult attachment interviews of now-competent young adults who experienced significant adversity during their adolescent years.

In their adolescent years, these young adults encountered three serious misfortunes. Between 13 and 16 years old (middle adolescence) they were sent to live in a psychiatric hospital, from 2 to 12 months. Their physical home ties with their parents and community friends were abruptly severed, as they lived full-time in High Valley Hospital. In addition, experiencing a serious psychiatric disorder leading to hospitalization, regardless of how time limited, can markedly change the experience of self, often leading to lowered self-regard and lowered personal competence. The label of psychiatric patient is made even more indelible by living in a psychiatric hospital. Their third serious misfortune was trauma. Many of the young adults previously reported serious child and adolescent physical abuse at the hands of immediate family members or other close relatives. Using a profile definition (ego development levels, attachment coherence, close relationships, and social competence), we identified nine young adults who were now functioning in the upper 50th percentile of all former patients and same age high school nonpatient adolescents. After being identified, our intensive study of the narratives embedded in earlier interviews revealed key themes for these resilient young adults—including agency, reflectiveness, relationship recruiting—differentiating them from contrasting young adults, who were also former patients. We illustrate these differences through narratives of two resilient young adults.     

Being close and being social: peer ratings of distinct aspects of young adult social competence

The present study had three main objectives: (1) to develop and validate scales of young adult social competence in two domains, close relationships and social groups, using peer ratings of California Q-sort (Block, 1974; Kremen & Block, 2002) items; (2) to test the hypothesis that social competence is associated with young adult well-being and ego development; (3) to test the hypothesis that close relationship competence aligns more closely than social group competence with young adult functioning. Psychometric data on peer ratings of social competence are presented. For 133 young adults, peer ratings of social competence were correlated in expected directions with indices of functioning (e.g., self-worth, education, psychological distress, criminal behavior, and ego development). Associations were generally stronger for competence in close relationships than in social groups.     

Intellectual and adaptive functioning in Sturge-Weber Syndrome

The present study examined the intellectual and adaptive functioning in a sample of children and young adults with Sturge-Weber Syndrome (SWS). A total of 80 research participants from a SWS study database underwent full neurological evaluation as part of their participation or concurrent medical care. Twenty-nine of the participants received neuropsychological evaluations. Analyses indicated no significant demographic or neurological differences between those who did and did not receive neuropsychological evaluations. Overall, the neuropsychological evaluation sample displayed significantly lower functioning relative to published normative data across domains of intellectual and adaptive functioning. Thirty-two percent of the sample displayed impaired performance (standard score ≤ 75) in intellectual functioning and 58% displayed impaired performance in adaptive functioning. Hemiparesis status independently predicted overall adaptive functioning while seizure frequency independently predicted overall intellectual functioning. Younger participants displayed significantly higher (more intact) ratings in adaptive functioning compared to older participants, specifically in overall adaptive functioning, motor skills, and community living skills. A composite measure of neurological status (SWS-NRS) incorporating seizure and hemiparesis status effectively distinguished between individuals with impaired or nonimpaired adaptive and intellectual functioning and showed promise as a screening method for identifying individuals with more involved intellectual and/or adaptive needs.     

Relationships among parental reports of child, parent, and family functioning.

Most children with psychosocial problems do not present for treatment in mental health settings. They are managed by primary care physicians. Children with psychosocial problems often have parents and/or families with psychosocial distress. The present study measured associations between parental reports of child, parent, and family functioning in individuals in the general population. Participants were 226 parents of children, aged 2-16 years, who presented for routine primary care. Parents reported on the psychosocial functioning of themselves, their child, and their family. All correlations of measures were significant, ranging from .55 to .23. Similar to data from psychiatric samples, the psychological functioning of children, parents, and families were significantly correlated. Unlike in psychiatric settings, child mental health problems were not as closely related to parent or family distress as parent and family distress were related to each other and to child behavior problems.     

Psychosocial Impact of Familial Adenomatous Polyposis on Young Adults: A Qualitative Study

The aim of this study was to explore in detail the psychosocial impact of either having familial adenomatous polyposis (FAP) or being at risk for FAP amongst young adults. In-depth interviews were conducted with eleven individuals aged 18–35 with a clinical or genetic diagnosis of, or at risk of developing FAP. While being at risk did not seem to have a major psychosocial impact upon clinically unaffected participants, clinically affected individuals discussed a number of major stressors including issues in relation to changes in body image and physical functioning as a result of surgery, concerns about discussing FAP with new partners, difficulties in relation to childbearing decision-making, and impact on employment. Genetic counseling was described as being highly effective in providing support, but most participants were not aware of any other support services. Providing longer-term support through ongoing genetic counseling appears necessary to adequately address the ongoing challenges faced by young adults who are dealing with FAP.     

Ego Identity,Ethnic Identity,and the Psychosocial Well-Being of Ethnic Minority and Majority College Students

Although empirical studies have linked a consolidated ego identity to positive psychosocial outcomes for White middle-class adolescents, there is little research documenting this relationship for ethnic minority youth. This study investigated the relationships among ego identity, ethnic identity, and psychosocial functioning, and compared these relationships for ethnic minority and majority college students. The findings revealed that students with an achieved ego identity status had a more positive sense of ethnic identity than did students with a diffused ego identity. Findings also revealed that ethnic minority students reported stronger ethnic identification than did White students and that a stronger sense of ethnic identity was associated with more positive psychosocial outcomes among ethnic minority students, but not among White students. Implications for future research are discussed.     

Identity Processing Styles and Psychosocial Balance during Early and Middle Adulthood: The Role of Identity in Intimacy and Generativity

Identity styles and Eriksonian psychosocial balance were examined in young adults (N = 163; 64.4% women) and middle-aged adults (N = 132; 51.5% women). Participants completed self-report measures of identity styles (informational, normative, and diffuse-avoidant), identity commitment, and psychosocial balance (identity, intimacy, and generativity). Different patterns of psychosocial balance were found for each identity style, with largely consistent findings across age groups. The diffuse-avoidant style was negatively associated with all forms of psychosocial balance, the normative style was positively associated with identity and intimacy balance, and the informational style was positively associated with intimacy and generativity. Structural equation modeling revealed that identity balance predicted both intimacy and generativity for the diffuse-avoidant style (negative prediction) and normative style (positive prediction), whereas the informational style provided direct positive prediction of intimacy and generativity. The importance of an informational identity style for psychosocial balance during both early and middle adulthood is discussed.     

Psychosocial Considerations in Sickle Cell Disease (SCD): The Transition from Adolescence to Young Adulthood

Sickle cell disease (SCD) occurs in 1 of every 400 to 500 African American births. Despite its prevalence, there has been a relative dearth of attention paid to SCD in the psychological literature. African American SCD adolescents and young adults, individuals at an already vulnerable developmental stage, are at increased risk for psychological distress and psychosocial impairments (e.g., depression and low self-esteem, poor social and academic/vocational functioning). Such difficulties often result in problematic adherence to medical regimens, and thus represent a potentially serious clinical and public health problem that merits the attention of psychologists working in medical settings. This article (1) reviews the psychosocial needs peculiar to SCD patients transitioning from adolescence to young adulthood; (2) applies a culturally informed stress-coping-adjustment framework to assess and address the psychological status, psychosocial functioning, and disease outcomes of these individuals; and (3) describes a culturally and developmentally sensitive, psychoeducational group intervention.     

Conduct Disorder and Psychosocial Outcomes at Age 30: Early Adult Psychopathology as a Potential Mediator

Conduct disorder (CD) is associated with a number of adverse psychosocial outcomes in adulthood. There is consistent evidence that CD is predictive of antisocial behavior, but mixed evidence that CD is predictive of other externalizing and internalizing disorders. Further, externalizing and internalizing disorders are often associated with similar psychosocial outcomes as CD. However, relatively little work has examined whether forms of psychopathology (e.g., externalizing and/or internalizing disorders) mediates the relationship between youth CD and adult psychosocial outcomes. The present study examined associations between youth CD and adult psychosocial outcomes and sought to identify forms of psychopathology that may potentially mediate this relationship. Participants completed self-report measures of psychosocial functioning and semi-structured diagnostic interviews during adolescence and young adulthood. Analyses found that most domains of adult psychosocial functioning were associated with youth CD. Adult antisocial behavior was the only form of psychopathology predicted by CD. Adult antisocial behavior appeared to mediate the relationship between CD and marital status, life satisfaction, and being in jail and partially mediated the relationship between CD and family support and global functioning. These data suggest that reducing the progression to adult antisocial behavior may improve multiple psychosocial outcomes among those with a history of CD.     

Psychosocial aspects of successful ageing and resilience: critique,integration and implications / Aspectos psicológicos del envejecimiento exitoso y la resiliencia: crítica,integración e implicaciones

Abstract

As the number of older adults increases worldwide, it is becoming increasingly important to find effective ways of fostering better ageing trajectories. The models used to shape this process inform research, policy and practice and impact older adults themselves. Two important ageing models are successful ageing (SA) and resilience (RES). Aligning the conceptual framework in research contexts with those of older adults’ perspectives is an integral component of driving forward the research agenda in a manner that has the greatest potential to benefit older adults. Studies conducted with laypersons indicate that psychosocial components are important components of successful ageing models; therefore, it is imperative that these non-biomedical components are incorporated. There are many similarities between SA and RES models, but an important distinguishing feature is the incorporation of adversity into conceptualizations of resilience. SA models suggest high levels of functioning as a requirement for ageing successfully, regardless of the circumstances the individual experiences; resilience models take into account the level of adversity being experienced by the individual. Individuals can demonstrate RES by having a more positive outcome than would be expected given their level of adversity. The incorporation of psychosocial constructs into SA models and the integration of SA and RES paradigms has important implications for research and for older adults themselves. Through the promotion of models of ageing that include psychosocial components and elements of adversity, greater generalizability to a broader population is possible with enhanced potential for research derived from these efforts to more positively influence individuals’ trajectories of ageing.     

Personality Preferences and Their Relationship to Ego Development in Australian Leadership Program Participants

The growth of adult ego development to post-conventional levels is associated with many adaptive advantages for the individual and society. However, the vast majority of adults across a wide range of samples demonstrate ego stages well below the maximum potential. In an effort to advance understanding of why and how development to higher ego levels might occur for some individuals and not others, we explored whether particular personality preferences and combinations thereof (as measured by the Myers-Briggs Type Indicator or MBTI) are associated with higher ego levels and whether particular personality preferences might act as inhibiting or facilitating factors in ego development. Participants were 374 adults (aged 18–61; 50 % female) undertaking 11 community leadership development and 2 professional management development programs. After adjusting for effects of age and education, a preference for Intuition on the MBTI was associated with significantly higher ego development on program entry and with greater ego development during the programs. These results are consistent with previous research and provide support for Manners’ and Durkin’s (Developmental Review, 20:475–513, 2000) proposal that dispositional personality characteristics may enhance or constrain ego development.     

Are Young Adults' Suicides Psychologically Different from Those of Other Adults? (The Shneidman Lecture)

ABSTRACT: This Shneidman Lecture addresses the question: Are young adults' suicides psychologically different from those of other adults? Eight clusters (or patterns) as possible predictors of suicide notes and, by implication, suicide are discussed to address this question. The eight clusters are as follows: unbearable psychological pain, interpersonal relations, rejection-aggression, inability to adjust, indirect expressions, identification-egression, ego, and cognitive constriction. Comparisons between young adults (aged 18–25) and other adults indicate that young adults' suicides do differ psychologically in a number of patterns, but that considerable commonalities exist across the adult life span. The presentation emphasizes that a life span developmental perspective is essential when one is attempting to understand the suicides of young adults. A number of genuine suicide notes of young adults are presented to illustrate, from an idiographic view, what it might have been like for these individuals in the last moments of their lives.     

Attachment dimensions as predictors of medical hospitalizations in individuals with DSM IV cluster B personality disorders

This study investigates predictors of health service utilization in individuals with cluster B personality disorders. We hypothesized an association of severity of psychopathology (that is, global psychosocial functioning and psychiatric comorbidity) and attachment style with the length of medical hospitalizations in this population. Forty-one female subjects were interviewed regarding their diagnoses, level of functioning and service utilization. Attachment style was assessed with a self-report questionnaire. Our findings indicate that degree of psychiatric comorbidity and level of psychosocial functioning do not predict length of hospital stays, whereas preoccupied attachment predicted 23.9% of the variance in the length of hospitalizations. We conclude that the quality of interpersonal relatedness appears to be a better predictor of health service use than severity of pathology in patients with cluster B personality disorders.     

Prospective Associations of Coping Styles With Depression and Suicide Risk Among Psychiatric Emergency Patients

Suicide is the second leading cause of death for those ages 13–25 in the United States. Coping is a mediator between stressful life events and adverse outcomes, and coping skills have been incorporated into interventions (e.g., cognitive-behavioral therapy, dialectical behavior therapy, safety-planning interventions) for suicidal populations. However, longitudinal research has not directly examined the prospective associations between multiple coping styles and suicide-related outcomes in high-risk samples. This study identified cross-sectional and 4-month longitudinal associations of coping styles with suicide risk factors (i.e., depression, suicidal ideation, suicidal behavior) in a sample of 286 adolescent and young adult psychiatric emergency patients. Positive reframing was the coping style most consistently associated with positive outcomes, whereas self-blame and disengagement were consistently associated with negative outcomes. Active coping protected against suicidal behavior for males, but not for females. This was the first study to examine longitudinal relationships between coping and suicide-related outcomes in a high-risk clinical sample. Findings suggest that clinical interventions with suicidal adolescents and young adults may benefit from a specific focus on increasing positive reframing and reducing self-blame.     

Androgyny and psychosocial development among college students and adults

The present study examined the relation of androgyny to psychosocial development in the context of Erikson's life-span theory of personality. Samples of male and female college students and adults completed the Bem Sex Role Inventory and the Inventory of Psychosocial Development. The highest scores on psychosocial development were obtained by individuals with an androgynous orientation, followed by those with masculine, feminine, or undifferentiated orientations, in that order. Particular aspects of psychosocial development were differentially associated with masculinity and femininity, in accordance with the agentic or communal quality of successful resolutions of particular developmental crises. Overall, these results support the view that the simultaneous endorsement of both masculine and feminine qualities represents an added adaptive capacity. These findings applied equally to both sexes and both age groups studied.     

Brief report: Neurocognitive functioning in adolescents following childhood maltreatment and evidence for underlying planning & organizational deficits

Children and adolescents with a history of childhood maltreatment are at risk for a host of psychiatric conditions, although the underlying neurocognitive functioning of these individuals remains largely understudied. This study examined the neurocognitive functioning of childhood maltreatment victims in an adolescent psychiatric inpatient setting. The sample consisted of adolescent inpatients (ages 13–19) that completed intellectual testing as part of a neuropsychological/psychological assessment during hospitalization (n = 39). The sample was grouped based on childhood maltreatment history with one group categorized by maltreatment history (n = 15) and the other group characterized by no maltreatment history (n = 24). Analyses revealed statistically significant differences (p < .01) between maltreatment groups on the majority of assessed domains. When controlling for intelligence, only performance differences on the RCFT remained. RCFT differences remained after controlling for the influence of visual-motor and visual-perceptual/visual-spatial functioning, highlighting the influence of organizational and planning difficulties in those individuals with maltreatment history. Group differences in the frequency of impaired performance for neuropsychological tasks were largest (p < .001) for FSIQ and RCFT. Compromised neurocognitive functioning may negatively contribute to the clinical presentation of this population, highlighting the importance of the child neuropsychologist in the effective treatment of children and adolescents with a history of childhood maltreatment.