成功老化内涵及影响因素分析

本文在Rowe和Kahn成功老化模型的基础上,结合中国文化背景,提出了生理健康、心理功能、社会参与、生活满意度的四维度成功老化模型。人口学特征、早期经历、社会互动环境、社会历史文化等被动因素,生活方式和习惯、认知活动与训练、老化态度等主动因素,都会影响老年人的成功老化。成功老化是老年人为之奋斗的目标,积极老化是通往该目标的途径。     

Contextual Design for driving: Developing a trip-planning tool for older adults

Independent living depends on mobility, and mobility depends on driving, particularly for people 65 years and older. The longer older adults can safely drive, the longer they can independently run errands, shop, exercise, and maintain social networks. Age-related decline of perceptual, motor, and cognitive abilities can undermine the mobility and driving safety of older drivers. Data from driving simulators, on-road tests, surveys, and crash reports describe the driving safety and mobility challenges of older adults, but these methods offer a limited view of these challenges and fail to indicate design solutions. Contextual Design—a combination of Contextual Inquiry interviews, model building, and affinity diagrams—offers a complementary approach to uncover challenges that older adult drivers’ experience. For two weeks, 39 drivers age 65 and above, had their vehicles instrumented to collect driving and video data. Applying Contextual Design to these data showed that older drivers in urban and rural settings faced different mobility challenges and adopted various strategies to mitigate risk: older drivers often involved their spouse or passenger in the driving task, avoided certain driving maneuvers such as left turns, avoided unfamiliar or poorly lit roads at night, and planned trips to avoid risky driving situations. Ridesharing and trip planning emerged as important strategies to improve the safety and mobility of older drivers. Ridesharing could serve as a potential solution to prolong mobility; however, factors such as wait time, scheduling conflicts, costs, and trust were concerns for older drivers. A paper prototype was developed to validate the driving challenges faced by older drivers, and guide the development of a customized web-based trip-planning tool. The trip-planning tool could help older drivers make safer route choices by offering routes with fewer driving challenges, thereby enhancing their driving safety, mobility, and independence.     

情景记忆成功年老化的神经机制

随着年龄的增长,大部分老年人的情景记忆会出现衰退,但也会有一部分老年人的情景记忆表现出成功的年老化,即记忆成绩较好或随增龄的衰退程度较小。脑保持理论、神经去分化理论、认知储备理论以及神经补偿理论分别从不同角度解释了情景记忆成功年老化的神经机制。基于选择性优化与补偿模型对现有理论进行整合,发现情景记忆成功年老化可能与个体的认知储备水平直接相关：高认知储备的老年人能够对情景记忆相关的脑区和脑网络进行优化且具备更强的神经补偿能力,因而其脑功能(比如,神经表征和神经加工通路的特异性)可能会保持地更好。未来研究需要更多地采用纵向设计来考察各理论之间的关系及其影响因素,从而更好地解释记忆成功年老化的神经机制并为提升老年人的脑与认知健康提供支持。     

Old Age,Finitude and Meaning: Reflections on the Care of Older Adults Based on Logotherapy

Due to the steady increase in the number of older adults among the Brazilian population, the aim of the present article is to reflect on the care provided to the elderly based on Viktor Frankl’s logotherapy as an alternative approach to understanding more deeply what this life stage means. For this purpose, demographic data on the population of older adults are provided, together with distinct views on aging and its relationship to the quality of life. Next, logotherapy, from its conceptions about the relationship of the person to finitude and to the person’s possibilities for existence, is presented as a psychological theory likely to improve the understanding of aging and to represent a possible approach to the care of older adults. Based on an understanding of humans as beings of power and therefore as self-transcendent and endowed with the will to meaning, the possibility of psychology investing in the relationship with alterity as the grounds for interventions targeting older adults is emphasized.     

Definition of psychotherapy from a methodologic viewpoint

Psychotherapy is the psychological treatment of disturbed person-environment relationships, associations or connections which are learned in a lifelong process of socialization. Accordingly, psychotherapy is a process of learning for the patient and a process of educating for the therapeutist, a process which is controlled by specialists in the case of children as well as adults with serious psychic disorders and which is usually a means of self-education in the case of subjects with slight psychic disorders. The primary objective of psychotherapy is to modify both the attitude and behavior in the sense of improving a subject's ability to fulfill his duties in society.     

Interpersonal Psychotherapy for Late Life Depression: Current Status and New Applications

Interpersonal Psychotherapy (IPT) is an empirically-supported treatment for depression and other mental disorders. This article discusses the structure of IPT, its use with older adults, and research that supports its efficacy with depressed older people. Depressed older persons with significant health problems or cognitive impairment present special challenges for those conducting IPT and other psychotherapies. Promising new psychotherapies developed for depressed older adults with cognitive impairment and those living in nursing homes are reviewed. Recommendations are made for use of IPT with older adults in nursing homes.     

Predictors and impact of psychotherapy side effects in young adults

What should we tell our younger clients—who may or may not have chosen to come to therapy—about possible risks of engaging in psychotherapy? To explore this question, we examined psychotherapy side effects in 366 young adults with a history of psychotherapy or counselling. Psychotherapy side effects were common, with 41% of participants reporting at least one. Perceived lack of control over the decision of when and how to engage in therapy was the strongest predictor of experiencing therapy side effects. Of the different kinds of side effects, feeling that therapy had gone on too long and experiencing worsening of existing symptoms were the most strongly predictive of poor therapy outcomes such as dissatisfaction with care and lower perceived improvements. Finally, there was a significant association between reporting side effects of psychiatric medications and side effects of psychotherapy, suggesting common factors that contribute to side effect experience across treatment modalities. These findings highlight the need to monitor possible side effects during psychotherapy and counselling, and to have an open dialogue with our youngest clients and their families about the likelihood for negative outcomes when they are compelled to engage in therapy.     

Expectations of Psychotherapy Duration by Disorder: A Comparison Between Professional and Young Adult Expectations

Using more precise methodology, the current study investigated expectations of psychotherapy duration for specific disorders. Duration expectations were obtained for young adults and compared to those obtained from psychotherapists as reported by Lowry and Ross (Psychotherapy: Theory, Research, Practice, Training 34:272–277, 1997). Results revealed that expected duration for young adults by disorder was quite similar to the psychotherapists, where less severe psychological disorders and problems were expected to require shorter treatment durations than moderate and severe disorders and problems. For disorders and problems with which young adults were familiar, their expectations were essentially the same as psychotherapists. A meaningful difference was found for suicidal ideation, with young adults expecting significantly longer treatment duration.     

Takeover performance of older drivers in automated driving: A review

IntroductionThe introduction of automated vehicles to the road environment brings new challenges for older drivers. Level 3 of conditional automation requires drivers to take over control of their vehicle whenever the automated system reaches its limits. Even though autonomous vehicles may be of great benefit to older drivers in terms of safely maintaining their mobility, a better understanding of their takeover performance remains crucial. The objective of this review of the literature is to shed more light on the effects that aging has on takeover performance during automated driving.MethodsThree database searches were conducted: PsychINFO, Web Of Sciences, and TRID. Studies from the last decade which included groups of older drivers were reviewed.ResultsAfter checking through abstracts and texts of articles, 9 articles, 4 proceedings papers, and 1 technical report were included in this review. All studies included a driving simulator that refers to level 3 of automation (which requires supervision by the driver). Five out of fourteen studies showed that older adults had poorer takeover performance (in terms of takeover time and takeover quality) than younger adults. However, several factors, such as the type of non-driving related task (NDRT), were seen to influence takeover performance in older adults. Speed, type and duration of notification interval, distribution and duration of driving modes, and number of takeovers were all also factors of influence.ConclusionThis review synthesizes the results of 14 articles which investigate the effects of age-related changes on takeover performance. Various external factors as NDRTs, speed, type and duration of notification to take over, duration of the automated phase, distribution of the automated/manual phases may affect takeover performance in older adults. Even if the majority of articles showed that older adults are globally slower at taking over a vehicle than younger adults, findings concerning take over quality yield divergent results. It's probably due to age related cognitive changes, particularly in executive functions or to a great heterogeneity in this population. This literature review highlights the need to develop new research on the impact of aging on takeover performance.     

Spiritual and Religious Implications of Aging with HIV: A Conceptual and Methodological Review

ABSTRACT

Spirituality and religious practices can buffer people from stressful life circumstances and promote positive biopsychosocial outcomes. The beneficial effects of spirituality and religious practices have been documented in aging and HIV. Unfortunately, little is known about spirituality and religious practices in older adults with HIV. As the number of older adults with HIV increases, with an estimated 91,000 adults over 50 being diagnosed with this disease in the United States, spirituality and religious practices may help HIV-positive people to age successfully. Crisis competence and spiritual trajectories are ways of conceptualizing spiritual development when confronting aging with a life-changing event such as a being diagnosed with HIV. Methodological issues in studying spirituality in adults aging with HIV are identified including defining spirituality and religiosity, heterogeneity of the population, timing of diagnosis, mode of transmission, sexual orientation, religious and cultural stigma, and hardiness. Implications for possible interventions are also posited.     

Counseling Older Adults with Dementia: A Survey of Therapists in Massachusetts

Although much has been written about therapeutic interventions with caregivers, little is known about the counseling services that are available for victims of dementia. The present study was designed to explore community mental health center (CMHC) services and therapists' experiences in providing psychotherapy to this population in Massachusetts. Only 27 of the 36 CMHCs in the state reported providing mental health services to older adults with a dementing illness. A survey of therapists who specialized in working with older adults found that the percentage of older adult clients estimated to have dementia averaged about half of their caseload. Older persons in the early phase of a dementing illness were most frequently referred for depression and anxiety, whereas those with moderate decline were most frequently referred for management of disruptive behavior. The most common services provided to clients with dementia consisted of assessment and individual counseling. The latter finding indicates a discrepancy between what is practiced and the professional literature. Most of the psychotherapy described in the literature concerns group interventions, which were rarely provided by the mental health centers in Massachusetts. The centers tended to offer individual counseling; however, little information on how to provide this form of treatment can be found.     

老年夫妻的老化刻板印象对死亡焦虑的行动者效应和对象效应

目的：考察老年人的老化刻板印象对自身及配偶的死亡焦虑的影响。方法：145对老年夫妻完成老化印象量表和死亡焦虑量表,并运用行动者-对象互依模型进行数据分析。结果：（1）老化刻板印象和死亡焦虑在夫妻内部分别具有一致性;（2）老化刻板印象对自身死亡焦虑的行动者效应显著;（3）丈夫的积极老化刻板印象对妻子死亡焦虑的对象效应显著,妻子的消极老化刻板印象对丈夫死亡焦虑的对象效应显著。结论：老年人的老化刻板印象不仅影响自身而且影响配偶的死亡焦虑,但夫妻之间的影响存在性别差异。     

Everyday Problem Solving and Emotion: An Adult Developmental Perspective

ABSTRACT— Despite cognitive declines that occur with aging, older adults solve emotionally salient and interpersonal problems in more effective ways than young adults do. I review evidence suggesting that older adults (a) tailor their strategies to the contextual features of the problem and (b) effectively use a combination of instrumental and emotion-regulation strategies. I identify factors of problem-solving contexts that affect what types of problem-solving strategies will be effective. Finally, I discuss how this identification of factors affects what we know about developmental differences in everyday problem-solving competence.     

David and Judith

SUMMARY

This paper begins with a discussion of Dialogicai Psychotherapy-that “healing through meeting” which comes when the relation between therapist and patient is central-and explores inclusion, making present, confirmation, and the “normative limitation of mutuality.” Secondly, it discusses a Dialogicai Psychotherapy particularly important for couples therapy-Ivan Bos-zormenyi-Nagy's Contextual (intergenerational family) Therapy with its emphases on multidirected partiality, trustbuilding, rejunction, and the intergeneration merit ledger. The third part of the paper applies Dialogicai and Contextual therapy to the case of David and Judith, a couple who show clearly the importance of families of origin.     

The Neuropsychology of HIV/AIDS in Older Adults

Highly active antiretroviral therapy is allowing increasing numbers of adults to age with HIV. The neuropsychological effects of aging with HIV are reviewed through three types of studies. First, the separate effects of HIV and aging on cognition are examined in studies that compare younger adults with HIV with neurologically normal older adults. Second, studies examine the impact of aging within samples of adults with HIV only. Third, providing the most critical evidence, are studies that assess cognition in younger and older adults with HIV relative to younger and older adults without HIV. In general research findings are inconclusive. Large individual differences among older adults with HIV as well as co-factors (APOE4 and detectable viral load) may account for inconsistent findings in the literature. A subgroup of older adults with HIV may be at greater risk for cognitive impairment, especially in attention functioning.     

跨期选择中的年龄差异及其机制

随着老龄化形势日益严峻, 老年人的跨期选择受到越来越多学者的关注。目前关于跨期选择的年老化研究尚存分歧:有研究发现老年人比年轻人更偏好未来获得更大收益; 也有研究发现老年人的选择偏好和年轻人一样, 甚至比年轻人更偏好近期收益。从时间表征和结果价值表征两个维度上的加工过程去分析其对老年人跨期选择的影响, 并进一步阐述认知、动机和情绪因素对两个维度加工过程的影响, 这对于理解当前老年人跨期选择领域研究的分歧有重要科学意义。     

An exploratory investigation of the personality correlates of aging using the Hand Test.

The Hand Test was administered to 27 older adults of both sexes (Mage = 66.56) to investigate possible changes in personality concomitant with normal aging. To control partially for such factors as cultural influences and intelligence differences a matched-pair design was used in which the test protocols of the older adults were matched with those of their children of the same sex (Mage = 36.44). Though the Hand Test has not been independently validated on older adults, results were consistent with past findings using projective techniques inasmuch as depletion and constriction of personality were noted. Criticisms of research on the clinical assessment of the elderly were discussed.     

我国老年人的社会支持与服务

鉴于我国老龄化现状,简要地回顾了社会支持的定义与种类,考察了我国传统的孝顺价值观和行为;并着重分析了我国老年人的社会支持与服务,包括老年人的社会支持与幸福感,老年人的家庭支持与照料,老年组织与公共老年服务;以及我国老年人社会支持的城乡差异。     

Filial Piety,Generativity and Older Adults’ Wellbeing and Loneliness in Denmark and China

The article considers the potential of intergenerational encounters and family and social ties for alleviating loneliness and promoting older adults’ wellbeing. Loneliness has been widely recognized as one of the factors that are most deeply and pervasively detrimental to older adults’ wellbeing. We combine theoretical reflections with a comparative study of older adults in Denmark and China. Both countries have to deal with an aging population and growing number of cases of isolation and loneliness in an increasingly individualized society. They differ, however, with regard to how far they have developed a system of institutionalized care, as well as with regard to their culture-specific views of family life and parent-child relationships. We apply the notions of filial piety, known from Confucian philosophy but often misinterpreted as conservative and conformist, and generativity, to qualitative studies of older adults in Denmark and China. The great potential of intergenerational ties is confirmed. Our study also shows that filial piety is still highly valued, in both China and Denmark, and can be maintained even in a highly individualized society. There is, however, considerable uncertainty among both older adults and their younger relatives as to what is required and what can be expected; realism, and an emphasis on the quality, rather than the quantity of interaction, may be sensible coping strategies, but can also lead to unnecessary acquiescence and self-abnegation. Our study also serves to distinguish different aspects and effects on wellbeing of intergenerational relationships.