Resources and life-management strategies as determinants of successful aging: on the protective effect of selection, optimization, and compensation

In this research, the authors investigated the specific and shared impact of personal resources and selection, optimization, and compensation (SOC) life-management strategies (A. M. Freund & P. B. Baltes, 2002) on subjective well-being. Life-management strategies were expected to be most relevant when resources were constrained, particularly in very old age. In Study 1 (N=156, 71-91 years), age-differential predictive patterns supported this assumption: Young-old individuals' well-being was predicted independently by resources and SOC, whereas SOC buffered the effect of restricted resources in old-old individuals. Study 2 replicated the findings longitudinally with resource-poor and resource-rich older individuals (N=42). In both studies, specific SOC strategies were differentially adaptive. Results confirm that resources are important determinants of well-being but that life-management strategies have a considerable protective effect with limited resources.     

Mindfulness-Based Stress Reduction and Sense of Coherence Among Women with Fibromyalgia

Sense of Coherence (SOC) is conceptualized as a disposition to experience life as meaningful and manageable. Research suggests a protective effect of SOC on psychological health in stressful circumstances. This study assessed the capacity of SOC to buffer the effect of illness symptoms on psychological distress among patients with fibromyalgia. Self-reported changes in SOC after participation in a Mindfulness-Based Stress Reduction (MBSR) program were also examined. Ninety-one women with fibromyalgia provided baseline data pertaining to illness symptoms, perceived stress, and depression prior to participation in a randomized trial of MBSR. SOC and fibromyalgia symptoms were independently related to perceived stress and depression at baseline. SOC was not a statistically significant moderator of symptom effects on psychological distress. In comparison with wait-listed controls, program participants reported a significant increase in SOC after MBSR participation. These results provide the first demonstration from a randomized trial that SOC may be enhanced via intervention.     

Life-management strategies of selection, optimization, and compensation: measurement by self-report and construct validity

The authors examined the usefulness of a self-report measure for elective selection, loss-based selection. optimization, and compensation (SOC) as strategies of life management. The expected 4-factor solution was obtained in 2 independent samples (N = 218, 14-87 years; N = 181, 18-89 years) exhibiting high retest stability across 4 weeks (r(tt) = .74-82). As expected, middle-aged adults showed higher endorsement of SOC than younger and older adults. Moreover, SOC showed meaningful convergent and divergent associations to other psychological constructs (e.g., thinking styles, NEO) and evinced positive correlations with measures of well-being which were maintained after other personality and motivational constructs were controlled for. Initial evidence on behavioral associations involving SOC obtained in other studies is summarized.     

Youth adjustment to parental illness or disability: the role of illness characteristics, caregiving, and attachment

This study aimed to (1) examine relations between youth adjustment and three sets of predictors: parental illness/disability characteristics, caregiving, and parent-child attachment, and (2) explore differences on these variables between youths of parental physical illness/disability and youths of parental mental illness. Eighty-one youths between 10 and 25 years of a parent with a physical illness/disability (35%) or a mental illness (43%) completed a series of self-report measures assessing perceived characteristics of the parent's illness/disability, caregiving experiences, and adjustment outcomes. Results revealed a set of predictors of poorer youth adjustment: gradual illness/disability onset, being male, isolation, lower perceived maturity, and less choice in caregiving. Youths of parental mental illness differed from youths of parental physical illness/disability on emotional distress (worry and discomfort) dimensions of caregiving. Youth-parent attachment security was associated with youth caregiving and there was a trend for attachment to vary according to parental illness/disability type. Findings highlight young caregiving as an important target for service and policy planning.     

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。     

Age differences in coping with chronic illness

We examined the correlation between age and six coping strategies in a sample of 151 middle-aged and older chronically ill adults. Coping strategies included cognitive restructuring, emotional expression, wish fulfilling fantasy, self-blame, information seeking, and threat minimization. Older adults were less likely to use emotional expression or information seeking than were middle-aged adults in their efforts to cope with the illness. These strategies were related to age even when numerous illness characteristics (e.g., physical limitations) were used as control variables. Interaction effects showed that older adults who perceived their illnesses as highly serious were less likely than were others to cope by seeking information, reconstruing their illness as having positive aspects, or engaging in wishfulfilling fantasies, and more likely to cope by simply minimizing the illness's threat. Consideration of related research studies suggests that the age differences in emotional expression may be due to age-related shifts in the types of stresses experienced, whereas the age differences in information seeking may be more strongly linked to cohort phenomena.     

Sense of coherence moderates the relationship between life stress and natural killer cell activity in healthy older adults

A sense of coherence (SOC) has been found to be a strong predictor of health outcomes and life satisfaction in older adults. This study investigated mood and immune effects of anticipated voluntary housing relocation in 30 healthy older adults and 28 age-matched controls and examined whether SOC would buffer effects of relocation on natural killer (NK) cell activity. Movers completed assessments and had blood drawn 1 month before relocation to congregate living facilities; controls were assessed concurrently. Compared with the control group, movers showed decreased positive mood and NK activity and elevated thought intrusion. Positive mood mediated the relationship of moving with NK activity, whereas SOC moderated this relationship. Low SOC movers had the poorest NK activity; that of high SOC movers was less compromised. These findings are consistent with possible salutogenic contributions of SOC and positive mood to immune function in older adults facing stressful life transitions.     

Selection,optimization, and compensation strategies: Interactive effects on daily work engagement

The theory of selective optimization with compensation (SOC) proposes that the “orchestrated” use of three distinct action regulation strategies (selection, optimization, and compensation) leads to positive employee outcomes. Previous research examined overall scores and additive models (i.e., main effects) of SOC strategies instead of interaction models in which SOC strategies mutually enhance each other's effects. Thus, a central assumption of SOC theory remains untested. In addition, most research on SOC strategies has been cross-sectional, assuming that employees' use of SOC strategies is stable over time. We conducted a quantitative diary study across nine work days (N = 77; 514 daily entries) to investigate interactive effects of daily SOC strategies on daily work engagement. Results showed that optimization and compensation, but not selection, had positive main effects on work engagement. Moreover, a significant three-way interaction effect indicated that the relationship between selection and work engagement was positive only when both optimization and compensation were high, whereas the relationship was negative when optimization was low and compensation was high. We discuss implications for future research and practice regarding the use of SOC strategies at work.     

Being engaged when resources are low: A multi-source study of selective optimization with compensation at work

This study examined self-regulation in the form of selective optimization with compensation (SOC) at work as a moderator of the relationships of job control (as a job resource) and feeling recovered and energized in the morning (as a personal energy resource) with self- and coworker-rated work engagement. SOC was hypothesized to offset low levels of job control and low levels of personal energy. Based on a sample of 405 public-service employees in Germany, including a multi-source subsample of 141 employees and their respective coworkers, the results showed that SOC use moderated the relationship between the level of personal energy and self-ratings as well as coworker ratings of work engagement such that SOC mitigated low levels of personal energy. SOC at work did not offset low job control. The results suggest that using SOC is particularly important when employees lack energy. SOC strategies should, therefore, be fostered by managers and organizations.     

Psychosocial Adaptation to Chronic Illness and Disability: A Primer for Counselors

In this article, the authors discuss 3 broad domains of psychosocial adaptation to chronic illness and disability. These include the dynamics (basic concepts, psychosocial responses, and coping strategies) typically associated with the process of adaptation to disabling conditions, assessment of adaptation as evidenced by 6 commonly used measures, and intervention strategies applied to facilitating coping with and adaptation to chronic illness and disability.     

Mapclus: A mathematical programming approach to fitting the adclus model

We present a new algorithm, MAPCLUS (MAthematicalProgrammingCLUStering), for fitting the Shepard-Arabie ADCLUS (forADditiveCLUStering) model. MAPCLUS utilizes an alternating least squares method combined with a mathematical programming optimization procedure based on a penalty function approach, to impose discrete (0,1) constraints on parameters defining cluster membership. This procedure is supplemented by several other numerical techniques (notably a heuristically based combinatorial optimization procedure) to provide an efficient general-purpose computer implemented algorithm for obtaining ADCLUS representations. MAPCLUS is illustrated with an application to one of the examples given by Shepard and Arabie using the older ADCLUS procedure. The MAPCLUS solution uses half as many clusters to achieve nearly the same level of goodness-of-fit. Finally, we consider an extension of the present approach to fitting a three-way generalization of the ADCLUS model, called INDCLUS (INdividualDifferencesCLUStering).We are indebted to Scott A. Boorman, W. K. Estes, J. A. Hartigan, Lawrence J. Hubert, Carol L. Krumhansl, Joseph B. Kruskal, Sandra Pruzansky, Roger N. Shepard, Edward J. Shoben, Sigfrid D. Soli, and Amos Tversky for helpful discussions of this work, as well as the anonymous referees for their suggestions and corrections on an earlier version of this paper. We are also grateful to Pamela Baker and Dan C. Knutson for technical assistance. The research reported here was supported in part by LEAA Grant 78-NI-AX-0142 and NSF Grants SOC76-24512 and SOC76-24394.     

Illness perceptions are the main predictors of depression and anxiety symptoms in patients with chronic pain

Depression and anxiety symptoms in chronic pain are associated with adverse clinical outcomes, and appear highly related to patient’s illness perceptions as well as with marital adjustment. This study aimed to investigate the predictive value of pain variables, marital adjustment and illness perceptions on depression and anxiety in patients with chronic pain. Two hundred patients were recruited from a pain unit in a public hospital in the north of Portugal. Patients completed a questionnaire that assessed illness perceptions (IPQ-Brief), marital adjustment (revised dyadic adjustment scale), depression and anxiety symptoms (hospital anxiety depression scale) and pain variables (pain intensity and pain disability index). Depression and anxiety symptoms were associated with pain intensity, pain-related disability, marital adjustment and illness perceptions. Results from hierarchical regression showed that illness perceptions contributed significantly to depression and anxiety symptoms over and above the effects of pain intensity, pain-related disability and marital adjustment, after controlling for gender. In multivariate analyses, pain intensity, pain-related disability and marital adjustment were uniquely related to depression and anxiety symptoms, whereas specific illness perceptions were uniquely related to depression symptoms (identity, treatment control, emotional response and coherence) and to anxiety symptoms (identity, emotional response and concern). Perceptions of greater symptomatology (identity) and of emotional impact, and lesser perceptions of treatment control and understanding of chronic pain (illness comprehensibility) were significantly associated with increased depression symptoms. Perceptions of greater symptomatology (identity), emotional impact and greater concern were associated with anxiety symptoms. These findings indicate that the contribution of illness perceptions was greater than that made by traditional covariates, and may therefore be a useful basis for future psychological interventions.     

Adaptation to stroke using a model of successful aging

The process of adaptation to the physical and psychosocial consequences after stroke is a major challenge for many individuals affected. The aim of this study was to examine if stroke patients within 1 month of admission (n = 153) and followed up at 1 year (n = 107) engage in selection, optimization, and compensation (SOC) adaptive strategies and the relationship of these strategies with functional ability, health-related quality of life (HRQOL) and depression 1 year later. Adaptive strategies were measured using a 15-item SOC questionnaire. Internal and external resources were assessed including recovery locus of control, stroke severity, and socio-demographics. Outcome measures were the Stroke Specific Quality of Life Questionnaire (SS-QoL), the Nottingham Extended Activities of Daily Living Scale and the Depression Subscale of the Hospital Anxiety and Depression Scale. Findings indicated that stroke patients engaged in the use of SOC strategies but the use of these strategies were not predictive of HRQOL, functional ability or depression 1 year after stroke. The use of SOC strategies were not age specific and were consistent over time, with the exception of the compensation subscale. Results indicate that SOC strategies may potentially be used in response to loss regulation after stroke and that an individual's initial HRQOL functional ability, levels of depression and socio-economic status that are important factors in determining outcome 1 year after stroke. A stroke-specific measure of SOC may be warranted in order to detect significant differences in determining outcomes for a stroke population.     

The roles of fatalism, self-confidence, and intellectual resources in the disablement process in older adults

In this study, the authors examined the relations between 3 psychological variables-fatalism, self-confidence, and intellectual resources-and the subsequent development of illness and disability 20 years later in an adult sample. Results indicated that greater fatalism, assessed in 1974, predicted greater difficulty in everyday cognitive tasks as well as illness in 1994. Higher self-confidence in 1974 was associated with lesser degrees of cognitive and fine motor difficulty in 1994. Greater intellectual resources in 1974 (a combination of intellectual flexibility and education) predicted less cognitive and gross motor difficulty as well as lesser degrees of illness in 1994. Some of these relations were stronger for older than for middle-aged individuals. Results are discussed in the context of models of the disablement process.     

Adaptation to stroke using a model of successful aging

ABSTRACT

The process of adaptation to the physical and psychosocial consequences after stroke is a major challenge for many individuals affected. The aim of this study was to examine if stroke patients within 1 month of admission (n?=?153) and followed up at 1 year (n?=?107) engage in selection, optimization, and compensation (SOC) adaptive strategies and the relationship of these strategies with functional ability, health-related quality of life (HRQOL) and depression 1 year later. Adaptive strategies were measured using a 15-item SOC questionnaire. Internal and external resources were assessed including recovery locus of control, stroke severity, and socio-demographics. Outcome measures were the Stroke Specific Quality of Life Questionnaire (SS-QoL), the Nottingham Extended Activities of Daily Living Scale and the Depression Subscale of the Hospital Anxiety and Depression Scale. Findings indicated that stroke patients engaged in the use of SOC strategies but the use of these strategies were not predictive of HRQOL, functional ability or depression 1 year after stroke. The use of SOC strategies were not age specific and were consistent over time, with the exception of the compensation subscale. Results indicate that SOC strategies may potentially be used in response to loss regulation after stroke and that an individual's initial HRQOL functional ability, levels of depression and socio-economic status that are important factors in determining outcome 1 year after stroke. A stroke-specific measure of SOC may be warranted in order to detect significant differences in determining outcomes for a stroke population.     

Group Therapy with Individuals and Families Coping with Illness or Disability in Israel

This paper illustrates a group intervention with individuals and family caregivers coping with illness/disability, and focuses on the relationship between the process of group development and the process of coping with the illness/disability. People experiencing illness/disability cope with a great deal of pressure and stress that stem from the illness's biopsychosocial demands. A group can provide encouragement and support and reduce helplessness, isolation, and despair through cooperation and use of mutual resources. The design of the intervention was based on our clinical experience with numerous groups for ill/disabled individuals or their family. The process is described and analyzed using examples from three documented groups, and is presented in terms of four variables: group process, group atmosphere, group content, and group intervention.     

On Disability and Illness. A Reply to Edwards

This paper is a reply to an article by Steven Edwards in a previous issue of Theoretical Medicine and Bioethics. In this paper Edwards discusses two types of problems which he finds to be inherent in my theory of disability, mainly as presented in my On the Nature of Health, Kluwer 1995. First, Edwards discerns a tension in my basic definition of health, a tension between my “subjectivistic” and my “objectivistic” aspirations in the definition. Second, he finds that my theory of disability does not allow for a distinction between disability due to illness or injury and disability which has no such (at least not immediate) background. In my answer to Edwards's arguments I claim that his first criticism must be due to a misunderstanding of my intentions. I find his second criticism to be more to the point. It raises important issues in the theory of health which partly concern our interpretation of the notion of illness. Edwards introduces the notion of capacity in order to separate between disability due to illness or injury and disability without such a background. In the last part of my paper I argue that this distinction, however, will not fulfil its purpose. This revised version was published online in August 2006 with corrections to the Cover Date.     

The role of religious resources for older adults coping with illness

The present study investigated the role of religious/spiritual appraisal and coping among a community sample of older adults with illness. In particular this study explored the relationship between these religious resources and nonreligious cognitive appraisals (e.g., threat) and coping behavior in response to illness. These religious resources were related to more adaptive forms of general appraisal and coping. For example, meaning-making related to God (e.g., God's will) was linked to more positive appraisals of the illness and its potential to lead to growth. As well, various forms of religious coping behavior were associated with older adults' use of positive reframing and active forms of general coping. Such findings have implications for counselors and health care providers in their work with older adults adjusting to illness.     

Sense of coherence as a protective factor for psychological distress among gay men: a prospective cohort study

Gay men face a greater risk of psychological distress than heterosexual men, yet research on protective factors among gay men has been limited. This prospective cohort study investigated whether a sense of coherence (SOC), as a form of coping, helps to protect against psychological distress among middle-aged and older gay men. A nationwide online survey was conducted among a baseline sample of 1135 Australian gay-identified men aged 40 years and older, with a follow-up survey 12 months later. SOC was measured using the 13-item SOC Scale. Psychological distress was measured using the K10 Psychological Distress Scale. Hierarchical regressions were conducted, with analyses controlling for several potential risk factors for distress. Over half of participants had moderate or high psychological distress. However, baseline distress was significantly lower among those with stronger baseline SOC. In addition, baseline SOC significantly predicted distress 12 months later. This predictive effect of SOC was independent of baseline distress levels and occurred despite a strong correlation between baseline and follow-up distress. With SOC appearing to be a protective factor, strategies among middle-aged and older gay men that strengthen SOC may assist in the prevention and treatment of anxiety and other psychological distress in this vulnerable population.     

Adversarial Growth in Patients with Multiple Sclerosis and their Partners: Relationships with Illness Perceptions,Disability and Distress

The purpose of this study was to investigate whether patients with multiple sclerosis (MS) and their partners show adversarial growth and to examine which psychological and disability variables contribute to this in patients and their partners. The study also investigated the relationship between growth and distress. Seventy-two patients with MS and their partners provided demographic information and completed measures of posttraumatic growth, illness perceptions, depression, cognitive function and disability. Both patients and partners showed adversarial growth, with patients reporting significantly higher growth than partners. The only significant predictor for patient growth was partner growth, and vice versa. Dissimilarity in illness representations between patients and their partners on the consequences of MS dimension, patient mood and patient growth accounted for significant variance in partner growth. The findings support the idea of a ‘communal search for meaning’ where patients and their partners experience the trauma of having a chronic illness and subsequently find positive aspects together.