Mandated Reporting of Abuse/Maltreatment of Older Adults: A Primer for Counselors

Maltreatment of older adults is a serious and underrecognized problem. Every state and 6 Canadian provinces have enacted legislation to protect vulnerable older adults from abuse, and many require that mental health professionals report disclosures of abuse to authorities. However, these laws have received little attention in the counseling literature. This article examines the scope of maltreatment of older persons and describes the content of elder abuse and elder maltreatment laws, with special focus on counselors' responsibilities to report maltreatment to authorities. It concludes with strategies for assessing maltreatment and with implications of these laws for confidentiality and informed consent.     

Cultural and Religious Variation in Attitudes to Young People Consenting to Health Interventions

There is a limited amount of empirical data available regarding the cultural and religious variation in perceptions about the age when young people should be regarded as competent to make decisions in health settings. A public survey of 400 adults from diverse religious and ethnic backgrounds was conducted in the UK and Spain. Attitudes were assessed using case vignettes. It was found that high religious practice was associated with recommending a higher age of consent for medical interventions. White British adults were more likely than Spanish adults to agree that younger adolescents should be allowed to consent to medical interventions. The study suggests that there is social, cultural and religious variation in adults’ attitudes regarding the age when youngsters should consent to health interventions.

     

Minors' competence to consent to abortion

In the light of legal restrictions in some states, the psychological evidence for whether adolescents are competent to give informed consent to abortion is reviewed. It would be important to know whether competence to decide on pregnancy outcome reflects maturity to be a parent; further, whether degrees of maturity can be traced throughout adolescence. Research shows that parents, not peers, are major sources of advice for minors' abortion decisions. Younger and less competent minors are more likely to consult parents than older, mature minors. There is no evidence that adolescent issues or developmental tasks influence pregnancy decisions. Decision making competence does not differ from that of adults, except as affected by the living situation of the adolescent. Decision performance does differ: minors are more likely to consider their present family's opinion, and not consider future risks, than are adults. The sparse research available on this problem provides no basis for restricting minors' decision making on the ground of competence alone.     

Goodness-of-fit ethic for informed consent to research involving adults with mental retardation and developmental disabilities

This article reviews current theory and research on informed consent policies for adults with mental retardation within a relational ethics framework that re-conceptualizes consent vulnerability in terms of the goodness-of-fit between participant decisional capacities and the specific consent context. Conceptualizing informed consent competence as a product of the relationship between person and consent context shifts assessment of decisional capacity away from an exclusive focus on a research participant's cognitive deficiencies to (a) an examination of those aspects of the consent setting that are creating or exacerbating consent vulnerability and (b) consideration of how the setting can be modified to produce a consent process that best reflects and protects the hopes, values, concerns, and welfare of adults with developmental disabilities.     

Vulnerability of older adults to deception in prison and nonprison contexts

Media reports frequently depict older adults as victims of deception. The public perceives these stories as particularly salient because older adults are seen as fragile victims taken advantage of because of trusting behaviors. This developmental investigation of deception detection examines older and younger adults interacting in 2 contexts, prison and the "free world," to discover whether older adults are vulnerable to deception. Younger prisoners were found to be lie biased. Older adults were better able to discriminate lies than younger adults, and this effect was localized primarily to older female adults. Findings indicate that discriminability strongly increases from younger to older age for women, whereas men do not show an improvement, as age increases, in making decisions about statement veracity.     

Dissociations in perceptual learning revealed by adult age differences in adaptation to time-compressed speech

When presented with several time-compressed sentences, young adults' performance improves with practice. Such adaptation has not been studied in older adults. To study age-related changes in perceptual learning, the authors tested young and older adults' ability to adapt to degraded speech. First, the authors showed that older adults, when equated for starting accuracy with young adults, adapted at a rate and magnitude comparable to young adults. However, unlike young adults, older adults failed to transfer this learning to a different speech rate and did not show additional benefit when practice exceeded 20 sentences. Listeners did not adapt to speech degraded by noise, indicating that adaptation to time-compressed speech was not attributable to task familiarity. Finally, both young and older adults adapted to spectrally shifted noise-vocoded speech. The authors conclude that initial perceptual learning is comparable in young and older adults but maintenance and transfer of this learning decline with age.     

Age-related deficits in face recognition are related to underlying changes in scanning behavior

Previous studies demonstrating age-related impairments in recognition memory for faces are suggestive of underlying differences in face processing. To study these differences, we monitored eye movements while younger and older adults viewed younger and older faces. Compared to the younger group, older adults showed increased sampling of facial features, and more transitions. However, their scanning behavior was most similar to the younger group when looking at older faces. Moreover, while older adults exhibited worse recognition memory than younger adults overall, their memory was more accurate for older faces. These findings suggest that age-related differences in recognition memory for faces may be related to changes in scanning behavior, and that older adults may use social group status as a compensatory processing strategy.     

Susceptibility to retroactive interference: The effect of context as a function of age and cognition

Previous studies have shown that contextual cues improve memory performance and reduce interference in younger adults. However, it is not clear whether middle-aged and older adults can also benefit from contextual cues, or if this ability diminishes with ageing and cognitive decline. In order to test this question, we tested 69 middle-aged adults (aged 30–50 years) and 65 older adults (aged 65–85). Participants completed a retroactive interference paradigm with or without contextual cues. Cognitive functioning of older adults was assessed using the Montreal Cognitive Assessment, which is a sensitive and highly validated tool to detect cognitive decline in older age. The results showed that while middle-aged adults were able to benefit from context to improve recognition and reduce interference, older adults were not able to benefit from it. However, when we compared older adults with lower (<26) and higher (≥26) scores on the Montreal Cognitive Assessment, we found that older adults with high cognitive functioning could benefit from context advantage at retrieval to improve recognition compared to those with lower cognitive functioning. Yet, similar to older adults with lower cognitive functioning, they could not benefit from context advantage at encoding and hence were still susceptible to interference.     

Source monitoring and suggestibility to misinformation: adult age‐related differences

We compared young and older adults' source monitoring performance on an explicit source identification test using the misinformation paradigm. Several age‐related differences in source memory were demonstrated: (a) older adults were more likely than were young adults to say that they saw information that was actually only suggested to them; (b) older adults were more confident in their false memories than were young adults; (c) older adults were less confident in their accurate memory for the source of information than were young adults. Together, the data suggest that older adults either lacked or failed to use helpful diagnostic source information (e.g. perceptual details or temporal information), and that their confidence in their false memories reflected an over‐weighting of semantic information. Copyright © 2002 John Wiley & Sons, Ltd.     

Age-Related Deficits in Face Recognition are Related to Underlying Changes in Scanning Behavior

ABSTRACT

Previous studies demonstrating age-related impairments in recognition memory for faces are suggestive of underlying differences in face processing. To study these differences, we monitored eye movements while younger and older adults viewed younger and older faces. Compared to the younger group, older adults showed increased sampling of facial features, and more transitions. However, their scanning behavior was most similar to the younger group when looking at older faces. Moreover, while older adults exhibited worse recognition memory than younger adults overall, their memory was more accurate for older faces. These findings suggest that age-related differences in recognition memory for faces may be related to changes in scanning behavior, and that older adults may use social group status as a compensatory processing strategy.     

Age similarities in matching pro- and contra-hedonic emotional strategies to everyday scenarios

ABSTRACT

Older adults are motivated to maximize positive affect in the present. Young adults will purposely feel negative and high arousal emotions in order to achieve a goal. However, this type of contra-hedonic emotional alignment has not been extensively studied with older adults. We expected older adults are less likely than young adults to select high arousal and negative emotions within specific scenarios where those states could be useful. In two studies, participants selected the emotion they preferred in hypothetical problems that varied on the arousal and valence best suited for goal achievement. Young and older adults were equally likely to endorse affective strategies that matched both pro and contra-hedonic scenarios. While older adults may be generally motivated to avoid negative and high-arousing emotions, they are just as likely as young adults to indicate that these states could be helpful in certain situations.     

Listening to discourse in distracting settings: the effects of aging

Younger and older adults listened to discourse in quiet and in conversational noise, before answering questions concerning the material. Some questions required listeners to recall specific details; others were of a more integrative nature. When the listening situation was adjusted for individual differences in hearing, younger and older adults were equally adept at remembering the gist of the passages in both quiet and in two levels of noise. The two age groups also did not differ with respect to memory for specific details when listening in quiet or in a moderate level of noise, even when required to perform a concurrent task. Only at the loudest noise level did younger adults tend to recall more detail than older adults. However, when no adjustments were made to compensate for the poorer hearing of older adults (all participants tested under identical listening conditions), older adults could not recall as much detail as younger adults, either in quiet or in noise. The results indicate that the speech-comprehension difficulties of older adults primarily reflect declines in hearing rather than in cognitive ability.     

Testing the limits of cognitive plasticity in older adults: application to attentional control

Laboratory based training studies suggest that older adults can benefit from training in tasks that tap control aspects of attention. This was further explored in the present study in which older and younger adults completed an adaptive and individualized dual-task training program. The testing-the-limits approach was used [Lindenberger, U., & Baltes, P. B. (1995). Testing-the-limits and experimental simulation: Two methods to explicate the role of learning in development. Human Development, 38, 349-360.] in order to gain insight into how attentional control can be improved in older adults. Results indicated substantial improvement in overlapping task performance in both younger and older participants suggesting the availability of cognitive plasticity in both age groups. Improvement was equivalent among age groups in response speed and performance variability but larger in response accuracy for older adults. The results suggest that time-sharing skills can be substantially improved in older adults.     

Stronger evidence for own-age effects in memory for older as compared to younger adults

Three studies examined whether younger and older adults better recall information associated with their own than information related to another age group. All studies compared young and older adults with respect to incidental memory for previously presented stimuli (Studies 1 and 2: everyday objects; Study 3: vacation advertisements) that had been randomly paired with an age-related cue (e.g., photo of a young or an old person; the word "young" or "old"). All three studies found the expected interaction of participants' age and age-associated information. Studies 1 and 2 showed that the memory bias for information arbitrarily associated with one's own as compared to another age group was significant for older adults only. However, when age-relevance was introduced in a context of equal importance to younger and older adults (information about vacations paired either with pictures of young or older adults), the memory bias for one's own age group was clearly present for both younger and older adults (Study 3).     

The moderating role of executive functioning in older adults' responses to a reminder of mortality

In previous research, older adults responded to mortality salience (MS) with increased tolerance, whereas younger persons responded with increased punitiveness. One possible explanation for this is that many older adults adapt to challenges of later life, such as the prospect of mortality, by becoming more flexible. Recent studies suggest that positively oriented adaptation is more likely for older adults with high levels of executive functioning. Thus, we hypothesized that the better an older adult's executive functioning, the more likely MS would result in increased tolerance. Older and younger adults were randomly assigned to MS or control conditions, and then evaluated moral transgressors. As in previous research, younger adults were more punitive after reminders of mortality; executive functioning did not affect their responses. Among older adults, high functioning individuals responded to MS with increased tolerance rather than intolerance, whereas those low in functioning became more punitive.     

Stronger evidence for own-age effects in memory for older as compared to younger adults

Three studies examined whether younger and older adults better recall information associated with their own than information related to another age group. All studies compared young and older adults with respect to incidental memory for previously presented stimuli (Studies 1 and 2: everyday objects; Study 3: vacation advertisements) that had been randomly paired with an age-related cue (e.g., photo of a young or an old person; the word “young” or “old”). All three studies found the expected interaction of participants’ age and age-associated information. Studies 1 and 2 showed that the memory bias for information arbitrarily associated with one's own as compared to another age group was significant for older adults only. However, when age-relevance was introduced in a context of equal importance to younger and older adults (information about vacations paired either with pictures of young or older adults), the memory bias for one's own age group was clearly present for both younger and older adults (Study 3).     

Age differences in suggestibility to contradictions of demonstrated knowledge: the influence of prior knowledge

People maintain intact general knowledge into very old age and use it to support remembering. Interestingly, when older and younger adults encounter errors that contradict general knowledge, older adults suffer fewer memorial consequences: Older adults use fewer recently-encountered errors as answers for later knowledge questions. Why do older adults show this reduced suggestibility, and what role does their intact knowledge play? In three experiments, I examined suggestibility following exposure to errors in fictional stories that contradict general knowledge. Older adults consistently demonstrated more prior knowledge than younger adults but also gained access to even more across time. Additionally, they did not show a reduction in new learning from the stories, indicating lesser involvement of episodic memory failures. Critically, when knowledge was stably accessible, older adults relied more heavily on that knowledge compared to younger adults, resulting in reduced suggestibility. Implications for the broader role of knowledge in aging are discussed.     

Patterns of On-line Resource Allocation to Narrative Text by Younger and Older Readers

Younger and older adults read narrative texts word by word for immediate recall. There were no age differences in recall performance, showing that older adults were effective in narrative memory. Analysis of reading times demonstrated the existence of interindividual variability in sensitivity to text demands, which was predictive of subsequent memory performance. Contrary to the view that older readers do not encode text analytically, for these naturalistic narratives both younger and older adults optimized memory through the allocation of processing resources to the construction of a proposition-based representation of content. Overall, attentiveness to narrative structure also facilitated narrative memory, but this relationship was more reliable among older readers.     

Age-related differences in medial prefrontal activation in response to emotional images

Research has suggested that aging results in a "positivity effect," with young adults dwelling on negative information, and older adults attending to positive information. In order to understand age-related changes in emotional processing underlying this effect, the present fMRI study compared neural activity in young and older adults as they viewed positive, negative, and neutral images. Results indicated a striking age-related reversal in the valence of information eliciting activity within the ventromedial prefrontal cortex (VMPFC). Negative in comparison with positive images activated the VMPFC more for young adults, whereas positive in comparison with negative images activated the VMPFC more for the older adults. The VMPFC is a region associated with the processing of emotional information, and more specifically, with emotion generation and emotion regulation. Therefore, the present results suggest that age-related changes in these processes implemented by the VMPFC contribute to older adults' "positivity effect."