Spirituality in Older Adults: A Cross-Cultural and Interfaith Perspective

The definition of spirituality poses a variety of problems for the development of theory and research, as well as practical problems for persons interested in promoting the spiritual well-being of older adults. Although any definition of spirituality is problematic, a definition is proposed that comes out of the writer's clinical experience and is relevant to his understanding of the aging process in different cultural and religious contexts. Two case studies are presented to illustrate the relevance of the definition to the experience of older persons from different cultural and religious backgrounds. Reflections on the case studies suggest ways that an appropriately trained advocate might have helped the persons in these illustrations make changes in their situations that might have improved the quality of their lives. Material from the case studies is also used to clarify differences among terms such as spirituality, religion, religiosity, and piety. The paper proposes to be a contribution to a theoretical foundation for studying and working with spirituality in older adults.     

Psychosocial Correlates and Outcomes of Yoga or Walking Among Older Adults

Few researchers have compared psychological correlates and outcomes of yoga with more traditional forms of exercise. The authors' primary aim was to compare changes in the psychosocial outcomes of mood and state anxiety produced by an acute bout of yoga or walking among older adults. The secondary aim was to compare selected psychosocial correlates of activity. Participants were 51 adults who were 50 years of age or older who walked for exercise or participated in a yoga class. Results revealed that yoga participants had significantly greater levels of depression and perceived barriers to exercise, and lower quality of life than did walkers. With control for these differences, yoga practitioners had improved levels of fatigue pre- to postsession, compared with walkers. With control for differences in demographic variables, these changes were no longer significant. It is possible that yoga practitioners seek out mindful-based exercise to cope with greater levels of depression and lower levels of quality of life.     

老年人社会适应性与主观幸福感的结构关系

该研究通过编制适应老年人的社会适应性与主观幸福感问卷,探讨了老年人社会适应性与主观幸福感的结构关系。结果表明,问卷具有良好的结构效度和内部一致性信度,人际交往适应性和角色转换适应性对主观幸福感各维度具有显著的预测价值,生活自理适应性对积极情感具有显著预测作用,但预测力不如人际交往适应性和角色转换适应性,而社会整体变化适应性对主观幸福感不存在预测的价值。地区差异对老年人社会适应性和主观幸福感结构预测关系存在显著的调节效应。     

Personality Dysfunction, Coping Styles, and Clinical Symptoms in Younger and Older Adults

This study examined age-related differences in personality disorders, dispositional coping strategies, and clinical symptoms between younger (n = 79; age range = 18–29; M age = 21.2 years) and older (n = 79; age range = 55–89; M age = 65.5 years) persons (matched on gender and ethnicity). Participants completed the Coolidge Axis II Inventory (CATI), Coping Orientations to Problems Experienced Scale (COPE), and Brief Symptom Inventory (BSI). Personality results (t tests) based on the CATI revealed that older persons were significantly more obsessive–compulsive and schizoid than younger adults but significantly lower on 7 scales, including antisocial, borderline, histrionic, and sadistic. As assessed by the COPE, older adults reported lower levels of dysfunctional coping strategies than younger adults. Specifically, older persons were less likely to use mental disengagement, venting of emotions, and alcohol/drugs to cope with problems. BSI results for clinical symptoms revealed that younger adults were significantly higher on 5 of 9 scales, including anxiety, depression, and hostility. Results suggest that younger adults experience higher levels of personality and clinical symptoms and use more dysfunctional coping strategies than older adults, dispelling the myth that old age is associated with inevitable psychological impairment. Theoretical considerations, clinical implications, and future research ideas are discussed.     

Relationships with Parents, Spousal Reciprocity, and Psychological Distress in Middle-Age Adults

Data from 301 middle-age couples were employed to investigate links between their recalled parents’ parenting styles and perceptions of reciprocity with their parents, as well as their current perceptions of spousal reciprocity, on their psychological distress. The research extends Baumrind’s theory of childhood parenting styles and Youniss’ theory of late adolescents’ perceived reciprocity to a developmental model for middle-age psychological distress. Differential effects were found according to the gender of both the offspring and the parent. There were significant positive findings only if the opposite-sex parent was perceived as authoritative, and significant negative findings if the same-sex parent was perceived as authoritarian. Regression models indicated mediated, integrated relationships (through maternal and spousal reciprocity) for females, but no mediations were found for males. Significantly more variance in emotional distress was explained by spousal reciprocity than by the parent related variables, and for the men than for the women.     

Alexithymia and Cardiovascular Risk in Older Adults: Psychosocial,Psychophysiological, and Biomedical Correlates

Psychosocial correlates of alexithymia were examined in 102 healthy, older adults (ages 53-83; 76% male). Alexithymic ( n = 26) and non-alexithymic ( n = 30) groups, defined by top ( S 70) and bottom ( h 54) quartiles of the distribution of Toronto Alexithymia Scale (26-item) scores, were compared with respect to psychosocial, psychophysiological, and biomedical risk factors for cardiovascular disease. Both categorical ratings and continuous scores of alexithymia were associated with significantly greater levels of trait anxiety, anger-in, neuroticism, hostility, perceived stress, depression, and lower levels of social support. Compared to non-alexithymics, alexithymics displayed significantly greater blood pressure responses to anger provocation and tended to have a greater percent body fat. The groups did not differ in resting cardiovascular parameters, heart rate reactivity, fasting glucose and lipoprotein lipids, body mass index, waist-to-hip ratio, social desirability, or trait anger. These findings suggest several psychosocial and psychophysiological pathways by which alexithymia may confer risk for cardiovascular disease among older adults.     

The Role of Spirituality in Advance Directive Decision Making Among Independent Community Dwelling Older Adults

The purpose of this grounded theory study, based on Strauss and Corbin’s (1998) grounded theory methodology, was to investigate the meaning, definition, and needs regarding the role of spirituality in end of life care among independent community dwelling older adults in relation to advance directive decision making (ADDM). Findings revealed that through the use of story telling, independent community dwelling older adults were able to define spirituality and describe the important role spirituality plays in everyday life and in ADDM. A theoretical model was constructed consisting of a mirrored basic social process, Spirituality as Connecting.     

Spirituality and Healthy Lifestyle Behaviors: Stress Counter-balancing Effects on the Well-being of Older Adults

The goal of this study was to examine stress-ameliorating effects of religiosity, spirituality, and healthy lifestyle behaviors on the stressful relationship of chronic illness and the subjective physical well-being of 221 older adults. We also investigated whether the intervening variables functioned as coping behaviors and orientations or as adaptations in late life. Guided by the stress paradigm, path analysis was used to assess these relationships in a stress suppressor model and a distress deterrent model. No suppressor effects were found; however a number of distress deterrent relationships were detected. Spirituality, physical activities, and healthy diet all contributed to higher subjective physical well-being, as counter-balancing effects, in the distress deterrent model. The findings have implications for future research on the role of spirituality, religiosity and lifestyle behaviors on the well-being of chronically ill older adults. Findings also support the need for studying different dimensions of religiosity and spirituality in an effort to understand coping versus adaptation in behaviors and orientations. Gracie H. Boswell, Ph.D., M.Ed. (Case Western Reserve University) and (M. Ed.- Kent State University). She is a Carolina Program in Health and Aging Research Scientist at the Institute on Aging- University of North Carolina at Chapel Hill. Her research interests have been social gerontology and quality of life, emphasizing religiosity/spirituality. Eva Kahana, Ph.D. (University of Chicago) is Pierce T. and Elizabeth D. Robson Professor of Humanities and Director of the Elderly Care Research Center- Case Western Reserve University. Her research concentration has been the sociology of aging (coping & stress and institutionalization). Peggye Dilworth-Anderson, Ph.D. (Northwestern University) is Director- Center for Aging and Diversity, Institute on Aging, Professor- School of Public Health, Department of Health Policy and Administration at University of North Carolina at Chapel Hill. Her research interests have been caregiving and minority health disparities.     

Health,Finances, Religious Involvement,and Life Satisfaction of Older Adults

ABSTRACT

This study examines the patterns and relationships between twelve independent variables and the expressed subjective well-being of older adults within that classic community setting of the Lynds' “Middletown.” The twelve variables include measures of church attendance, religious activity, religious conservatism/liberalism, subjective health status, social participation, importance of leisure, participation in physical activity, age, sex, marital status, and level of education.     

Introduction: Special Issue on Spirituality and Adult Development, Part III

This paper reviews the purpose of the three-part Special Issue on Spirituality and Adult Development, described in the Introduction to Special Issue Parts I and II (J. D. Sinnott, 2001, in press). It also outlines the contents of Part III. Developing adults express their belief that spirituality plays a key role in their development, and humanistic psychology supports this view, yet developmental psychologists have given comparatively little attention to this factor. Also the concept of spirituality seldom has been considered separately from that of religion. The purpose of this Special Issue is to begin to remedy this neglect and to begin to examine the meanings spirituality has for the developing adult. How might spirituality be adaptive? How might it relate to our connections with others and our society? This introduction is a summary of the five empirical and theoretical papers that form Part III of the Special Issue on Spirituality and Adult Development.     

Psychosocial Treatments for Major Depression and Dysthymia in Older Adults: A Review of the Research Literature

Older adults represent a growing segment of the population with the highest suicide rate and an increasing need of counseling services for major depression and dysthymia. The present study examined the literature with the purpose of identifying research addressing psychosocial treatments of depression in later life. A summary of treatments currently supported by research as being efficacious when treating older individuals experiencing depression or dysthymia is presented. Limitations of the findings are discussed.     

Nursing Home Adaptation in Visually Impaired Older Adults Using a Narrative Approach1,2

This study used a narrative approach to examine the difficulties that older visually impaired people experience when adapting to life in a nursing home. The interview data were collected from one blind aged person (n = 1), focusing on the adaptation process from moving into the nursing home to the present and maintaining context of narrative that included the life history. Subcategories were extracted based on a framework of temporal coherence, causal coherence, thematic coherence, and situational coherence. This study revealed three factors related to adaptation to life in a nursing home for a visually impaired person, including psychological adaptation: becoming accustomed to life in the facility after changes in the living environment, having gratitude and maintaining “moderating human relationships,” and participating in activities connected to one's purpose in life. He was able to psychologically adapt and came to accept his death through an awareness of aging.     

Spirituality and Health Outcomes in the Elderly

The purpose of this mail survey was to examine the relationship of attitudinal and behavioral measures of spirituality to physical and mental health outcomes in a sample of elderly community residents. Frequency of prayer, importance of faith, and reliance on religion for their coping were compared for their association with eight categories of physical and mental health. All three measures, prayer, faith and religious coping, correlated strongly with positive mental health, but not with the other seven physical health categories. Multiple regression analyses indicated importance of one's faith had the strongest association with positive mental health, even after controlling for the effect of other significant variables, age and education. The behavioral measure of prayer was a component of importance of faith to mental health, with no independent impact. This study highlights attitudes rather than practices, as the stronger spiritual variables related to mental health in the elderly.     

Ego Development and Psychosocial Functioning in Young Adults With and Without Psychiatric History

Ego development has been associated with positive outcomes, namely, with a better psychosocial adjustment and establishment of satisfactory relationships. However, ego development and psychosocial functioning are independent domains and a developed ego does not guarantee successful adaptation. Moreover, it is not clear whether ego development differentially influences psychosocial functioning in clinical and normative samples. The present study investigated the impact of ego development on the psychosocial functioning of young adults with (high-risk) and without (normative) psychiatric history. Results show an association between those two variables, especially strong for the high-risk group. High-risk individuals with successful psychosocial functioning exhibited levels of ego development more similar to those of normative young adults than to those of the remaining high-risk individuals. Moreover, as predicted, ego development mediated the relationship between psychiatric history and psychosocial functioning. Further support was found for the protective role of ego development, especially for individuals with psychiatric history.     

Decreasing Neuroleptic Doses in Older Adults with Schizophrenia

This prospective study of 27 older adults, residing in long-term care facilities, examined the effects of reducing neuroleptic medications to the point of controlling symptoms and reducing side effects. Schizophrenia is a challenging health care condition that leads to delusions, hallucinations, disorganized speech, and a host of other symptoms. Unfortunately, medications control many of the symptoms but cause unwanted side effects unless monitored closely and regulated to each person's needs. This study addresses six research questions related to the reduction of neuroleptic medications. Study findings related to neuroleptic medication dose reduction were encouraging. Additionally, the findings strongly suggest that health care providers working with older adults with the diagnosis of schizophrenia would benefit from planned educational programs about behavior, observations, and medications.     

Predicting Treatment Response in Older Adults with Insomnia

This study examined potential predictors of treatment outcome in late-life insomnia. Fifty-four older adults with chronic insomnia were treated with cognitive–behavior therapy (CBT), pharmacotherapy (PCT), or combined CBT plus PCT. Pretreatment characteristics such as demographic, clinical, psychometric, and sleep variables were examined as correlates or potential predictors of treatment response. Treatment response was defined by posttreatment sleep efficiency as measured subjectively by daily sleep diary and objectively by polysomnography. The results indicate that age, insomnia duration, medical illness, and previous use of sleep medications can moderate subjective or objective treatment outcome or both of these in late-life insomnia. However, there are no reliable predictors of outcome across all treatment and assessment modalities. The implications of these findings for the treatment of insomnia in older adults seen in primary care settings are discussed.     

Unconscious Semantic Priming Influences Performance of Visuomotor Tasks Differently but the Effects are Similar in Young and Older Adults

We examined the effects of semantic priming of attention on two sequentially presented visuomotor tasks, traffic judgments and saccadic adaptation. Priming was accomplished with the scrambled sentence task: participants formed meaningful sentences from a list of words where a word denoting wide attention focus was involved. The results showed that semantic priming influenced positively saccade adaptation (its’ benefit increased) while it attenuated visuomotor performance in the traffic task (RT of hand movements increased). We found the effects of priming on both tasks’ performance to be comparable in young and older participants. It was suggested that semantic priming effect on visuomotor tasks depended on the cognitive resources which were needful as for the priming as for the primed task.     

Spiritual,Religious, Nonspiritual,and Nonreligious Narratives in Marginalized Older Adults: A Typology of Coping Styles

SUMMARY

Narrative therapy is an important tool in the phenomenological framing of life events with older clients. Seventy-nine older adults who lived independently in four subsidized high-rise housing facilities in Chicago were interviewed in a research project about managing life challenges. Cases represent four types in a spiritual-religious typology: religious and spiritual, religious only, spiritual only, and neither religious nor spiritual (Zinnbauer, 1997). This article explores how older adults managed adversity and maintained a sense of self-efficacy. Findings indicate that older adults use many references to religion and spirituality in their narratives, either embracing these domains or defining themselves in contrast to them. Narrative therapy suggests that the implications of religious and spiritual resources addressed in client stories may reinforce coping capacity and promote aging well.