Human behavioral momentum in a sample of older adults.

Behavioral momentum, the persistence of behavior under altered environmental contingencies, is derived from Newtonian physics and operant psychology. It has relevance to behavior analysis in terms of shaping strong behaviors and ensuring effective relapse prevention strategies in behavior modification and therapy. The authors investigated whether changing the operant schedule contingencies affects the responses of older humans to different stimuli when reinforcement density is systematically manipulated. Fifteen older adults participated in a computer study in which each of 2 keys in a baseline condition was associated with the same schedule of reinforcement and multiple variable intervals; the only difference was that 1 reinforcer was 10 times larger than the other. After 6 sessions, the authors changed the contingency schedule to either an extinction condition, a variable-time schedule, or a different variable-interval schedule, to assess how participants' responses persisted when reinforcement contingencies were systematically changed. The results were consistent with the predictions of behavioral momentum. The participants not only biased their responses in favor of the more densely reinforcing key, but when contingencies changed, they showed significantly biased responses. Results supported the conclusion that healthy older adults allocate their behaviors in a manner very sensitive to training stimuli conditions; consistent with the basic principles of behavioral momentum, they show a degree of resistance to change in their behaviors when the behavioral contingencies are altered.     

Objective risk, subjective risk, and colorectal cancer screening among a clinic sample

Among cancers, colorectal (CRC) is the third most incident and the second most lethal. Although screening for the disease has been shown to be effective in reducing morbidity and mortality, screening rates remain low. Risk of disease has been shown to increase screening uptake, but different types of risk may influence intent to screen, screening in a timely manner, or participating in screening at all. A cross-sectional design was used to select a diverse sample of CRC asymptomatic patients 50 or more years of age (N=104) visiting one of three Midwestern medical clinics. Results showed a positive relationship between receipt of CRC screening and planning to screen for CRC in the future. Objective risk factors (personal/family history and having a primary care physician) were associated with CRC screening uptake and screening within the time intervals recommended by professional screening guidelines, but subjective risk did not obtain significance for screening participation. Both objective (primary care physician) and subjective risk (long-term comparative risk, knowledge) were associated with future plans to screen. Findings suggest that CRC screening behaviors may be differentially influenced by type of risk.     

Change in cognitive functioning associated with apoE genotype in a community sample of older adults

The influence of a genetic risk factor, apolipoprotein E (apoE) epsilon4 variant, was assessed in older adults aged 70 to 94 on 3 occasions over 7 years. The results of latent growth curve analyses are reported for individuals genotyped for apoE at the 2nd measurement occasion (n = 601) and for a subsample of individuals without probable or definite dementia during the 1st or 2nd occasion (n = 434). ApoE-epsilon4 status was a significant predictor of level and change in memory performance and change in speed performance in the full sample, and of initial level and change in memory performance in the nondemented subsample. These results support previous findings that apoE-epsilon4 is associated with accelerated memory deterioration in individuals without clinical dementia.     

A pilot evaluation of the efficacy of a couple-tailored print intervention on colorectal cancer screening practices among non-adherent couples

The objective of this study was to evaluate the efficacy of a couple-tailored print (CTP) intervention on colorectal cancer screening (CRCS), CRCS intentions, and on knowledge and attitudes among couples in which neither partner is on schedule with regard to CRCS. A total of 168 married couples with both members non-adherent with CRCS were randomly assigned to receive either a CTP pamphlet accompanied by a generic print (GP) pamphlet or a GP pamphlet only. Couples completed measures of CRCS, intentions, relational perspective on CRCS, discussions about CRCS, spouse support for CRCS, spouse influence strategies, CRC knowledge, perceived CRC risk, and CRCS benefits and barriers. Results indicated there was no significant benefit of CTP vs. GP on CRCS, but there was a significant increase in CRCS intentions in CTP compared with GP. There was also a significant increase in relationship perspective on CRCS, a significant increase in husbands’ support of their wives’ CRCS, and a significant increase in CRCS benefits in CTP. In summary, CTP did not increase CRCS practices but increased intentions and perceived benefits of CRCS as well as improving couples’ ability to view CRCS as having benefit for the marital relationship.     

The association between change in cognitive ability and cause-specific mortality in a community sample of older adults

While there is consistent evidence that initial levels of cognitive ability predict mortality, there is mixed evidence for a relationship between changes in cognition and mortality. There have been few studies that have examined whether the level and slope of cognitive performance is predictive of subsequent mortality from all causes or from cardiovascular disease, stroke, heart disease, respiratory disease, or cancer. This study aimed to assess whether the level and slope of cognitive ability were associated with all-cause or cause-specific mortality. A cohort of 896 community-based elderly people in Australia was interviewed four times over 12 years, with vital status followed for up to 17 years. Of these, 592 participants completed two or more interviews and were included in survival models of six mortality outcomes. Cognitive change in five domains of ability was estimated using latent growth models. Poorer initial processing speed or verbal fluency was significantly associated with greater all-cause and/or cardiovascular mortality. In addition, declines in global ability were associated with greater all-cause, cardiovascular, and heart disease mortality. Vocabulary and episodic memory were not associated with mortality, and none of the cognitive tests significantly predicted respiratory or cancer mortality. Initial levels of cognitive ability tended to be better predictors of subsequent mortality than were changes in ability. The results suggest that vascular events may be largely responsible for the overall relationship between cognition and mortality.     

The impact of the nature of relationships on perceived burdensomeness and suicide ideation in a community sample of older adults

Older adults die by suicide at very high rates, and previous research indicates that perceived burdensomeness may contribute to deaths by suicide. In this study, the impact of the nature of relationships on perceived burdensomeness and suicide ideation was examined. Results indicated that older adults' perceptions of burden on younger generations were associated with greater overall perceived burdensomeness and suicide ideation when compared to the older adults' own or older generations. Thus, clinicians should examine general perceived burdensomeness as well as the types of relationships the older adult perceives himself or herself to be a burden on.     

Social support as a moderator of the relationship between religious participation and psychological distress in a sample of community dwelling older adults

This study investigated relationships among religious participation, social support, and psychological distress within a sample of older adults while controlling for the influence of significant demographic variables. Community-dwelling older adults between the ages of 65 and 90 (n?=?115) completed a packet of instruments including the Negative Affect Scale of the PANAS, the Social Provisions Scale (SPS) and a tailored survey that included questions regarding religious participation and demographic variables. Correlational and multiple regression analyses were performed to determine predictors of negative affect. Results indicated that religious participation continued to predict negative affect with the effect of demographic variables statistically controlled for. Subjective social support was also found to moderate the relationship between religious participation and psychological distress. Religious participation appears to be more important regarding alleviating distress for those elderly low in social support compared with those high in social support. Religious participation may thus occupy an important position with regards to factors that manage psychological distress among elderly individuals, particularly for those low in social support.     

Psychological adjustment among African American breast cancer patients: one-year follow-up results of a randomized psychoeducational group intervention.

The effectiveness of support group interventions for cancer patients has been established among White patients but has been virtually unstudied among minority patients. The current study represents the 1st randomized support group intervention targeted to African American women with breast cancer. Participants (N = 73) with nonmetastatic breast cancer were randomly assigned to an 8-week group intervention or an assessment-only control condition At 12 months, the intervention resulted in improved mood as well as improved general and cancer-specific psychological functioning among women with greater baseline distress or lower income. Subsequent research is needed to address effective methods of enrolling and following women with fewer psychosocial and financial resources, as they were the most likely to benefit from this particular intervention.     

Space Fortress game training and executive control in older adults: a pilot intervention

We investigated the feasibility of using the Space Fortress (SF) game, a complex video game originally developed to study complex skill acquisition in young adults, to improve executive control processes in cognitively healthy older adults. The study protocol consisted of 36 one-hour game play sessions over 3 months with cognitive evaluations before and after, and a follow-up evaluation at 6 months. Sixty participants were randomized to one of three conditions: Emphasis Change (EC)--elders were instructed to concentrate on playing the entire game but place particular emphasis on a specific aspect of game play in each particular game; Active Control (AC)--game play with standard instructions; Passive Control (PC)--evaluation sessions without game play. Primary outcome measures were obtained from five tasks, presumably tapping executive control processes. A total of 54 older adults completed the study protocol. One measure of executive control, WAIS-III letter-number sequencing, showed improvement in performance from pre- to post-evaluations in the EC condition, but not in the other two conditions. These initial findings are modest but encouraging. Future SF interventions need to carefully consider increasing the duration and or the intensity of the intervention by providing at-home game training, reducing the motor demands of the game, and selecting appropriate outcome measures.     

Loneliness and mental health in a representative sample of community-dwelling Spanish older adults

Research seems to support loneliness as a risk factor for mental health problems in the elderly. Most studies analyzing the effects of loneliness on older adults' mental health have relied on convenience samples. In this study, the prevalence and predictors of feelings of loneliness were studied in a representative sample of 272 community-dwelling Spanish older adults. The potential of feelings of loneliness to significantly contribute to the explanation of mental health of the elderly was also explored. The percentage of people reporting feelings of loneliness was 23.1%. Being a woman, being older, living alone, having fewer economic resources, having lower perceived health, and being dissatisfied with the frequency of contact with relatives and friends were found to be significant predictors of feelings of loneliness. Loneliness contributed significantly to the explanation of mental health, even when other significant variables were statistically controlled. The results of this study suggest that loneliness is a relevant factor for the analysis and understanding of mental health in the elderly.     

Increasing the prevalence of successful children: The case for community intervention research

This paper makes a case for research on community interventions on child rearing. Sufficient evidence has accumulated about the development of children's problem behavior to justify evaluating efforts to reduce the prevalence of these problems in whole communities. The contextual risk factors for diverse child behavior problems are well understood, and interventions to ameliorate individual risk factors have been developed and evaluated. Because interventions with individual children have proven to be efficacious, it is now appropriate to direct energy toward reducing the prevalence of children with behavior problems. At the same time, existing interventions have limitations. Community interventions may be needed to modify the larger social context for families. This paper enumerates possible components of a community intervention to improve child-rearing outcomes. Existing evidence indicates that communities would benefit from making parent training and family support programs available to parents. Validated methods of identifying and remediating academic and behavioral problems in schools are available, but influencing schools to adopt them remains a problem. Community organizing could mobilize communities to allocate the resources necessary to support such parenting and schooling programs as well as encourage their adoption. Media campaigns could foster community support and directly influence parenting practices. Efforts to modify peer influences to use illicit substances have received empirical support; similar efforts may be relevant to preventing other problems. The development of a science of community interventions on child rearing is hampered by overreliance on randomized control trials. For this reason, two examples of time-series experimental evaluations of community intervention components are described here.     

Predictors of self-reported prospective and retrospective memory in a population-based sample of older adults

In this article, the authors examined predictors of self-reported everyday memory failures using the Prospective and Retrospective Questionnaire (PRMQ; Smith, Della Sala, Logie, & Maylor, 2000) in a population-based sample of older adults (age range = 60-90 years; N = 250). The results showed that a higher frequency of reported failures was associated with lower scores on the personality dimension of self-directedness as assessed by the Temperament and Character Inventory (TCI; Cloninger, Dragan, Svrakic, & Przybeck, 1993) and more depressive symptoms on the Center for Epidemiological Studies Depression Scale (CES-D; Radloff, 1977). However, PRMQ scores showed no relationships with objective memory ability, as reflected by a series of retrospective memory measures and a measure of prospective memory. Neither were the PRMQ scales associated with general cognitive functioning as assessed by the Mini-Mental State Examination (MMSE; Folstein, Folstein, & McHugh, 1977). Taken together, the results indicate that within the older population, self-reported memory as assessed by the PRMQ may reflect mood-state and personality factors rather than individual differences in memory and cognitive ability.     

Psychometric properties of reverse-scored items on the CES-D in a sample of ethnically diverse older adults

Reverse-scored items on assessment scales increase cognitive processing demands and may therefore lead to measurement problems for older adult respondents. In this study, the objective was to examine possible psychometric inadequacies of reverse-scored items on the Center for Epidemiologic Studies Depression Scale (CES-D) when used to assess ethnically diverse older adults. Using baseline data from a gerontologic clinical trial (n = 460), we tested the hypotheses that the reversed items on the CES-D (a) are less reliable than nonreversed items, (b) disproportionately lead to intraindividually atypical responses that are psychometrically problematic, and (c) evidence improved measurement properties when an imputation procedure based on the scale mean is used to replace atypical responses. In general, the results supported the hypotheses. Relative to nonreversed CES-D items, the 4 reversed items were less internally consistent, were associated with lower item-scale correlations, and were more often answered atypically at an intraindividual level. Further, the atypical responses were negatively correlated with responses to psychometrically sound nonreversed items that had similar content. The use of imputation to replace atypical responses enhanced the predictive validity of the set of reverse-scored items. Among older adult respondents, reverse-scored items are associated with measurement difficulties. It is recommended that appropriate correction procedures such as item readministration or statistical imputation be applied to reduce the difficulties.     

Self-reported attachment, interpersonal aggression, and personality disorder in a prospective community sample of adolescents and adults

Anxious and avoidant attachment were assessed in the Children in the Community (CIC) Study during adolescence and adulthood using self-report scales developed for this prospective study. The convergent and discriminant validity of the new CIC attachment scales were evaluated and their stability was assessed across a 17-year interval. Attachment scales predicted DSM-IV personality disorders in theoretically coherent and clinically meaningful ways, especially when supplemented with a separate measure of interpersonal aggression. Cluster B and C personality disorder symptoms were associated with elevated anxious attachment. Avoidant attachment was positively associated with Cluster A symptoms and inversely associated with Cluster B and C symptoms. Interpersonal aggression was higher in Cluster B symptoms and lower in Cluster C symptoms, thus differentiating between these symptom clusters.     

Exploring the experience of episodic past,future, and counterfactual thinking in younger and older adults: A study of a Colombian sample

Although extant evidence suggests that many neural and cognitive mechanisms underlying episodic past, future, and counterfactual thinking overlap, recent results have uncovered differences among these three processes. However, the extent to which there may be age-related differences in the phenomenological characteristics associated with episodic past, future and counterfactual thinking remains unclear. This study used adapted versions of the Memory Characteristics Questionnaire and the Autobiographical Interview in younger and older adults to investigate the subjective experience of episodic past, future and counterfactual thinking. The results suggest that, across all conditions, younger adults generated more internal details than older adults. However, older adults generated more external details for episodic future and counterfactual thinking than younger adults. Additionally, younger and older adults generated more internal details, and gave higher sensory and contextual ratings, for memories rather than future and counterfactual thoughts. Methodological and theoretical consequences for extant theories of mental simulation are discussed.     

Prospective relationships between drug problems and work adjustment in a community sample of adults

The prospective relationships between drug problems and work adjustment (e.g., job instability, job satisfaction) were examined in a community sample of 470 adults. Polydrug problems (alcohol, marijuana, and cocaine problem drug use) were both predictors and consequences of work adjustment. In partial support of the impaired functioning theory, polydrug problems predicted reduced job satisfaction 4 years later. Supporting the work-related strain theory, early job instability predicted polydrug problems 4 years later. In support of the theory of general deviance, low social conformity predicted later job instability. Finally, supporting social support theory, early support for drug problems reduced polydrug problems and increased job satisfaction 4 years later.     

The delay of gratification test for adults: Validating a behavioral measure of self-motivation in a sample of older people

Most previous delay of gratification tests were developed for children and are inappropriate for application in adults. The authors therefore developed the Delay of Gratification Test for Adults (DoG-A), which includes four types of reward that are meaningful to adults, namely snacks, real money, hypothetical money, and magazines. Four subscores and two composite scores can be calculated. This study is the first to evaluate the DoG-A and to investigate its association with external variables. A community sample of 147 cognitively healthy participants aged between 60 and 94 years completed a questionnaire and cognitive tests measuring delay discounting, self-regulation, motivational self-concept, personality, wellbeing, and cognitive function. The intercorrelations of the subscales were low to medium and the internal consistency of the composite scores was moderate (?? = .4), indicating relative domain independence of the four reward types. The nomological net established by investigating the relations of the DoG-A with other constructs proved to be fairly meaningful. The correlations of all subscales with the delay discounting rate were significant and moderate. The Snacks subscale showed the most consistent pattern of results in terms of moderate positive correlations with self-reported motivation regulation, optimism, dutifulness, and deliberation. The Snacks subscale also correlated with various measures of wellbeing. A regression analysis showed that DoG Snacks remained a significant predictor of wellbeing when self-reported self-regulation and other variables were controlled. These findings indicate that the DoG-A yields an interpretable behavioral measure of self-motivation and offers a developmentally adequate extension of the delay of gratification paradigm for use with adults.