Late‐life Depression,Suicidal Ideation,and Attempted Suicide: The Role of Individual Differences in Maximizing,Regret, and Negative Decision Outcomes

Suicide rates are highest in adults of middle and older age. Research with psychiatric patients has shown that proneness to feel regret about past decisions can grow so intense that suicide becomes a tempting escape. Here, we examine the additional role of individual differences in maximizing, or the tendency to strive for the best decision, rather than one that is good enough. We provided individual‐difference measures of maximizing, regret proneness, and negative life decision outcomes (as reported on the Decision Outcome Inventory) to a nonpsychiatric control group, as well as three groups of psychiatric patients in treatment for suicide attempts, suicidal ideation, or non‐suicidal depression. We found that scores on the three individual‐difference measures were worse for psychiatric patients than for nonpsychiatric controls and were correlated to clinical assessments of depression, hopelessness, and suicidal ideation. More importantly, maximizing was associated with these clinical assessments, even after taking into account maximizers' worse life decision outcomes. Regret proneness significantly mediated those relationships, suggesting that maximizers could be at risk for clinical depression because of their proneness to regret. We discuss the theoretical relevance of our findings and their promise for clinical practice. Ultimately, late‐life depression and suicidal ideation may be treated with interventions that promote better decision making and regret regulation. Copyright © 2015 John Wiley & Sons, Ltd.     

老年肺栓塞临床诊治进展

急性肺栓塞在老年患者中属于高发疾病,并可能严重危及生命,其危险因素、临床表现常因基础疾病的掩盖而造成误诊或漏诊。当患者出现特异性较高的易患因素及晕厥表现,应高度警惕肺栓塞的发生,并根据临床具体条件确定诊查策略,选择合适的诊断手段,尽早确定或排除诊断。抗凝治疗仍是所有肺栓塞患者的基本治疗方法,当血流动力学不稳定时,可以考虑启动溶栓治疗。老年肺栓塞的治疗更强调个体化施治以最大限度地提高治疗收益,降低治疗风险。     

The factors associated with geriatric depression in rural China: stratified by household structure

Depressive symptoms and empty nest phenomenon of rural elderly people are both important public health issues, which should not be ignored. We aimed to estimate the prevalence of depressive symptoms and related factors of the empty nest elderly in rural China. We recruited 3182 eligible subjects and gathered data by face-to-face interview. Multivariate logistic regression models were used to explore the related factors of depressive symptoms. The present study showed that the prevalence of depressive symptoms significantly differed between empty nest old adults and non-empty nesters (24.1% vs. 19.0%). The elderly living alone had highest OR of depressive symptoms. Depressive symptoms of empty nest elderly was associated with sleep quality, economic status, pain, social support and ADL. While it was associated with gender, economic status, pain and PSMS in non-empty nest group. Number of chronic disease showed significant associations with depressive symptoms in the elderly living alone. Subjective support, support utilization and pain were positively associated with depressive symptoms in the elderly living with spouse. Sleep quality, economic status and ADL were common factors. Depressive symptoms obviously prevail among empty nest elderly than non-empty nesters. It reminded us that complementary social support from family and society is essential.     

Spirituality,quality of life,and depression in older people with dementia

ABSTRACT

This study aimed to observe dementia’s role in the relationship between spirituality, quality of life, and depression in aging. The sample included 61 participants between 65 and 98 years old, separated into two groups: participants diagnosed with dementia (N = 31) and control participants (N = 30). There was no significant difference in spirituality between demented and control participants; however, different patterns of correlation were observed between spirituality, depression, and quality of life in these groups. Although the level of spirituality did not differ despite dementia, this pathology would appear to play a role in the relationship between spirituality, quality of life, and depression.     

日常小团体多样性与老年人身体症状的关系：团体积极情绪的中介作用和心理压力感的调节作用

采用日记追踪法,以53名老年人为被试,探讨日常小团体的多样性对其身体症状的影响及机制。结果显示:(1)日常小团体内多样性负向预测老年人当天的身体症状;(2)在个体内水平,团体积极情绪在老年人小团体内多样性对身体症状的关系中起中介作用;(3)心理压力感能够跨层正向调节日常小团体内多样性对每日身体症状的影响。研究结果有助于揭示小团体多样性如何与老年人身体症状相联系,以及两者之间的关系在何种条件下更强,这对于老年人身体症状的干预工作具有一定实践意义。     

社区老年人执行功能和加工速度与运动能力的关系

随着年龄的增长,老年人的运动能力和执行功能,以及心理加工速度都出现不同程度的衰退。已有的研究多集中于步行与跌倒,未能统合考察运动能力、心理加工速度以及执行功能各子成分之间的关系。本研究对66名老年人的运动能力、执行功能以及加工速度进行了测试,通过经典范式对老年人四种运动能力测试(握力、30秒连续坐起、闭眼单足站立、起立行走计时)与执行功能各子成分(抑制控制、刷新功能、转换功能以及工作记忆)及心理加工速度进行了统合考察,更深入地探究了老年人运动能力与认知能力之间的关系。结果发现,在运动能力中,起立行走计时的成绩与执行功能和加工速度的关系最为密切,对起立行走计时的预测模型中加工速度权重最大。结果提示,对老年人认知功能的干预可能会影响老年人的基本运动能力。     

农村老年人社会参与对老化态度的影响：自我效能感和孤独感的中介作用

本文从积极老龄化的角度,采用入户问卷调查的方式,探究了河南某地农村老年人社会参与对其老化态度的影响,以及自我效能感和孤独感在二者关系中的作用。研究结果显示,社会参与对老化态度具有积极的促进作用,同时,自我效能感、孤独感以及自我效能感与孤独感的链式中介效应在社会参与和老化态度之间起部分中介作用。因此,提高农村老年人的社会参与度,能够一定程度上改变老年人的认知,减少消极情绪,促进成功老化。     

老年肺癌患者个性特征调查给我们的启示

采用症状自评量表(SCL-90)、成人艾克人格问卷(EPQ)、抑郁自评量表(SDS)对127例老年肺癌患者进行调查。发现老年肺癌患者存在着特定的个性特征和情绪障碍,并且不同病期间相似。我们在老年肺癌诊疗决策中要给予足够的关注。     

Narrating the negative consequences of elder care and familial obligation in Atlantic Canada

At a time when renewed emphasis is being placed on the role of the family in providing care for elderly people, shifts in family structures and the demographic profile of societies such as Atlantic Canada are impacting on community structures foundational to familial caregiving practices. Research shows that family members who attempt to provide familial care without adequate support risk negative health and interpersonal consequences. Hence many find it necessary to reflect upon their familial obligations. This article investigates the storytelling processes through which caregivers, aged between 45 and 55 years (N = 26), make sense of their efforts to provide care. We explore the ways in which participants in four focus groups and 12 interviews refer to negative consequences of caring in order to navigate dilemmas arising from their enactment of familial obligations in the absence of adequate support. Copyright © 2003 John Wiley & Sons, Ltd.     

老年公寓60岁以上老年人幸福感与应付方式调查分析

①目的：了解老年公寓老年人的幸福度、应付方式及其两者的相关性。②方法：采取随机整群抽样的方法，从西部欠发达地区和沿海发达地区各选取一个城市的两家老年公寓，对入住其中6个月以上150例60岁以上老年人用MUNSH量表、应付方式问卷逐个进行调查，将调查结果用SPSS统计软件进行分析。结果：四川南充老年公寓老年人幸福度（28．97±9．94）高于山东济南老年公寓老年人（23．95±8．97）；老年男性和女性在幸福度各因子上得分均无显著性差异（P〉0.05）；南充老人和济南老人在幻想、退避、合理化三因子上存在显著性差异（P〈0.05）：合理化应付因子在老年男性和女性间有显著性差异（P〈0．05）；幸福度总分与解决问题、求助两因子成显著正相关。结论：当前老年公寓老年人幸福度总体上处于中等左右水平，内地高于沿海；人口统计学变量对幸福感的影响十分有限；培养积极的应付方式是提高老年公寓老年人幸福度的途径之一。