Application of Problem Solving Therapy for Late-Life Anxiety

Cognitive behavioral therapy for anxiety has demonstrated lower efficacy in older compared with younger adults. Yet, few other evidence-based options for late-life anxiety have been examined. This case series aimed to demonstrate the application of Problem Solving Therapy (PST) to older adults with anxiety disorders building on PST’s strong empirical support for treating late-life depression. PST was implemented to treat three older primary-care patients diagnosed with anxiety disorders. We present treatment outcomes and discuss the feasibility and acceptability of using PST to treat these patients. Implications and lessons learned from these patients are discussed to inform further development of PST to better meet the needs of older patients suffering from late-life anxiety.     

Retrospective Predictors of Successful Career Change Among Older Workers: Perceived Objective Success Versus Perceived Subjective Success

An increasing number of older workers are attempting career changes; however, little is known about the antecedents or outcomes of these changes. Results indicate that perceived objective and perceived subjective career‐change success are predicted by different combinations of variables. Implications for both future research and practice are discussed.     

“This phone saved my life”: Older persons’ experiences and appraisals of an mHealth intervention aimed at addressing loneliness

This qualitative study aimed to explore older persons’ experiences and appraisals of the utility of an mHealth intervention for reducing their sense of loneliness. Participants (n = 13; 86.42% females; age range 65 to 87 years) received training in the use of a smartphone and a social networking application (WhatsApp). Following the intervention, they completed a focus group discussion. For data triangulation, participants shared their social media postings. Content analysis of the focus group discussion and social media data indicated that the mobile device was used to mitigate perceptions of loneliness and isolation, thus facilitating social network building, enhancing self-efficacy, and improving cognitive flexibility. Mobile phones and a social networking application appear to reduce loneliness experienced by the elderly.     

越老越风险规避吗？——年龄对冲动性预测决策行为的调节效应

年老化伴随着风险承担倾向的改变,而决策行为受冲动性的影响是否受到年龄的调节尚不清楚。研究采用两种不同类型的决策任务以及Barratt冲动性量表,考察老年人风险承担在自我报告和决策行为上的改变。结果显示老年人在剑桥博弈任务中更加风险寻求而在模拟充气球任务中更加风险规避。同时冲动性可以显著预测模拟充气球的行为,且该预测受到年龄的调节。研究结果提示,老年人并不是单一的更加风险规避或者风险寻求,而是与任务特异性相关。同时,冲动性可以较好的预测年轻人的决策行为,而对老年人的决策行为没有预测作用。     

God of the hinge: treating LGBTQIA patients

This paper looks at systems of gender within the context of analysis. It explores the unique challenges of individuation faced by transsexual, transgender, gender queer, gender non‐conforming, cross‐dressing and intersex patients. To receive patients generously we need to learn how a binary culture produces profound and chronic trauma. These patients wrestle with being who they are whilst simultaneously receiving negative projections and feeling invisible. While often presenting with the struggles of gender conforming individuals, understanding the specifically gendered aspect of their identity is imperative. An analyst's unconscious bias may lead to iatrogenic shaming. The author argues that rigorous, humble inquiry into the analyst's transphobia can be transformative for patient, analyst, and the work itself. Analysis may, then, provide gender‐variant patients with their first remembered and numinous experience of authentic connection to self. Conjuring the image of a hinge, securely placed in the neutral region of a third space, creates a transpositive analytic temenos. Invoking the spirit of the Trickster in the construction of this matrix supports the full inclusion of gender‐variant patients. Nuanced attunement scaffolds mirroring and the possibility of play. Being mindful that gender is sturdy and delicate as well as mercurial and defined enriches the analyst's listening.     

The Effect of External and Internal Focus of Attention on Gait Variability in Older Adults

Internal focus of attention on a movement or focusing on an external target are both strategies that can affect motor performance. The authors explored whether manipulating subjects' focus of attention while walking would alter gait variability, a measure reflecting consistency of gait and associated with the risk of falling in older adults. Twenty community-living older adults participated in the study and were tested while focusing their attention on (a) gait consistency (internal focus) or (b) metronome beats (external focus). In both conditions gait variability increased (i.e., worsened p < .05) or did not change. No benefit was found in instructing subjects to focus on gait consistency or metronome beats. Such instructions may actually have distracted and interfered with the execution of gait.     

Age-Related Differences in Locomotor Strategies During Adaptive Walking

Simultaneous control of lower limb stepping movements and trunk motion is important for skilled walking; adapting gait to environmental constraints requires frequent alternations in stepping and trunk motion. These alterations provide a window into the locomotor strategies adopted by the walker. The authors examined gait strategies in young and healthy older adults when manipulating step width. Anteroposterior (AP) and mediolateral (ML) smoothness (quantified by harmonic ratios) and stepping consistency (quantified by gait variability) were analyzed during narrow and wide walking while controlling cadence to preferred pace. Results indicated older adults preserved ML smoothness at the expense of AP smoothness, shortened their steps, and exhibited reduced stepping consistency. The authors conclude that older adults prioritized ML control over forward progression during adaptive walking challenges.