Older Adults’ Psychosocial Responses to a Fear of Falling: A Scoping Review to Inform Occupational Therapy Practice

Abstract

Falls in older adults are a major health concern, yet the “fear of falling”, a common psychosocial response that can occur post-fall, has seldom been investigated. A scoping review was conducted to identify and map interventions that occupational therapists can use to manage the fear of falling psychosocial response (FoFPR) among older adults. Thirteen electronic databases were searched and 22 studies were retrieved. Cognitive behavioral therapy, guided imagery, and Tai Chi were interventions found to help older adults deal with their FoFPRs. Occupational therapists assisting older adults in this area can play a significant role.     

Aristotle's Cognitive Science: Belief,Affect and Rationality

I offer a novel interpretation of Aristotle's psychology and notion of rationality, which draws the line between animal and specifically human cognition. Aristotle distinguishes belief (doxa), a form of rational cognition, from imagining (phantasia), which is shared with non‐rational animals. We are, he says, “immediately affected” by beliefs, but respond to imagining “as if we were looking at a picture.” Aristotle's argument has been misunderstood; my interpretation explains and motivates it. Rationality includes a filter that interrupts the pathways between cognition and behavior. This prevents the subject from responding to certain representations. Stress and damage compromise the filter, making the subject respond indiscriminately, as non‐rational animals do. Beliefs are representations that have made it past the filter, which is why they can “affect [us] immediately.” Aristotle's claims express ceteris paribus generalizations, subject to exceptions. No list of provisos could turn them into non‐vacuous universal claims, but this does not rob them of their explanatory power. Aristotle's cognitive science resolves a tension we grapple with today: it accounts for the specialness of human action and thinking within a strictly naturalistic framework. The theory is striking in its insight and explanatory power, instructive in its methodological shortcomings.     

Fostering social and emotional intelligence: What are the best current strategies in parenting?

This review focuses on parenting practices that are beneficial or antagonistic to the development of emotional and social intelligence in children. We start by reviewing the somewhat nebulous concepts of emotional and social intelligence. This is followed by an examination of the association between well‐known parenting styles such as authoritative, authoritarian, permissive, and directive parenting and various indicators of child emotional and social intelligence. The strategic emotion‐coaching parenting style is also examined for its connections to comparable child outcomes. Parenting practices such as inductive discipline and parental availability also appear to cultivate emotional and social intelligence in children. Finally, overparenting is discussed as a parenting practice that apparently corrupts the development of these traits in emerging adults. We conclude that best practices, where emotional intelligence and social intelligence are the benchmarks, blend parental care and concern with a degree of parental demands on children that are appropriate for their developmental stage.     

AN EVALUATION OF ORIENTATION AND ASSESSMENT EFFECTIVENESS IN THE WORK INCENTIVE PROGRAM

The purpose of this study was to evaluate the effectiveness of a Work Incentive (WIN) Orientation and Assessment Program which was designed to (a) assess enrollee attitudes and abilities, and (b) provide enrollee pre-employment test orientation. A sample of 155 WIN enrollees was divided into two groups; the experimental group received two weeks of orientation and assessment. Results were obtained by using two criteria: First, the number of terminations prior to completing the EDP was examined for each group, and second, the total number of referrals to each of three major components was examined. Findings revealed a significantly lower number of terminations among the experimental group, but did not yield any difference in the number of referrals per component. It is suggested that further studies of this type include a more refined measure of enrollee success and satisfaction in various WIN components.     

Childhood pay for grades is related to college grade point averages

In a sample of 87 college students from four junior level courses, being paid for earning good grades in childhood was related to higher college GPAs relative to students who were not paid for good grades in childhood.     

Poor social skills are a vulnerability factor in the development of psychosocial problems

This 2‐wave panel study sought to test a social skills deficit vulnerability model of psychosocial problems. According to this model, poor social skills are thought to make people vulnerable to psychosocial problems pursuant to the experience of stressful life events. This model was tested in a sample of 118 students who were moving at least 200 miles away from their home town and making the transition to their first semester of college. At the end of their high school career, participants completed measures of social skills and the following psychosocial problems: depression, loneliness, and social anxiety. Toward the end of their first semester of college, they again completed measures of the psychosocial problems and a measure of stressful life events. Results indicated that lower social skills scores at T1 were predictive of a worsening of psychosocial problems over the course of the study. Furthermore, social skills interacted with stressful life events to predict changes in depression and loneliness. In each case, those with lower social skills at T1 appeared more vulnerable to the development of psychosocial problems by T2 than those with better social skills at T1.     

Can self-affirmation exacerbate adverse reactions to stress under certain conditions?

Objective: Self-affirmation has repeatedly been shown to reduce adverse psychological and physiological responses to stress. However, it is plausible that self-affirmation could exacerbate negative reactions to stress under certain conditions. The current research explored whether self-affirmation would increase negative psychological responses to a stressor occurring in a central life domain characterised by low levels of control.

Design: Female participants (Study 1 N = 132; Study 2 N = 141) completed baseline measures of anxiety and mood. They were then randomly allocated to complete a self-affirmation or control task, before reading a narrative documenting a stressful birth and imagining themselves in the place of the woman giving birth. After completing this task, participants again reported their levels of anxiety and positive mood.

Main outcome measures: Anxiety and positive mood assessed at follow-up.

Results: Study 1 demonstrated that self-affirmed women experienced increased anxiety and less positive mood at follow-up, compared both to baseline and to women in the control condition. Study 2 revealed that the effect of self-affirmation on outcomes was moderated by fear of childbirth.

Conclusion: These results provide preliminary evidence that self-affirmation may worsen negative responses to stressors under certain conditions and for certain individuals.     

White-matter microstructure and language lateralization in left-handers: A whole-brain MRI analysis

Most people are left-hemisphere dominant for language. However the neuroanatomy of language lateralization is not fully understood. By combining functional magnetic resonance imaging (fMRI) and diffusion tensor imaging (DTI), we studied whether language lateralization is associated with cerebral white-matter (WM) microstructure. Sixteen healthy, left-handed women aged 20–25 were included in the study. Left-handers were targeted in order to increase the chances of involving subjects with atypical language lateralization. Language lateralization was determined by fMRI using a verbal fluency paradigm. Tract-based spatial statistics analysis of DTI data was applied to test for WM microstructural correlates of language lateralization across the whole brain. Fractional anisotropy and mean diffusivity were used as indicators of WM microstructural organization. Right-hemispheric language dominance was associated with reduced microstructural integrity of the left superior longitudinal fasciculus and left-sided parietal lobe WM. In left-handed women, reduced integrity of the left-sided language related tracts may be closely linked to the development of right hemispheric language dominance. Our results may offer new insights into language lateralization and structure–function relationships in human language system.     

Procedural Fairness and Creativity: Does Voice Maintain People's Creative Vein Over Time?

Although some research suggests a link between procedural fairness and creativity, so far no study has directly tested whether a real manipulation of procedural fairness affects creativity. Additionally, research on procedural fairness effects consists mostly of unique studies, but more realistic, life-like longitudinal experiments with repeated fairness manipulations are lacking. This study investigated the influence of procedural fairness (i.e., having voice) on similar creativity tasks over a period of 4 weeks. Participants in the fair procedure condition maintained their level of creativity during the course of the experiment, whereas participants who were treated unfairly showed a decline in creativity. This research confirms the supporting role of conditions of procedural fairness regarding creativity and the importance of longitudinal designs to fully explore procedural fairness effects.