Psych 250 Exam 3 Flashcards

Middle age

• Ages 40-65

• Health issues become more salient

• Command generation

Relatively new historical phenomenon

• 1900 – 47 years

• 2004 – 77.9 years

• Now – 79.0

Accommodation of the eye

• Ability to focus & maintain an image on the retina

Weakening of muscle & thickening of the lens leads to

Difficulty viewing close objects and reading small print

Size of pupil shrinks & lens yellow leads to

• Limited ability to see in dim light

• Limited color discrimination

Reduced blood supply decreases

Size of visual field and increases eye’s blind spot

What % of American adults between 45 and 64 have hearing loss?

14%

Declines in hearing are both

Hereditary and age-related

Hearing declines typicially start with

A loss at high frequencies

Men vs. women hearing declines

Men’s hearing declines earlier and at a faster rate than women’s

Middle-age spread

• Slowed metabolism

• Increase in body fat & gradual loss of lean body mass (muscle & bone)

What makes bones weaker?

Gradual loss in bone mass & loss in bone density

What causes height shrinkage?

Disks in spinal column move closer

Cosmetic surgery and cosmetic culture

Used to make self look younger despite natural aging

• Plastic surgery - eyelid surgery, tummy tuck, liposuction, breast augmentation

• Minimally-invasive cosmetic procedures – laser hair removal, chemical peel, soft tissue filler, Botox

Climacteric definition

Mid-life transition in which fertility declines

Nature of climacteric / perimenopause

Gradual changes for women over a 10-year period

• Production of estrogen drops

• Cycles shorten & become more irregular

Climacteric concludes with menopause

The cessation of menstruation and of reproductive capacity – no period for 12 consecutive months

Timing of menopause

Typically between 50 and 55; 50 or 51 is average

What affects and doesn’t affect timing of menopause?

• Genetics are a key factor in timing; smoking

• Not affected by age of first period or usage of birth control pills

Reduction in female sex hormones

• Decreased elasticity of skin

• Risk of heart disease increases (estrogen slows plaque accumulation)

• Bones may lose more calcium – risk of osteoporosis and bone fractures

Typical physical symptoms of menopause

• Hot flash

• Profuse sweating and “night sweat”

• Other changes: weight gain, changes in sexual response, headaches

• Extent & duration varies extensively

2 types of Hormone Replacement Therapy (HRT) for menopause

• Estrogen only – have had a hysterectomy

• Estrogen plus progesterone – intact uterus

Why was HRT created?

Believed to reduce risks of heart disease and osteoporosis & relieve some symptoms

% of US women who used HRT

45% of US women born between 1897 & 1950 used for at least 1 month

Early evidence supported the benefits of HRT

Hormone regimens associated with reduced “bad” LDL cholesterol and increased “good” HDL cholesterol

Design of Women’s Health Initiative Studies

• A large, randomized, clinical trial sponsored by NIH – launched in 1991 – 15-year period

• Study 1 – 16,608 postmenopausal women took estrogen + progesterone therapy or placebo

• Study 2 – 10,739 women who have had a hysterectomy took estrogen alone or a placebo

• Study 1 was stopped in 2002 and Study 2 was stopped in 2004 because risks of HRT appeared to outweigh benefits

• Currently no longer recommended for long term use

Increased risks findings of Women’s Health Initiative Studies

Compared with placebo, after 5 years, HRT resulted in:

• 26% increase in breast cancer

• 41% increase in strokes

• 29% increase in heart attacks

• Doubled rate of blood clots in legs & lungs

• Elevated risk of mild cognitive declines

• Nearly double the risk of Alzheimer’s among women 65+

Increased benefits findings of Women’s Health Initiative Studies

• 37% less colorectal cancer

• 34% fewer hip fractures

HRT now

Individualized approach; risks overstated for women under 60 using modern, lower-dose formulations

Psychological impact of menopause - positives

Perspectives/attitudes may help ease stress

• Positive attitude

• Knowledge and awareness of symptoms

• Role models – older female family members

Emergence to a new freedom

% of middle adults who rate health as good or excellent

85%

What is an important factor for maintaining health

Keeping active

2 leading causes of death in middle age

• Cancer

• Cardiovascular disease

Death rate increase from cancer between early and middle adulthood

Multiplies tenfold from early to middle adulthood

Most common types of cancer between men and women

•   Women: breast, lung

• Men: prostate, lung

What percentage of people with cancer are cured

60%

What percentage of American adults (45-64) die from cardiovascular disease?

25%

Cardiovascular disease is a silent killer and signs often go undetected

• High blood pressure

• High blood cholesterol

• Atherosclerosis (build up of plaque in coronary arteries)

Symptoms of cardiovascular disease

• Heart attack

• Angina pectoris - feels like indigestion or chest pain

• Arrhythmia - irregular heartbeat

Erikson’s psychosocial conflict of middle adulthood

Generativity vs. stagnation

Nature of generativity

• Reaching out to others in ways that give to and guide the next generation

• Making a lasting contribution - less “selfish” stage

4 ways people may express generativity

1. Biological generativity - conceive & give birth'

2. Parental generativity - nurturing children

3. Work generativity - passing on skills; mentoring adults

4. Cultural generativity - e.g. creative output, politics

Highly generative people tend to be

Psychologically fulfilled and healthy

Negative outcome = stagnation or self-absorption

• Preoccupied with themselves

• Lack of involvement or concern for young people or future generations

Levinson’s nature of transition to middle adulthood

• Transition is a time of turmoil and confusion

• Work to reevaluate life - What do I really want?

4 developmental tasks must be confronted in middle adulthood

1. young-old – seek new ways of being both

2. destruction-creation – acknowledge past destructiveness; try to create products of value

3. masculinity-femininity – come to terms with both parts of self

4. engagement-separateness – balance between engagement with external world and separateness

Aspects of successful transitions

Depends on how effectively you reduce these polarities and accept each of them as an integral part of your being

Mid-life crisis

A state of physical & psychological distress that arises when developmental tasks threaten to overwhelm a person’s internal & external resources

Current research about mid-life crisis

• Little evidence that 40’s is a period of exceptional stress (contrary to what Levinson believed)

• Other scholars found a few crises in their samples

  • MIDUS data – 25% - but definitions and ages varied

  • Valliant – Harvard graduates – few examples

  • Chiriboga – random samples – 2-5%

Is mid-life crisis a universal experience?

No

7 changes in self-concept and personality at mid-life

1. Rise in introspection

2. Changes in possible selves - future-oriented representations of what one hopes to become and is afraid of becoming

3. Increase in self-acceptance – less self-critical

4. Increase in autonomy (independence and commitment to personal values)

5. Increase in sense of environmental mastery

6. Increase in effective coping strategies

7. Increase in androgyny

Sandwich generation

Competing demands of aging parents & own children

Empty nest syndrome

Emotional crisis, typically linked to sadness & depression, brought on by children leaving home

Crisis is not the norm when children leave

• Many report increased happiness, marital satisfaction, and sense of well-being after children leave

• Parent-child relationships often improve

• Need to adjust and adopt new roles (e.g. kinkeeper) & routines

 

Marital satisfaction changes over time and follows what pattern?

A U-shaped pattern

Marriages at mid-life = stage of “stability” or “working through”

• Accepting of relationship & its strength & weakness

• Conflict patterns – predictable, familiar

• Expectations are more realistic

Lauer et al. (1995) five reasons for marital success

• Seeing spouse as best friend

• Viewing marriage as a long-term commitment

• Liking spouse as a person

• Laughing together frequently

• Agreeing on aims and goals

Cuber & Harnoff, 1965 method

Interviewed 107 men, 104 women married 10+ years, never considered divorce

Cuber & Harnoff identified 5 types of couples

1. The conflict-habituated – underlying tension & conflict - quarreling

2. The devitalized – discrepancy from earlier years – characterized now by indifference

3. The passive-congenial – indifference has been norm throughout

4. The vital – intensely bound together – sharing & togetherness is genuine

5. The total relationship – like vital, but multifaceted

Concerns with Cuber & Haroff

• Stable categories?

• Do other couple types exist?

• Cohort effect?

Allen & Olson (2001)

• 415 African-American couples

• Classified based on ten different domains

• Produced 5 types of couples – 4 matched Cuber & Haroff’s model

• “Traditional couple” instead of passive-congenial -  moderate overall satisfaction, poor sex life, poor communication skills (strong, mutual religious orientation)

Relationship to aging parents

Shift in helping often occurs

Percentage of U.S. adult children that provide unpaid care to aging adult

25%

Caring for aging parents

• Reevaluate relationship – role reversal

• Often difficult on the aging parent as well – now dependent

• Buffers: social support, secure attachment style, rewarding career

 

Why is caring for aging parents difficult?

• A highly stressful situation. Why?

• Typically occurs suddenly with little time for preparation

• Difficult emotionally to watch decline

• Duration is uncertain and parent typically declines over time and becomes more dependent

• Psychological costs-depression (30-50%), resentment

• Financial pressures