Associations between early experiences with parents and well-being in old age

Ghosts from the past? The association between childhood interpersonal trauma, attachment and anxiety and depression in late life

Objectives: Research suggests that vulnerability for anxiety and depression in late life results from a complex interaction between (neuro)biological and environmental factors. In this context, there is growing evidence for the role of childhood trauma on vulnerability for both anxiety and depression throughout the course of life, mainly through its effects on attachment as a biologically based neurodevelopmental stress regulation system. Yet, the impact of childhood trauma on depression and anxiety in late life specifically remains unclear. The current study therefore aims to investigate the association between retrospectively reported childhood interpersonal trauma, attachment dimensions and levels of anxiety and depression in late life.Method: A sample of 81 community dwelling older adults completed measures of early and current adversity, attachment dimensions, and levels of anxiety and depression.Results: The occurrence and frequency of childhood trauma, but not later negative adult life events, was associated with late life anxiety and depression. Both attachment anxiety and avoidance were related to anxiety and depression. Only attachment anxiety affected the association between childhood trauma, and emotional neglect in particular, and late life anxiety and depression.Conclusion: Childhood trauma may be associated with anxiety and depression in late life. Part of this association is probably indirect, via the effect of insecure attachment and high levels of attachment anxiety in particular.

Exposure to caring parenting and adult mental health in extremely low birthweight survivors

AIM

Individuals born at extremely low birthweight (ELBW; <1000 g) are exposed to early adversities that increase the risk of mental health problems in later life. Caring parenting has been shown to offset the negative effects of early adversity in general population samples. However, the long-term impact of caring parenting on the mental health of preterm survivors in adulthood is not known.

METHODS

Using data from the world's oldest longitudinally followed cohort of ELBW survivors (n = 179) and matched normal birthweight (NBW) control participants (n = 145), we examined if caring parenting moderated the link between preterm birth and mental health at 30-35 years of age. Participants reported on the parenting they received from their mothers using the parental bonding instrument. Self-esteem and internalising problems (i.e. depression, anxiety) were self-reported at 30-35 years of age using the Coopersmith Self-Esteem Inventory and Young Adult Self-Report questionnaire, respectively.

RESULTS

A statistically significant interaction was found between birthweight status and caring maternal parenting on self-esteem and internalising psychopathology in adulthood. Stratified analyses demonstrated that caring parenting was associated with better self-esteem (P < 0.001) and lower levels of internalising symptoms (P = 0.001), but in NBW participants only.

CONCLUSIONS

While the receipt of caring maternal parenting promoted mental health in adults born at NBW, it did not have the same protective effect on ELBW survivors. More research is needed to elucidate the aspects of parenting and the family environment that promote the long-term mental health of preterm survivors.

Maternal bonding behavior, adult intimate relationship, and quality of life

Continuity and discontinuity in the development of social relationships have been investigated by reviewing the course of social bonds and by analyzing the effects of a sound intimate relationship in adulthood in conjunction with recalled maternal bonding on the quality of life among students.

A questionnaire-based study of 207 students was conducted. Perceptions of maternal bonding were designated as being representative of one of the two contrasting bonding types “optimal maternal bonding” and “affectionless maternal control” assessed by the Parental Bonding Instrument (PBI) and combined with perceptions of a sound intimate adult relationship measured by the Family Assessment Measure III Dyadic Relationships Scale (FAM-III-D). Quality of life and general health data were determined by using the World Health Organization Quality of Life (WHOQOL-BREF) instrument.

Students who reported “optimal maternal bonding” had intimate relationships in adulthood that were of significantly higher quality than those who recalled “affectionless maternal control”. Students who recalled “optimal maternal bonding” and described their intimate relationship as sound showed significantly higher scores in all domains of quality of life and indicated having better general health than those who reported “affectionless maternal control” and a sound intimate relationship.

A sound intimate relationship in adulthood does not appear to compensate the impact of a recalled maternal bonding behavior in terms of affectionless control, on quality of life. Furthermore, results seem to support the hypothesis of continuity of the development of social relationships among psychologically well individuals based on the association between maternal bonding and later intimate relationships.

Parenting style, resilience, and mental health of community-dwelling elderly adults in China

BACKGROUND

Given the increasing elderly population worldwide, the identification of potential determinants of successful ageing is important. Many studies have shown that parenting style and mental resilience may influence mental health; however, little is known about the psychological mechanisms that underpin this relationship. The current study sought to explore the relationships among mental resilience, perceptions of parents' parenting style, and depression and anxiety among community-dwelling elderly adults in China.

METHODS

In total, 439 community-dwelling elderly Chinese adults aged 60-91 years completed the Personal and Parents' Parenting Style Scale, Connor-Davidson Resilience Scale, Zung Self-Rating Depression Scale, and Zung Self-Rating Anxiety Scale.

RESULTS

Elderly adults whose parents preferred positive and authoritative parenting styles had higher levels of mental resilience and lower levels of depression and anxiety. Elderly adults parented in the authoritarian style were found to have higher levels of depression and anxiety, with lower mental resilience.

CONCLUSIONS

The findings of this study provide evidence related to successful ageing and coping with life pressures, and highlight the important effects of parenting on mental health. The results suggest that examination of the proximal determinants of successful ageing is not sufficient-distal factors may also contribute to the 'success' of ageing by modifying key psychological dispositions that promote adaptation to adversity.

The contribution of adult personality and recalled parent–child relations to friendships in middle and old age

In this study we examined personality traits, in particular openness to experience and agreeableness, and–in an exploratory step – recalled parent–child relations as antecedents of friendship involvement in adulthood. Data from 392 middle-aged (43–46 years) and 345 older participants (61–64 years) in the first wave of the Interdisciplinary Longitudinal Study of Adult Development (ILSE) support the hypothesis that openness contributes to friendship involvement in middle age, while agreeableness contributes to friendship involvement in old age. Further, structural equation models showed that the relation between recalled mother–child relationship and friendship involvement in older adults was mediated by agreeableness. Recalled father–child relationship was directly associated with friendships in both age groups, independent of personality traits.

The Structure and Stability of Perceived Togetherness in Elderly People during a 5-Year Follow-Up

The objective of this study was to study the structure andstability of perceived togetherness using cross-sectional and longitudinal confirmatory factor analysis models. Togetherness was measured with the self-administered Social Provision Scale (SPS). The sample consisted of 111 persons interviewed in connection with the Evergreen project’s 5-year follow-up at ages 80 and 85. One and two-factormodels were specified separately at two different pointsof measurement. The stability of the factor models’ structure and the level of latent factors was studied using longitudinal factor analysis models. The two-factor model fit the data better than the one-factor model. Perceived togetherness was differentiated into factors of emotional and social togetherness. The structure of perceived togetherness remainedunchanged during the 5-year follow-up. In terms of means, the latent factors showed a statistically highly significant decline in time (i.e. perceived togetherness decreased with increasing age).

Do cherished children age successfully? Longitudinal findings from the Veterans Affairs Normative Aging Study

Although early adversity has been linked to worse mental and physical health in adulthood, few studies have investigated the pathways through which positive and negative dimensions of early experiences can jointly influence psychological well-being in later life. This study examined: (a) profiles of early experiences across multiple domains, (b) the relations of these profiles to hedonic and eudaimonic well-being in later life, and (c) whether midlife social support mediated these relations. We first conducted latent class analysis of early experiences using data from 1,076 men in the VA Normative Aging Study who completed the Childhood Experiences Scale (age: M = 69, SD = 7). Analyses yielded 3 profiles of early experiences, labeled as cherished (strong support and some losses), harshly disciplined (harsh parental discipline, low positive reinforcement, and nonnormative stressors), and ordinary (few stressors and low parental attention). Next, we applied structural equation modeling to data on a subset of this sample assessed 7 years later on hedonic and eudaimonic well-being (n = 496; age: M = 76, SD = 7). In general, the cherished group reported stronger qualitative social support in midlife than the harshly disciplined and ordinary groups, which in turn was related to greater hedonic (life satisfaction, positive affect) and eudaimonic (competence, positive relations with others) well-being in later life. The cherished group also reported higher autonomy than the ordinary group, but this association was independent of midlife social support. Our findings suggest that experiencing adversity in the context of a nurturing early environment can promote successful aging through the maintenance of supportive relationships in midlife.

Loneliness, loss, and social support among cognitively intact older people with cancer, living in nursing homes--a mixed-methods study

BACKGROUND

Loneliness is a significant psychosocial effect following a cancer diagnosis and may prevent people from engaging in social activities, thus creating difficulties in interpersonal relationships. This study investigated loneliness and social support among cognitively intact nursing home residents with cancer by using a quantitatively driven mixed-methods design with sequential supplementary qualitative components.

METHODS

The quantitative component consisted of face-to-face interviews of 60 nursing home residents (≥65 years) using the one-item Loneliness Scale and the Social Provisions Scale. The supplementary psychosocial component consisted of qualitative research interviews about experiences related to loneliness with nine respondents.

RESULTS

The quantitative results indicated that reassurance of worth was associated with loneliness. The experience of loneliness was identified by the following: loneliness that was dominated by a feeling of inner pain, feeling of loss, and feeling small. Loneliness was alleviated by the following: being engaged in activities, being in contact with other people, and occupying oneself.

CONCLUSION

Enhancing the lives of nursing home residents with cancer requires attending to the residents' experience of loneliness and social relationships in a targeted and individualized manner. This might require screening all nursing home residents for early detection of loneliness. Revealing factors that may contribute to or reduce loneliness improves the ability to enhance people's lives.

Suffering and mental health among older people living in nursing homes-a mixed-methods study

Background. Knowledge about mixed-methods perspectives that examine anxiety, depression, social support, mental health and the phenomenon of suffering among cognitively intact NH residents is scarce. We aimed to explore suffering and mental health among cognitively intact NH residents.

Methods. This study used a mixed-methods design to explore different aspects of the same phenomena of interest to gain a more comprehensive understanding. The qualitative core component comprised a qualitative interview from 18 nursing home residents (≥65 years) about experiences related to pain, grief and loss. The supplementary component comprised interview from the same respondents using the SF-36 Health Survey subscales, the Hospital Anxiety and Depression Scale and the Social Provisions Scale.

Results. The individual descriptions reveal suffering caused by painful experiences during life. The quantitative results indicated that symptoms of anxiety and depression were related to mental health and symptoms of anxiety were related to bodily pain and emotional role limitations. Attachment and social integration were associated with vitality and social functioning.

Discussion. To improve the situation, more attention should be paid to the residents’ suffering related to anxiety, depression and psychosocial relations.

Burden of care, social support, and sense of coherence in elderly caregivers living with individuals with symptoms of dementia

Family members are often the care providers of individuals with dementia, and it is assumed that the need for this will increase. There has been little research into the association between the burden of care and the caregiver's sense of coherence or receipt of social support. This study examined the relationship between the social support subdimensions and sense of coherence and the burden of care among older people giving care to a partner with dementia. The study was a cross-sectional observation study of 97 individuals, ≥65 years old and living with a partner who had symptoms of dementia. We used the Informant Questionnaire on Cognitive Decline in the Elderly, the Relative Stress Scale, the Social Provisions Scale, the Sense of Coherence Scale, and a questionnaire on sociodemographic variables. We used multiple regression analysis in a general linear model procedure. We defined statistical significance as p < 0.05. With adjustments for sociodemographic variables, the association with burden of care was statistically significant for the subdimension attachment (p < 0.01) and for sense of coherence (p < 0.001). The burden of care was associated with attachment and with sense of coherence. Community nurses and other health professionals should take necessary action to strengthen attachment and sense of coherence among the caregivers of people with dementia. Qualitative studies could provide deeper understanding of the variation informal caregivers experience when living together with their partner with dementia.

Sense of coherence among cognitively intact nursing home residents--a five-year longitudinal study

AIM AND OBJECTIVES

To examine how stable the sense of coherence (SOC) is over a five-year period among residents of nursing homes (NH) who are not cognitively impaired and whether components of social support influence SOC.

BACKGROUND

Many studies have investigated the stability of SOC, and the findings have been inconsistent. Social support is a crucial resource in developing SOC. Few researchers have studied the stability of SOC and how various social support dimensions influence changes in SOC among older NH residents who are cognitively intact.

DESIGN

The study was prospective and included baseline assessment and five-year follow-up.

METHODS

The sample comprised 52 cognitively intact NH residents (Clinical Dementia Rating score ≤0.5). We obtained data through direct interviews using the Social Provisions Scale and Sense of Coherence Scale.

RESULTS

SOC increased statistically significantly from baseline to follow-up. The social support subdimension reassurance of worth predicted change in SOC after adjustment for sociodemographic factors. When controlled for baseline SOC, attachment was associated with change in SOC, but reassurance of worth was not.

CONCLUSIONS

The study indicates that the change in SOC over time during the 5 years of follow-up and the social support dimension attachment appear to be important components of change in SOC. Nursing personnel should be aware of the residents' individual needs for attachment and the importance of emotional support for personal strength and ability to cope.

Acute hospital admission for nursing home residents without cognitive impairment with a diagnosis of cancer

Studies of hospitalisation of cognitively intact nursing home (NH) residents with cancer are scarce. Knowledge about associations between socio-demographic, medical and social support variables and hospital admissions aids in preventing unnecessary admissions. This is part of a prospective study from 2004 to 2005 with follow-up to 2010 for admission rates. We studied whether residents with cancer have more admissions and whether socio-demographic and medical variables and social support subdimensions are associated with admission among cognitively intact NH residents with (n = 60) and without (n = 167) cancer aged ≥65 years scoring ≤0.5 on the Clinical Dementia Rating Scale and residing ≥6 months. We measured social support by face-to-face interview. We identified all respondents through NH medical records for hospital admission, linking their identification numbers to the hospital record system to register all admissions. We examined whether socio-demographic and medical variables (medical records) and social support subscales were associated with the time between inclusion and first admission. Residents with cancer had more admissions (25/60) than those without (53/167) (odds ratio 1.7). Social integration was correlated with admission (P = 0.04) regardless of cancer diagnosis. Residents with cancer had more hospital admissions than those without. Higher social integration gave more admissions independent of cancer diagnosis.

Parental emotional support during emerging adulthood and Baby Boomers’ well-being in midlife

This study examined whether parental emotional support around emerging adulthood influenced well-being in midlife. We applied latent growth curve (LGC) models on 337 Baby Boomers who were in their late teens to early 20s when they entered the Longitudinal Study of Generations (LSOG) in 1971. There was a small but significant decline in self-rated health and positive emotions through 2005, but not depressive symptoms. Greater support from fathers in 1971 was associated with better self-rated health, less depression, and a slower decline in self-rated health across midlife. Greater support from mothers was associated with more positive emotions. These associations did not significantly differ among sons and daughters. Findings are discussed in the context of cumulative advantage/disadvantage and life-stage specific challenges to highlight the importance of parental emotional support during life transitions.

Attachment Style and Well-being in Elderly Adults: A Preliminary Investigation

L'étude examine la relation entre les styles d'attachement et le bien-être subjectif dans la fin de la vie d'adulte. Soixante-seize aînés âgés en moyenne de 67,9 ans ont rempli un questionnaire servant à mesurer les styles d'attachement (Relationship Questionnaire) et le MUNSH, un questionnaire servant à mesurer le bien-être subjectif, le tout ayant été évalué en fonction de L'état de santé perçu et de l'état civil. Les résultats indiquent que la santé et le style d'attachement ont des effets importants, sans réciprocité cependant, sur le bien-être. Plus précisément, les personnes en santé sont plus heureuses que celles qui sont en mauvaise santé; les personnes interrogées dont les styles d'attachement étaient solides et dégagés étaient remarquablement plus heureuses que celles qui vivaient des attachements empreints de peur. La répartition des styles d'attachement entre les catégories <solide, tendu, centré sur la peur et dégagé> présentait des différences par rapport aux recherches précédentes effectuées chez les jeunes adultes.

Predictors of loneliness in U.S. adults over age sixty-five

The purpose of this study was to examine sociodemographic and health-related risks for loneliness among older adults using Health and Retirement Study Data. Overall prevalence of loneliness was 19.3%. Marital status, self-report of health, number of chronic illnesses, gross motor impairment, fine motor impairment, and living alone were predictors of loneliness. Age, female gender, use of home care, and frequency of healthcare visits were not predictive. Loneliness is a prevalent problem for older adults in the United States with its own health-related risks. Future research of interventions targeting identified risks would enhance the evidence base for nursing and the problem of loneliness.

Within-family variability in representations of past relationships with parents

BACKGROUND

We examined within-family variation in siblings' memories of experiences with parents and their associations with current positive and negative affect.

METHODS

Participants were 1,369 adults with at least 1 sibling, aged 26-74 years from 498 families in the MacArthur Study of Midlife in the United States (M(age) = 47 years, 59% women, 94% White).

RESULTS

There was considerable variability in recalled maternal and paternal treatment across the dimensions of affection (intraclass correlation coefficients [ICCs] 0.33 and 0.41, respectively), discipline (ICCs 0.39 and 0.43), and conflict (ICCs 0.24 and 0.26). In turn, recalled parental treatment, particularly affection, made unique contributions to current positive (ICC 0.12) and negative affect (ICC 0.08) over and above individual and familial level characteristics such as offspring demographic characteristics, extraversion and neuroticism, family structure, recalled early family environment, and parents' current status.

CONCLUSIONS

Results link adults' memories of experiences with their parents in childhood to their current well-being and highlight the importance of considering within-family models for family theory.

Continuity and Change in the Study of Family Relationships

Recent work on family life in old age may be considered in several dimensions. First, it encompasses different substantive areas: parentchild relationships, care-giving, changing family forms. Second, it involves different types of discourse, which variously reflect social policy considerations, legal and ethical debates, academic discourses and prescriptive writing for professionals and older people. A third dimension consists of methodological and theoretical variations. These include synchronic and life history approaches, quantitative and qualitative methods, positivistic and phenomenological research paradigms, and cross-cultural and historical comparisons.

The impact of social support and sense of coherence on health-related quality of life among nursing home residents--a questionnaire survey in Bergen, Norway

BACKGROUND AND OBJECTIVES

Few studies have examined the association between social support and health-related quality of life (HRQOL) among nursing home residents and whether the sense of coherence (SOC) modifies the effect of social support on health-related quality of life. The main aims of this study were to determine the relationship between social support and HRQOL and to investigate whether the SOC modifies the effect of social support on HRQOL.

DESIGN

A cross-sectional, descriptive, correlational design.

SETTINGS

All 30 nursing homes in Bergen in western Norway.

PARTICIPANTS

Two hundred and twenty-seven mentally intact long-term nursing home residents 65 years and older.

METHODS

Data were obtained through face-to-face interviews using the SF-36 Health Survey, Social Provisions Scale and Sense of Coherence Scale. Possible relationships between the Social Provisions Scale and the eight SF-36 subdimensions were analysed using multiple linear regression while controlling for age, sex, marital status, education and comorbid illness. Interactions between the Sense of Coherence Scale and Social Provisions Scale were investigated.

RESULTS

Attachment affected the mental health subdimension (p=0.001), opportunity for nurturance affected social functioning (p=0.003) and reassurance of worth affected vitality (p=0.001) after adjustment for demographic variables and comorbid illness. After the analysis included the sense of coherence, nurturance still significantly affected social functioning and reassurance of worth still significantly affected vitality. No interaction with sense of coherence was found, and sense of coherence significantly affected all SF-36 subdimensions.

CONCLUSIONS

The opportunity to provide nurturance for others appears to be important for social functioning, and sense of competence and sense of self-esteem appear to be important for vitality. Further, the residents' relationships with significant others comprise an important component of mental health. Finally, independent of the level of sense of coherence, social support is an important resource for better health-related quality of life. Clinical nurses should recognize that social support is associated with health-related quality of life and pay attention to the importance of social support for the residents in daily practice.

When parents matter to their adult children: filial reliance associated with parents' depressive symptoms

A neglected topic in aging depression research is the potential role of the parent-adult child relationship. In this study we examined whether adult children's reports of having relied upon parents for instrumental and expressive support are associated with parents' depressive symptoms. The sample included 304 parents (aged 50-72 years), matched to a randomly selected adult offspring, from the University of Southern California Longitudinal Study of Generations. We measured parents' depressive symptoms by using the Center for Epidemiologic Studies Depression Scale at baseline and 3 and 6 years later. The final longitudinal analysis showed that, when we adjusted for relevant variables including age, gender, income, self-rated health, and child's depressive symptoms, the adult child's reliance on instrumental support was associated with fewer parental depressive symptoms (p =.036). Expressive support did not show the same pattern. Thus, adult children's reliance on instrumental support might contribute to their parents' mental health.

The relationship between social participation and self-rated health by sex and age: a cross-sectional survey

BACKGROUND

Social participation contributes to better health and has been regarded as an important component of quality of life. Despite its importance, social participation significantly decreases as age advances. Social participation may vary by sex and age and, consequently, may have different influences on health by age and sex. Few studies have examined how sex and age affect individual health status in this regard.

OBJECTIVES

This paper focuses on whether the association between self-rated health and social participation differs between men and women, and among age groups.

DESIGN

The study was based on cross-sectional analysis of data from the 2003 Social Statistics Survey.

SETTINGS

This survey was conducted in South Korea.

PARTICIPANTS

The survey respondents were 59,202 Koreans aged 25 and over. The sample population comprised each household member of 33,000 sample households who were selected by multistage probability sampling of household registries based on geographic area, sex and age group.

METHODS

Face-to-face interviews were nationally conducted. Multiple logistic regression analysis was performed to examine factors that associated social participation with self-rated health, and the adjusted odds ratios (ORs) were presented, together with their 95% confidence intervals (CIs). The model included various individual socioeconomic characteristics, health behaviors, and morbidity variables, such as marital status, education level, housing tenure, employment status, smoking status, alcohol intake, number of restricted activity days, and bed days.

RESULTS

For both sexes, self-rated good health was strongly associated with social participation levels in all age groups. The influence of social participation increased as age advanced. Particularly among elderly women, those who had participated in more than two activities had more than twice the odds of self-rated good health of those who did not participate in any activities.

CONCLUSIONS

Social participation significantly decreases as people age, however, the influence of social participation on health status increases with age. This study has shown that social participation, which is an individual psychological resource, is important for health in all age groups, notwithstanding that the effect of social participation differs by age and sex. Social participation should be a basic consideration in the field of community nursing intervention, especially for the elderly and women's health promotion. Promoting social participation by individuals may lead to better health, and may therefore be an effective strategy for enhancing health.

Childhood adversity and psychosocial adjustment in old age

OBJECTIVE

The objective of this study was to test the hypothesis that higher level of childhood adversity is associated with lower level of psychosocial adjustment in old age.

METHOD

Participants are 253 older persons (mean age: 79.8, standard deviation: 2.1; 73.9% women) from the Rush Memory and Aging Project, a clinicopathologic study of common chronic conditions of old age. Childhood adversity was assessed with a 16-item measure based on portions of the Childhood Trauma Questionnaire and other inventories. Psychosocial adjustment was assessed with multiple measures of neuroticism (i.e., proneness to negative emotions) and social engagement.

RESULTS

Based in part on a factor analysis, composite measures of total adversity, emotional neglect, parental intimidation, parental violence, family turmoil, and financial need were developed. In a series of linear regression models adjusted for age, sex, own education, and parental education, the composite measure of childhood adversity was associated with all facets of neuroticism and accounted for more than 13% of the variance in the composite neuroticism measure. Emotional neglect and parental intimidation had the strongest associations with neuroticism. Childhood adversity was not related to frequency of participation in social activities, but more adversity was associated with having a smaller network (accounting for 3% of the variance) and feeling more emotionally isolated (accounting for 7% of the variance).

CONCLUSION

Childhood adversity is associated with less adaptive psychosocial functioning in old age.

Attachment theory, ageing and dementia: a review of the literature

The following review draws together recent theoretical contributions and research findings highlighting the pertinence of attachment issues for older adults. Beginning with a brief overview of the principles of attachment theory, the paper proceeds to illustrate that attachment remains a key feature of relationships throughout the life cycle. Research findings suggest that past and present secure attachment relationships function as a protective resource in later life and preliminary studies highlight the continuing salience of parents as attachment figures for older adults. Particular attention is given to the significance of attachment theory in thinking about the subjective experiences of people with dementia, for whom unwilling separation and disruption of attachment bonds can be common themes. Research indicates the frequent occurrence of attachment behaviours and parent fixation amongst people with dementia living in residential care. Pre-morbid attachment style has been shown to interact with emotional and behavioural expression during the course of dementia. Clinical applications of attachment theory in dementia care are discussed and initial evidence for the effectiveness of Simulated Presence Therapy is provided. Methodological issues raised by the review are considered, together with suggestions for future research.

Predictors and subjective causes of loneliness in an aged population

The aim of the study was to examine the prevalence and self-reported causes of loneliness among Finnish older population. The data were collected with a postal questionnaire from a random sample of 6,786 elderly people (>or=75 years of age). The response rate was 71.8% from community-dwelling sample. Of the respondents, 39% suffered from loneliness, 5% often or always. Loneliness was more common among rural elderly people than those living in cities. It was associated with advancing age, living alone or in a residential home, widowhood, low level of education and poor income. In addition, poor health status, poor functional status, poor vision and loss of hearing increased the prevalence of loneliness. The most common subjective causes for loneliness were illnesses, death of a spouse and lack of friends. Loneliness seems to derive from societal life changes as well as from natural life events and hardships originating from aging.

Young adults' recollections of parental bonds--does satisfaction with partner relationships mediate the longitudinal association with mental disorders?

BACKGROUND

Recollections of cold and overprotective behaviors from parents have been hypothesized to lead to the presence of mental disorders in young adulthood through their detrimental effects on individuals' satisfaction in later partner relationships. Previous studies have not explicitly tested, however, whether partner relationship satisfaction mediates the longitudinal relationship from parental bonds to DSM-III-R disorders in young adults.

METHODS

We examined: (1) whether recollections of parental bonds in the first 16 years of life were related to the prevalence of DSM-III-R mental disorders in young adulthood, and (2) whether young adults' satisfaction with current partner relationships mediated these links. Data were used from 1,581 Dutch young adults aged 18-34 years, who were interviewed in three waves (1996, 1997, and 1999) of a nationwide epidemiological study.

RESULTS

Structural Equation Models demonstrated that recollections of caring, non-intrusive parenting behaviors were significantly, negatively associated with the prevalence of mood and anxiety disorders (but not substance disorders) in young adulthood. The satisfaction with current partner relationships did not mediate these negative associations.

CONCLUSIONS

Results replicate and extend earlier findings from the National Comorbidity Survey (Enns et al. 2002), demonstrating that mental disorders are directly related to people's recollections of parental care and overprotection. Low-quality parental bonds were only related to internalizing types of psychopathology, however, and were of a modest strength. Results may indicate that there is relatively little cross-relationship continuity in the experience of intimacy between relationships with parents and with partners.

The importance of activities of daily living and social contact for loneliness: a survey among residents in nursing homes

The aim of this study was to examine associations between functional ability to perform basic activities of daily living (ADL) functions (feeding, continence, going to the toilet, transferring from bed to chair, dressing and bathing), social contacts with family and friends/neighbours and emotional and social loneliness. A quantitative research approach, using a survey design, was performed. The sample comprised 113 subjects aged 65-101 years, living in nursing homes. Data were gathered through structured interviews by using the following measures: the modified Katz Index of ADL, the Revised Social Provisions Scale (SPS), and Family and Friendship Contacts Scale. Descriptive statistics, factor analyses, multiple correlation analyses and multiple regression analyses were used. Data showed a statistically significant relationship between dependence on the environment in carrying out ADL and low level of social loneliness. Likewise, high frequencies of social contact with sons, daughters and grandchildren had a statistically significant effect on low level of social loneliness. A confirmatory factor analysis (varimax rotation, eigenvalue 1.0) was employed to explore the two predefined dimensions (attachment and social integration) of the SPS. The results confirmed, to a very high degree, the two dimensions of the Weiss Model. Reliability (internal consistency), measured by Cronbach alpha, was 0.85 and 0.92, for attachment and social integration respectively. Based on this analysis, dependence in ADL function is important for a low level of social loneliness. From the present study it is concluded that ADL (feeding, continence, going to the toilet, transferring from bed to chair, dressing and bathing) and contact with a social network have a statistical effect on a low level of social loneliness. Hence, such associations may be of significance in nursing intervention and may influence the well-being of residents in nursing homes in different stages of life.

Predictors of loneliness in centenarians: a parallel study

The purpose of this study was to evaluate predictors of loneliness in centenarians for two countries: The USA and Sweden. It was hypothesized that cognition, personality, social support and physical health would predict loneliness. Results indicated that personality, social support and physical health were good predictors of loneliness in the US sample, while cognition and social support were the strongest predictors in the Swedish sample. Social support predicted loneliness negatively in the US sample, but was positively associated with loneliness in Sweden.

Attachment among older adults: current issues and directions for future research

Although John Bowlby conceptualized attachment theory as applicable across the life span, researchers have been relatively slow to examine attachment phenomena specifically among older adults. The present article reviews the extant research applying attachment theory to older populations; preliminary findings suggest that attachment issues hold particular relevance for older adults, given the increased potential for separation, loss and vulnerability associated with aging. Although many of the studies reviewed are somewhat limited methodologically, the overall pattern of results suggests that attachment patterns are associated with a variety of outcomes in later life (such as adaptation to chronic illness and caregiver burden among family members, reactions to the death of a loved one, and general well-being) in a theoretically consistent manner. The implications of and questions raised by current findings are reviewed, and directions for future research are discussed.

Loneliness and depression in caregivers of persons with Alzheimer's disease or related disorders

Secondary analysis of data from a sample of 242 husbands, wives, and daughters providing care for Alzheimer's disease family members was conducted to examine the relationships among loneliness and depression and the following variables: quality of the past relationship, relational deprivation, quality of the current relationship, and distance felt due to caregiving. Loneliness was significantly related to depression (r = .66, p < .001), relational deprivation (r = .36, p < .001), and quality of the current relationship (r = .34, p < .001), indicating that the more loneliness reported by the caregivers, the more the caregiver experienced depression, relational deprivation, and a poorer quality of the current relationship. Significant gender differences were found with the caregiving wives and daughters reporting higher mean scores than caregiving husbands on relational deprivation, loneliness, and depression. Loneliness was the only variable significant for predicting depression in caregiving husbands, wives, and daughters. In order for loneliness and depression to be addressed in the Alzheimer's disease caregiver, they must first be recognized by nurses.

Relation between premorbid personality and patterns of emotion expression in mid- to late-stage dementia

Twenty-seven nursing home patients with mid- to late-stage dementia participated in a study of the relation between preillness personality, as indexed by attachment and emotion regulation style, and current emotional behavior. Preillness measures were completed by family members and current assessments of emotion were supplied by nursing home aides and family members; in addition, emotion was coded during a family visit using an objective coding system for facial emotion expressions. Attachment style was found to be related to the expression of positive affect, with securely attached individuals displaying more positive affect than avoidantly attached individuals. In addition, high ratings on premorbid hostility were associated with higher rates of negative affect and lower rates of positive affect. These findings indicate that premorbid aspects of personality show continuity over time, even in mid- to late-stage dementia.

Loneliness in elderly people: an important area for nursing research

The phenomenon of loneliness occurs in people of all ages but may be a particular problem in the elderly. It is acknowledged that loneliness is not a necessary accompaniment to ageing and that ageing is not solely responsible for the development of loneliness in elderly people. However, there is a relationship between ageing and loneliness. Four major theories of loneliness are reviewed and their utility for application to research in the elderly is examined along with a consideration of the ways in which loneliness can be measured. While causal relationships are difficult to determine, there is evidence that loneliness is associated with a number of physical and psychological pathologies and the relevance of these to nursing is discussed. There is a growing awareness of the phenomenon of loneliness in elderly people in the nursing literature and some evidence that nursing intervention can be beneficial in this regard both at alleviating loneliness and reducing some of the adverse effects of loneliness. Finally some directions for nursing research are presented which are aimed at improving the assessment and nursing intervention for loneliness in elderly people.

Loneliness among the oldest old, a comparison between residents living in nursing homes and residents living in the community

Two groups of individuals, eighty years of age or older, were compared with respect to the experience of loneliness and the influence of social relationships. One group was living in nursing homes. The other group was living alone in their own homes in the community. There were no significant differences in experienced loneliness between residence with close contacts with members of family and friends compared to residents without such contacts in either of the two groups, with one exception: institutional residents with existing contacts with former neighbors reported significantly lower levels of loneliness compared to institutional residents without such contacts. Frequency of contacts with family and neighbors did not influence significantly the degree of loneliness for residents in institutions. For residents in the community there were significant differences in experienced loneliness between those who had frequent contacts with family members and neighbors and those with infrequent contacts. Institutional residents, like residents in the community who desired more frequent contacts with family members and friends, reported higher levels of loneliness, compared to those who reported sufficient contacts.