Does menopause or a hysterectomy quash or quicken your sex life? This question applies not only to those of us who might face these, but also to the romantic partners who love and live with many of us. Since our most important sexual organ is between our ears and not our legs, I believe our interest in sex (libido) is largely dependent on our beliefs about sex and what we can and should expect.

In my practice, I work with many older women who have read about increasing their estrogen levels in order to improve their sexual experiences and increase their sexual desire. Some swear by bioidentical hormones, while some declare that testosterone (T) is their favorite “hormone of desire.” (Susan Rako’s popular book bearing this title swears by T, but she backs her theory with personal anecdotes and no scientific data whatsoever.)

In 1985, researcher Barbara Sherwin wondered if lack of testosterone caused problems with libido. She discovered that administering T to women who had undergone hysterectomies enhanced the intensity of their sexual desire and increased frequency of sexual fantasies. But there was no evidence the hormone had affected their physiological response, so its effect was more motivational than physical.

There have been few well-designed studies of sexual interest in healthy people. Most studies of sexual problems have come from women who consulted their physician because of some health concern and thus had issues of some kind already. When well-known sexologist Alfred Kinsey and his colleagues spoke to women throughout their life cycles, they found that as age increased there was a distinct decline in the frequency of intercourse. But there was no decline in solitary self-pleasuring until well after age 60.

Among people I’ve talked to about sex, I’ve found over the years that men report a greater loss of sexual interest between 45 and 55 than women do; perhaps that’s why some of these women are masturbating! Many women over the course of menopause do report some decrease in intercourse and vaginal lubrication, but not in solitary sexual enjoyment when utilizing one of the many intimate lubricants available. Hooray for the slippery stuff!

A high percentage of our feelings about sex are determined by the culture that surrounds us. I once read about a study of aging women in a small village in Thailand. Some of them experienced a decline in libido, but they celebrated this, perceiving it as a welcome release from having to worry about sex. So while uterine changes may cause some lessening of sexual desire, not everyone experiences it and not everyone who does experience it considers it a problem.

I once worked with a young, single woman who underwent surgical menopause when she was in her late twenties. (I don’t recall whether her ovaries were removed.) She initially lost interest in sex, but when she regained her libido she began to lament that men were no longer interested in dating her. She would sit in my office and weep: “I’ve lost my mojo!” I scoured professional journals and spoke to colleagues about how the surgery might have affected her level of sexual attractiveness or desirability, and finally read about a study of monkeys that showed that males were no longer attracted to females who had hysterectomies. But when vaginal secretions containing pheromones from “intact” females were rubbed on the ones who had hysterectomies, males regained interest.

Pheromone secretion aromas are sexually stimulating, and after hysterectomy they are no longer produced in females. We do, of course, need to be careful about drawing conclusions about human sexuality from animal studies such as this, since so much of our sexuality is psychological and sociological. But popular magazines have recently published findings that seem to show that men “rate” women they’re watching on video who are ovulating as “more attractive” than women of a similar age and appearance who are in other stages of their menstrual cycle.

However, it isn’t as simple as no womb, no pheromones, no sex. Many older women are seen as sexy and are enjoying as much sex as they want. I guess we’re more complicated than monkeys!

According to a new study led by Panayotes Demakakos of the Department of Epidemiology and Public Health at University College London, older people with depression walk slower than their peers who do not have depression. Gait speed, or the speed that a person walks, is influenced by a host of factors, including physical ability, range of motion, musculoskeletal health, and mental health. Although there has been some evidence that psychological conditions can affect gait by way of diminished physical health, there is little research focused on examining a direct link between gait speed and psychological health, and in particular, depression.

Demakakos wanted to explore how depression and gait speed were related and also to evaluate whether their influence was bidirectional. In particular, Demakakos wanted to find out if older individuals with depression had slower gait speeds than those without, and if slow gait speeds predicted depression in older individuals.

Using a sample of 4,581 individuals over age 60, Demakakos measured depressive symptoms and gait speed across a six-year period. The results revealed that people with slow gait speeds had a higher risk of developing depression in the two years following assessment than those with average gait speeds. Further, Demakakos also discovered that depressive symptoms were directly linked to slow gait speeds.

The results can be interpreted in many ways. First, as people age, they experience declines in physical health and mobility. These factors can decrease gait speed and by limiting physical ability, can eventually erode mental well-being and put people at risk for depression. Second, as depressive symptoms increase, physical mobility can become impaired, pain can increase and fatigue can set in, all of which combine to decrease walking speed.

The results presented here were consistent even after demographic factors such as marital status, socioeconomic status, and gender were taken into consideration. In sum, this study shows that gait speed could act as an early indicator for depression. Demakakos added, “These findings point to depression as a modifiable risk that needs to be targeted by disability prevention programs at older ages.”

Reference:
Demakakos, P., Cooper, R., Hamer, M., de Oliveira, C., Hardy, R., et al. (2013). The bidirectional association between depressive symptoms and gait speed: Evidence from the English Longitudinal Study of Ageing (ELSA). PLoS ONE 8(7): e68632. doi:10.1371/journal.pone.0068632

Alfred Kinsey reported that men hit their sexual prime in their late teens, while women don’t get that pleasure until their mid-thirties. But does the 60-year-old research that Kinsey conducted still hold true today? Was it even true back then?

According to Dr. Bella Ellwood-Clayton, a sexual anthropologist and author, the results of Kinsey’s research probably did not consider the myriad of other factors that influence sexual peak. Even though measuring the amount of orgasms a person has is a pretty good indicator, is not the only barometer by which to gauge sexual appetite.

Ellwood-Clayton says that at the time of the study, boys were masturbating and 30-something women were probably finding their own identities in stable relationships. For the first time in their lives, they were comfortable with their own sexuality. Today, women are finding this level of comfort at even older ages that extend well into their 50s, 60s, and beyond.

Opportunity is another factor that has a big impact on libido. When the opportunity for sex is unavailable, you can lose your desire. Raising children or being in a hostile or abusive relationship can cause even blazing sexual desires to smolder to ashes. But with the peak in sexual medications and the revival of sexual promiscuity in the older generation, it appears that sexual peaks are based more on social psychology than on physical ability.

Sure, men might have more testosterone than women and younger women might be a little more hormonally balanced than older women. But with hormone replacement therapy, physical health, and the right bed-fellow, people of all ages are reporting great sex drives. And there is an awful lot to be said about sexual maturity, which can add intense pleasure to sexual encounters (think Mrs. Robinson).

Overall, Ellwood-Clayton and other experts think that sexual peaks are not simply biological, but more the result of spiritual, physical, emotional, and biological components all aligning at just the right time. “Sexual prime, then, is the result of ‘sexiness.’ And that,” adds Ellwood-Clayton, “can peak at any age.”

Reference:
Ellwood-Clayton, Bella. (2013). Sexual prime: Fact or fiction. Huffington Post (n.d.): n. pag. Web http://www.huffingtonpost.com/bella-ellwoodclayton/sexual-prime_b_3424410.html

Avoidance is a behavior that can be seen as both adaptive and maladaptive. In psychological research, people with anxious personalities tend to avoid social situations and use avoidance as a way to circumvent threatening environments. People with depression also engage in avoidance behaviors.

In contradiction to these theories, attentional bias toward certain stimuli is also common in certain psychological conditions. Although avoidance is not always a bad practice, people who avoid emotional stimuli may internalize feelings and increase their risk for further symptoms of depression and/or anxiety. Existing research on emotional bias and avoidance focuses mostly on children, adolescents, young adults, and middle-aged adults. But few studies have looked at how emotional avoidance and processing changes with advanced age.

To address this, Ineke Demeyer of the Department of Experimental Clinical and Health Psychology at Ghent University in Belgium recently led a study that compared 25 middle-aged adult emotional bias to attentional and emotional bias in a group of 37 older adults between the ages of 75 and 88. Demeyer also looked at how the presence of depression or anxiety affected attention bias.

The results revealed that the older participants engaged in avoidant behaviors to all of the stimuli, regardless of whether the cues were neutral, sad, or happy. The middle-aged participants did not demonstrate any attentional bias. When Demeyer looked further, it was revealed that the older adults showed avoidant behavior toward the sad and happy cues more than the neutral ones. Demeyer added, “When taking a closer look into the role of mood and affective symptoms, we found that older adults who experienced more anxiety symptoms showed more avoidance of negative stimuli.”

Demeyer believes that these findings can be interpreted in several ways. First, older individuals may have higher levels of emotional regulation, which causes them to temper their emotional responses more than younger adults. Second, because older individuals are aware of their limited life span, they may choose to avoid any negative stimuli in particular, as they would rather only expend energy on positive things. Finally, their limited energy resources may cause them to have a blunted emotional response to all stimuli in general.

In conclusion, these findings show that there are differences in how older and middle-aged adults respond to emotional stimuli. Future work should explore these variances and their overall impact on well-being in more depth.

Reference:
Demeyer, I., De Raedt, R. (2013). Attentional bias for emotional information in older adults: The role of emotion and future time perspective. PLoS ONE 8(6): e65429. doi:10.1371/journal.pone.0065429

History repeats itself, especially in our psychological lives and in our relationships.

Although this fact has been recognized for millennia, one of its earliest formulations in the field of psychology is called repetition compulsion. According to Freud (1914) repetition compulsion is a psychological phenomenon in which a person repeats a traumatic event or its circumstances over and over again, either in real life or in dreams.

Does this idea resonate with you? Are there patterns you tend to repeat in your relational life that you just can’t seem to break or, at the very least, have been slow in changing?

Although Freud attempted many explanations of this phenomenon, some more satisfactory than others, it was only in later years that we’ve gained a fuller picture of why these sorts of events are repeated.

Over the course of our lives, we interact with many different systems. However, our family of origin – the first system we encounter – has the most pervasive influence on our emotional and physical development and future relationships. As we grow up, our parents teach us what’s good or bad, valued or worthless, important or unimportant. In many cases, we learn this from what our parents say and do. In other cases, we learn more indirectly, impacted by our family’s emotional atmosphere [1].

Dorothy was a 45-year-old woman who came to psychotherapy knowing exactly what the problem was but with no idea how to solve it. Mostly, I was struck by her exhaustion – she had deep circles beneath her eyes and looked completely drained.

“I’m not living my own life anymore,” she quickly told me.

As we talked, I learned that Dorothy was exclusively caring for her aging mother, in spite of the fact that her two sisters lived less than an hour away. She visited her mother morning and night. Most days, they talked on the phone ten times. Dorothy’s mother was emotionally abusive, often calling her a terrible, hateful daughter; at other times, she phoned Dorothy’s husband to complain about Dorothy’s failings. Dorothy never confronted her mother or insisted that her sisters contribute to their mother’s care.

Dorothy experienced ongoing emotional neglect during her childhood. Although her mother was well intentioned, she’d suffered from severe mental health issues. Dorothy recounted innumerable incidents in which she sought, without success, to elicit her mother’s love. “I remember her lying on the couch almost every afternoon when I got home from school. She’d been crying and hadn’t changed out of her pajamas.”

After a brief pause, I asked, “You just wanted her to notice you?”

Dorothy sighed. “Yes,” she continued, “but no matter what I did, that never happened. I brought home artwork from school, cleaned up the house. Several times, I even cooked dinner. But my mother never got off the couch or thanked me for my effort.”

“I wonder,” I offered, “whether you’re still trying to get her to love you now.” Dorothy began to cry, a first lightly but then in more heavily, making contact with deeply held but rarely acknowledged feelings of disappointment and loss.

We all leave our family of origin with emotional baggage. Some people have more baggage than others, and some are more aware of what’s packed in their bags than others [1]. Learning what’s packed in these bags, and perhaps deciding to work through and leave a few items behind, is the essence of family of origin work.

Dorothy understood that she was repeating a pattern from her early childhood. But change did not come quickly. Over a series of meetings, we discussed the strong emotional pull Dorothy felt to recapture her mother’s love and attention – though she freely admitted that she’d never had these in the first place. Several months later, Dorothy came in and said, “My mother started insulting me again on the phone today.”

“And?” I said, waiting for her to respond.

“And I told her, ‘If you can’t speak to me kindly, then we’ll have to talk another time. Maybe tomorrow when you’re feeling better.’”

“What happened next?” I asked

Dorothy sighed. “She kept going, like we expected she would. But I rose to the occasion. I said, ‘I’m sorry mother, we’ll have to talk later,’ and I hung up the phone.”

This article will be continued in future installments.

References:

1. Brown, F.H. (2006). Reweaving the family tapestry: A multigenerational approach to families. New York: W.W. Norton & Company.
2. Freud, S. (1914). Remembering, Repeating and Working-Through (Further Recommendations on the Technique of Psycho-Analysis II). The Standard Edition of the Complete Psychological Works of Sigmund Freud, Volume XII (1911-1913): The Case of Schreb¬¬History Repeats Itself

Prospective memory describes the ability to remember to do something in the future, like go to a doctor’s appointment or attend a meeting. Research on attention deficit hyperactivity (ADHD) in children has shown that deficits exist in numerous areas of cognitive functioning and behavior control. In fact, behavioral and cognitive difficulties appear to be equally pervasive in children with ADHD. However, as children mature, they overcome the challenges they face with behavioral issues, but cognitive obstacles still exist. Adult ADHD is thought to affect cognitive tasks such as planning, shifting attention, and other executive functions. But the influence of ADHD on prospective memory in adults is still unknown.

Anselm B. M. Fuermaier of the Department of Clinical and Developmental Neuropsychology at the University of Groningen in the Netherlands recently led a study that looked at which prospective memory deficits were present in a sample of 45 adults with ADHD. The participants, who were not on medication for ADHD, were presented with a paradigm that required they plan for, initiate action toward and execute an act in the future. Fuermaier compared the performance of the participants with ADHD to that of 45 non-ADHD adults throughout the process and found several differences.

The biggest deficit that appeared in the ADHD participants was in the area of planning. They made less detailed plans and planned less for multiple future events than the control participants. Initiation of the plan was another area in which the two groups differed significantly. Although both groups were able to recall an impending event, the ADHD participants had difficulty initiating their action plans. “Prospective memory is crucial for everyday occupational and social functioning,” said Fuermaier.  Not only is it essential in order to complete most activities related to work, family, and social interactions, it is also critical to treatment. Clients who cannot remember to attend therapy appointments or who forget to take their medications at designated times are at risk of experiencing worsening symptoms. This can result in negative outcomes such as physical illness, job loss, and relationship conflict that can ultimately increase stress. Overall, this research shows that prospective memory deficits exist in adults with ADHD and addressing this should be part of any treatment program.

Reference:
Fuermaier, A.B.M., Tucha, L., Koerts, J., Aschenbrenner, S., Westermann, C., et al. (2013). Complex prospective memory in adults with attention deficit hyperactivity disorder. PLoS ONE 8(3): e58338. doi:10.1371/journal.pone.0058338

Family burden is a term that encompasses all of the challenges that may exist for an individual who lives with someone who has experienced a significant illness, particularly a long-term illness. Even if the illness does not require that the family member provide care for their loved one, the emotional toll that the illness can have on the family is part of the overall burden. Additionally, any caregiving responsibilities and financial, relational, and personal effects are considered part of family burden. Because family caregiving is becoming increasingly popular and more individuals are living for longer periods with physical and mental illnesses, it is imperative to understand how family burden affects the caregivers and even significant others who do not have to provide care. Therefore, Edel Ennis of the School of Psychology at the University of Ulster in the UK recently conducted a study that explored the relationship between family health, family burden, and participant psychological well-being.

Ennis considered the type of illness, noting that some illnesses such as bipolar, dementia, and Alzheimer’s are particularly emotionally taxing on family members, the relationship between the participant and ill family member, marital status, income, and gender. After examining over 3,000 participants, Ennis found a direct and distinct relationship between family burden and individual mental health. Specifically, the higher the perceived family burden was; the worse the psychological well-being of the participant. For women, high family burden was related to increased risk for depression. For men and women, low income, and singlehood were risk factors for increased stress and poor mood. Ennis believes that limited finances and lack of other people in the home to provide support could explain this finding.

One result that was unexpected was that the participant’s relationship to the ill family member did not affect overall psychological well-being. Previous research has suggested that caring for a spouse is often more emotionally depleting than caring for a parent or child. However, in this study, that was not the case. But, Ennis did find that younger caregivers were more vulnerable to negative psychological outcomes. For all the participants, higher family burden was reported for family member mental health problems versus physical health problems. In conclusion, this study shows that individuals living with an ill family member, even those who do not directly provide care, are at risk for psychological problems and should be targeted for interventions. Ennis added, “This is essential given the increasing numbers of individuals requiring additional support, and the increasing reliance on the family to provide this support.”

Reference:
Ennis E., Bunting, B.P. (2013). Family burden, family health and personal mental health. BMC Public Health 13: 255. Published online 2013 March 21. doi: 10.1186/1471-2458-13-255

Contrary to what we may think, getting older is actually not all that bad. There may be financial and emotional challenges, and health conditions may change the way we live. But according to an abundance of research, older people have lower levels of negative affect, or disposition, than younger people. To better understand why this is, Amanda J. Shallcross of the Department of Psychology at the University of Denver recently led a study that looked at acceptance. She believes that acceptance to negative life events weakens the negative reactions to those events and causes them to impact a person’s affect less. In other words, as we age we are more accepting of things and, ultimately, less unhappy.

Shallcross used the emotional states of anger, anxiety, and sadness to explore her theory. She evaluated 340 participants ranging in age from 21 to 73 years old and subjected them to a stress-inducing experiment designed to cause negative affect. She measured their responses to the induction at the time of the experiment and several more times over the next six months. She found that the older individuals had more acceptance of the stressful condition and responded with less anger and anxiety than the younger participants. However, she did not find lower levels of sadness in the older participants.

These results suggest that as people age they learn to accept conditions in their lives. Perhaps anger and anxiety no longer serve their goals of forming intimate relationships, maintaining family bonds and social networks. They may alter their emotional responses to events in order to secure those relationships. As for sadness, Shallcross believes that older individuals may actually benefit from acceptance there as well. Because they experience more adversity, loss, and life challenges as they age, older individuals should have higher levels of sadness than younger individuals. But in this study, their sadness was equal to the younger participants. Again, Shallcross believes that this was the result of acceptance. “This skill may decrease levels of sadness to remain on par with those of younger individuals,” said Shallcross. “Thereby, net levels of sadness remain constant across age groups.” Overall, these findings demonstrate that acceptance is an important skill for maintaining a positive well-being. And most importantly, people do not have to wait until they are old to acquire that skill. It can be learned at any age.

Reference:
Shallcross, A. J., Ford, B. Q., Floerke, V. A., and Mauss, I. B. (2012). Getting better with age: The relationship between age, acceptance, and negative affect. Journal of Personality and Social Psychology. Advance online publication. doi: 10.1037/a0031180

Couples who have been married for decades seem to know the secret to successful relationships. But when couples bicker and fight after years of being together, is it a sign of an unhappy relationship or cognitive decline? According to a recent article, children and caregivers of couples who exhibit tension and anger may merely be witnessing what has always been there, just with different eyes. When children reach adulthood and enter into their own relationships, they may begin to view their parents’ relationship with different, often more critical, eyes. This could shed new light on not-so-subtle patterns between their parents that have always existed.

But when fighting, arguing, or hostility are new behaviors, they may signify a deeper problem. Mild cognitive impairment (MCI) is an insidious, subtle offender that creeps up on people. Individuals who begin to forget things, or become overwhelmed by things that used to come easily, may hide their impairment from those closest to them out of fear and shame. When a wife who used to be able to tackle all the household chores suddenly stops doing them, her husband may think she is being lazy. Likewise, when a husband who used to enjoy socializing becomes reclusive, his wife may respond with anger and hurt. These mixed signals can increase hostility and tension in the relationship.

Other indications are suspicion and jealousy. Delusions of infidelity or callousness can cause someone to become accusatory of their spouse. This can lead to resentment. And even though they may be unfounded, they set the stage for anger and conflict. The same can happen with physical health declines. Many illnesses can decrease sexual arousal and stifle sexual intimacy. Without that type of connection, couples can become emotionally and physically distant. Dr. Nancy K. Scholssberg, a professor of counseling psychology at the University of Maryland, knows that even though fighting isn’t the answer to the fear or uncertainty that accompanies illness, it is often the most commonly used coping strategy. “Fighting may come from a misguided notion that you can regain power by asserting it over your spouse,” said Schlossberg. “It doesn’t work, it’s false power – but they’ll [spouses] try anything.” Add to that the stress of caring for an ailing spouse, and you’ve got a recipe for disaster. Even though MCI may not be to blame for the battles in most relationships, it is especially important for clinicians to explore this possibility when working with older couples.

Reference:
Seliger, Susan. In the middle: Why elderly couples fight. (n.d.): n. pag. The New York Times. 17 Dec. 2012. Web. 30 Dec. 2012. http://newoldage.blogs.nytimes.com/2012/12/17/in-the-middle-why-elderly-couples-fight/

Being married to the same person for a long time can be quite an achievement. But for many older couples, the celebration of a long life together is overshadowed by health issues, caregiver stress, and lack of independence. Tensions can run high when one spouse is no longer able to care for themselves or tend to their partner’s needs the way they used to. But experts say there are a number of things that couples in their golden years, and their children can do to keep the marriage happy, healthy, and firing on all pistons. One of the first tips that experts give is for children, especially those who have assumed the role of caregiver, to butt out! “Couples who have been together for 60 years tend to have worked out ways to manage conflict – or they wouldn’t still be together,” said psychologist Dr. Gordon Herz from Wisconsin.

In fact, most experts agree that couples who could benefit from some third party direction would be better off consulting a relationship therapist rather than their own children. Some studies suggest marital therapy is most beneficial for older couples because that is when change is most difficult. Lifestyle changes, social changes and physical changes make the older years some of the most stressful. Marriage therapy can help individuals work through their challenges and continue to have a happy and healthy relationship.

Even if couples are struggling with physical and cognitive problems, intimacy is still one of the core elements of a strong relationship. Holding hands, cuddling, or engaging in an activity together can help couples bolster intimacy. But experts also warn not to spend too much time together. As couples age, they tend to be less active and spend more time with each other and not socializing with other people. This is particularly true if one spouse is disabled in some way. It is important for each spouse to take time to care for themselves and rejuvenate their bodies and minds so that they can be fully plugged in when they interact with each other. One recommendation is for spouses, especially those who feel dependent on others, to take time to volunteer in a way that allows them to feel productive and useful. This will improve their well-being and will spill over into their relationship with their spouse.

Reference:
Seliger, Susan. In the middle: Helping unhappy couples. (n.d.): n. pag. The New York Times. 18 Dec. 2012. Web. 19 Dec. 2012. http://newoldage.blogs.nytimes.com/2012/12/18/in-the-middle-helping-unhappy-couples/

Generalized anxiety (GAD) is the most commonly diagnosed form of anxiety among adults. Symptoms of GAD include excessive worry or fear that interferes with daily life. For younger adults, a wealth of data exists showing the effectiveness and safety of Lexapro (escitalopram) in treating GAD. However, far less information exists regarding treatment outcomes for older adults.

Surveys indicate that at least 7% of adults in residential living centers undergo treatment for GAD. Those living on their own may experience GAD at an even greater rate. The elderly population as a whole experiences mood problems at a disproportionately higher rate. In addition, the elderly often have comorbid conditions such as dementia or major depression. For these reasons and others, elderly individuals with GAD often respond poorly to treatment. A study published in the Journal of the American Medical Association shed light on the question of whether Lexapro is a good choice for older adults, but still there are more questions than answers.

Study authors recruited 177 subjects aged 60 years or older with confirmed diagnoses of GAD. Approximately half of the participants received a 12-week treatment with Lexapro, while the remainder received placebo. A variety of psychological tests were administered to gauge response to the treatment. Self-reporting also weighed heavily in the final results.

Because adverse effects represent a potentially more serious concern among older adults, vital signs were taken at regular intervals. At the end of the 12-week study, the Lexapro group showed significant improvement in GAD symptoms. Side effects were mostly minor and included fatigue and sleep disturbances. Regular checks of vital signs confirmed that Lexapro caused no cardiac anomalies for any of the participants.

Among the interesting findings from this study is the observation that Lexapro only separated itself from placebo at week 4. This finding highlights the fact that adherence to a treatment regimen is an essential, but sometimes neglected, component of generating benefits for the individual. Geriatric individuals are in fact more likely to miss doses or stop taking medication entirely, especially if 2 or 3 weeks pass with no changes to their anxiety. Add to this circumstance the fact that elderly people often have additional diagnoses and decreased cognitive functioning, and this population becomes far more at risk.. Primary care physicians must be sure to emphasize the slow-acting nature of Lexapro as they screen the elderly for anxiety problems.

Reference:

1. PubMed Health [Internet]. (n.d.). Bethesda (MD): National Library of Medicine. Escitalopram. Retrieved from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000214/
2. Jenze, E. J., Rollman, B. L., Shear, M. K., Dew, M. A., Pollock, B. G., Ciliberti, C., Constantino, M. (2009). Escitalopram for older adults with generalized anxiety disorder: a randomized controlled trial. Journal of the American Medical Association, 301(3), 295-303.

As people age, they face challenges that they may never have experienced before. Loss of friends due to death, loss of independence as a result of diminished income, and loss of physical health can all create significant stress in a person’s life. The way that people choose to cope with that stress is directly related to the skills they learned throughout their lives. Attachment styles developed in early childhood can dictate the response people have to a variety of stressors, including ones encountered in later years. Additionally, an individual’s ethnic origin influences how he or she will respond to stress at various stages. To better understand how attachment style affects coping and overall well-being in older adults and what role ethnicity plays, Eva-Maria Merz of the Netherlands Interdisciplinary Demographic Institute at The Hague in the Netherlands recently conducted a study of 1,116 older adults from varying cultural backgrounds.

The participants, which included European Americans, African Americans, Eastern European immigrants, and Caribbean immigrants, were examined to determine how attachment style affected their well-being. Specifically, Merz looked at secure or dismissive attachment styles in comparison to avoidant and fearful attachment styles. “As expected, secure attachment and dismissive attachment were associated with greater well-being, whereas ambivalent/fearful attachment was related to reduced well-being in this older cohort,” said Merz. The link between secure attachment and positive well-being was most evident among the Caribbean and African American participants and weakest among the other two groups. When she looked at avoidant/fearful attachment styles, Merz discovered that it negatively impacted well-being in all the ethnic groups with the exception of the Caribbeans.

The results of this study support previous research highlighting the importance of healthy attachment styles on well-being. This new evidence extends the existing data by demonstrating that attachment styles are especially important in later life when unique challenges arise. Further, attachment styles are influenced by ethnicity. Taken together, this information provides new insight into the underlying factors that contribute to the general physical and mental health of older adults and should be considered when implementing interventions to help older adults cope with life’s stressors.

Reference:
Merz, E.-M., Consedine, N. S. (2012). Ethnic group moderates the association between attachment and well-being in later life. Cultural Diversity and Ethnic Minority Psychology. Advance online publication. doi: 10.1037/a0029595

Related articles:
Patterns of Attachment in Adults
Individuation Issues with Elderly and Ailing Parents
The Importance of Attachment in Early Caregiving