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Thesis Defense: Older Adults and Coping

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I successfully defended my thesis last Friday. Although it was somewhat nervewracking, the meeting went really well. It felt more like a discussion than a presentation by the end and I got lots of good feedback and suggestions from my committee. The next step is to try to publish a journal article using the findings from the study.

The gist of the results is that problem- and emotion-focused coping appear to be adaptive, whereas dysfunctional coping appears to be somewhat less related to resilience to suicide. Implications of the study are that some coping strategies may serve as protective factors against suicide and coping strategies should be evaluated as part of a thorough assessment of at-risk older adults.

Thanks again to my committee for their guidance and to those who participated in the study.

Becoming a Geropsychologist

I've gotten a few questions recently on how one becomes a geropsychologist. While there are many paths leading to a career in geropsychology, here is one of the most efficient routes:

1) Get a bachelor's degree in Psychology: if not Psychology, another social science (e.g., Sociology) or physical science (e.g., Biology) is also helpful, as long as you take enough Psychology classes to get a basic, broad understanding of the field.

2) Get a doctorate degree in Psychology: if you'd like to go into clinical work, you'll need to complete a program in Clinical or Counseling Psychology. With a bachelor's degree, these programs usually take 5 - 6 years to take classes, write a dissertation, and complete one year of internship. The internship year is typically the last year of one's program and involves full-time clinical work.

3) Get a post-doctoral ("post-doc") position: In order to gain enough supervised clinical experience to be eligible for licensure or additional research experience (and rack up publications), many people choose to do a post-doc. Depending on what your goals are, this could take 1 - 3 years to complete.

Some people (myself included) decide to work or get a master's degree before entering a PhD program. This can add several years to the process, but is often very valuable experience.

Division 12 II of the American Psychological Association (APA) has a lot of useful information for students in geropsychology. APA Division 20 has a comprehensive list of graduate programs that provide specialization in adult development and aging.

2008 GSA Poster Presentation

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Older adults have a disproportionally high rate of completed suicide as compared to the general population, but relatively little is known about the extent to which coping styles and beliefs serve as protective factors against suicide in this population.

We had a group of community-dwelling older adults complete questionnaires on coping, reasons for living, and suicidal ideation. Some of the findings include:

- Suicidal ideation had a significant negative relationship with both problem- and emotion-focused coping and a significant positive relationship with dysfunctional coping.

- Suicidal ideation had a significant negative relationship with survival and coping beliefs, responsibility to family, child-related concerns, and total reasons for living score and a significant positive relationship with fear of suicide.

The findings suggest that a full assessment of coping styles and reasons for living should be part of a thorough evaluation of at-risk older adults. Future research should test the extent to which interventions that bolster coping skills and reasons for living reduce suicidal ideation and suicidal behaviors.

2008 APA Poster Presentation

A substantial literature has documented that sexual abuse relates to suicidal behaviors but relatively less is known about resilience to suicide, especially cognitive deterrents to suicide.

The present study investigated the effects of a history of sexual victimization on reasons for living. Female participants (N = 138; M age = 24.4 years, SD = 7.3 years; range = 18 to 53 years; 79% Caucasian) completed the Sexual Experiences Survey (SES) and the Reasons For Living (RFL) Inventory. According to SES responses, participants were classified into 5 mutually exclusive groups: no victimization, sexual contact, sexual coercion, attempted rape, and rape. ANOVAs showed that degree of sexual victimization had a significant effect on the RFL Total scale and 2 subscales (Survival and Coping Beliefs; Moral Objections). The general pattern was that mean RFL scores in the no victimization group were significantly higher than the mean scores in the sexual coercion and rape groups.

An implication is that having a history of sexual victimization, especially sexual coercion and rape, limits one’s later reasons for not committing suicide. Bolstering these modifiable deterrents to suicide should be part of suicide prevention efforts among at-risk women.

The "How" of Suicide

In the U.S., older adults have a disproportionally high rate of completed suicide as compared to the general population, with white men over the age of 85 being at greatest risk (National Center for Health Statistics, 2007). The state of Colorado has similar trends (The Colorado Trust, 2002). Compared with other age groups, older adults are more likely to use firearms as their choice of suicide method, which more often results in death (Steffens & Blazer, 1998).

As mental health practitioners and researchers, we typically focus on the psychosocial cause(s) of suicide, usually associated with the presence of risk factors, to guide our suicide prevention interventions. In reviewing the literature for my thesis, I discovered the general consensus that suicidal individuals are poor problem-solvers; that is, they tend to see one solution, and one solution only, to their problems.

However, a recent article in the New York Times ("The Urge to End It All"), highlighted the importance of focusing on the method of suicide in prevention efforts. By simply creating physical barriers to suicide, the risk of completed suicide can be mitigated. Ironically, this may be due in part to the poor problem-solving abilities of those who attempt suicide. If an obstacle is put in the way (e.g., keeping guns in a locked case or putting some time in-between the thought and the act), the individual is less likely to go through with it.

If you (or somebody you know) are suicidal, the best thing to do is call 911 or a suicide prevention hotline (like 1-800-273-TALK) or go to the nearest emergency room.

Thesis Proposal: Older Adults and Coping

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Last week I successfully proposed my thesis project titled, "Coping Strategies, Suicidal Risk, and Protective Factors Against Suicide in Older Adults." The goals of this study are to investigate coping abilities in older adults and how those relate to suicidal ideation and cognitive deterrents to suicide. We've already begun data collection and hope to have the study completed by the end of the year. Thank you to my committee (Daniel L. Segal, Ph.D., Frederick L. Coolidge, Ph.D., and Brian Yochim, Ph.D.) for all of their thoughtful comments and questions.

Intergenerational Volunteering in Schools

NPR had an interesting story this morning on adults with dementia volunteering at a school in Cleveland. As of yet there are no research data on this specific program; however, it appears that older volunteers without dementia benefit from their volunteer experience in schools through increased social interaction and cognitive activity (see articles on Experience Corps).

The Science of Change

The Psychological Society of the Pikes Peak Region sponsored a conference today titled "The Science of Change: Translating What Works in Therapy." Barry Duncan, Psy.D., co-director of the Institute for the Study of Therapeutic Change, challenged recent trends in the field of mental health that emphasize treatment methods over other factors responsible for psychotherapy outcome. From his years of experience as a practitioner and review of the literature, he has come to a few conclusions:

- the therapeutic alliance is more important for psychotherapy outcome than the theoretical orientation of the service provider (e.g., clients generally don't remember what brilliant techniques we use in therapy, but how well we build a relationship with them)

- evidence based treatments aren't "bad," but overemphasized in the field of mental health and should be used on a client-by-client basis (taking into consideration client characteristics, culture, and preferences)

- most of the outcome variance in psychotherapy is due to client/extratherapeutic factors (i.e., something that happens outside of the therapy hour that helps a client to change)

- therapeutic power does not come out of identifying what clients need, but in identifying their strengths and resources that can be put to use in reaching their goals (Dr. Duncan calls this "finding the heroic client," my clinical supervisor calls it "being curious")

- asking clients what they'd like to do to deal with their problems and asking for feedback on how they think they are progressing throughout therapy improves the quality and outcome of services

Episodic Memory and Aging Study

The UCCS Gerontology Center sponsors a seminar series for students, faculty, and community members. Today, David McCabe, Ph.D. of Colorado State University presented the results of a study on memory and executive functioning across the lifespan.

Dr. McCabe used the analogy, "age is to memory as time is to rust." Basically, age does not cause memory loss, rather memory loss is caused by some underlying variable (associated with age). A few hypotheses for why episodic memory (memory for events) decines with age include reduced working memory capacity, processing speed, executive function, and general fluid intelligence.

The findings of Dr. McCabe's study suggest that tests of executive function and working memory capacity measure a common construct, which he calls "Executive Attention." Executive attention was found to be more closely related to episodic memory than processing speed or general fluid intelligence, implying that problems with episodic memory are due to executive dysfunction in older adults.

The Art of Aging Well

The scientific study of "successful aging" is still relatively new and the precise ways in which individuals manage to thrive as older adults is not very well understood. Recently, the results from the first study on aging visual artists in New York City were released by the Research Center for Arts and Culture at Teachers College, Columbia University.

The aim of the project was to document the survival skills and social support of aging artists in New York City's five boroughs. The study found that the artists in this sample rank high in life satisfaction, have high self-esteem as a person and an artist, communicate daily or weekly with other artists, and are very satisfied with their careers. The authors of the report made several recommendations for both redefining "work" and "old age" and policy changes that would improve the lives of this hardy group of seniors.