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Physical Illness and Depression in Older Adults: A Handbook of Theory, Research, and Practice PDF

371 Pages·2002·2.45 MB·English
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Physical Illness and Depression in Older Adults THE PLENUM SERIES IN SOCIAL/CLINICAL PSYCHOLOGY Series Editor: C. R. Snyder University of Kansas Lawrence, Kansas Current Volumes in the Series: ADVANCED PERSONALITY EditedbyDavidF. Barone,MichelHersen,andVincentB.VanHasselt AGGRESSION Biological, Developmental, and Social Perspectives Edited by Seymour Feshbach and Jolanta Zagrodzka AVERSIVE INTERPERSONAL BEHAVIORS EditedbyRobinM. Kowalski COERCIONANDAGGRESSIVE COMMUNITYTREATMENT A New Frontier in Mental Health Law Edited by Deborah L. Dennis and John Monahan HANDBOOK OF SOCIAL COMPARISON Theory and Research Edited by Jerry Suls and Ladd Wheeler HUMOR The Psychology of Living Buoyantly HerbertM. Lefcourt THE IMPORTANCE OF PSYCHOLOGICAL TRAITS A Cross-Cultural Study John E. Williams, Robert C. Satterwhite, and José L. Saiz PERSONAL CONTROL IN ACTION Cognitive and Motivational Mechanisms Edited by Miroslaw Kofta, Gifford Weary, and Grzegorz Sedek PHYSICALILLNESSANDDEPRESSIONINOLDERADULTS A Handbook of Theory, Research, and Practice Edited by Gail M. Williamson, David R. Shaffer, and Patricia A. Parmelee THE REVISED NEO PERSONALITY INVENTORY Clinical and Research Applications Ralph L. Piedmont SOCIALCOGNITIVEPSYCHOLOGY History and Current Domains David F. Barone, James E. Maddux, and C. R. Snyder SOURCEBOOK OF SOCIAL SUPPORT AND PERSONALITY Edited by Gregory R. Pierce, Brian Lakey, Irwin G. Sarason, and Barbara R. Sarason AContinuation Order Plan isavailable for thisseries.Acontinuation order will bring delivery of each new volume immediately upon publication. Volumes are billedonlyupon actual shipment. Forfurther information please contact the publisher. Physical Illness and Depression in Older Adults A Handbook of Theory, Research, and Practice Edited by GailM.Williamson David R. Shaffer University ofGeorgia Athens, Georgia and Patricia A. Parmelee Genesis Health Ventures Kennett Square, Pennsylvania Kluwer Academic Publishers NewYork Boston Dordrecht London Moscow eBookISBN: 0-306-47178-7 Print ISBN: 0-306-46269-9 ©2002 Kluwer Academic Publishers New York, Boston, Dordrecht, London, Moscow Print ©2000 Kluwer Academic / Plenum Publishers New York All rights reserved No part of this eBook may be reproduced or transmitted in any form or by any means, electronic, mechanical, recording, or otherwise, without written consent from the Publisher Created in the United States of America Visit Kluwer Online at: http://kluweronline.com and Kluwer's eBookstore at: http://ebooks.kluweronline.com To NELL MCEWIN, mother of Gail Williamson, and quintessential role model of combining femininity with independence, achievement, and overcoming adversity to set one's sights on nothing less than the best Contributors KatherineL.Applegate, Department ofPsychiatry, Ohio StateUniversityCollegeof Medicine, Columbus, Ohio 43210 Jamila Bookwala, Department of Psychology, Pennsylvania State University, Abington, Pennsylvania 19001 Martha L. Bruce, Department of Psychiatry, Weill Medical College of Cornell Univer- sity, White Plains, New York 10605 EricD. Caine, DepartmentofPsychiatry, UniversityofRochesterMedicalCenter, Roch- ester, New York 14642 Jen Cheavens, Department of Psychology, University of Kansas, Lawrence, Kansas 66045 Mary Amanda Dew, Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh, Pittsburgh, Pennsylvania 15213 Ronald Glaser, Department of Medical Microbiology and Immunology, Ohio State University College of Medicine, Columbus, Ohio 43210 Barry Gurland, Columbia University Stroud Center, New York, New York 10032 Sidney Katz, Columbia University Stroud Center, New York, New York 10032 Janice K. Kiecolt-Glaser, Department of Psychiatry, Ohio State University College of Medicine, Columbus, Ohio 43210 Ellen J. Klausner, Department of Psychiatry, Weill Medical College of Cornel1 Univer- sity, White Plains, New York 10605 Charles E. Lance, Department of Psychology, University of Georgia, Athens, Georgia 30602 M. Powell Lawton, Polisher Research Institute, Philadelphia Geriatric Center, 5301 York Road, Philadelphia, Pennsylvania 19141 Jeffrey M. Lyness, Department of Psychiatry, University of Rochester Medical Center, Rochester, New York 14642 Adam W. Meade, Department of Psychology, University of Georgia, Athens, Georgia 30602 vii viii CONTRIBUTORS L. Stephen Miller, Department of Psychology, University of Georgia, Athens, Georgia 30602 Mark D. Miller, Department of Psychiatry, University of Pittsburgh School of Medi- cine, Pittsburgh, Pennsylvania 15213 Benoit H. Mulsant, Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh, Pittsburgh, Pennsylvania 15213 Patricia A. Parmelee, Managed Care Division, Genesis Health Ventures, 148 West State Street, Kennett Square, Pennsylvania 19348 Zachary M. Pine, Geriatric Division, Department of Medicine, University of Califor- nia at San Francisco, San Francisco, California 94143 Bruce G. Pollock, Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh, Pittsburgh, Pennsylvania 15213 John W. Reich, Department of Psychology, Arizona State University, Tempe, Arizona 85287 Charles F. Reynolds III, Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh, Pittsburgh, Pennsylvania 15213 Bruce Rollman, Department of Psychiatry, University of Pittsburgh School of Medi- cine, Pittsburgh, Pennsylvania 15213 Ramesh Sairam, Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas 75235 Herbert C. Schulberg, Department of Psychiatry, Weill Medical College of Cornell University, White Plains, New York 10605 Amy S. Schultz, Department of Psychology, Arizona State University, Tempe, Arizona 85287 Richard Schulz, Department of Psychiatry, University of Pittsburgh School of Medi- cine, Pittsburgh, Pennsylvania 15213 David R. Shaffer, Department of Psychology, University of Georgia, Athens, Georgia 30602 C.R. Snyder, Department of Psychology, University of Kansas, Lawrence, Kansas 66045 Myron F. Weiner, Department of Psychiatry, University of Texas Southwestern Medi- cal Center, Dallas, Texas 75235 Gail M. Williamson, Department of Psychology, University of Georgia, Athens, Geor- gia, 30602 Jennifer L. Yee, Center for Social and Urban Research, University of Pittsburgh, Pitts- burgh, Pennsylvania 15213 Alex J. Zautra, Department of Psychology, Arizona State University, Tempe, Arizona 85287 Foreword Aging is inevitable-A "psychological recession" is not . . . As I go about my daily life, I read and hear about the sometimes scary things that are happeningtootherpeople. Asthe sayinggoes, badnews sells newspapers. ButIusu- ally can take some solace in reasoning that this bad stuff assuredly will notoccur in my life. After readingthis book, however, one message has gotten through–I cannot dis- miss "those" olderpeopledescribedinthevarious chapters asbeingdissimilar tome. After all, "old person" is a term that can be applied to me in a few more years. On this point, Ionceheardthefollowingrhetoricalquestionappliedtotheprejudiceactionsof theTVcharacterArchieBunker: "Whatwouldhesayabout "those"PuertoRicans,if, onhisnextbirthday,heknewthathewouldbecomeaPuertoRican?"Asto aging,we bestpayclose attentionbecausewe soonwillbe "those" elders. This is why the alarming facts of this book-that our elders often are experiencing elevatedlevelsofphysicalillnessesanddepression–grabbedmebytheproverbialthroat. So, too, should these facts alert America's baby boomers, because the talk of illness and depression certainly takes some ofthe shine offtheir ensuing "goldenyears." As the physical illnesses and dark shadows of depression creep into many elders' lives, they are rendered far from painless, less than happy, and generally not too "golden." I call this a "psychological recession," where large numbers of elders have lost their goodhealth, aswellas theirpositiveoutlooks. To compoundmatters, apsychological recessioninvolvestheelder'simplicitandsometimesexplicitcomparisonofthepresent circumstances with those ofhis or heryounger days. Physical illnesses and depression are serious: anyone who has experienced them can testify to suchanassertion. Theytake awaylife's pleasures, rob simplejoys, and leave us wondering about our purpose in being. And such physical problems and de- pression do not impact just the one personwho "has" them. They spread, and soon friends and loved ones also are engulfed by them. The "downer" grows–and so we have a psychological recession for all those involved. Whatcanwe dotobetterunderstandandhelpthewavesofagingpeoplewhoare mired in such psychological recession? This question portends answers for the present elders, aswell as thewaves offuture elders–people likeyou andme. For this reason, this book both alarms and excites me. The alarm I already have sounded. As to the excitement, inthe followingpageswe are treatedtonewinsightsaboutunderstanding and lifting the veils from the illness and despondencyproblems. The thinkingin this volume is catalytic and fresh, producinga reaction akin to that ofsolvinga problem. After thoroughly describingthe depth andbreadth ofthe physical illness and depres- ix x FOREWORD sion problems faced by elders, the present researchers share their insights and solu- tions. They tell us what we now know, and provide an agenda for future research and interventions. Thus, the editors and authors of this volume paint a realistic view about how the forces of physical illness and depression can be understood and overcome. In conclusion, there is bad and good news on these pages. The bad news is that physical illness and depression may touch us in the senior years. The good news is that these threats to our well-being can be understood and, in many, if not most instances, changed for the better. As such,agingisinevitable; apsychologicalrecessionisnot. C.R.SNYDER Lawrence, Kansas Preface The population is aging. Baby boomers are approaching retirement age, and individu- als over age 85 make up the single fastest-growing segment of the population. Our society is faced with quickly finding answers to questions about longevity and quality of life that, because they pertained to so few people, were not matters of urgency just a few decades ago. Historically, diagnosis and treatment of depression in elderly people was ham- pered by mythical thinking. Depression was viewed as an unavoidable consequence of the losses (e.g., declining health, retirement, and bereavement) that naturally accom- pany advancing age. Epidemiological studies exploded this myth by indicating that severe depression was not as widespread a problem in older adults as was commonly believed. Still, even clinically diagnosable depression typically went untreated. Among the reasons were the difficulty of diagnosing depression when it is accompanied by physi- cal illness and beliefs that available treatments for depression were not suitable for and would not be accepted by elderly persons. In recent years, we have seen some major breakthroughs. First, researchers and practitioners took note of the fact that, although major depression is relatively uncommon in elderly adults, it is not necessary for depressed affect to meet clinical diagnostic criteria to negatively impact quality of life. Second, substantial strides have been made toward better methods for identifying depressive symptomatology in this segment of the population. Third, research efforts have clearly shown that the association between physical illness and depression is bidirectional and complicated by numerous biological, social, and psychological fac- tors. Finally, advances in pharmacological and behavioral therapies have produced more suitable interventions, and current treatment strategies have been proven to be both effective for and accepted by depressed older adults. Professionals working at the intersection of physical illness and depression are an interdisciplinary group that can model (albeit less than perfectly) cross-discipline co- operation. From its inception, the idea for this handbook was to bring together in one place a comprehensive sample of up-to-date work from various disciplines in an effort to stimulate further theoretically based and intervention-oriented research. In addition to introductory and final summary chapters, this handbook consists xi

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Aging is inevitable-A "psychological recession" is not . . . As I go about my daily life, I read and hear about the sometimes scary things that are happening to other people. As the saying goes, bad news sells newspapers. But I u- ally can take some solace in reasoning that this bad stuff assuredly
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