Kelsey E. Woods, Christina M. Danko, and Andrea Chronis-Tuscano
Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by developmentally inappropriate levels of hyperactivity, impulsivity, and/or inattention. ADHD is chronic, may persist into adulthood, and is associated with impairment in social and academic/work domains across the lifespan. Children and adolescents with ADHD often present with executive function deficits and emotion dysregulation, and these deficits may increase impairment and risk for co-occurring disorders. The etiology of ADHD is not yet understood, though research suggests that biological and environmental factors (e.g., family, community) contribute to its development and course. It should be noted that ADHD commonly co-occurs with additional psychiatric disorders, such as oppositional defiant disorder (ODD), conduct disorder (CD), and major depressive disorder.
Evidence-based assessment of ADHD requires information from multiple informants using multiple assessment methods to determine the presence of ADHD symptoms across settings and any co-occurring disorders. The evidence-based treatment options for ADHD are manifold. Pharmacotherapy for ADHD is common, although numerous behavioral interventions are also effective. Stimulant medications are commonly prescribed and are typically effective in ameliorating core ADHD symptoms. There is also evidence that the nonstimulant medication atomoxetine substantially decreases the symptoms of ADHD. Importantly, medication therapy works to reduce symptoms but typically does not alleviate the impairments associated with the disorder. Combined medication and behavioral interventions are more likely to reduce impairments and normalize behavior.
Victoria I. Michalowski, Denis Gerstorf, and Christiane A. Hoppmann
Aging does not occur in isolation, but often involves significant others such as spouses. Whether such dyadic associations involve gains or losses depends on a myriad of factors, including the time frame under consideration. What is beneficial in the short term may not be so in the long term, and vice versa. Similarly, what is beneficial for one partner may be costly for the other, or the couple unit over time. Daily dynamics between partners involving emotion processes, health behaviors, and collaborative cognition may accumulate over years to affect the longer-term physical and mental health outcomes of either partner or both partners across adulthood and into old age. Future research should move beyond an individual-focused approach to aging and consider the importance of and interactions among multiple time scales to better understand how, when, and why older spouses shape each other’s aging trajectories, both for better and for worse.
Allison R. Heid and Steven H. Zarit
Individuals are living longer than they ever have before with average life expectancy at birth estimated at 79 years of age in the United States. A greater proportion of individuals are living to advanced ages of 85 or more and the ratio of individuals 65 and over to individuals of younger age groups is shrinking. Disparities in life expectancy across genders and races are pronounced. Financial challenges of sustaining the older population are substantial in most developed and many developing countries. In the United States in particular, employer-based pension programs are diminishing. Furthermore, Social Security will begin taking in less money than it pays out as early as 2023, and the debate over its future in part entails discussions of equitable distribution of resources for the young in need and the old. Living longer is associated with a greater number of chronic health conditions—over two-thirds of Medicare beneficiaries in the United States have two or more chronic health conditions that require complex self-management regimes partnered with informal and formal care services from family caregivers and institutional long-term services and supports. Caregiver burden and stress is high as are quality care deficiencies in residential long-term care settings. The balance of honoring individuals’ autonomous wishes and providing person-centered care that also addresses the practicalities of safety is an ever-present quandary. Furthermore, complex decisions regarding end-of-life care and treatments plague the medical and social realms, as more money is spent at the end of life than at any other point and individuals’ wishes for less invasive treatment are often not accommodated. Yet, despite these challenges of later life, a large percentage of older individuals are giving financial support, time, and energy to younger generations, who are increasingly strained by economic hardship, the pressures on dual earner parents, and the problems faced by single parenthood. Older individuals’ engagement in society and the help they provide others runs counter to stereotypes that render them helpless and lonely. Overall, the ethical challenges faced by society due to the aging of the population are considerable. Difficult decisions that must be addressed include the sustainability of programs, resources, and social justice in care, as well as how to marshal the resources, talents, and wisdom that older people provide.
Jonathan S. Gooblar and Sherry A. Beaudreau
Anxiety disorders are among the most prevalent and understudied mental health problems in late life. Specific phobia, social anxiety disorder, and generalized anxiety disorder are the most prevalent anxiety disorders in older adults among the 11 disorders identified by the Diagnostic and Statistical Manual of Mental Disorders (fifth edition). Anxiety disorders lead to significant functional burdens and interface with physical health problems and cognitive impairment, concerns frequently experienced in adults over age 65. Additional contextual factors should be considered when assessing and treating late-life anxiety, including the effects of polypharmacy, other mental health conditions, role changes, and societal attitudes toward aging. The relationship between anxiety and physical health problems in older adults can be causal or contextual, and can involve poorer estimates of subjective health and lower ratings of functioning. These factors present unique challenges to the detection, conceptualization, and treatment of late-life anxiety, including the tendency for older adults to focus on somatic symptoms and the potential for long-term behaviors that can mask distress such as substance use. Researchers are increasingly incorporating a gerodiversity framework to understand the contributions of cultural, individual, and other group differences that may affect the presentation of anxiety symptoms and disorders. Older adults in general are less likely to be treated for anxiety disorders, and intersecting individual and group differences likely further affect how anxiety disorders are perceived by healthcare providers. Cognitive behavioral therapy and its variants have the most empirical support for treatment. Newer evidence lends support to acceptance and commitment therapy and problem-solving therapy, which tend to address some of the contextual factors that may be important in treatment.
Ye In (Jane) Hwang and Julian Trollor
Autism spectrum disorder (ASD), or autism, is a neurodevelopmental disorder that is typically recognized and diagnosed in childhood. There is no established biological marker for autism; rather, the diagnosis is made based on observation of behavioral traits, including (a) persistent deficits in social interaction and communication, and (b) restricted, repetitive patterns of behavior, interests, or activities. Because autism is a spectrum disorder, autistic individuals are a highly heterogeneous group and differ widely in the presentation and severity of their symptoms. The established prevalence of ASD is approximately 1% of the population.
Information about autism in adulthood is limited; most of the literature examines childhood and adolescence. While the term “later life” has traditionally been associated with those over the age of 65, a dire lack of understanding exists for those on the autism spectrum beyond early adulthood.
Individuals remain on the spectrum into later life, though some mild improvements in symptoms are observed over time. Autistic adults experience high levels of physical and mental health comorbidities. Rates of participation in employment and education are also lower than that of the general population. Quality of life is reportedly poorer for autistic adults than for nonautistic peers, though this is not affected by age. More robust studies of the health, well-being, and needs of autistic adults are needed, especially qualitative investigations of adulthood and aging and longitudinal studies of development over the lifespan.
Anne Josephine Dutt, Hans-Werner Wahl, and Manfred Diehl
The term Awareness of Aging (AoA) incorporates all aspects of individuals’ perceptions, behavioral experiences, and subjective interpretations related to their process of growing older. In this regard, AoA goes beyond objective descriptions of the aging process, such as calendar age or biological age. Commonly used AoA constructs referring to the ongoing experience of the aging process encompass concepts such as subjective age, attitudes toward one’s own aging, self-perceptions of aging, and awareness of age-related change. AoA also incorporates elements that are more pre-conscious in nature, such as age stereotypes and culturally held notions about the aging process. Despite their theoretically broad common foundation, AoA constructs differ according to their specific frames of reference, such as whether and how they take into account the multidimensionality and multi-directionality of development. Examining the existing body of empirical work identifies several antecedents of AoA, such as sociodemographic “background” variables, physical health and physical functioning, cognition, psychological well-being and mental health, psychological variables (e.g., personality, anxiety), and life events. In general, more positive manifestations on these variables are accompanied by a more positive perception and evaluation of the aging process. Moreover, AoA is longitudinally linked to important developmental outcomes, such as health, cognition, subjective well-being, and mortality. Overall, the study of AoA has developed as a promising area of psychological aging research that has grown in its conceptual and empirical rigor during recent years.
Lizbeth Benson and Nilam Ram
In ecological sciences, biodiversity is the dispersion of organisms across species and is used to describe the complexity of systems where species interact with each other and the environment. Some argue that biodiversity is important to cultivate and maintain because higher levels are indicative of health and resilience of the ecosystem. Because each species performs functional roles, more diverse ecosystems have greater capability to respond, maintain function, resist damage, and recover quickly from perturbations or disruptions. In the behavioral sciences, diversity-type constructs and metrics are being defined and operationalized across a variety of functional domains (socioemotional, self, cognitive, activities and environment, stress, and biological). Emodiversity, for instance, is the dispersion of an individual’s emotion experiences across emotion types (e.g., happy, anger, sad). Although not always explicitly labeled as such, many core propositions in lifespan developmental theory—such as differentiation, dedifferentiation, and integration—imply intraindividual change in diversity and/or interindividual differences in diversity. For example, socioemotional theories of aging suggest that as individuals get older, they increasingly self-select into more positive valence and low arousal emotion inducing experiences, which might suggest that diversity in positive and low arousal emotion experiences increases with age. When conceptualizing and studying diversity, important considerations include that diversity (a) provides a holistic representation of human systems, (b) differs in direction, interpretation, and linkages to other constructs such as health (c) exists at multiple scales, (d) is context-specific, and (e) is flexible to many study designs and data types. Additionally, there are also a variety of methodological considerations in study of diversity-type constructs including nuances pertaining theory-driven or data-driven approaches to choosing a metric. The relevance of diversity to a broad range of phenomena and the utility of biodiversity metrics for quantifying dispersion across categories in multivariate and/or repeated measures data suggests further use of biodiversity conceptualizations and methods in studies of lifespan development.
Thomas M. Hess, Erica L. O'Brien, and Claire M. Growney
Blood pressure is a frequently used measure in studies of adult development and aging, serving as a biomarker for health, physiological reactivity, and task engagement. Importantly, it has helped elucidate the influence of cardiovascular health on behavioral aspects of the aging process, with research demonstrating the negative effect of chronic high blood pressure on various aspects of cognitive functioning in later life. An important implication of such research is that much of what is considered part and parcel of getting older may actually be reflective of changes in health as opposed to normative aging processes. Research has also demonstrated that situational spikes in blood pressure to emotional stressors (i.e., reactivity) also have implications for health in later life. Although research is still somewhat limited, individual differences in personal traits and living circumstances have been found to moderate the strength of reactive responses, providing promise for the identification of factors that might ameliorate the effects of age-related changes in physiology that lead to normative increases in reactivity. Finally, blood pressure has also been successfully used to assess engagement levels. In this context, recent work on aging has focused on the utility of blood pressure as a reliable indicator of both (a) the costs associated with cognitive engagement and (b) the extent to which variation in these costs might predict both between-individual and age-related normative variation in participation in cognitively demanding—but potentially beneficial—activities. This chapter elaborates on these three approaches and summarizes major research findings along with methodological and interpretational issues.
Lydia K. Manning, Lauren M. Bouchard, and James L. Flanagan
There is a great deal of concern about the increasing number of older adults who suffer from chronic disease. These conditions result in persistent health consequences and have an ongoing and long-term negative impact on people and their quality of life. Furthermore, the probability that a person will experience the onset of multiple chronic conditions, known as comorbidities, increases with age. Despite the prevalence of comorbidity in later life, scant research exists regarding specific patterns of disease and the co-occurrence and complex interactions of the chronic conditions most closely associated with aging. It is important to review the body of literature on comorbidities associated with physical and psychiatric syndromes in later life to gain an overview of some of the most commonly seen disorders in older adults: hypertension, diabetes, cardiovascular disease, chronic obstructive pulmonary disease, arthritis, depression, and dementia. Specific patterns of disease and the co-occurrence and complex interactions of chronic conditions in later life are explored. In conclusion, we consider the need for a more informed understanding of comorbidity, as well as a related plan for addressing it.
Alison Chasteen, Maria Iankilevitch, Jordana Schiralli, and Veronica Bergstrom
In 2016, Statistics Canada released the results of the most recent census. For the first time ever, the proportion of Canadians aged 65-plus years surpassed the proportion aged 15 and under. The increase in the proportion of older adults was viewed as further evidence of the faster rate of aging of Canada’s population. Such demographic shifts are not unique to Canada; many industrialized nations around the world are experiencing similar changes in their populations. Increases in the older adult population in many countries might produce beneficial outcomes by increasing the potential for intergenerational contact and exposure to exemplars of successful aging. Such positive intergenerational contact could counter prevailing age stereotypes and improve intergenerational relations. On the other hand, such increases in the number of older adults could be viewed as a strain and potential threat to resources shared with younger age groups. The possibility of increased intergenerational conflict makes it more important than ever before to understand how older adults are stereotyped, how those stereotypes can produce different kinds of biased behavior toward them, and what the impact of those stereotypes are on older adults themselves.
Social-cognitive age representations are complex and multifaceted. A common stereotype applied to older people is one of warmth but incompetence, often resulting in paternalistic prejudice toward them. However, such benevolent prejudice, characterized by warm overtones, can change to hostile bias if older adults are perceived to violate prescriptive norms about age-appropriate behavior. In addition to coping with age prejudice, older adults also have to deal with the deleterious effects of negative age stereotypes on their day-to-day function. Exposure to negative aging stereotypes can worsen older adults’ cognitive performance in a number of contexts. As well, age stereotypes can be incorporated into older adults’ own views of aging, also leading to poorer outcomes for them in a variety of domains. A number of interventions to counteract the effects of negative aging stereotypes appear promising, but more work remains to be done to reduce the impact of negative aging stereotypes on daily function in later life.
Ideas regarding what it means to age well date back centuries. Gerontological scholarship includes countless conceptual, theoretical, and empirical contributions to how to make sense of these ideas. The construct of successful aging is therefore one of the most debated operationalizations of what it means to age well. Empirical research on successful aging taps into either understandings of successful aging or the strategies that people use to age well. The very essence of the construct of successful aging is, however, sociocultural. This is why this chapter proposes that exploring the cultural values that underpin the understandings of successful aging that inform this scholarship is a theoretically profuse approach to making sense of the controversy that surrounds this construct.
Two decades ago, a culture-relevant framework for the study of understandings of successful aging was formulated to address the disregard for cultural values that lie at the very core of this controversy. This framework proposes that there is congruence between the value orientations that people prefer and the understandings of successful aging that they hold, and that if we are to make sense of this congruence, we need to acknowledge that the foundations of value orientations (i.e., political, economic, and religious systems) shape what we deem to be necessary for aging well. From this it follows that there are bound to be more understandings of successful aging than what the scholarship in this area tends to acknowledge. After all, gerontological scholarship relies most heavily on contributions made on the basis of data from highly industrialized societies in the part of the world referred to as “the West.” In other words, gerontological scholarship on successful aging is extremely ethnocentric in its take on this construct, since only a handful of cultural understandings of what it means to age well are regarded as the norm. A failure to acknowledge this very fact leads gerontologists to disregard or downplay (often inadvertently) understandings of what it means to age well that do not resonate well with their own value paradigms or to impose (sometimes unintentionally) the Western template on findings about successful aging that do not rhyme well with what this scholarship assumes to be a given (i.e., a future, activity, independence, and mastering of nature orientation to what aging well means).
Michael Cole and Martin Packer
This is an advance summary of a forthcoming article in the Oxford Research Encyclopedia of Psychology. Please check back later for the full article.
There is a growing appreciation of the importance of understanding the role of culture in children’s psychological development (also called human ontogenesis). In particular, the texts of Lev Vygotsky contributed greatly to a “cultural psychology” in which the study of culture and development is seen as central. At the same time, cross-cultural research in psychology has paid growing attention to developmental issues. Although there continues to be much debate over how to define culture, it is generally agreed that different human social groups have distinct cultures. It is common to assume, in addition, that cultural differences lead to differences in the trajectories of children’s development. This is true, but it is also the case that culture is a universal requirement for development. The interdependence of human communities—which probably had its origins in collaborative hunting and cooperative childrearing—seems to have placed demands on children’s development, selecting for a sensitivity to norms and to other people’s goals and intentions. Every child is born into a family and community with a language, customs, and conventions, and in which people have institutional rights and responsibilities. These define universal requisites of human psychological development: These include the acquisition of language, the development of a social identity, the understanding of community obligations, and the ability to contribute to the reproduction of the community. An open question today is the character of the capacities that children bring to these developmental tasks: the apparently species-unique ability that has made possible vast “cumulative” societies.
Shevaun D. Neupert and Jennifer A. Bellingtier
Daily diary designs allow researchers to examine processes that change together on a daily basis, often in a naturalistic setting. By studying within-person covariation between daily processes, one can more precisely establish the short-term effects and temporal ordering of concrete daily experiences. Additionally, the daily diary design reduces retrospective recall bias because participants are asked to recall events that occurred over the previous 24-hour period as opposed to a week or even a year. Therefore, a more accurate picture of individuals’ daily lives can be captured with this design. When conclusions are drawn between people about the relationship between the predictors and outcomes, the covariation that occurs within people through time is lost. In a within-person design, conclusions can be made about the simultaneous effects of within-person covariation as well as between-person differences. This is especially important when many interindividual differences (e.g., traits) may exist in within-person relationships (e.g., states).
Daily diary research can take many forms. Diary research can be conducted with printed paper questionnaires, divided into daily booklets where participants mail back each daily booklet at the end of the day or entire study period. Previous studies have called participants on the telephone to respond to interview questions each day for a series of consecutive days, allowing for quantitative as well as qualitative data collection. Online surveys that can be completed on a computer or mobile device allow the researcher to know the specific day and time that the survey was completed while minimizing direct involvement with the collection of each daily survey. There are many opportunities for lifespan developmental researchers to adopt daily diary designs across a variety of implementation platforms to address questions of important daily processes. The benefits and drawbacks of each method along with suggestions for future work are discussed, noting issues of particular importance for aging and lifespan development.
Manfred Diehl, Eden Griffin, and Allyson Brothers
Dynamic integration theory (DIT) describes emotion development across the lifespan, from childhood to old age. In doing so, DIT draws on a number of perspectives, such as equilibrium theories, theories of cognitive development, and theories of behavioral adaptation, and takes a strong cognitive-developmental view on emotion experience and emotion regulation. Two propositions are at the core of DIT. First, the development of emotion experience and emotion regulation proceeds from simple and automatic reactions to increasingly complex and integrated cognitive-affective structures (i.e., schemas). These cognitive-affective structures can be ordered in terms of increasing levels of cognitive complexity and integration, with integration referring to a person’s ability to acknowledge both positive and negative affect states and to tolerate and reconcile the contradictions and tensions that these states generate. Second, DIT also postulates that the efficiency with which cognitive-affective systems work is a result of the dynamic interplay between contextual variables and person-specific characteristics. Three key factors contribute to this dynamic interplay between person and context: (1) the strength of the affective arousal, (2) the person’s cognitive resources for dealing with different affect states, and (3) pre-existing trait-like dispositions and reaction tendencies that may either hinder or facilitate emotion regulation. Thus, a person’s emotion experience and emotion regulation in a given situation are the product of the dynamic interaction of these factors. Considerable empirical evidence supports the theoretical propositions of DIT, including findings speaking to changes in emotion experience and emotion regulation in later life when declines in cognitive functioning tend to become normative.
Dyslexia, or a reading disability, occurs when an individual has great difficulty at the level of word reading and decoding. Comprehension of text, writing, and spelling are also affected. The diagnosis of dyslexia involves the use of reading tests, but the continuum of reading performance means that any cutoff point is arbitrary. The IQ score does not play a role in the diagnosis of dyslexia. Dyslexia is a language-based learning disability. The cognitive difficulties of dyslexics include problems with recognizing and manipulating the basic sounds in a language, language memory, and learning the sounds of letters. Dyslexia is a neurological condition with a genetic basis. There are abnormalities in the brains of dyslexic individuals. There are also differences in the electrophysiological and structural characteristics of the brains of dyslexics. Hope for dyslexia involves early detection and intervention and evidence-based instruction.
Michaela Riediger and Antje Rauers
Experience-sampling methodology (ESM) captures everyday events and experiences during, or shortly after, their natural occurrence in people’s daily lives. It is typically implemented with mobile devices that participants carry with them as they pursue their everyday routines, and that signal participants multiple times a day throughout several days or weeks to report on their momentary experiences and situation. ESM provides insights into short-term within-person variations and daily-life contexts of experiences, which are essential aspects of human functioning and development. ESM also can ameliorate some of the challenges in lifespan-developmental methodology, in particular those imposed by age-comparative designs. Compared to retrospective or global self-reports, for example, ESM can reduce potential non-equivalence of measures caused by age differences in the susceptibility to retrospective memory biases. Furthermore, ESM maximizes ecological validity compared to studies conducted in artificial laboratory contexts, which is a key concern when different age groups may differentially respond to unfamiliar situations. Despite these strengths, ESM also bears significant challenges related to potential sample selectivity and selective sample attrition, participants’ compliance and diligence, measurement reactivity, and missing responses. In age-comparative research, these challenges may be aggravated if their prevalence varies depending on participants’ age. Applications of ESM in lifespan methodology therefore require carefully addressing each of these challenges when planning, conducting, and analyzing a study, and this article provides practical guidelines for doing so. When adequately applied, experience sampling is a powerful tool in lifespan-developmental methodology, particularly when implemented in long-term longitudinal and cross-sequential designs.
Philip Sayegh, David J. Moore, and Pariya Fazeli Wheeler
Since the first cluster of people with HIV was identified in 1981, significant biomedical advances, most notably the development of antiretroviral therapy (ART), have led to considerably increased life expectancy as well as a reduction in the morbidity and mortality associated with HIV/AIDS. As a result, HIV/AIDS is no longer considered a terminal illness, but rather a chronic illness, and many persons living with HIV/AIDS are beginning to enter or have already reached later life. In fact, Americans ages 50 years and older comprise approximately half of all individuals with HIV/AIDS and represent the most rapidly growing subpopulation of persons living with HIV/AIDS in the United States.
Despite significant advances in HIV/AIDS treatment and prognosis, older adults living with HIV (OALH) face a number of unique challenges and circumstances that can lead to exacerbated symptoms and poorer outcomes, despite demonstrating generally better ART adherence than their younger counterparts. These detrimental outcomes are due to both chronological aging and cohort effects as well as social and behavioral factors and long-term ART use. For instance, neurocognitive deficits and neuropsychiatric symptoms, including depression, anxiety, apathy, and fatigue, are often observed among OALH, which can result in feelings of loneliness, social isolation, and reduced social support. Taken together, these factors can lead to elevated levels of problems with everyday functioning (e.g., activities of daily living) among OALH. In addition, sociocultural factors such as race/ethnicity, ageism, sexism, homophobia, transphobia, geographic region, socioeconomic status and financial well-being, systemic barriers and disparities, and cultural values and beliefs play an influential role in determining outcomes.
Notwithstanding the challenges associated with living with HIV/AIDS in later life, many persons living with HIV/AIDS are aging successfully. HIV/AIDS survivor and community mobilization efforts, as well as integrated care models, have resulted in some significant improvements in overall HIV/AIDS patient care. In addition, interventions aimed at improving successful aging outcomes among OALH are being developed in an attempt to effectively reduce the psychological and physical morbidity associated with HIV disease.
Psychoanalyst Erik Erikson was the first professional to describe and use the concept of ego identity in his writings on what constitutes healthy personality development for every individual over the course of the life span. Basic to Erikson’s view, as well as those of many later identity writers, is the understanding that identity enables one to move with purpose and direction in life, and with a sense of inner sameness and continuity over time and place. Erikson considered identity to be psychosocial in nature, formed by the intersection of individual biological and psychological capacities in combination with the opportunities and supports offered by one’s social context. Identity normally becomes a central issue of concern during adolescence, when decisions about future vocational, ideological, and relational issues need to be addressed; however, these key identity concerns often demand further reflection and revision during different phases of adult life as well. Identity, thus, is not something that one resolves once and for all at the end of adolescence, but rather identity may continue to evolve and change over the course of adult life too.
Following Erikson’s initial writings, subsequent theorists have laid different emphases on the role of the individual and the role of society in the identity formation process. One very popular elaboration of Erikson’s own writings on identity that retains a psychosocial focus is the identity status model of James Marcia. While Erikson had described one’s identity resolution as lying somewhere on a continuum between identity achievement and role confusion (and optimally located nearer the achievement end of the spectrum), Marcia defined four very different means by which one may approach identity-defining decisions: identity achievement (commitment following exploration), moratorium (exploration in process), foreclosure (commitment without exploration), and diffusion (no commitment with little or no exploration). These four approaches (or identity statuses) have, over many decades, been the focus of over 1,000 theoretical and research studies that have examined identity status antecedents, behavioral consequences, associated personality characteristics, patterns of interpersonal relations, and developmental forms of movement over time. A further field of study has focused on the implications for intervention that each identity status holds. Current research seeks both to refine the identity statuses and explore their dimensions further through narrative analysis.
Stephanie J. Wilson, Alex Woody, and Janice K. Kiecolt-Glaser
Inflammatory markers provide invaluable tools for studying health and disease across the lifespan. Inflammation is central to the immune system’s response to infection and wounding; it also can increase in response to psychosocial stress. In addition, depression and physical symptoms such as pain and poor sleep can promote inflammation and, because these factors fuel each other, all contribute synergistically to rising inflammation. With increasing age, persistent exposure to pathogens and stress can induce a chronic proinflammatory state, a process known as inflamm-aging.
Inflammation’s relevance spans the life course, from childhood to adulthood to death. Infection-related inflammation and stress in childhood, and even maternal stress during pregnancy, may presage heightened inflammation and poor health in adulthood. In turn, chronically heightened inflammation in adulthood can foreshadow frailty, functional decline, and the onset of inflammatory diseases in older age.
The most commonly measured inflammatory markers include C-reactive protein (CRP) and proinflammatory cytokines interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α). These biomarkers are typically measured in serum or plasma through blood draw, which capture current circulating levels of inflammation. Dried blood spots offer a newer, sometimes less expensive collection method but can capture only a limited subset of markers. Due to its notable confounds, salivary sampling cannot be recommended.
Inflammatory markers can be added to a wide range of lifespan developmental designs. Incorporating even a single inflammatory assessment to an existing longitudinal study can allow researchers to examine how developmental profiles and inflammatory status are linked, but repeated assessments must be used to draw conclusions about the associations’ temporal order and developmental changes. Although the various inflammatory indices can fluctuate from day to day, ecological momentary assessment and longitudinal burst studies have not yet incorporated daily inflammation measurement; this represents a promising avenue for future research.
In conclusion, mounting evidence suggests that inflammation affects health and disease across the lifespan and can help to capture how stress “gets under the skin.” Incorporating inflammatory biomarkers into developmental studies stands to enhance our understanding of both inflammation and lifespan development.
Deborah M. Capaldi, David C. R. Kerr, and Stacey S. Tiberio
Intergenerational studies are key to informing research, preventive intervention, and policy regarding family influences on healthy development and maladjustment. Continuities in family socialization and contextual risks across generations, as well as genetic factors, are associated with the development of psychopathology—including externalizing problems in children—and with intergenerational associations in the use of marijuana, alcohol, tobacco, and other drugs; these continuities are reflected in the low-to-moderate associations generally found in prospective studies. Until recent years, estimates of intergenerational continuities in problem behaviors and the processes explaining such associations (e.g., parenting behaviors) have been based largely on retrospective reports by adults about their own parents’ behaviors. Now there are some long-term prospective studies spanning as many as 30 years that can assess linkages between behaviors in one generation and the next. Whereas such studies have considerable design and implementation challenges, and are very expensive, it is of critical importance to examine the magnitude of associations of behaviors across generations. For example, a modest association across generations suggests either that genetic factors have a limited influence on that behavior or that they are subject to considerable moderation by environmental factors. These prospective studies relate to theoretical developments regarding intergenerational influences that are reviewed—for example, individual differences in genetic sensitivity to environmental influences. The theoretical approach employed in the Oregon Youth Study—Three Generation Study is a Dynamic Developmental Systems (DDS) model of continuous feedback across systems throughout development. A new hypothesis encompassed by DDS is developmental congruence of intergenerational associations in problem behaviors. As used in geometry, congruence refers to figures of a similar shape and size. This term has been adapted to refer to the expectation that ages of onset and patterns of growth in key behaviors will show similarity across generations. This is based on the theory that genetic and temperamental factors increase an individual’s risk when these factors are expressed at sensitive developmental periods. Thus, the timing of these manifestations (e.g., susceptibility to deviant peer influences) is expected to be similar across generations. Developmental similarity is also likely due to continuities in social-risk context and family mechanisms, such as parenting.