Aging is often associated with inevitable biological decline. Yet research suggests that subjective aging—the views that people have about their own age and aging—contributes to how long and healthy lives they will have. Subjective age and self-perceptions of aging are the two most studied aspects of subjective aging. Both have somewhat different theoretical origins, but they can be measured reliably. A total of 41 studies have been conducted that examined the longitudinal health effects of subjective age and self-perceptions of aging. Across a wide range of health indicators, these studies provide evidence for the longitudinal relation of subjective aging with health and longevity. Three pathways might explain this relation: physiological, behavioral, and psychological pathways. The evidence for behavioral pathways, particularly for health behaviors, is strongest, whereas only a few studies have examined physiological pathways. Studies focusing on psychological pathways have included a variety of mechanisms, ranging from control and developmental regulation to mental health. Given the increase in the number of older people worldwide, even a small positive change in subjective aging might come with a considerable societal impact in terms of health gains.
Article
Subjective Aging and Health
Gerben J. Westerhof and Susanne Wurm
Article
Substance Use in Later Life
Stephen J. Bright
In the 21st century, we have seen a significant increase in the use of alcohol and other drugs (AODs) among older adults in most first world countries. In addition, people are living longer. Consequently, the number of older adults at risk of experiencing alcohol-related harm and substance use disorders (SUDs) is rising. Between 1992 and 2010, men in the United Kingdom aged 65 years or older had increased their drinking from an average 77.6 grams to 97.6 grams per week. Data from Australia show a 17% increase in risky drinking among those 60–69 between 2007 and 2016. Among Australians aged 60 or older, there was a 280% increase in recent cannabis use from 2001 to 2016. In the United States, rates of older people seeking treatment for cocaine, heroin, and methamphetamine have doubled in the past 10 years. This trend is expected to continue.
Despite these alarming statistics, this population has been deemed “hidden,” as older adults often do not present to treatment with the SUD as a primary concern, and many healthcare professionals do not adequately screen for AOD use. With age, changes in physiology impact the way we metabolize alcohol and increase the subjective effects of alcohol. In addition, older adults are prone to increased use of medications and medical comorbidities. As such, drinking patterns that previously would have not been considered hazardous can become dangerous without any increase in alcohol consumption. This highlights the need for age-specific screening of all older patients within all healthcare settings.
The etiology of AOD-related issues among older adults can be different from that of younger adults. For example, as a result of issues more common as one ages (e.g., loss and grief, identity crisis, and boredom), there is a distinct cohort of older adults who develop SUDs later in life despite no history of previous problematic AOD use. For some older adults who might have experimented with drugs in their youth, these age-specific issues precipitate the onset of a SUD. Meanwhile, there is a larger cohort of older adults with an extensive history of SUDs. Consequently, assessments need to be tailored to explore the issues that are unique to older adults who use AODs and can inform the development of age-specific formulations and treatment plans. In doing so, individualized treatments can be delivered to meet the needs of older adults. Such treatments must be tailored to address issues associated with aging (e.g., reduced mobility) and may require multidisciplinary input from medical practitioners and occupational therapists.
Article
The Medicalization of Stress
Vanessa L. Burrows
Stress has not always been accepted as a legitimate medical condition. The biomedical concept stress grew from tangled roots of varied psychosomatic theories of health that examined (a) the relationship between the mind and the body, (b) the relationship between an individual and his or her environment, (c) the capacity for human adaptation, and (d) biochemical mechanisms of self-preservation, and how these functions are altered during acute shock or chronic exposure to harmful agents. From disparate 19th-century origins in the fields of neurology, psychiatry, and evolutionary biology, a biological disease model of stress was originally conceived in the mid-1930s by Canadian endocrinologist Hans Selye, who correlated adrenocortical functions with the regulation of chronic disease.
At the same time, the mid-20th-century epidemiological transition signaled the emergence of a pluricausal perspective of degenerative, chronic diseases such as cancer, heart disease, and arthritis that were not produced not by a specific etiological agent, but by a complex combination of multiple factors which contributed to a process of maladaptation that occurred over time due to the conditioning influence of multiple risk factors. The mass awareness of the therapeutic impact of adrenocortical hormones in the treatment of these prevalent diseases offered greater cultural currency to the biological disease model of stress.
By the end of the Second World War, military neuropsychiatric research on combat fatigue promoted cultural acceptance of a dynamic and universal concept of mental illness that normalized the phenomenon of mental stress. This cultural shift encouraged the medicalization of anxiety which stimulated the emergence of a market for anxiolytic drugs in the 1950s and helped to link psychological and physiological health. By the 1960s, a growing psychosomatic paradigm of stress focused on behavioral interventions and encouraged the belief that individuals could control their own health through responsible decision-making. The implication that mental power can affect one’s physical health reinforced the psycho-socio-biological ambiguity that has been an enduring legacy of stress ever since.
This article examines the medicalization of stress—that is, the historical process by which stress became medically defined. It spans from the mid-19th century to the mid-20th century, focusing on these nine distinct phases:
1. 19th-century psychosomatic antecedent disease concepts
2. The emergence of shell-shock as a medical diagnosis during World War I
3. Hans Selye’s theorization of the General Adapation Syndrome in the 1930s
4. neuropsychiatric research on combat stress during World War II
5. contemporaneous military research on stress hormones during World War II
6. the emergence of a risk factor model of disease in the post-World War II era
7. the development of a professional cadre of stress researchers in the 1940s and 50s
8. the medicalization of anxiety in the early post–World War II era
9. The popularization of stress in the 1950s and pharmaceutical treatments for stress, marked by the cultural assimilation of paradigmatic stress behaviors and deterrence strategies, as well pharmaceutical treatments for stress.
Article
Theoretical Approaches to Physical Activity Promotion
Nikos Ntoumanis, Cecile Thørgersen-Ntoumani, Eleanor Quested, and Nikos Chatzisarantis
Compelling evidence worldwide suggests that the number of physically inactive individuals is high, and it is increasing. Given that lack of physical activity has been linked to a number of physical and mental health problems, identifying sustainable, cost-effective, and scalable initiatives to increase physical activity has become a priority for researchers, health practitioners, and policymakers. One way to identify such initiatives is to use knowledge derived from psychological theories of motivation and behavior change. There is a plethora of such theories and models that describe a variety of cognitive, affective, and behavioral mechanisms that can target behavior at a conscious or an unconscious level. Such theories have been applied, with varying degrees of success, to inform exercise and physical activity interventions in different life settings (e.g., schools, hospitals, and workplaces) using both traditional (e.g., face-to-face counseling and printed material) and digital technology platforms (e.g., smartphone applications and customized websites). This work has offered important insights into how to create optimal motivational conditions, both within individuals and in the social environments in which they operate, to facilitate long-term engagement in exercise and physical activity. However, we need to identify overlap and synergies across different theoretical frameworks in an effort to develop more comprehensive, and at the same time more distinct, theoretical accounts of behavior change with reference to physical activity promotion. It is also important that researchers and practitioners utilize such theories in interdisciplinary research endeavors that take into account the enabling or restrictive role of cultural norms, the built environment, and national policies on physical activity.
Article
Use of Wearable Activity Trackers for Physical Activity Promotion
Nicola D. Ridgers and Samuel K. Lai
Commercially available wearable activity trackers are small, non-invasive electronic devices that are worn on the body for the purposes of monitoring a range of outcomes including steps, energy expenditure, and sleep. These devices utilize sensors to track movement, and these recorded data are provided to the user via a visual display on the device itself and/or by syncing the device with an accompanying app or web-based program. Combined together, these devices and accompanying apps incorporate a broad range of behavior change techniques that are known to change behavior, including self-monitoring, goal setting, and social support. In recent years, wearable activity trackers have become increasingly popular, and the growth in ownership within different populations has occurred at an exponential rate. This growth in appeal has led to researchers and practitioners examining the validity and reliability of wearable activity trackers for measuring a range of outcomes and integrating the results into physical activity promotion strategies. Acceptable validity has been reported for steps and moderate validity for measuring energy expenditure. However, little research has examined whether wearable activity trackers are a feasible and effective method for changing physical activity behaviors in the short- and longer-term, either alone or in combination with additional strategies. Some initial results are promising, though concerns have been raised over longer-term use and impacts on motivation for physical activity. There is a need for research examining the longer-term use of wearable activity trackers in different population groups, and establishing whether this technology has any positive effects on physical activity levels.
Article
Wisdom Across Cultures
Igor Grossmann and Franki Kung
The concept of wisdom is ancient and deeply embedded in the cultural history of humanity. However, only since 1980s have psychologists begun to study it scientifically. Taking a culturally and philosophically informed perspective, this article integrates insights from the quantitative science of wisdom. Analysis of epistemological traditions and research on folk theories of wisdom suggest cultural similarities in the domain of cognition (e.g., wisdom as reasoning ability and knowledge). These similarities can be contrasted with cultural differences concerning folk-theoretical affective and prosocial themes of wisdom, as well as expression of various wisdom-related themes, rooted in distinct sociocultural and ecological environments. Empirical evidence indicates that wisdom is an individually and culturally malleable construct, consistent with an emerging constructionist account of wisdom and its development. Future research can benefit from integration of ecological and cultural-historical factors for the meaning of wisdom and its expression.
