How reminiscing about deceased close others together with continuing bonds relates to grief severity and personal growth: a cross-sectional study with bereaved adults.

OBJECTIVES: One of the reasons why people engage in reminiscences about their past is to maintain intimacy with deceased close others. Although previous research alerts to the negative effects of reminiscence for intimacy maintenance on mental health, little is known about its relation to individuals' reactions to loss (i.e. grief severity and personal growth). In two samples, we focus on time since loss and continuing bonds, to elucidate the role of reminiscence for intimacy maintenance in grief. METHOD: The samples comprised 111 and 198 bereaved adults. All participants rated the frequency of reminiscence for intimacy maintenance and loss-related variables, such as time since loss, continuing bonds, and grief severity. Sample 2 additionally completed measures of personal growth, loss-centrality, and their interconnectedness with the deceased. RESULTS: Reminiscence on intimacy maintenance was positively related to grief severity. This relation was independent of time since loss and partly driven by externalized bonds. Internalized bonds mediated the relation between reminiscence for intimacy maintenance and grief severity (in sample 1) and personal growth (in sample 2). CONCLUSION: Continuing bonds help explain why reminiscing for intimacy maintenance can be harmful in terms of grief severity but also fosters personal growth after the loss.

Functions of reminiscence in later life: Predicting change in the physical and mental health of older adults over time.

OBJECTIVE: Research has repeatedly shown that reminiscence affects the mental health and well-being of older adults contemporaneously and over time. Cross-sectional research also points to a link between reminiscence and physical health. The direction of this relationship is unclear, however. Does physical health affect how and why older adults think of themselves in the past? Or conversely, do various functions of reminiscence affect both mental and physical health now, and in future? METHODS: Online responses were collected from a primarily Canadian sample of 411 older adults at three time points, separated by eight months on average. Participants responded to the Reminiscence Functions Scale at baseline and reported their health conditions, perceived state of health, life satisfaction, and psychological distress at subsequent points of measurement. A structural equation model was computed to identify direct and indirect associations between reminiscence functions and health over time. RESULTS: Self-negative reminiscence functions at baseline (T1) predicted physical health 8 months later (T2), whereas self-positive reminiscence functions at T1 predicted both physical health and psychological distress at T2. The associations among self-positive functions and subsequent physical and mental health were maintained over time. Additionally, longitudinal crossover was observed in which psychological distress at T2 predicted physical health at T3, controlling for physical and mental health at T2. CONCLUSIONS: Findings confirm longitudinal associations among reminiscence functions and subsequent indicators of health. For older adults, this extends to both physical and mental health. Future research should examine the physiological mechanisms by which autobiographical memory affects health over time.

Reminiscence functions over time: consistency of self functions and variation of prosocial functions.

The current study examines the temporal stability of the tripartite model of reminiscence functions in which eight separate reminiscence functions map onto three second-order factors which contribute significantly to measurement of an overarching reminiscence latent construct. We collected online responses from 411 adults 50+ years of age. Confirmatory factor analytic models were computed at three points of data collection over 16 months. Invariance analyses were next undertaken to simultaneously compare the measurement properties to assess within-person stability of reminiscence functions over time. The tripartite structure of reminiscence functions was replicated at each point of data collection. As hypothesised, self-positive and self-negative functions are consistent across points of data collection, whereas prosocial functions vary over time. The temporal stability of the self functions may be attributed to enduring characteristics of the individual such as personality traits and life attitudes, as well as their solitary nature. Previous research indicates that consistency of self-positive reminiscence functions has ensuing benefits for physical health and psychological well-being; the opposite is true for self-negative functions. The temporal variation of prosocial functions may be due to the varying availability of others to share memories and their responsiveness to the emotional context.

Reminiscence functions and the health of Israeli Holocaust survivors as compared to other older Israelis and older Canadians.

OBJECTIVES: Existing research with English-speaking samples indicates that various ways in which older adults recall their past affect both their physical and mental health. Self-positive reminiscence functions (i.e. identity, problem-solving, death preparation) correlate and predict mental health in later life whereas self-negative functions (i.e. bitterness revival, boredom reduction, intimacy maintenance) correlate and predict the physical health of older adults. METHOD: For this study, we recruited 295 Israeli Holocaust survivors to ascertain if early life trauma affects these associations between reminiscence and health. In order to distinguish cross-national differences from survivor-specific effects, we also recruited two comparative samples of other older Israelis (not Holocaust survivors; n = 205) and a second comparative sample of 335 older Canadians. Three separate structural equation models were computed to replicate this tripartite reminiscence and health model. RESULTS: Coefficients for self-negative functions significantly differed between survivors and both Canadians and other older Israelis, and between Canadians and both Israeli samples. However, no differences were found between prosocial and self-positive functions. Moreover, the higher order structure of reminiscence and health appears largely indistinguishable across these three groups. CONCLUSION: Early life trauma does not appear to fundamentally affect associations between reminiscence and health. These findings underscore the resilience of Holocaust survivors.

Functions of reminiscence and the psychological well-being of young-old and older adults over time.

Existing cross-sectional research demonstrates an association between reminiscence functions and well-being in later life. The results of this study replicate and extend previous findings in separate participant samples above and below 70 years of age. Findings suggest a link between reminiscence functions and psychological well-being, and indirectly between reminiscence and well-being 16 months thereafter. Invariance analyses reveal few differences in association between reminiscence and well-being when young-old (n = 196) and older adults (n = 215) are compared. These findings suggest a direct positive association between self-positive reminiscence functions (identity, death preparation, and problem-solving) and a direct negative association between self-negative functions (boredom reduction, bitterness revival, and intimacy maintenance) and psychological well-being (life satisfaction, depressive, and anxiety symptoms). In contrast, prosocial reminiscence functions (conversation, teach/inform others) appear to have an indirect association with well-being (i.e., via self-positive and self-negative functions). These findings are discussed relative to evolving theory and research linking cognition and health.

Coping mediates the relationships between reminiscence and psychological well-being among older adults.

Cross-sectional and longitudinal studies have demonstrated an association between various functions of reminiscence and well-being in later adulthood. This study investigates to what extent the links between reminiscence (self-positive and self-negative functions) and psychological well-being (depressive symptoms, anxiety level and life satisfaction) are mediated by assimilative and accommodative coping. This mediational model was tested using structural equation modelling. The results support the hypothesis that coping completely mediates the links between reminiscence and psychological well-being. Specifically, self-positive reminiscences are related to improved psychological well-being via assimilative and accommodative coping, while, in contrast, self-negative reminiscences are associated to reduced psychological well-being through their negative relationships with both coping modes. These findings suggest that reminiscence contributes to psychological well-being in part because it promotes assimilative and accommodative coping, which are protective mechanisms through which the self-system constructs continuity and meaning over the life course.

Factorial structure and psychometric properties of the reminiscence functions scale.

OBJECTIVES: This study reports on the psychometric properties and the factorial structure of the Reminiscence Functions Scale (RFS), a 43-item self-report instrument used to assess the frequencies of reminiscence for distinct functions. METHOD: The factorial validity (exploratory factor analysis, n = 453; confirmatory factor analysis, n = 456), the invariance of factorial structure across gender (males = 228; females = 240), and psychometric properties were examined. RESULTS: They support an eight-factor structure similar to the original one, yet question the value of a few of the items. Cronbach's alphas for the various subscales ranged from 0.76 to 0.87. Test-retest reliability ranged from r = 0.48-0.63. CONCLUSION: The RFS is confirmed as a psychometrically sound instrument for use in research on the functions of reminiscence with samples of older adults.

A community-based intervention for treating depression in seniors.

This study piloted and refined a community-based behavioural intervention for depressed seniors. The intervention, based on Lewinsohn's Control Your Depression, was administered in bibliotherapy format adapted for seniors. It was delivered in a minimal-contact format by home care nurses. The intervention was tested and refined in a series of3 multiple-baseline studies, each with 2 participants. Each series consisted of baseline, 6 weekly treatment sessions, and 3-month follow-up. Series A tested the feasibility of the intervention. Series B examined the role of pleasant activities as a pivotal part of the treatment. Series C replicated the findings of series B and tested the final version of the intervention. In all the series, there was a reduction in depression that remained at 3-month follow-up. The results indicate that this form of intervention can be supported by home care nurses working with an underserved population that is prone to depression.

Perceived control and coping in women faced with activity restriction due to osteoarthritis: relations to anxious and depressive symptoms.

The study focuses on perceived control and coping strategies regarding activity restriction due to osteoarthritis in a sample of older women. Using a cross-sectional design, it examines how these variables, separately and in combination, predict anxious symptoms and depressive symptoms. Perceived control did not predict anxious symptoms, while approach-type coping strategies did. Perceived control and approach-type coping strategies individually predicted depressive symptoms. Higher perceived control in interaction with avoidant-type coping strategies significantly predicted lower depressive symptoms. Overall, the findings suggest that perceived control and coping strategies with regard to activity restriction relate in different ways to anxious symptoms and to depressive symptoms.

Empirical validation of a model of reminiscence and health in later life.

This study addresses the adaptive value of functions of reminiscence with respect to physical and mental health in later life. A model examining the relationships between the functions of reminiscence and life satisfaction, psychiatric distress, and health is presented and tested. Self-positive (reminiscence for Identity, Death Preparation, and Problem Solving) and self-negative (reminiscence for Boredom Reduction, Bitterness Revival, and Intimacy Maintenance) functions have statistically significant and direct associations with the well-being of this sample of older adults, the first positively and the second negatively. Prosocial functions (reminiscence for Conversation, and to Teach-Inform Others) appear to have no direct link with health. Self-functions appear to have an important and lasting influence on physical and mental health, whereas prosocial functions may affect health by means of their role in emotional regulation.

Personality traits and existential concerns as predictors of the functions of reminiscence in older adults.

This study examines to what extent personality and existential constructs predict the frequency of reminiscence, in general, and its various functions, in particular. Eighty-nine older adults completed the NEO-Five Factor Inventory, the Life Attitude Profile--Revised, and the Reminiscence Functions Scale. Neuroticism predicted total reminiscence frequency, as well as reminiscence for self-understanding and ruminating about a negative past. Extraversion predicted total reminiscence frequency, as well as reminiscence for generating stimulation, conversation, and maintaining memories of departed loved ones. Openness to experience predicted total reminiscence frequency and reminiscence for addressing life meaning and death. Existential concerns, and in particular low desire to seek new challenges, added significant additional predictive power for total reminiscence frequency and for such uses as generating stimulation, preparing for death, and ruminating about the past. The discussion draws the implications of the finding that the combination of personality traits and existential concerns predicted the overall reminiscence frequency together with the intrapersonal functions of reminiscence.

Depressive symptoms and physical health of caregivers of persons with cognitive impairment: analysis of reciprocal effects over time.

UNLABELLED: Research indicates that caregivers of persons with cognitive impairment are at elevated risk for clinical depression. The current study examines the association between physical illness and depressive symptoms among caregivers over a 5-year interval. METHODS: Participants were recruited as part of a longitudinal study of dementia prevalence in Canada (N = 382). Persons with cognitive loss and their primary caregivers were randomly identified from each Canadian province. RESULTS: Subsequent to control for sociodemographic variables, patient illness characteristics and initial depressive symptomatology, baseline health of caregivers contributed significantly to the prediction of depressive symptoms five years later. In contrast, depressive symptomatology was not a significant predictor of physical health over this same interval (again controlling for sociodemographic variables, patient illness characteristics, and caregivers' health at baseline). DISCUSSION: These analyses provided partial support for reciprocal effects between physical illness and depression. Findings are discussed in terms of the applicability of a model of reciprocal effects to older adults.

Effects of manipulating valence and arousal components of mood on specificity of autobiographical memory.

An important cognitive deficit in clinical depression is the inability to be specific in recalling personal memories, a phenomenon coined "overgeneral memory" by Williams and Broadbent. Although there is general consensus that overgeneral memory is not state-dependent, most of the evidence originates from studies of this effect in clinical populations. The two components of mood, valence and arousal, were manipulated to examine their influence on memory specificity in a nonclinical sample of university undergraduate students. In Exp. 1, a Velten procedure was used to induce elated, depressed, or neutral mood states. No difference was found in autobiographical memory specificity among the three groups. In Exp. 2, high and low arousal states were induced through physical exercise. A low arousal state resulted in an increased proportion of overgeneral memories, suggesting that this memory phenomenon may be influenced by the arousal component of mood.

Meaning in life and mastery mediate the relationship of negative reminiscence with psychological distress among older adults with mild to moderate depressive symptoms.

To understand the adaptive value of reminiscence, a mediational model of reminiscence was tested in a sample of older adults with mild to moderate depressive symptoms. Using structural equation modeling, we investigated if psychological resources (mastery and meaning in life) mediate the relation between reminiscence (positive: identity construction and problem solving; and negative: bitterness revival and boredom reduction) and psychological distress (depressive symptoms and anxiety symptoms). A total of 202 older Dutch adults living in the community participated in this study. The present study consisted of baseline measurements of a randomized controlled trial that evaluated the effectiveness of a life-review therapy intervention on depression. Results showed that psychological resources fully mediated the relation between negative reminiscence and psychological distress. Specifically, negative reminiscing is related to decreased psychological distress through meaning in life and sense of mastery. The study contributes to current knowledge on the relation between reminiscence and mental health, both empirically and clinically. It helps to increase understanding of how reminiscence is related to psychological distress, especially in depressed older adults, and the relative importance of psychological resources, i.e., mastery and meaning in life. From a clinical perspective, these findings suggest the usefulness of focusing on strengthening psychological resources in therapeutic reminiscence-based strategies for older adults with depressive symptoms.

[Attitude and perceived control of the elderly towards the consumption of anxiolytic, sedative and hypnotic medications]. / Attitudes et perception de contrôle des personnes âgées envers la prise de médicaments à action anxiolytique, sédative et hypnotique (ASH).

This study examines the importance of variables from the Theory of Planned Behaviour (i.e., attitudes toward behaviour, subjective norms, and perceived control) for the prediction of consumption of anxiolytic and sedative-hypnotic (ASH) medications in a sample of older persons, aged 69 years on average, 62 consumers and 92 non-consumers. A favourable attitude toward ASH and a sense of having less control regarding these drugs predict both current usage and intention to continue. Perceived control predicts intention to start consumption of ASH in current non-consumers. This study underlines the importance of considering the role of the older person's decisional power in the consumption of these medications.

Recurrent depressive symptomatology and physical health: a 10-year study of informal caregivers of persons with dementia.

OBJECTIVE: To examine the degree to which recurrent depressive symptomatology predicts the decline in the health status of a randomly derived national sample of caregivers of persons with dementia. METHOD: Individuals with dementia and their caregivers were recruited from each Canadian province as part of a national epidemiologic study of dementia prevalence and the health and welfare of care providers. Both patients and caregivers were assessed at 3 points over a 10-year period. Cohabiting family members who shared the same residence as care recipients were selected for the current study (n = 96 pairs). We computed a repeated measures analysis of variance to compare the health of caregivers who were consistently asymptomatic for depression, of those symptomatic at 1 of 3 points of measurement, and of those symptomatic at 2 of 3 points. RESULTS: As hypothesized, caregivers presenting with elevated depressive symptomatology at multiple points of measurement reported poorer and worsening physical health over time. CONCLUSIONS: The results of this study support the assertion that depressive symptomatology significantly predicts the decline in health status of caregivers of persons with dementia. Concerted effort to treat depression in this population is warranted to forestall this trajectory of decline and premature patient institutionalization.

Mental health for older adults and benzodiazpine use.

Benzodiazepine (BZD) drug use among community-dwelling seniors is a significant health issue. Although long-term use of BZDs by seniors is a recognized problem, little is known about the mental health of the consumers. Better knowledge of their mental health would help nurses in identifying the psychological needs of this population. The goals of this longitudinal study1 (n = 138) were to describe the mental health status of long-term users of BZDs and to compare it with the mental health of seniors who have either begun or stopped consuming BZDs over a 1-year period (from Phase 1 to Phase 2). Results showed that one third of long-term users of BZDs do not present any mental health problem. Furthermore, no differences were observed between the mental health statuses of new users of BZDs, individuals who stopped using BZDs, and long-term users of BZDs. In conclusion, at least one third of long-term users of BZDs should stop using these drugs, and nurses should play a leading role in helping these seniors withdraw from BZD consumption.

Temporal references in dreams and autobiographical memory.

In an attempt to determine whether temporal references identified in dreams follow the same temporal distributions as those documented for autobiographical memories, 28 younger women (18-35 years of age) and 30 older women (60-77 years of age) kept a home dream diary for 1 week and then slept 1 night in the laboratory for rapid eye movement sleep dream collection. The following morning, they identified temporal references in their dreams and produced a sample of autobiographical memories using the semantic cuing method. For both groups, there was a linear decrease in temporal references identified in dreams and autobiographical memories with increased remoteness for the last 30 years. As predicted, for the older group, there were similar cubic trends reflecting a disproportionately higher number of both temporal references identified in dreams and autobiographical memories from adolescence/early adulthood compared with adulthood and childhood. The results support the notion of continuity between waking and dreaming memory processes.

Profiles of reminiscence among older adults: perceived stress, life attitudes, and personality variables.

The goal of the present study was to identify subgroups of older participants on the basis of unique configurations of variables among functions of reminiscence, personality traits, life attitudes, and perceived stress by means of cluster analysis. Ninety-three older adults (M = 66.7 years of age) completed the NEO-Five Factor Inventory, the Life Attitude Profile-Revised, the Reminiscence Functions Scale, and the Psychological State of Stress Measure. Cluster membership was determined on the basis of intra-personal functions of reminiscence (Boredom Reduction, Death Preparation, Identity, Bitterness Revival). These groups were subsequently compared on personality traits (Neuroticism, Extraversion, Openness to experience), life attitudes (Existential Vacuum, Goal Seeking), and perceived stress. Three distinct groupings emerged. A greater tendency to ruminate about negative memories and lower extraversion characterized the negative reminiscers. Higher frequency of reminiscence related to issues of identity, life meaning and death, together with a tendency toward openness to experience, typified the meaning seekers. Lower reminiscence frequency for each of the four functions, combined with lower perceived stress and neuroticism, characterized the infrequent reminiscers. These results are interpreted in terms of differential patterns of coping and adaptation.