When the "Golden Years" Turn Blue: Using the Healthy Aging Literature to Elucidate Anxious and Depressive Disorders in Older Adulthood.

Current treatments for disorders of emotion, like pathological anxiety, are often less effective in older adults than in younger adults and have poorly understood mechanisms, pointing to the need for psychopathology models that better account for age-related changes in normative emotional functioning and the expression of disordered emotion. This article describes ways in which the healthy aging and emotion literature can enhance understanding and treatment of symptoms of anxiety and depression in later life. We offer recommendations for how to integrate the healthy aging literatures' theories and findings with psychopathology research and clinical practice, and highlight opportunities for future research.

Age moderates response to acceptance and commitment therapy vs. cognitive behavioral therapy for chronic pain.

OBJECTIVE: The purpose of this study was to examine age differences in response to different forms of psychotherapy for chronic pain. METHODS: We performed a secondary analysis of 114 adults (ages 18-89 years) with a variety of chronic, nonmalignant pain conditions randomly assigned to 8 weeks of group-administered acceptance and commitment therapy (ACT) or cognitive behavioral therapy (CBT). Treatment response was defined as a drop of at least three points on the Brief Pain Inventory-interference subscale. RESULTS: Older adults were more likely to respond to ACT, and younger adults to CBT, both immediately following treatment and at 6-month follow-up. There were no significant differences in credibility, expectations of positive outcome, attrition, or satisfaction, although there was a trend for the youngest adults (ages 18-45 years) to complete fewer sessions. CONCLUSIONS: These data suggest that ACT may be an effective and acceptable treatment for chronic pain in older adults.

Information processing bias and pharmacotherapy outcome in older adults with generalized anxiety disorder.

Information processing bias was evaluated in a sample of 25 older adults with generalized anxiety disorder (GAD) over the course of 12 weeks of escitalopram pharmacotherapy. Using the CANTAB Affective Go/No Go test, treatment response (as measured by the Hamilton Anxiety Rating Scale, Penn State Worry Questionnaire, and Generalized Anxiety Disorder Severity Scale) was predicted from a bias score (i.e., difference score between response latencies for negative and positive words) using mixed-models regression. A more positive bias score across time predicted better response to treatment. Faster responses to positive words relative to negative words were associated with greater symptomatic improvement over time as reflected by scores on the GADSS. There was a trend toward significance for PSWQ scores and no significant effects related to HAMA outcomes. These preliminary findings offer further insights into the role of biased cognitive processing of emotional material in the manifestation of late-life anxiety symptoms.

Prefrontal asymmetry predicts affect, but not beliefs about affect.

Self-reported emotional feelings are easily biased by situational or identity-related beliefs. Such biases vary as a function of memory. Recent memories draw more on veridical felt affective experience whereas distant memories draw more on situational or identity-related biases. For this study, frontal EEG asymmetry was used to predict feeling- versus belief-based self-reports of freshmen year homesickness in college freshmen and sophomores. Relatively greater right frontal EEG asymmetry predicted greater feeling-based, experiential reports of freshman year homesickness, whereas no associations were found between frontal EEG asymmetry and belief-based, retrospective reports of freshman year homesickness. These results support the status of frontal EEG asymmetry as a measure of affective vulnerability and suggest that links between frontal EEG asymmetry and self-reported affect are detectable to the extent that self-reports capture current emotional feelings and not situational or identity-related beliefs about what one ought to have felt.

Proactive coping, gratitude, and posttraumatic stress disorder in college women.

This study investigated relationships among proactive coping, positive emotions, and posttraumatic stress disorder (PTSD) symptom severity for 182 undergraduate women with trauma histories. Participants were administered the Life Events Checklist (LEC), PTSD Checklist, Proactive Coping Inventory, Proactive Attitude Scale, General Perceived Self-Efficacy Scale, and measures of posttrauma gratitude and emotional growth. An Exploratory Factor Analysis (EFA) with proactive coping, proactive attitude, and self-efficacy items indicated a one-factor solution. The proactive coping style factor and posttrauma gratitude were independently negatively associated with current PTSD symptom level, above and beyond the effects of trauma severity, trauma history, and time elapsed since the trauma. The implications of these results for future research and understanding of the development of PTSD and its treatment are discussed.