Emotional support across adulthood: A 60-year study of men's social networks.

Past research shows that social networks get smaller with age. But not all types of relationships may shrink at the same rate or for similar reasons. In the present study, we used a unique data set from a sample of 235 men who were followed longitudinally for 71 years to examine how the general pattern of network shrinkage documented in previous research generalizes to the number of emotional support providers in people's networks. We additionally examined early-life predictors of the size of later-life support network. Growth curve analyses revealed that, mirroring the more general pattern of network shrinkage, emotional support networks shrink by as much as 50% between the ages of 30 and 90, reflecting an average reduction from two to one support providers. Examining the associations between prospectively collected measures of childhood family environment and later-life emotional support, we also found that men who grew up in warmer family environments had larger support networks in adulthood. In contrast, childhood family socioeconomic status was not connected to the size of emotional support networks later in life. The generalizability of this work is limited by the use of an archival all-male sample from the United States. Despite this limitation, these findings make important contributions to our understanding of adult socioemotional development and underscore the importance of prospectively collected longitudinal data in developmental research. Additional research is needed to examine the consequences of changing emotional support across the lifespan for health and well-being. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

More organized white matter is associated with positivity bias in older adults.

On average, healthy older adults prefer positive over neutral or negative stimuli. This positivity bias is related to memory and attention processes and is linked to the function and structure of several interconnected brain areas. However, the relationship between the positivity bias and white matter integrity remains elusive. The present study examines how white matter organization relates to the degree of the positivity bias among older adults. We collected imaging and behavioral data from 25 individuals (12 females, 13 males, and a mean age of 77.32). Based on a functional memory task, we calculated a Pos-Neg score, reflecting the memory for positively valenced information over negative information, and a Pos-Neu score, reflecting the memory for positively valenced information over neutral information. Diffusion-weighted magnetic resonance imaging data were processed using Tract-Based Spatial Statistics. We performed two non-parametric permutation tests to correlate whole brain white matter integrity and the Pos-Neg and Pos-Neu scores while controlling for age, sex, and years of education. We observed a statistically significant positive association between the Pos-Neu score and white matter integrity in multiple brain connections, mostly frontal. The results did not remain significant when including verbal episodic memory as an additional covariate. Our study indicates that the positivity bias in memory in older adults is associated with more organized white matter in the connections of the frontal brain. While these frontal areas are critical for memory and executive processes and have been related to pathological aging, more extensive studies are needed to fully understand their role in the positivity bias and the potential for therapeutic interventions.

Is there intergenerational continuity in early life experiences? Findings from the Harvard Study of Adult Development.

There has been longstanding and widespread interdisciplinary interest in understanding intergenerational processes, or the extent to which conditions repeat themselves across generations. However, due to the difficulty of collecting longitudinal, multigenerational data on early life conditions, less is known about the extent to which offspring experience the same early life conditions that their parents experienced in their own early lives. Using data from a socioeconomically diverse, White U.S. American cohort of 1,312 offspring (50% female) and their fathers (N = 518 families), we address three primary questions: (1) To what extent is there intergenerational continuity in early life experiences (social class, home atmosphere, parent-child relationship quality, health)? (2) Is intergenerational continuity in early life experiences greater for some domains of experience compared to others? and (3) Are there person-level (offspring sex, birth order, perceptions of marital stability) and family-level factors (family size, father education level and education mobility, marital stability) that moderate intergenerational continuity? Multilevel models indicated that intergenerational continuity was particularly robust for childhood social class, but nonsignificant for other early life experiences. Further, intergenerational continuity was moderated by several family-level factors, such that families with higher father education/mobility and marital stability, tended to have offspring with the most optimal early life experiences, regardless of what their father experienced in early life. We discuss the broader theoretical implications for family systems, as well as practical implications for individual-level and family-level interventions. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Senior Resident as Junior Supervisor: Case Report of an Apprenticeship Model for Training Psychotherapy Supervisors.

Psychotherapy supervision is an essential component of graduate medical education in psychiatry. However, most psychotherapy supervisors have never had training specific to supervision, and the requisite skills have received little attention in the literature. The authors of this article describe the first year of a pilot project that was aimed at fostering interest and skill in psychotherapy supervision among senior residents. In this model, a postgraduate year (PGY)-4 resident supervised a PGY-2 resident's psychodynamic psychotherapy while receiving supervisory support from a senior faculty member. Feedback from the two residents and the residency program director was positive. The PGY-2 resident reported benefiting from near-peer supervision. The PGY-4 resident continued to supervise residents after graduation and felt well prepared to assume that role. The residency program continued to use this model after the pilot period. Other training programs can replicate this model to nurture the next generation of psychotherapy supervisors.

Treatment of Overthinking: A Multidisciplinary Approach to Rumination and Obsession Spectrum.

Classic psychiatry patients are rare; real-world patients tend to have overlapping features of multiple disorders. Striving for diagnostic certainty, and treatments aimed at tentative diagnoses, often fail these patients. In such cases, tolerating diagnostic ambiguity and "treating the symptoms" can sometimes be transformative. An important symptom, often undertreated in a diagnosis-based approach, is rumination. We present a case study of a woman who, after 20 years of treatment failure, achieved significant symptom relief when her primary complaint-"labored thinking"-was targeted specifically. However, because no seriously ill person has only 1 symptom, 6 clinicians from different subdisciplines will discuss the patient's other issues, ones that an overfocus on rumination might leave out.

Self-distancing and Avoidance Mediate the Links Between Trait Mindfulness and Responses to Emotional Challenges.

OBJECTIVES: Mindfulness has been linked to better emotion regulation and more adaptive responses to stress across a number of studies, but the mechanisms underlying these links remain to be fully understood. The present study examines links between trait mindfulness (Five Facets of Mindfulness Questionnaire; FFMQ) and participants' responses to common emotional challenges, focusing specifically on the roles of reduced avoidance and more self-distanced engagement as key potential mechanisms driving the adaptive benefits of trait mindfulness. METHODS: Adults (n = 305, age range: 40-72) from the Second Generation Study of the Harvard Study of Adult Development completed two laboratory-based challenges - public speaking combined with difficult math tasks (the Trier Social Stress Test) and writing about a memory of a difficult moment. State anxiety and sadness were assessed immediately before and after the two stressors. To capture different ways of engaging, measures of self-distancing, avoidance, and persistent worry were collected during the lab session. RESULTS: As predicted, individuals who scored higher on the FFMQ experienced less anxiety and persistent worry in response to the social stressors. The FFMQ was also linked to less anxiety and sadness when writing about a difficult moment. The links between mindfulness and negative emotions after the writing task were independently mediated by self-distanced engagement and lower avoidance. CONCLUSIONS: Affective benefits of trait mindfulness under stress are associated with both the degree and the nature of emotional engagement. Specifically, reduced avoidance and self-distanced engagement may facilitate reflection on negative experiences that is less affectively aversive.

Coherence Between Feelings and Heart Rate: Links to Early Adversity and Responses to Stress.

Past research suggests that higher coherence between feelings and physiology under stress may confer regulatory advantages. Research and theory also suggest that higher resting vagal tone (rVT) may promote more adaptive responses to stress. The present study examines the roles of response system coherence (RSC; defined as the within-individual covariation between feelings and heart rate over time) and rVT in mediating the links between childhood adversity and later-life responses to acute stressors. Using data from 279 adults from the Second Generation Study of the Harvard Study of Adult Development who completed stressful public speaking and mental arithmetic tasks, we find that individuals who report more childhood adversity have lower RSC, but not lower rVT. We further find that lower RSC mediates the association between adversity and slower cardiovascular recovery. Higher rVT in the present study is linked to less intense cardiovascular reactivity to stress, but not to quicker recovery or to the subjective experience of negative affect after the stressful tasks. Additional analyses indicate links between RSC and mindfulness and replicate previous findings connecting RSC to emotion regulation and well-being outcomes. Taken together, these findings are consistent with the idea that uncoupling between physiological and emotional streams of affective experiences may be one of the mechanisms connecting early adversity to later-life affective responses. These findings also provide evidence that RSC and rVT are associated with distinct aspects of self-regulation under stress. Supplementary Information: The online version contains supplementary material available at 10.1007/s42761-020-00027-5.

Assessing within- and between-family variations in an expanded measure of childhood adversity.

Previous measures of childhood adversity have enabled the identification of powerful links with later-life wellbeing. The challenge for the next generation of childhood adversity assessment is to better characterize those links through comprehensive, fine-grained measurement strategies. The expanded, retrospective measure of childhood adversity presented here leveraged analytic and theoretical advances to examine multiple domains of childhood adversity at both the microlevel of siblings and the macrolevel of families. Despite the fact that childhood adversity most often occurs in the context of families, there is a dearth of studies that have validated childhood adversity measures on multiple members of the same families. Multilevel psychometric analyses of this childhood adversity measure administered to 1,194 siblings in 500 families indicated that the additional categories of childhood adversity were widely endorsed, and increased understanding of the sources and sequalae of childhood adversity when partitioned into within- and between-family levels. For example, multilevel confirmatory factor analyses (MCFAs) indicated that financial stress, unsafe neighborhood, and parental unemployment were often experienced similarly by siblings in the same families and stemmed primarily from family wide (between-family) sources. On the other hand, being bullied and school stressors were often experienced differently by siblings and derived primarily from individual (within-family) processes. Multilevel structural equation modeling (MSEM) further illuminated differential criterion validity correlations between these categories of childhood adversity with midlife psychological, social, and physical health. Expanded, multidomain, and multilevel measures of childhood adversity appear to hold promise for identifying layered causes and consequences of adverse childhood experiences. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Capturing naturally occurring emotional suppression as it unfolds in couple interactions.

Most research examining the consequences of suppressing emotional expression has focused on either experimentally manipulated and conscious suppression, or self-reported suppression behavior. This study examined suppression as it naturally occurred in couple (n = 105) discussions regarding a challenging topic. A Suppression Index (SI) was created by calculating the difference between continuous self-reports of emotional experience, obtained using cued video recall, and coders' continuous ratings of expressed emotion. Suppression was common for both men and women, though there was also substantial individual variation. Autocorrelations of the SI were used to tap suppressive rigidity (Srig), or the tendency to inflexibly use suppression throughout the discussions. Srig scores were consistent within individuals across repeated conversations and varied across individuals, suggesting that Srig captures stable individual differences. Women's greater suppression of negative emotions combined with more rigid use of suppression was associated with their own lower relationship satisfaction but not their partners'. These findings indicate that suppressive behavior may be linked to relationship quality, and that it is not just the use of suppression that may matter but how rigidly one applies this regulatory approach. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Thriving in midlife: The roles of childhood nurturance and adult defense mechanisms.

The current study examined whether reliance on more adaptive defense mechanisms throughout early adulthood may help explain previously documented relationships between childhood nurturance and better midlife functioning. Utilizing a unique longitudinal study, data were from age 18 through midlife (age 63) on 135 males. Childhood nurturance was assessed upon study entry and defense mechanism usage was assessed throughout earlier adulthood. Percentage of 'engaging' (more adaptive) vs. 'avoidant' (less adaptive) defenses mediated the relationship between childhood nurturance and 3 midlife outcomes: participants' relationship quality with their children, marriage stability, and maximum earned income. Results suggest that greater childhood nurturance relates to more adaptive defensive styles in early adulthood, which is then associated with healthier midlife functioning at work and in relationships.

Reexamining the Call of Duty: Teaching Boundaries in Medical School.

Although healthy physician-patient boundaries are essential to medical practice, published research on how to teach this important topic to medical students is lacking. Physician-patient boundaries, the interpersonal limits placed on behavior within a clinical relationship, protect providers and patients alike, and they represent a key component of professionalism. However, these boundaries may be difficult to teach and frequently are not presented as part of the formal curriculum, except in communication-focused specialties such as psychiatry and palliative care. Medical students may be particularly susceptible to boundary concerns due to the inherent ambiguities of their role within the medical team. In this Perspective, the authors present the adapted, anonymized case of a medical student who encountered a boundary issue during a clinical rotation. Following a brief review of the limited published literature regarding the teaching of boundaries during medical school, the authors define key concepts, including the clinical frame, boundary crossings and violations, fiduciary duty, and dual relationships. Next, they provide examples of common boundary challenges that arise during the course of undergraduate medical education and later during clinical practice. The authors present factors that may contribute to boundary concerns, including characteristics of providers and patients, and they describe some of the potential consequences of boundary violations. They propose a curriculum for teaching medical students about boundaries, providing concrete suggestions for how to do so at both the preclinical and clinical levels. Before closing, they apply insights from the Perspective to the example case.

Friendship in War: Camaraderie and Prevention of Posttraumatic Stress Disorder Prevention.

Aspects of social support during combat deployment, such as unit cohesion, have been shown to affect later posttraumatic stress disorder (PTSD) development among veterans. We utilized a longitudinal database to assess how relationship quality with fellow soldiers in World War II (WWII) might be linked with postwar PTSD symptoms. Data were available on 101 men who experienced combat exposure in WWII, documented through postwar assessment. Upon study entry (1939 to 1942), data were collected on the quality of participants' early childhood relationships and their emotional adjustment during college. Data on WWII experiences were collected in 1946. Relationship quality with fellow soldiers in WWII was examined as a moderator of the link between combat exposure and postwar PTSD symptoms. Prewar emotional adjustment was examined as a mediator between quality of childhood relationships and subsequent quality of relationships quality with fellow soldiers during war. Better quality relationships with fellow soldiers attenuated (i.e., moderated) the link between combat exposure severity and PTSD symptom count, explaining a significant percent of the variance, R2 = .19, p < .001. There was also a significant indirect mediation effect of childhood relationship quality on relationships with soldiers through prewar emotional adjustment, ab = 0.02, 95% BCa CI [0.01, 0.05]. Results suggest that better peer relationship quality during deployment may reduce the likelihood of subsequent PTSD symptom development, and that the quality of early relationships may set the stage for better relationships during stressful contexts such as war. These findings have implications for PTSD risk factor screening prior to deployment, and underscore the importance of interpersonal support among soldiers during deployment.

Development of Adaptive Coping From Mid to Late Life: A 70-Year Longitudinal Study of Defense Maturity and Its Psychosocial Correlates.

The present study examines changes in defense maturity from mid to late life using data from an over 70-year longitudinal study. A sample of 72 men was followed beginning in late adolescence. Participants' childhoods were coded for emotional warmth. Defense mechanisms were coded by independent raters using the Q-Sort of Defenses (, Ego mechanisms of defense: A guide for clinicians and researchers 217-233) based on interview data gathered at approximately ages 52 and 75. We examined psychosocial correlates of defenses at midlife, late life, and changes in defense from mid to late life. Overall, defenses grew more adaptive from midlife to late life. However, results differed on the basis of the emotional warmth experienced in the participants' childhoods. In midlife, men who experienced warm childhoods used more adaptive (mature) defenses; yet by late life, this difference in defensive maturity had disappeared. Men who experienced less childhood warmth were more likely to show an increase in adaptive defenses during the period from mid to late life.

War and remembrance: Combat exposure in young adulthood and memory function sixty years later.

OBJECTIVE: Identifying adaptive ways to cope with extreme stress is essential to promoting long-term health. Memory systems are highly sensitive to stress, and combat exposure during war has been shown to have deleterious effects on cognitive processes, such as memory, decades later. No studies have examined coping styles used by combat veterans and associations with later-life cognitive functioning. Defenses are coping mechanisms that manage difficult memories and feelings, with some more closely related to memory processes (e.g., suppression, repression). Utilizing a longitudinal database, we assessed how reliance on certain defense mechanisms after World War II combat exposure could affect cognitive health 60years later. METHOD: Data spanning 75years were available on 71 men who had post-war assessment of combat exposure, defense mechanism ratings (ages 19-50), and late-life neuropsychological testing. Interaction models of combat exposure with defenses predicting late-life memory were examined. RESULTS: In bivariate analyses, greater reliance on suppression correlated with worse memory performance (r=-0.30, p=.01), but greater reliance on repression did not. Greater reliance on suppression strengthened the link between combat exposure and worse memory in late life (R2=0.24, p<.001). In contrast, greater reliance on repression attenuated the link between combat exposure and poorer late-life memory (R2=0.19, p<.001). CONCLUSIONS: Results suggest that coping styles may affect the relationship between early-adult stress and late-life cognition. Findings highlight the importance of understanding how coping styles may impact cognitive functioning as people move through adult life.

The Long Reach of Nurturing Family Environments: Links With Midlife Emotion-Regulatory Styles and Late-Life Security in Intimate Relationships.

Does the warmth of children's family environments predict the quality of their intimate relationships at the other end of the life span? Using data collected prospectively on 81 men from adolescence through the eighth and ninth decades of life, this study tested the hypotheses that warmer relationships with parents in childhood predict greater security of attachment to intimate partners in late life, and that this link is mediated in part by the degree to which individuals in midlife rely on emotion-regulatory styles that facilitate or inhibit close relationship connections. Findings supported this mediational model, showing a positive link between more nurturing family environments in childhood and greater security of attachment to spouses more than 60 years later. This link was partially mediated by reliance on more engaging and less distorting styles of emotion regulation in midlife. The findings underscore the far-reaching influence of childhood environment on well-being in adulthood.

Midlife Eriksonian psychosocial development: Setting the stage for late-life cognitive and emotional health.

Erikson's (1950) model of adult psychosocial development outlines the significance of successful involvement within one's relationships, work, and community for healthy aging. He theorized that the consequences of not meeting developmental challenges included stagnation and emotional despair. Drawing on this model, the present study uses prospective longitudinal data to examine how the quality of assessed Eriksonian psychosocial development in midlife relates to late-life cognitive and emotional functioning. In particular we were interested to see whether late-life depression mediated the relationship between Eriksonian development and specific domains of cognitive functioning (i.e., executive functioning and memory). Participants were 159 men from the over-75 year longitudinal Study of Adult Development. The sample was comprised of men from both higher and lower socioeconomic strata. Eriksonian psychosocial development was coded from men's narrative responses to interviews between the ages of 30-47 (Vaillant & Milofsky, 1980). In late life (ages 75-85) men completed a performance-based neuropsychological assessment measuring global cognitive status, executive functioning, and memory. In addition depressive symptomatology was assessed using the Geriatric Depression Scale. Our results indicated that higher midlife Eriksonian psychosocial development was associated with stronger global cognitive functioning and executive functioning, and lower levels of depression 3 to 4 decades later. There was no significant association between Eriksonian development and late-life memory. Late-life depression mediated the relationship between Eriksonian development and both global cognition and executive functioning. All of these results controlled for highest level of education and adolescent intelligence. Findings have important implications for understanding the lasting benefits of psychosocial engagement in mid-adulthood for late-life cognitive and emotional health. In addition, it may be that less successful psychosocial development increases levels of depression making individuals more vulnerable to specific areas of cognitive decline.

Empathic Accuracy and Aggression in Couples: Individual and Dyadic Links.

The authors examined links between intimate partner aggression and empathic accuracy-how accurately partners can read one another's emotions-during highly affective moments from couples' (N = 109) video recall of laboratory-based discussions of upsetting events. Less empathic accuracy between partners was generally related to higher levels of aggression by both partners. More specific patterns emerged based on the type of aggression and emotion being expressed. Women's poorer ability to read their partners' vulnerable and positive emotions was linked to both men's and women's greater physical and psychological aggression. Moreover, women's inaccuracy in reading their partner's hostility was linked to women's greater psychological aggression toward the men. Men's inaccuracy in reading their partner's hostility was linked to women's (not men's) greater physical and psychological aggression. The results suggest important nuances in the links between empathic inaccuracy and aggression, and implications for prevention and treatment of partner aggression are discussed.

Security of attachment to spouses in late life: Concurrent and prospective links with cognitive and emotional wellbeing.

Social ties are powerful predictors of late-life health and wellbeing. Although many adults maintain intimate partnerships into late life, little is known about mental models of attachment to spouses and how they influence aging. Eighty-one elderly heterosexual couples (162 individuals) were interviewed to examine the structure of attachment security to their partners and completed measures of cognition and wellbeing concurrently and 2.5 years later. Factor analysis revealed a single factor for security of attachment. Higher security was linked concurrently with greater marital satisfaction, fewer depressive symptoms, better mood, and less frequent marital conflicts. Greater security predicted lower levels of negative affect, less depression, and greater life satisfaction 2.5 years later. For women, greater security predicted better memory 2.5 years later and attenuated the link between frequency of marital conflict and memory deficits. Late in life, mental models of attachment to partners are linked to wellbeing concurrently and over time.

Childhood adversity, midlife generativity, and later life well-being.

OBJECTIVES: Prior studies confirm that after experiencing childhood adversity, resilient adults can recover and engage in generative growth. This study explored the long-term effects of childhood adversity (assessed as harsh parenting and/or childhood poverty) on successful aging for individuals who either achieved or failed to achieve Erikson's psychosocial developmental stage of generativity in midlife. METHOD: The study utilized a sample of 636 men from the Harvard Sample and Inner City Cohort of the 73-year longitudinal Study of Adult Development. Nested ordinary least squares regression models were used to test the mediating and moderating effects of midlife generativity on later life health and adjustment to aging. RESULTS: Men who experienced childhood adversity were less likely than men with no childhood adversity to achieve generativity in midlife. Although achievement of generativity was associated with better later life health and adjustment to aging, it neither mediated nor moderated the negative relation between childhood poverty and later life health outcomes. However, for men who experienced an adversarial childhood, achievement of generativity mediated and moderated adjustment to aging. DISCUSSION: Results suggest that psychosocial growth in adulthood can compensate for the long-term negative effects of an adversarial childhood on adjustment to aging, but not for later life health.