Real change or more of the same? Analysing Australian media's portrayal of intellectual disability during the NDIS rollout.

BACKGROUND: Through the filtering of information, the creation, and reinforcement of stereotypes, media moulds attitudes and set agendas on critical social issues including public policy and disability. METHODS: This study explored Australian media representations of the care of people with intellectual disability during a crucial period in disability policy change: the National Disability Insurance Scheme (NDIS) rollout (2013-2018). Search criteria identified 168 news stories, examined via content analysis and news framing. RESULTS: Four major issues were identified: Roles and responsibilities of government; housing; mistreatment of persons with intellectual disability, and responsibility of care for families. Stories tended to be presented negatively, however, regional and local/community metropolitan stories were more balanced or positive compared with major metropolitan stories. CONCLUSION: Despite significant disability policy change, media presentations continue to reinforce stereotypes of people with intellectual disability and position the government as one continuing to fall short in critical areas of funding, safety, and support.

The relationship among openness, wisdom, and humor: a preliminary mediation model.

OBJECTIVES: Wisdom researchers acknowledge the complex nature of this ancient construct, although they are yet to agree on its core components. A key question in the literature is whether Openness and Humour are aspects of wisdom or whether Openness is an antecedent of wisdom with Humour as a consequence. METHODS: Using structural equation modelling, we evaluated data from 457 online respondents aged 16-87 years (Mage = 35.19, SD = 17.45). We analyzed a model with Openness as a precursor to Wisdom (conceptualised as a latent mediator variable using parcels of the SAWS Experience, Reminiscence/Reflection, and Emotional Regulation items), with Humor as outcome. We compared this model with a model using Wisdom as a latent mediator variable using parcels of the Three-Dimensional Wisdom Scale-12 (3D-WS-12). RESULTS: A model using Self-Assessed Wisdom Scale (SAWS)-9 latent mediator variable with Openness as precursor to wisdom and Humour as a consequence was good fit for the data and displayed full mediation. Similarly, a model using the 3D-WS-12 as latent mediator variable to measure wisdom and with Openness as a precursor to wisdom and Humour as a consequence also fits the data with full mediation. DISCUSSION: These findings provide empirical support for theoretical suggestions in the literature that Openness is a precursor to wisdom and that Humour is a consequence of wisdom using two of the most common self-report measures of wisdom. An improved understanding of the nature of wisdom and especially of its potential precursors can also be of use in future efforts to facilitate the development of wisdom.

An evaluation of the factor structure of the Self-Assessed Wisdom Scale (SAWS) and the creation of the SAWS-15 as a short measure for personal wisdom.

OBJECTIVES: Although wisdom is a desirable life span developmental goal, researchers have often lacked brief and reliable construct measures. We examined whether an abbreviated set of items could be empirically derived from the popular 40-item five-factor Self-Assessed Wisdom Scale (SAWS). DESIGN: Survey data from 709 respondents were randomly split into two and analyzed using confirmatory factor analysis (CFA). SETTING: The survey was conducted online in Australia. PARTICIPANTS: The total sample consisted of 709 participants (Mage = 35.67 years; age range = 15-92 years) of whom 22% were male, and 78% female. MEASUREMENT: The study analyzed the 40-item SAWS. RESULTS: Sample 1 showed the traditional five-factor structure for the 40-item SAWS did not fit the data. Exploratory factor analysis (EFA) on Sample 2 offered an alternative model based on a 15-item, five-factor solution with the latent variables Reminiscence/Reflection, Humor, Emotional Regulation, Experience, and Openness. This model, which replicates the factor structure of the original 40-item SAWS with a short form of 15 items, was then confirmed on Sample 1 using a CFA that produced acceptable fit and measurement invariance across age groups. CONCLUSIONS: We suggest the abbreviated SAWS-15 can be useful as a measure of individual differences in wisdom, and we highlight areas for future research.

Characteristics and effectiveness of cognitive behavioral therapy for older adults living in residential care: a systematic review.

OBJECTIVES: Cognitive behavioral therapy (CBT) for depression and anxiety for older adults living in residential aged care facilities (RACFs) needs to accommodate the care needs of residents and the circumstances of RACFs. This systematic review examines the delivery and content characteristics of these interventions, in relation to participant satisfaction, staff appraisal, uptake rate, attrition rate, and treatment effectiveness. Such a review could provide important information for the development of future CBT-based interventions. METHOD: Studies that examined the application of CBT for depression or anxiety in RACFs were identified by systematically searching a number of relevant databases. Reference lists of all included studies were examined, and citation searches on the Web of Science were conducted. Two independent reviewers were involved in screening articles and in extracting data and assessing methodological quality of the selected studies. RESULTS: Across the 18 studies included in this review, the most common therapeutic strategy was pleasant activities scheduling. Studies varied on treatment duration (2-24 weeks), number of sessions (6-24), and length of sessions (10-120 min). Residents and staff members were satisfied with the CBT interventions. The average uptake rate was 72.9%. The average attrition rate was 19.9%. Statistically significant results were reported in 8 of the 12 randomized controlled trials (RCTs). In these eight RCTs, CBT was characterized by psychoeducation, behavioral activation, and problem-solving techniques; further, the therapists in six of these studies had training in psychology. CONCLUSION: CBT interventions for depression and anxiety are acceptable to RACF residents and judged positively by staff members. Effective studies differed from non-effective studies on content and training characteristics, but not on other delivery features.

Rural and urban older adults' perceptions of mental health services accessibility.

Objectives: Older adults have been recognised as a group with poor access to mental health services, particularly those in rural areas. Using a decision framework of recognizing psychological problems, deciding to seek help, and choice of help, this study investigated older adults' access to mental health services using a mixed methods design.Methods: Ninety-four older adults from remote, regional and urban Australia returned surveys and twenty-one of them participated in focus groups and in-depth interviews. Participants were asked to identify psychological problems, the decision to seek help including perceived barriers to accessibility of mental health services, and the choice of help including their understanding of mental health disciplines and their views of service use.Results: When regional differences appeared, inner regional older adults reported more access problems than either urban or outer regional participants. Although older adults have a good understanding of mental health disciplines and accurately identified depression and substance abuse, they had difficulty recognizing anxiety and were uncertain as to when symptom severity should indicate that one should seek help. Though stigma was largely dismissed as a thing of the past, self-sufficiency was implicated as a psychological barrier to accessibility.Conclusion: Older adults may have difficulty in recognizing anxiety and milder levels of mental health concerns. This may be further complicated by a high value of self-sufficiency. These barriers need to be considered by all professionals working with older adults, in particular GP's who were identified as expert health advisors.

Effects of age and mood on emotional face processing differ depending on the intensity of the facial expression.

Research suggests that mood can moderate age differences in recognizing facial emotion. In this study, we examined how an anxious versus calm mood state affected younger and older adults' processing of emotional faces. Older adults had greater difficulty identifying negative emotions, particularly when emotions were displayed at a low intensity level. However, an anxious mood did not affect age differences in emotional face recognition. In contrast, age, emotional intensity, and current mood state all affected the perceived intensity of emotion. The effects of age and mood on perceived emotional intensity were only observed for low intensity facial expressions. When induced into an anxious mood, younger adults perceived threatening emotions (i.e., fear, anger) as more emotionally intense, whereas older adults perceived anger and happiness to be more intense. These findings emphasize the need to consider both internal and external factors when investigating the effects of age on emotional face processing.

Characteristics of Cognitive Behavioral Therapy for Older Adults Living in Residential Care: Protocol for a Systematic Review.

BACKGROUND: The prevalence rates of depressive and anxiety disorders are high in residential aged care settings. Older adults in such settings might be prone to these disorders because of losses associated with transitioning to residential care, uncertainty about the future, as well as a decline in personal autonomy, health, and cognition. Cognitive behavioral therapy (CBT) is efficacious in treating late-life depression and anxiety. However, there remains a dearth of studies examining CBT in residential settings compared with community settings. Typically, older adults living in residential settings have higher care needs than those living in the community. To date, no systematic reviews have been conducted on the content and the delivery characteristics of CBT for older adults living in residential aged care settings. OBJECTIVE: The objective of this paper is to describe the systematic review protocol on the characteristics of CBT for depression and/or anxiety for older adults living in residential aged care settings. METHODS: This protocol was developed in compliance with the recommendations of the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). Studies that fulfill the inclusion criteria will be identified by systematically searching relevant electronic databases, reference lists, and citation indexes. In addition, the PRISMA flowchart will be used to record the selection process. A pilot-tested data collection form will be used to extract and record data from the included studies. Two reviewers will be involved in screening the titles and abstracts of retrieved records, screening the full text of potentially relevant reports, and extracting data. Then, the delivery and content characteristics of different CBT programs of the included studies, where available, will be summarized in a table. Furthermore, the Downs and Black checklist will be used to assess the methodological quality of the included studies. RESULTS: Systematic searches will commence in May 2018, and data extraction is expected to commence in July 2018. Data analyses and writing will happen in October 2018. CONCLUSIONS: In this section, the limitations of the systematic review will be outlined. Clinical implications for treating late-life depression and/or anxiety, and implications for residential care facilities will be discussed. TRIAL REGISTRATION: PROSPERO 42017080113; https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=80113 (Archived by WebCite at http://www.webcitation.org/70dV4Qf54). REGISTERED REPORT IDENTIFIER: RR1-10.2196/9902.

Understanding the Mechanisms of Change in a Lifestyle Intervention for Older Adults.

Purpose of the Study: This study investigated the mechanisms of change underlying an activity-based lifestyle intervention, an occupational therapy program aimed at promoting healthy habits, and routines in older adults. We examined two activity-relevant factors as potential mediators linking the intervention to reduced symptoms of depression: activity frequency and global perceptions of activity significance. Social connections and perceived control were assessed to understand how activity-related factors relate to reduced symptoms of depression. Design and Methods: The sample consisted of 460 multiethnic community-dwelling older adults aged 60-95 years. Participants were randomly assigned to a 6-month lifestyle redesign intervention (n = 232) or a no-treatment control (n = 228) condition. After the 6-month period, 360 individuals completed post-testing. Latent change score models were used to represent changes from baseline over the experimental interval. Structural equation models were applied to examine the indirect effects of the intervention on reduced depressive symptoms. Results: The results demonstrated significant indirect effects from intervention receipt to decreased depressive symptoms via increased activity frequency and activity significance. Higher activity frequency was linked to fewer depressive symptoms via heightened social connections, whereas increased activity significance was associated with fewer depressive symptoms via enhanced perceived control. Implications: The results support basic principles of occupational therapy by highlighting important mediating roles of activity frequency and activity significance in reducing depressive symptoms. Understanding of these change mechanisms can help optimize activity-centered interventions to reduce depressive symptoms.

Attentional avoidant biases as mediators in the association between experiential avoidance and blood pressure in dementia family caregivers.

OBJECTIVES: Experiential avoidance in caregiving (EAC) has been found to be related with dementia family caregivers´ distress and blood pressure (BP). The association between EAC and avoidant attentional biases to emotional stimuli in dementia caregivers, and the potential mediating role of these attentional biases in the association between EAC and increased BP are explored. METHOD: Seventy nine dementia family caregivers performed a dot-probe task with emotional pictures (distressing and positive) varying in content (general vs. caregiving-related (CR)) and time of exposure (100 vs. 500 ms). They also completed measures of EAC, anxiety, depression, alexithymia and rumination, and their BP was measured. RESULTS: EAC was associated with avoidant attentional biases to CR emotional pictures and negative pictures in general at 100 ms. Experiential Avoidance in Caregiving Questionnaire (EACQ) 'avoidant behaviors' and EACQ 'intolerance of negativity' factors were associated with diastolic and systolic BP, respectively, with attentional avoidance of CR emotional pictures (distressing and positive, respectively) mediating this association. CONCLUSION: Attentional avoidance of CR emotional stimuli may be the link between EAC and increased BP, as it prevents emotional processing and facilitates the maintenance of physiological activation. EAC may pose a risk for cardiovascular disease in dementia caregivers.

Caregiving Subgroups Differences in the Associations Between the Resilience Resources and Life Satisfaction.

Using a model of resilience, this study compared the direct and indirect associations between resilience resources (sense of mastery, openness to experience, emotion regulation, and social support) and life satisfaction among caregiving subgroups (spouses, adult-children, and parents). Participants were included from the survey of Midlife in the United States (MIDUS II). Estimates of direct and indirect relationships between the resources and life satisfaction were calculated for each subgroup, and differences in the relationships between subgroups were tested. The direct positive relationships between sense of mastery and life satisfaction were significant and stronger for spouses and parents than for adult-children. In contrast, an indirect relationship through social support between the two variables was stronger for adult-children than for spouses. Openness to experience had a direct positive link to life satisfaction among spouses, and emotion regulation was directly related to life satisfaction among parents. We suggested targeted interventions for caregiving subgroups.

Wisdom across the ages and its modern day relevance.

Wisdom is derived (in modern language terms) from the Old English words wis ("of a certainty, for certain"; "Wisdom," 2015) and dóm ("statute, judgment, jurisdiction"; "Wisdom," 2015); wisdom is, at its broadest, defined as the "Capacity of judging rightly in matters relating to life and conduct; soundness of judgement in the choice of means and ends; sometimes less strictly, sound sense, esp. in practical affairs" ("Wisdom," 2015). As a concept, wisdom has been acknowledged within our history since the time of the Sumerians (and estimated to have originated in around 2,500 BCE). However, in modern times, the relevance of the traditional wise person is less clear. Nonetheless, wisdom research has been on the rise since it emerged as a focus of researchers in the 1970's, and a part of that research focus has been to explore the significance of wisdom and its relevance in the current day (particularly with regards to how it is measured across cultures).

The Effects of the MORE Wisdom Resources on Spousal Caregivers' Life Satisfaction: An Application of the Resilience Model.

OBJECTIVES: Models of resilience suggest that psychosocial resources and their interactions facilitate resilience while experiencing life challenges of caregiving. The MORE wisdom resources (sense of Mastery, Openness to experience, Reflective attitude, and Emotion regulation) have been suggested as possible personal resources of resilience that predict positive health outcomes of caregivers. Applying a model of resilience, this study examined the direct and indirect effects of the three of the MORE wisdom resources (sense of Mastery, Openness to experience, and Emotion regulation) on caregiving spouses' life satisfaction and perceived physical health. METHODS: Using data from the survey of Midlife in the United States, caregiving spouses (n = 114) and matched non-caregivers (n = 114) were included. We compared the direct and indirect effects of the wisdom resources on life satisfaction and physical health between the two groups. RESULTS: The simple mediation model proposed in 2008 by Preacher and Hayes revealed that openness to experience was directly associated with better life satisfaction among caregiving spouses. Sense of mastery and emotion regulation had indirect effects on life satisfaction through spousal support. The effects the wisdom resources on caregiving spouses' perceived physical health were not found. CONCLUSIONS: This study demonstrated that the three of the MORE wisdom resources are possible personal resilience factors influencing life satisfaction among caregiving spouses. Moreover, the study showed how spousal support mediates the relationship between the wisdom resources and life satisfaction. CLINICAL IMPLICATIONS: Interventions aiming to increase life satisfaction among caregiving spouses should focus on increasing both personal and environmental resources and strengthening the relationship of the caregiver and care recipient.

Age Differences in Interpreting Ambiguous Situations: The Effects of Content Themes and Depressed Mood.

OBJECTIVES: This study aimed to investigate the boundary conditions of the positivity effect on appraisals of ambiguous situations across content themes and emotional states. We differentiated the processes of interpretation generation and selection to see whether older adults recognize negative aspects of ambiguous situations but tend to select positive interpretations. METHOD: Seventy-six younger and 67 older adults went through sad and neutral mood inductions and completed ambiguous situation tasks. Participants were asked to generate interpretations and select one as the most likely explanation for each scenario. RESULTS: Results demonstrated that compared with younger adults, older adults selected less negative interpretations across content themes but generated fewer negative interpretations in interpersonal but not in health situations. Depressed mood led to more negative interpretations at both generation and selection for younger adults but not older adults. CONCLUSIONS: Our results showed that thematic factors had an effect on the positivity effect on interpretation generation, but regardless of content themes, older adults selected a less negative interpretation as the most likely, despite knowing alternative negative explanations. The positivity effect remained for older adults in high trait and state depressed mood. Together these findings are consistent with the pattern of older adults' tendency to maximize emotional well-being through less negative interpretations of ambiguous situations.

Influences on the perception of elder financial abuse among older adults in Southern California.

BACKGROUND: Under-reporting of elder financial abuse is partly due to failure of those around the victim to perceive the financial mistreatment as abuse. This study explored the effect of victim and perceiver factors on perception of elder financial abuse in the context of Routine Activity Theory (RAT). METHODS: 488 older adults in Ventura County (CA) were surveyed about financial abuse using vignette method. In the study's Vignette 1, the amount of money taken, the type of frailty, and the relationship of perpetrator and victim were manipulated. In Vignette 2, the victim's age and relationship of perpetrator and victim were manipulated. Respondents' demographics (age, gender, education, and ethnicity) were collected. RESULTS: Logistic regression analyses revealed that children of the victim were least likely to be seen as committing abuse in both vignettes. In Vignette 1, there was an interaction of gender of respondent and the amount of money taken. In Vignette 2, non-Whites were less likely to perceive the signing over of the house as financial abuse. Respondents endorsed the concept of a special court with expertize in elder abuse as a way to increase the likelihood that they would report. CONCLUSIONS: Even though most financial abuse is perpetrated by family members, older adults are less likely to perceive a financial situation as abuse when it involves a child of the victim, thus making reporting and prevention less likely. The support for a specialty Elder Abuse Court (EAC) suggests that some reluctance to report is based on misgivings about punishing the perpetrator.

Age Differences in the Complexity of Emotion Perception.

BACKGROUND/STUDY CONTEXT: The current study examined age differences in the number of emotion components used in the judgment of emotion from facial expressions. METHODS: Fifty-eight younger and 58 older adults were compared on the complexity of perception of emotion from standardized facial expressions that were either clear or ambiguous exemplars of emotion. RESULTS: Using an intra-individual factor analytic approach, results showed that older adults used more emotion components in perceiving emotion in faces than younger adults. Both age groups reported greater emotional complexity for the clear and prototypical emotional stimuli. Age differences in emotional complexity were more pronounced for the ambiguous expressions compared with the clear expressions. CONCLUSION: These findings demonstrate that older adults showed increased elaboration of emotion, particularly when emotion cues were subtle and provide support for greater emotion differentiation in older adulthood.

Aging and the effects of emotion on cognition: Implications for psychological interventions for depression and anxiety.

We review findings from laboratory research on age differences in the effects of emotion on cognition. Particular attention is given to sadness leading to mood congruent memory and to anxiety leading to selective attention bias to threat. While older adults in normal moods show the positivity effect as expected from socio-emotional selectivity theory, older adults whose mood has changed from baseline to sad or anxious show these mood-related cognitive biases. These mood-related biases are a foundational part of the theory underlying cognitive behavior therapy (CBT) and so these laboratory findings suggest ways that CBT may work differently with older adults. Pilot work suggests that the presence or absence of these effects may also predict responsiveness to treatment using CBT.

Can we do better? Researchers' experiences with ethical review boards on projects with later life as a focus.

The goal of this study was to describe researchers' experiences in submitting ethical proposals focused on older adult populations, including studies with persons with dementia, to ethical review boards. Ethical approval was granted for an online survey. Researchers were recruited via listservs and snowballing techniques. Participants included 157 persons (73% female) from Australia and the United States, with a mean age of 46 (±13). Six main issues were encountered by researchers who participated in this survey. In descending order, these included questions regarding: informed consent and information requirements (61.1%), participants' vulnerability, particularly for those with cognitive impairments (58.6%), participant burden (44.6%), data access (29.3%), adverse effects of data collection/intervention (26.8%), and study methodology (25.5%). An inductive content analysis of responses revealed a range of encounters with ethical review panels spanning positive, negative, and neutral experiences. Concerns voiced about ethical review boards included committees being overly focused on legal risk, as well as not always hearing the voice of older research participants, both potential and actual. Respondents noted inability to move forward on studies, as well as loss of researchers and participant groups from gerontological and clinical research as a result of negative interactions with ethics committees. Positive interactions with the committees reinforced researchers' need to carefully construct their research approaches with persons with dementia in particular. Suggested guidelines for committees when dealing with ethics applications involving older adults include self-reflecting on potential biases and stereotypes, and seeking further clarification and information from gerontological researchers before arriving at decisions.

Adaptation of the three-dimensional wisdom scale (3D-WS) for the Korean cultural context.

ABSTRACT Background: Previous research on wisdom has suggested that wisdom is comprised of cognitive, reflective, and affective components and has developed and validated wisdom measures based on samples from Western countries. To apply the measurement to Eastern cultures, the present study revised an existing wisdom scale, the three-dimensional wisdom scale (3D-WS, Ardelt, 2003) for the Korean cultural context. Methods: Participants included 189 Korean heritage adults (age range 19-96) living in Los Angeles. We added a culturally specific factor of wisdom to the 3D-WS: Modesty and Unobtrusiveness (Yang, 2001), which captures an Eastern aspect of wisdom. The structure and psychometrics of the scale were tested. By latent cluster analysis, we determined acculturation subgroups and examined group differences in the means of factors in the revised wisdom scale (3D-WS-K). Results: Three factors, Cognitive Flexibility, Viewpoint Relativism, and Empathic Modesty were found using confirmatory factor analysis. Respondents with high biculturalism were higher on Viewpoint Relativism and lower on Empathic Modesty. Conclusion: This study discovered that a revised wisdom scale had a distinct factor structure and item content in a Korean heritage sample. We also found acculturation influences on the meaning of wisdom.

Functional assessment and neuropsychiatric inventory questionnaires: measurement invariance across hispanics and non-Hispanic whites.

PURPOSE OF THE STUDY: We tested the ethnic-group measurement invariance of 2 commonly used informant-report scales of patients' dementia symptoms: the Functional Assessment Questionnaire (FAQ), a measure of functional abilities, and the Neuropsychiatric Inventory Questionnaire (NPI-Q), a measure of behavioral and psychological symptoms of dementia. DESIGN AND METHODS: We conducted multigroup confirmatory factor analyses on 311 Hispanic and 10,863 non-Hispanic White (NHW) outpatients and their informants diagnosed with dementia or normal cognition at their initial Alzheimer's Disease Center evaluations nationwide. RESULTS: We confirmed our hypothesized one-factor FAQ and four-factor NPI-Q models for each ethnic group. We also found evidence for the configural (i.e., number of factors) and factorial (i.e., pattern of factor loadings) invariance of both scales and structural (i.e., factor covariances) invariance of the NPI-Q across groups. However, we did not obtain evidence for ethnic-group scalar (i.e., intercept) invariance for either scale. IMPLICATIONS: The FAQ and NPI-Q were operating similarly across Hispanics and NHWs, suggesting that they can be meaningfully used within and across these groups to measure informant-reported dementia symptomatology. However, their scalar noninvariance indicates that meaningful ethnic-group comparisons of their latent factor mean values cannot be made.