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.

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.

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.

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.

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.

Cross-cultural differences in dementia: the Sociocultural Health Belief Model.

BACKGROUND: Many minority ethnic (ME) older adults face several culturally associated and systemic barriers to timely dementia diagnoses that may result in delays to dementia care-seeking. We aimed to develop and propose a model illustrating variables that influence dementia care-seeking among ME older adults. METHODS: We conducted a literature review on the effects of these barriers on diagnostic delays and impairment levels at initial evaluation. We also strived to provide a basis for the Sociocultural Health Belief Model (SHBM) to guide future research and service planning pertaining to culture and dementia care-seeking. RESULTS: There was consistent evidence that ME older adults with dementia tended to have greater diagnostic delays and higher levels of cognitive impairment and behavioral and psychological symptoms of dementia at initial evaluation than their non-Hispanic White counterparts. We also found several barriers to dementia care-seeking among ME groups. These barriers included lower levels of acculturation and accurate knowledge about dementia, more culturally associated beliefs about dementia, such as the perception of memory loss as normal aging and stigma associated with dementia, and health system barriers. CONCLUSIONS: The SHBM provides an empirically based conceptual framework for examining cross-cultural differences in dementia care-seeking among diverse groups. We provide recommendations for future research, such as the need for research with more diverse ethnic subgroups and the examination of group-specific cultural values. We conclude with a discussion of the clinical and service implications of our review, including potential interventions aimed at facilitating timely dementia diagnoses among ME older adults.

Accreditation in the profession of psychology: a cautionary tale.

This article examines the history of accreditation in psychology and applies the lessons learned to the Association for Gerontology in Higher Education's (AGHE) consideration of forming an organization to accredit programs in gerontology. The authors identify the challenges met and unmet, the successes and failures, and the key issues that emerged from psychology's experience with accreditation. Psychology has been accrediting programs in clinical psychology for more than 65 years, and the process has been marked by several false steps, considerable tension, and some controversy and at times significant dissatisfaction. The accreditation process that has emerged today, which includes counseling, school psychology, graduate practica, and postdoctoral practica sites, is generally well received yet some tensions exist. The authors apply the lessons learned from psychology's evolution to AGHE. The experience of psychology suggests a need for clear minimum standards and consistency across programs in training goals, if not in curricula and practica. However, setting standards for specific curricula and practice content may result in a similar contentiousness that has plagued psychology. Ultimately, the authors conclude that the benefits of accreditation of programs outweigh the deficits.

Mental health and aging in the 21st century.

This article reviews pressing issues in mental health care for older adults in the 21st century. After examining current forces for change in older adults' mental health care and coverage, the authors discuss barriers to accessing mental health care resulting from the fragmentation of the United States health care system as well as the history behind the multiple and competing systems of care for older adults. The article continues with a discussion of goals for the provision of good mental health service delivery for older adults and concludes by addressing potential responses and future target areas regarding mental health care for older adults as well as a potential realistic collaboration to address mental health and aging.

Confirmatory factor analysis of the Center for Epidemiologic Studies-Depression Scale in black and white dementia caregivers.

OBJECTIVES: In order to better understand if measurement problems underlie the inconsistent findings that exist regarding differences in depression levels between Black and White caregivers, this study examined the factor structure and invariance of the Center for Epidemiologic Studies-Depression (CES-D) Scale. METHOD: A confirmatory factor analysis of the 20-item CES-D was performed on a sample of 167 Black and 214 White family caregivers of older adults with dementia from Los Angeles County. RESULTS: The relationships between the 20 items and the four factors, as well as the relationships among each of the factors, were equivalent across both caregiver groups, indicating that the four-factor model fit the data for both the racial groups. CONCLUSION: These findings offer further evidence that the standard four-factor model is the best fitting model for the CES-D and is invariant across racial groups.

Psychosocial factors and caregivers' distress: effects of familism and dysfunctional thoughts.

INTRODUCTION: Caring for a relative with dementia is linked with negative psychological and physical consequences for the caregiver. The number of studies analyzing the influence of specific values and thoughts on caregivers' distress remains sparse. OBJECTIVES AND METHOD: The aim of this study is to analyze the influence of both familism dimensions and dysfunctional thoughts specific to caregiving on depression in a sample of 334 dementia caregivers. RESULTS: The results of this study suggest that familism can have positive influences on caregiving distress when the family is perceived as a source of support. However, the dimensions of familism pertaining to a strong adherence to values regarding both feelings of obligation to provide support as well as behaviors and attitudes that should be followed by different members of a family were linked with caregivers' distress through their influence on dysfunctional thoughts. CONCLUSION: This study provides support for the importance of conceptualizing familism as a multidimensional construct with both positive and negative effects on caregivers' emotional distress and suggests that familism affects emotional distress through dysfunctional thoughts rather than through burden appraisals. Clinical implications include attending to both the positive and negative effects of familism values and the potential value of targeting dysfunctional thoughts in cognitive-behavioral interventions with caregivers.

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.

Pikes Peak model for training in professional geropsychology.

The aging of the population will increase demand for psychological services for older adults, which challenges the profession of psychology to provide those services. In response to that challenge, professional geropsychology has been developing over the past few decades to meet current and prepare for anticipated future demand. The development of a range of training opportunities is important to enable psychologists to work effectively with older adults. This article describes the Pikes Peak model for training in professional geropsychology. The model is an aspirational, competencies-based approach to training professional geropsychologists that allows for entry points at multiple levels of professional development.

Attentional bias for threat in older adults: moderation of the positivity bias by trait anxiety and stimulus modality.

Socioemotional selectivity theory suggests that emotion regulation goals motivate older adults to preferentially allocate attention to positive stimuli and away from negative stimuli. This study examined whether anxiety moderates the effect of the positivity bias on attention for threat. The authors employed the dot probe task to compare subliminal and supraliminal attention for threat in 103 young and 44 older adults. Regardless of anxiety, older but not young adults demonstrated a vigilant-avoidant response to angry faces. Anxiety influenced older adults' attention such that anxious individuals demonstrated a vigilant-avoidant reaction to sad faces but an avoidant-vigilant reaction to negative words.