Borderline Personality Disorder Across the Life Span

SUMMARY

Borderline personality disorder is characterized by affective dysregulation, intense, unstable interpersonal relationships, impulsivity and unstable identity. It overlaps considerably with both PTSD and bipolar spectrum disorders. Research on true late-life BPD is limited, but suggests that some of the core features of BPD including interpersonal difficulties, unstable affect and anger remain relatively unchanged, while impulsivity and identity disturbance decline or change their mode of expression in late life. Diagnosis of BPD in late life requires flexible application of the standard diagnostic criteria as well as a thorough longitudinal history. The etiology of BPD is best explained as a combination of genetic, neurobiological vulnerability combined with childhood trauma, abuse or neglect that leads to dysregulated emotions, distorted cognitions, social skills deficits, and few adaptive coping strategies. Treatment options include pharmacotherapy (especially mood stabilizers, SSRIs and atypical antipsychotics) and psychotherapeutic interventions that focus on distress tolerance, affective regulation, changing distorted beliefs, and introducing new social and relationship problem-solving skills (especially Dialectical Behavior Therapy and Schema Focused Cognitive Therapy). In late-life care environments, such as nursing homes and other residential facilities, staff need to be empowered to set appropriate limits on problematic behavior while maintaining empathy and validating the painful affect patients often experience.     

Perceived Sexual Orientation of Men and Women with Eating Disorders and Obesity

ABSTRACT

The present study explores the perceived sexual orientation of hypothetical men and women with various eating disorders and obesity. Undergraduates were randomly provided with one vignette describing a male or female with anorexia nervosa (AN), bulimia nervosa (BN), binge-eating disorder, or obesity and were asked about the target’s likely sexual orientation. Significant differences emerged between male and female targets with AN and BN on the forced-choice question, with a greater percentage of participants indicating that the male targets were probably non-heterosexual. On continuous items, participants rated the female targets as significantly more likely to be heterosexual and significantly less likely to be homosexual than male targets. The general public may be more likely to perceive men with eating disorders as gay or bisexual relative to females with eating disorders. Perceived sexual orientation might be an important factor to consider when exploring the potentially unique perspectives of men with eating disorders.     

Anxiety Disorders and Older Women

SUMMARY

Anxiety is a problem for millions of Americans. It poses special challenges for women as they grow into advanced age. This paper provides a general overview of anxiety disorders, including panic disorder, agoraphobia, specific phobia, social phobia, obsessive compulsive disorder, and generalized anxiety disorder. Etiology, assessment and treatment strategies are then addressed. Special focus is directed at biological and psychosocial issues as they relate to older women in the development, experience, treatment and prevention of anxiety disorders.     

Minority Stress and Binge Eating Among Lesbian and Bisexual Women

Previous research demonstrates that lesbian and bisexual (LB) women report more binge eating behaviors compared to heterosexual women although the explanations for this disparity are not well understood. LB women also experience distal (e.g., discrimination) and proximal (e.g., expectations of rejection) minority stressors that are related to negative mental and physical health outcomes. The present study investigated the association between minority stressors and binge eating behaviors in LB women. A sample of 164 LB women completed an online survey that included measures of distal and proximal sexual minority stressors, emotional-focused coping, social isolation, negative affect, and binge eating. The resultant model partially supported both the psychological mediation framework and the affect regulation model. The principal finding was that among LB women, proximal stressors were associated with social isolation and emotion-focused coping, which in turn were associated with negative affect and ultimately binge eating. Overall, the study provides evidence that minority stress is associated with binge eating and may partially explain the disparity in binge eating between LB and heterosexual women.     

The Satisfaction with Sex Life Across the Adult Life Span

Three separate issues concerning the relation between age and satisfaction with sex life are addressed in this article. The first issue was concerned with the age generalizability of the factor structure produced by responses to the Satisfaction with Sex Life Scale (SWSLS). The second issue was to examine whether there were differences in the satisfaction with sex life according to certain background characteristics, namely age. Finally, the relationship between scores on the SWSLS with those on other relational constructs was explored. Data collection involved completion of a questionnaire. The sample consisted of 1,144 participants. The mean ages of the sample were 38.99 years in (SD = 16.91); ages ranged from 20 to 80. The data indicated that the factor structure of responses to the SWSLS were highly similar through adult life. Religious involvement, marital status, and love status influenced satisfaction with sex life. Expected correlations with measures of other relationship constructs were found. The strongest predictor of satisfaction with sex live across the adult life span was love satisfaction. Suggestions concerning the use of the SWSLS for research and clinical purposes are offered.     

Creating the Self: Exploring the Life Journey of Late-Midlife Women

Studies on aging reflect the losses inherent in the aging process. How the aging process is viewed, either as a loss or as a natural process of living, may affect the adaptation by late-midlife women to life changes. Self-transcendence is a means of broadening one's perspective of the inner being. This article explores the meaning of life transitions, the role of life-course development, self-transcendence, and creativity in the evolution of the inner being as women age.     

Characteristics of Women with Body Size Satisfaction at Midlife: Results of the Gender and Body Image (GABI) Study

This study characterizes the profile of women (N?=?1,789) ages 50 and over who report body size satisfaction on a figure rating scale. Satisfied women (12.2%) had a lower body mass index and reported fewer eating disorder symptoms, dieting behaviors, and weight and appearance dissatisfaction. Interestingly, satisfied women exercised more than dissatisfied women, and weight and shape still played a primary role in their self-evaluation. Weight monitoring and appearance-altering behaviors did not differ between groups. Body satisfaction was associated with better overall functioning. This end point appears to represent effortful body satisfaction rather than passive contentment.     

Patterns of Time Use Across the Life Span in Korea: A Latent Class Analysis and Age and Gender Differences

The purpose of this study was to gain an understanding of time use and the patterns of time use across the life span using a socioemotional selectivity theory. The data used for this study were from the “Korean Time Use Survey,” which is collected every 5 years by Statistics Korea (KOSTAT). The data collected in 1999, 2004, and 2009 were used to analyze the patterns of time use using latent class analyses and to observe the differences of time use by age and gender. The results were summarized as follows: Based on the analyses of nine behavior classifications, after sleep and personal care, Korean allocated more time in daily activities to relationship and leisure time, followed by education, paid work, and household management, with the order differing between each age group and gender. Three different classes of time use were classified at each age group. Education-centered time use was revealed to be mainly in the young, paid work-centered in the middle-aged, and relationship and leisure-centered in older adults. We find significant gender differences. Men’s patterns of time did not change markedly across the 3 years, while women’s patterns have shifted. Meanwhile, in the age 65 and older group, paid work appeared alongside as well as leisure among most prominent activities, were appeared as dominant forms of time use. This phenomenon is closely related to reflecting high rates of elderly poverty in Korea. Further discussions concerning the time use by age and gender were provided and countermeasures for changing time use in later life were discussed.     

The Important Things in the Life of Older People: Elderly Women in Social Houses and Home Care

The purpose of the article is to analyze the aging experiences of elderly women in Estonia and the factors influencing them. The assessments of two groups using social services are compared—the elderly living in Tallinn’s social houses and the elderly receiving care at home. From February to August 2011, a total of 80 elderly women were interviewed. Inhabitants of social houses find that their old age is satisfying more often (65% of the inhabitants of social houses and 40% of the people in home care). Many home care clients were convinced that it is best to spend old age among loved ones and in a familiar environment. Those living at home have many difficulties, which is why 20% of them are on a waiting list to go to a social house. Home services should include services with which the inhabitants of social houses are very satisfied.     

Common Factors That Enhance the Quality of Life for Women Living in Their Own Homes or in Aged Care Facilities

A qualitative study of older women living in their own homes and older women living in aged care facilities found that the concerns of the women living in their own homes were the realities of life for the residents in the aged care facilities. Twenty-five female residents across two facilities and 11 older women living in their own homes were interviewed. The positive outcomes of aging at home are relevant and desirable for residents of aged care facilities. A smooth transition from community living to residential aged care involves retaining some of these positive aspects of their lives.     

Older Women with Cardiovascular Disease: Perceptions of Initial Experiences and Long-Term Influences on Daily Life

ABSTRACT

In 2004, we conducted qualitative interviews with 29 White women diagnosed with cardiovascular disease (CVD) living in Southwest Virginia, aged 69 to 92 years (M age = 79.2 years; SD = 6.8); time since diagnosis ranged from 1 to 50 years (M = 14.3; SD = 11.2). We explored the women's initial illness episode and the influence of CVD on their current daily functioning, family activities and relationships, and social engagement. The women were slow to seek help for CVD symptoms. Postrecovery, 62% of women perceived their heart disease as influencing change in their daily lives. The influence of CVD varied depending on how congruent behavior changes were with their sense of self.     

From the Editor

This study examined risk factors associated with self-reported health (SRH) in a genetically informative sample of older African American female twins. An interview was conducted with a national sample of 180 African American female twin pairs. Questions included: SRH, demographics, health behaviors, chronic diseases, and functional status. SRH was dichotomized into negative (fair/poor) and positive (good/very good/excellent). Logistic regression for clustered data was used to estimate the odds ratios and 95% confidence intervals. In multivariable analyses, IADL limitations (OR?=?1.5, 95% CI?=?1.7–2.0) and a chronic disease index (OR?=?1.9, 95% CI?=?1.4–2.5) were associated with negative SRH. In multivariate within-twin pair analysis, controlling for genetics/shared familial environment, IADLs (OR?=?1.8, 95% CI?=?1.1–2.7), and increasing numbers of chronic diseases (OR?=?2.0, 95% CI?=?1.3–3.2) remained significantly associated with negative SRH.     

Recent Perspectives on Active Life Expectancy for Older Women

SUMMARY

This article provides a critical review of recent active life expectancy literature, describing trends of special interest to women. We review findings from leading perspectives used to study life expectancy and active life expectancy, including gender, racial and socioeconomic differences, disease-specific effects, and biodemography. We examine three competing theories of population health that frame active life expectancy research—compression of morbidity, expansion of morbidity, and dynamic equilibrium—concluding there is support for both the compression of morbidity and dynamic equilibrium theories. Policy implications for women include a greater understanding of the role of education and racial and ethnic diversity in active life trends, and an increased public policy emphasis on prevention and treatment of chronic disease, together with adoption of more healthy lifestyles.     

Aging Public Services and the Position of Older Women: An Australian Case Study

Contemporary labor markets are characterized by both aging of the workforce and the increase in participation of women. At the intersection of these two policy agendas are older women. Governments and employers recognize the importance of attracting and retaining older workers to address skills shortages, but the aging workforce discourse remains largely gender neutral. This research considers the intersection of age and gender in the context of public services, which are large employers of both women and older workers. It focuses on the agencies in an Australian state public service. The research finds that, despite decades of equal opportunity programs, there is still evidence of subtle inequalities and cumulative disadvantage. While the case study agencies employ a large proportion of older women, these women were generally recruited at younger ages and aged within the workforce. Their advancement and development opportunities were also inferior to those of older men. Despite these lesser opportunities, older women are generally very satisfied with their employment, and the employer should explore these residual inequalities if genuinely seeking to attract and retain all older workers.     

Stress and Resilience in the Oral Histories of Rural Older Women

Oral history research has seldom focused on the reflections of rural older women. The purpose of this qualitative study was to identify: (a) stresses associated with major historical events that affected the lives of rural older women, and (b) strategies they used to deal with those stresses. Oral histories were gathered from a cross-section of 25 older women living in a small rural Midwestern community and analyzed using the method of constant comparison (Glaser & Straus, 1967 Glaser, B. and Strauss, A. 1967. The discovery of grounded theory, Chicago: Aldine.  [Google Scholar]). Content analysis revealed that economic hardship, disruption of family life, and fears and uncertainties were stressors associated with the Great Depression and world wars of the 20th century. Resilience was demonstrated by frugality, reliance on social supports, and acceptance. Implications for intervention with rural older women are discussed.     

Religion in the Lives of Older Women Serving Life in Prison

This exploratory qualitative study examined the roles of religiousness in the lives of 21 older women (mean age = 63) serving life sentences in one southern state. Based on survey and focus group methodology, several themes emerged as important focal points, including early religious experiences prior to incarceration, imprisonment and religious doubt, participation in formal and informal religious activities, and use of religion in coping with stressors such as interpersonal relationships, trauma, and health statuses. Irrespective of their religious upbringing, all participants agreed that religiosity/spirituality played a key role in their ability to cope with their prison experience as well as for maintaining hope and the opportunity for release.     

Activism Among Older Women in Quebec,Canada: Changing the World After Age 65

ABSTRACT

The aim of this article is to examine senior women's involvement experience in Quebec, Canada. Study results are based on a qualitative methodology, and shed light on family history and continuity in the involvement trajectory, diversity in terms of group type and involvement practices, and gender differences in involvement. The meaning that older women attribute to their involvement is also addressed, including attitudes toward feminism. The discussion highlights the extent to which older women's involvement has been marked by their life trajectories, above and beyond their age. In sum, their involvement in the private and public spheres is quite impressive.     

Using Changes in Life Satisfaction and Health to Predict the Survival Status Among Older Men and Women in Taiwan

Despite policies aimed at decreasing old-age income inequality, such as Social Security and Supplemental Security Income, research consistently finds that later-life poverty is highly concentrated among women. While the early-life economic disadvantages of motherhood are well established, little work has examined whether these disadvantages persist into later life. Life course research consistently demonstrates the relationship between early-life choices and later-life inequality, but few studies have examined whether the reproductive phase of a woman's life is associated with her later-life income. Using data from the 2003 wave of the National Longitudinal Survey of Mature Women cohort, this research examines whether women's age at first birth and parity are associated with her later-life income within the context of marriage. From a set of multivariate analyses, I find that despite a marginal statistically significant effect, substantively for the women in this cohort the effects of childbearing are not particularly consequential for later-life income. The results suggest that as women age the economic penalties associated with motherhood are less important to financial well-being than are other factors.