Challenges Experienced at Age 100: Findings From the Fordham Centenarian Study

ABSTRACT

This article examines the challenges experienced by very old individuals and their consequences for well-being and mental health. In order to capture unique issues experienced in very old age, 75 participants of the population-based Fordham Centenarian Study answered open-ended questions on everyday challenges. Theme-based coding was then used to categorize and quantify responses. The challenges mentioned most often were challenges faced in the functional (e.g., physical health/activities of daily living restrictions, mobility, sensory impairment), psychological (e.g., loss of well-liked activity, dependency, negative emotions, death), and social (e.g., family loss) life domains. Functional challenges were negatively associated with aging satisfaction and positively associated with loneliness. Psychological challenges were positively linked to aging satisfaction. Social challenges were marginally related to loneliness. Notably, challenges were not related to depression. In conclusion, the challenges experienced in very old age are multidimensional and multifaceted, unique in nature, and have differential relations to mental health. Functional, psychological, and social challenges affect very old individuals’ lives and therefore need to be better understood and addressed. Given their consequences, it is imperative for policy makers to develop an awareness for the different types of challenges faced by centenarians, as there may be unique policy implications related to each.     

Dynamic modelling of long-term care decisions

This paper describes and analyzes research on the dynamics of long-term care and the policy relevance of identifying the sources of persistence in caregiving arrangements (including the effect of dynamics on parameter estimates, implications for family welfare, parent welfare, child welfare, and cost of government programs). We discuss sources and causes of observed persistence in caregiving arrangements including inertia/state dependence (confounded by unobserved heterogeneity) and costs of changing caregivers. We comment on causes of dynamics including learning/human capital accumulation; burnout; and game-playing. We suggest how to deal with endogenous geography; dynamics in discrete and continuous choices; and equilibrium issues (multiple equilibria, dynamic equilibria). We also present an overview of commonly used longitudinal data sets and evaluate their relative advantages/disadvantages. We also discuss other data issues related to noisy measures of wealth and family structure. Finally, we suggest some methods to handle econometric problems such as endogeneous geography.     

Third-Person Effect,Religiosity and Support for Censorship of Satirical Religious Cartoons

The violent attack on the staff of Charlie Hebdo and an earlier plot to kill cartoonists from the Danish newspaper Jyllands-Posten raise the issue of censorship of satirical religious cartoons to avoid potential retaliatory violence from those offended by the cartoons. With third-person effect (TPE) as the theoretical underpinning, this study examined the relationship among TPE, religiosity, and support for censorship of religious satirical cartoons. Data were collected in May 2015. A national sample of participants (N=374) was acquired through Amazon’s Mechanical Turk. The results show that individuals with a higher degree of religiosity are more likely to support censorship of satirical religious cartoons, and though TPE is not positively correlated to support for censorship, respondents’ perception of the effect of the cartoons on themselves may indicate an increased propensity for supporting censorship.     

The Three-Item Thinking about Your Partner’s Drinking Scale (TPD-3): Item Response Theory,Reliability, and Validity

Interdependence is a defining feature of close relationships, and alcohol use is one domain where one person’s motivations and behaviors can affect a partner’s well-being. Concern about partner drinking is a gauge that determines whether a partner’s alcohol use has the potential to be problematic to the relationship, and brief and efficient measurement of this construct can be used to serve clinicians, scientists, and practitioners. Across four studies (N = 1,807), we use item response theory analysis to present a 3-item brief screening tool assessing concern about partner drinking: Thinking about your Partner’s Drinking-3 (TPD-3). The TPD-3 revealed strong test–retest reliability and expected patterns of convergent, concurrent, and incremental validity with perceived partner drinking and alcohol-related consequences, behavioral responses to partner drinking, and relationship well-being. We present the TPD-3 as a useful screening tool and for measurement of concern about partner drinking when efficient assessment is desired.     

Responding to Adolescent Violence in the Home – A Community Mental Health Approach

Family violence perpetrated by adults is increasingly understood as a health issue, and we argue that this pertains even more strongly to violence by adolescents. The co-dependence of the parent–child bond, lack of maturity in the adolescent, and often related issues of disability or mental illness make these young people both complex and also vulnerable. This research paper reviews the current literature relating to adolescent violence in the home, identifies known best practice, and evaluates the importance of taking a family-focused, therapeutic approach to adolescent family violence, in place of a punitive one. It describes the use of a co-design workshop to unpack gaps in service provision and develop a potential family focused model of care to address the needs both of young people who use violence, and their families. The findings indicate that an inclusive family approach is a key element in addressing adolescent violence in the home across a spectrum of behaviours and mental health care needs. The use of a coordinated, family-inclusive response through mental health care services is recommended to address the complexity of this issue, as well as to provide support both to adolescents and to their families and carers.     

Stakeholder Perspectives on Children's Mental Health Needs and Supports in Six Low‐ and Middle‐Income Countries

Low‐ and middle‐income countries (LMIC) are faced with disproportionately high levels of unmet child mental health needs. This study explored through interviews the perspectives of 17 inter‐agency service stakeholders from Brazil, Indonesia, Kenya, Pakistan, Rwanda and Turkey on existing supports and challenges. Four themes emerged on the holistic nature of children's mental health needs linked with disadvantage; limited resources and skilled workforce; stigma; and strategies for future implementation, including awareness, parental engagement, skills‐based programmes and cultural adaptation. Stakeholder input is essential in conceptualising, developing and evaluating culturally appropriate interventions for vulnerable children in LMIC.     

A qualitative investigation of risk and protective factors for interpersonal violence in adults on the autism spectrum

Abstract

Individuals on the autism spectrum are at an increased risk of experiencing violence. This study sought to understand the opinions of adults on the spectrum regarding potential risk and protective factors for interpersonal violence. Twenty-two adults (12 men; 18 to 53 years of age) participated in semi-structured qualitative interviews. Interviews were recorded, transcribed, and analysed. The results of the qualitative analysis identified individual and contextual risk and protective factors. Protective themes focused on individual needs (awareness of the self and the environment, interpersonal knowledge/skills, skill building strategies) and supportive contexts (benefits of a trusted person, advocates, fostering acceptance and inclusion). There is a need for strategies to decrease the vulnerability to, and the impact of, interpersonal violence. Individuals on the spectrum have the capacity to provide important information regarding safety promotion and risk factors for interpersonal violence, and their expertise should play a role in guiding efforts that promote safety.     

Clinical Social Work Practice with Former System Youth with Mental Health Needs: Perspective of Those in Need

The purpose of this study is to describe the types of programs and mental health services former system youth with mental health histories would be inclined to engage in to manage their mental health difficulties, along with the factors that might hinder them from engaging in these services. A series of closed and open-ended questions on potential programs and services were asked, as part of a larger study. Participants were former system youth; specifically 18?C30?year olds who were diagnosed with a mood disorder and were involved with public mental health and social services (e.g., public welfare, child welfare, juvenile justice) during childhood. Responses to the open-ended questions were categorized and percentages are reported from the yes/no items. Eighty-three percent and 76% reported that they would be enticed to come to a support group and panel discussion on mood disorders, respectively, while only 46% reported that they would attend a family support group. Talking with others who have had similar experiences, material possessions and creative expression were the most common responses regarding what would entice them to get involved. Further, peer disrespect, transportation, and daycare were common barriers to potential participation. As the field continues to build knowledge on system-wide strategies to improve agency-based mental health care for transitioning youth and young adults, new evidence-based approaches may benefit from listening to the specific needs, preferences, and suggestions of these youth themselves.