Bowling Alone: Growing Social Isolation in America

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Bowling AloneGrowing Social Isolation in America

• Robert Putnam published popular book on major
  social change in United States, which is growing
  isolation. Major points
• Participation in nearly all organizations/groups
• has waned since 3rd Q of 20th century
• Loss of social capital could be significant
  result
• Yet, is optimistic that renewal of civic
  engagement and social networks can occur

Putnam, 2000
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Reasons for Growing Social Isolation in America

• Declining interest in political system
• Voter apathy
• Disinterest in becoming involved
• Declining social connectedness at work
• More job changes
• Longer work weeks
• Declining participation in community groups

Putnam, 2000
3
Decline in Organization Membershipsfrom Peak
Years to 1997
Putnam, 2000
4
Growing Social Isolation in America Fewer
Confidants
McPherson, Smith-Lovin Brashears, 2006
5
Whom Do We Lose?Relationship of
Confidants1985-2004
(-31)
(-57)
(-63)
(-35)
(27)
( decline/gain from 1985 to 2004)
McPherson, Smith-Lovin Brashears, 2006
6
Bowling AloneNot a New Trend

• Major study compared social networks of Americans
  of the 50s with those of 70s
• Compared to 50s Ss, 70s Ss less often married,
  more likely to be living alone
• Less involved with organizations and visit
  informally with friends/relatives
• Trend toward greater isolation is growing and
• worrisome, but not new

Veroff, Douvan, Kulka, 1981
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Actions to Cope with Age-Associated Losses

• l Reweave/maintain social networks
• l Quality Over quantity
• l Seek virtual friends
• l Get comfortable accepting care of others

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Maintain/Reweave Social Networks

• Anticipate losses, and the need to replace
• Especially multilevel relationships
• Reach out
• Make younger friends
• Remain active in groups
• Watch out for alienation, practice forgiveness
• Difference between being alone and being lonely
• Also between being with people and still being
  lonely

PSYCH S-1293, 2005
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Choose Quality Over Quantity

• Expressive as well as instrumental support
• Growing distaste for those who trigger negative
  emotions
• Socioemotional selectivity

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Socioemotional Selectivity Theory
High
Emotional Regulation
Self Concept
Relative Importance of the Motive
Information Seeking
Low
Carstensen, 1995
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Seek Virtual Friends

• l Learn to work a computer
• l Use e-mail
• l Get on the Internet
• Learn to use instant messaging, blogging, chat
  rooms

12
Dependent and Independent Behaviors in Elderly

• Margaret Baltes addresses the Q of how to avoid
  learned dependency in older age
• Differentiates learned dependency from learned
  helplessness (?)
• Learned dependency based on differential
  environmental contingencies (reinforcement) for
  dependent or independent behavior
• Hypothesizes that some dependent behavior among
  elderly is learned, not result of physical
  limitations

M. Baltes, 1995
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Being Cared for When We Need ItAvoiding Learned
Dependency

• Advocates selective optimization with
  compensation (?)
• For elder, allowing some dependency creates
  opportunities for maximal independence
• For caregiver, crucial to help without
  subconsciously reinforcing learned dependency

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Responses of Family Members to Dependent or
Independent Self-Care Behaviors in Elderly
M. Baltes, 1995
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What Types of Social Contact Correlate with
Health Cognition? Findings

• Types of social contact associated with better
  health and cognition
• Size of social networks
• Satisfaction with degree of closeness
• Amount of time spent with others
• Intimacy
• Diversity

Rivera, 2003
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What Types of Social Contact Correlate With
Health? Findings from 3 Studies
Rivera, 2003
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What About Sex and Health? Data from 3rd Age
Study

• Examined Qaire responses for 275 Ss, 60-85
• 14 YoE, 57 female, largely middle class
• Analyzed responses about sexual activity
• Sexual energy
• Frequency of sexual release
• Cuddling
• Overall sexual satisfaction

Powell, 2002
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Sex and HealthIs There a Correlation?
Powell, 2002
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Bravery What Makes People Courageous?

• Medal of Honor winners
• Oncology waiting room
• Other settings?

20
Class 10 Normal Psychological Aging

• Depression/anxiety and aging
• Stress responses
• General adaptation syndrome
• Effects of stress responses on health
  cognition
• The hardy personality
• Happiness

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Normal Psychological AgingA Provisional
Definition

• Normal psychological aging (NPA) is functioning
  emotionally and behaviorally within average
  limits, at a level characteristic of our age
  group, as influenced by relevant demographic
  factors
• It is being free of disabling mental health
  problems that consistently affects quality of
  life
• NPA is being unaware of the potential adverse
  impact of imbalance in work, love play, and
  maladaptive ways of coping with stress, on
  psychological adjustment
• It is also not doing things to reduce imbalances
  in our lives, lower the level of stress we
  confront, and/or improve ways of coping

PSYC S-1293, 2004
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Aging and Depression

• Widely held theory is that aging is associated
  with greater risk of depression
• Common belief is that oldsters are at greater
  risk for depression than younger people
• Data on suicide

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What Do We Mean by Depression?Major Depressive
Episode (MDE)5 or more symptoms in 2-week period

• Depressed mood
• Hopelessness
• Anhedonia
• Chronic fatigue
• l 5 per month weight gain/loss

• l Disturbed sleep
• l Psychomotor retardation
• l Feeling inappropriately worthless/guilty
• Cognitive impairment
• Suicidal ideation

DSM-IV, 1994
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DSM-IV Criteria for Dysthymia (Chronic Depressive
State)

• Depressed mood for most of the time
• for 2 years
• Not without symptoms for more than 2
• months at a time
• Two or more symptoms from Major Depressive
  Episode list

DSM-IV, 1994
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Age and Depression Duke Studies

• Found small correlation between age and
  depression
• But disability, low SES, and low social support
  were more powerfully associated with depression
  than age
• When these elements were factored out of the
  age\depression correlation disappeared

Blazer, et al., 1991
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Getting Older and Suicide

• 65 population at greater risk
• l 17 of suicides, 12 of population
• l Older white males (75), 7 times more
  frequent
• Risk factors
• l Older white male living alone
• l Loss of spouse, loved one
• l Poor health

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Incidence of Depression by Gender

• How frequent?
• Major Depressive Episodes
• l Females 9-26
• l Males 5-12
• Dysthymia
• l Females 20
• l Males 10
• Little difference in first episode frequency

DSM-IV, 1994
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Does Depression Increase with Age?

• Recent studies show no increase in MDE
• or Dysthymia with age
• No difference in cross-sectional studies
• between adults, young-olds and old-olds
• Individuals at mid-life show more lower mood
  indicators
• Increase in depressive symptoms associated
  with real-life events rather than aging

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Clinical Ratings of Depression Relative to Age 2
Studies
Newmann, 1989
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Age Differences in Depression and Anxiety

• Ss (18-65) given clinical interviews to
  determine frequency of depression and anxiety
• 4 different areas Baltimore, North Carolina,
  New Haven and St. Louis
• Percentage of those diagnosed with depression
  and anxiety calculated by age

Caplan Maye, 2005 Gatz Smyer, 1992
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Incidence of Depression and Anxiety by Age
Caplan Maye, 2005 Gatz Smyer, 1992
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Why the Differences in Estimates of Depression
Among Older Ss?

• Measuring incidence of depressive symptoms not
  the same as diagnosing clinical depression
• Also, co-morbiditycould be that depressive
  symptoms occur at the same time as other
  psychological problems such as anxiety
• Surveys in mental health clinics find that
  symptoms of depression and anxiety can occur in
  the same patients simultaneously

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Depression Is One Response to Stress Other
Stress Emotions?
PSYC S-1293, 2005
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Responses to Stress Stress Emotions

• Usual stress-related emotions include
• Anxiety
• Anger
• Depression
• Suspicion
• Co-morbidities common

PSYC S-1293, 2005
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Responses to Stress Anxiety As an Example

• How does it affect us?
• Physically
• Emotionally
• Cognitively
• Performance anxiety

PSYC S-1293, 2005
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Yerkes-Dodson Model of Anxiety and Performance
High
Low
Yerkes Dodson, 1908
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Catastrophic Model of Performance Anxiety
High
Low
Hardy Parfitt, 1991
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Catastrophic Model of Anxiety

• At a certain point of being anxious
• Performance drops dramatically
• Difficult to maintain even a mediocre level of
  performance
• Small reductions in anxiety doesnt help

PSYC S-1293, 2005
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Nature of Stress

• Stress Any event taxing our emotional or
  physical state to cause unpleasant reactions
• Stressor can be experienced as unpleasant
  distress or pleasant excitement
• 4 Variations
• l Overstress l Understress
• l Good stress l Bad stress

Selye, 1956
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Type of Stress MattersConflict-Based Stress
Most Dangerous

• 3 types of conflict-based stress
• Approach-approach (Grief for the joys down road
  not taken)
• Approach-avoidance (Want and dont want
  something simultaneously)
• Avoidance-avoidance (Damned if you do, damned if
  you dont)

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Stress Measuring Severity

• l Amount
• l Duration

Powell, 1983
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Amount of StressSocial Readjustment Rating Scale

• Life Event Impact in Life
• Change Units
• Death of Spouse 100
• Divorce 73
• Marriage 45
• Outstanding Achievement 28
• Christmas 27
• Whats wrong with this approach to measuring
  stress?

Holmes and Rahe, 1967
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Amount of StressSocial Readjustment Rating Scale

• Whats wrong with this approach to measuring
  stress?
• People have different stress responses to same
  event
• For example, impact of death of spouse
• (-2)--------------(-1)-----------(0)-----------(1
  )-------------(2)
• Extremely Somewhat Neutral Somewhat Extremely
  Negative Positive

Sarason, et al., 1979

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Marriage Possible Life Change Units (LCUs)

• Event LCUs
• Marriage 50
• Change in living conditions 30
• Change in personal habits 24
• Change of residence 20
• Change in social activities 18
• Change in family structure 15
• Change in eating habits 15
• Total 172

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Amount of Stress Adverse Effects on Health

• Total LCUs Showing Adverse
• in Past Year Health Changes
• 150 - 199 37
• 200 - 299 51
• 300 79

Holmes and Masuda, 1974
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Duration of Stress Selyes General Adaptation
Syndrome

• Three overlapping phases to long periods of
  stress
• Alarm
• Resistance
• Exhaustion

Selye, 1956
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Duration of StressSelyes General Adaptation
Syndrome
Selye, 1956
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Stress and the Central Nervous System

• Central nervous system 2 components
• Parasympathetic nervous system-controls involuntar
  y slowing of vital functions
• Sympathetic nervous system (SNS)-controls
  involuntary increase of vital functions to
  stress
• Under stress, SNS secretes epinephrine (aka,
  adrenaline) and cortisol

Kemeny, 2003
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Stress and the Central Nervous System

• Exposure to stress stimulates fight-flight
  reaction (aka, adrenalin rush) by the
  sympathetic nervous system
• Physiological systems needed to cope with stress
  are mobilized those not needed suppressed
• Examples are increased heart rate, BP more
  glucose for energy inhibition of digestion,
  reproductive system

Kemeny, 2003
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Why Is Stress Bad for You?

• Depresses immune system functions
• Stress produces cortisol that inhibits cells
  that produce antibodies (lymphocytes) to
  disease
• Slows wound healing
• Enhances inflammatory response, including body
  temperature

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Why Is Stress Bad for You?

• When it becomes chronic stress response remains
  switched on
• Exposure to stress may stimulate an
  inappropriate inflammatory response, an
  inflammation with no injury/infection
• Chronic inflammation may increase vulnerability
  to ulcers, autoimmune diseases, and cognitive
  impairment

Kemeny, 2003
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Two Week Sick Call Rate and Number of Missions
Flown by 8th Air Force Bomber Crews in June 1944
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Brain Volume and Number of Days Depressed
Sapolsky, 1996
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Duration of Viet Nam Combat Exposure and Neuronal
Count
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Social Networks Stress and Immunity to Colds

• Sheldon Cohen at CMU gave 420 Ss a cold virus
• Asked about social networks and their diversity
• Classified social interactions into 12 groups
• Then followed Ss in a hospital to see who
  developed colds and who did not
• Correlated the incidence/severity of colds with
  the diversity of social networks

Cohen et al., 1997
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Stress and Immunity to Colds
Cohen, et al., 1997
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Social Network Diversity and the Common Cold
Diversity
Cohen, et al., 1997
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But WaitQuestioning Social Network Diversity
and the Common Cold

• Hamrick at CMU found the Diversity/Colds link
  puzzling because of greater exposure to
  infections
• Studied healthy college Ss who completed Qaires
• about their health, stresses, network
  diversity
• Followed Ss for 3 months to see who developed
  upper respiratory infections and who didnt
• Discovered stress/network diversity interaction

Hamrick, Cohen Rodriguesz, 2002
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Diverse Social Networks Increase Vulnerability to
Colds Under Stress
Hamrick, Cohen Rodriguesz, 2002
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Correlating Emotional StateWith Better Health
and Cognition
gt
lt
lt
lt
lt
lt
Less More
Powell, 2002
61
Are Most People Happy, Sad or in Between?
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Are Most People Happy? Studies of Subjective
Well Being (SWB)

• Diverse groups of Ss, balanced for race,
• national origin, health and age
• Asked Ss to rate themselves on SWB scale
• 0_______________________________10
• Most Most
• Unhappy Happy

1 2 3 4 5 6 7
8 9
Diener and Diener, 1996
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Are Most People Happy? An International Survey
Average Subjective Well-Being on 0 to 10 Scale
Diener and Diener, 1996
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Are Most People Happy? Studies ofReported
Subjective Well Being

• Most surveys of Subjective Well Being find most
  people report more positive than negative
  emotions
• l College students (1986) 71
• l College students (1992) 79
• l Elderly 74
• Disabled 72

Diener and Diener, 1996
65
Are Most People Happy? Estimates of SWB of
Others by Working Adults

• Estimates of others by working adults
  consistently underestimate actual SWB
• Group Estimated SWB Actual SWB
• Clin Depressed 49 13
• Happy balance 33 57
• mostly happy groups incorrectly estimated as
  unhappy
• Poor African-Americans 83
• Unemployed men 100
• Elderly people 38

Diener and Diener, 1996
66
Ages of Ss Reporting Worse, Same or Better Health
Than 5 Years Ago

Present Health
Powell, 2002
67
Elders Present Health Compared With 5 Years
Earlier
Compared to 5 Years Ago
Powell, 2002
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Reducing Negative Impact of StressThe Hardy
Personality

• The three Cs of the Hardy Personality
• l Feeling in Control vs. out of control
• l Feeling Challenged vs. intimidated
• l Feeling Committed vs. alienated
• Hardiness, exercise social support associated
  with greater resistance to illness

Kobasa, 1985