The role of self-compassion in the psychological (mal)adjustment of older adults: a scoping review

BACKGROUND

The identification of protection factors regarding older adults' mental health is essential. Self-compassion, the capacity to be kind towards the self during challenging times, may be one such factor. Although still scarce, some research in this field has already been conducted with older adults. Our research question was the following: what is currently known about the role of self-compassion in the psychological (mal)adjustment of older adults?

OBJECTIVES

To review any study designs, in any setting, where self-compassion and any indicators of psychological (mal)adjustment were assessed in participants aged ≥60 years.

DESIGN

A scoping review of English, Portuguese, and Spanish published and unpublished materials, using the EBSCOhost Research and PubMed databases and reference lists. Search terms included self-compassion, self compassion, older adults, elderly, seniors, and geriatrics. After screening and selection of the studies, we charted the relevant data.

RESULTS

Eleven published studies (2012-2018) were reviewed. Self-compassion was associated with, and a predictor of, diverse mental health indicators in older adults. Self-compassion was also associated with indicators of physical health, moderated the relationship between physical health indicators and mental health indicators, and mediated the relationship between diverse mental health indicators. Results were obtained with participants of different nationalities and age. All studies had a cross-sectional design, and most studies recruited well-functioning community residents.

CONCLUSIONS

Self-compassion is beneficial for the psychological adjustment of older adults and may also benefit their biological functioning. Self-compassion seems particularly relevant for those experiencing more negative life events. Studies with more robust methodologies are needed in order to replicate these findings.

Effects of protective factors on the depressive status of elderly people in Taiwan

This study was conducted to examine the effect of protective factors on the relationship between crisis episodes and depression in the elderly population in Taiwan.In this study, the Taiwan Longitudinal Study on Aging was used as basis for a cross-sectional secondary data analysis. After eliminating respondents below the age of 65 years and those with missing values, 2426 samples were collected. Predictive variables, such as crisis episodes, personal resources, family ties, social participation, and social support, were investigated, and the dependent variable of "depression status" was measured using the Center for Epidemiologic Studies Depression scale.According to the results of regression analysis, the protective factors of self-assessed health (ß = -0.290, P < .001), instrumental support (ß = -0.153, P < .001), financial satisfaction (ß = -0.126, P < .001), emotional support (ß = -0.101, P < .001), crisis episodes (ß = 0.087, P < .001), support satisfaction (ß = -0.081, P < .001), leisure participation (ß = -0.053, P < .05), family ties (ß = -0.048, P < .05), and community participation (ß = -0.042, P < .05) had a significant effect on depression status. Moreover, leisure participation had a moderating effect on the relationship between crisis episodes and depression (ß = -0.07, P < .01). In addition, according to path analysis results, family ties had a significant negative predictive power on depression (β = -0.225, P < .001), as did social support (β = -0.978, P < .001). The predictive power of crisis episodes on depression through social support was 0.197 (-0.201 × -0.978 = 0.197, P < .001), and it was -0.324 (-0.331 × -0.978 = -0.324, P < .001) through social participation, which indicated that social support plays a mediating role between crisis episodes and depression and between social participation and depression.Strengthening effective protective factors can improve the resilience of elderly people and enable them to cope with dilemmas rapidly and effectively when faced with crisis episodes as well as restore their health status and enjoy a satisfactory life.

Self-rated health and depressive symptoms in older adults: A growth mixture modeling approach

OBJECTIVE

Self-Rated Health (SRH) and depressive symptoms are important indicators of global quality of life in older adults. Prior research suggests associations between SRH and depressive symptoms. The current study assessed latent groups in levels and trajectories of these two subjective health indicators and how the latent groups relate to each other.

METHODS

Participants from the Australian Longitudinal Study of Aging (N = 2,087, ages 65+) were assessed over six waves of data collection, spanning eight years.

RESULTS

Growth Mixture Models were run for SRH and depressive symptoms, each yielded three latent groups with similar patterns: for both SRH and depressive symptoms two groups differing in their level with worsening status over time, and a third stable, but poorer functioning group. Analysis of the assignment of the latent groups revealed a consistent pattern for the majority, but some people were high in depression and high in SRH and some were low in depression and low in SRH.

CONCLUSIONS

SRH and depressive symptoms yielded both three latent groups whose combination supported the expected assignment for the majority and an unexpected assignment for some people. This may be a result of a protective factor existing for one variable but not the other.

Efficacy of group psychotherapy for geriatric depression: A systematic review

BACKGROUND

Geriatric depression is a common and debilitating psychopathology, but evidence supports the efficacy of psychotherapy in its treatment. Group therapy provides advantages over individual interventions. However, only three systematic reviews have focused specifically on the efficacy of group therapy for geriatric depression.

OBJECTIVE

To ascertain the effects of group psychotherapy on geriatric depression in people aged 60 years and older, compared with alternative treatments or no treatment.

DATA SOURCES

A systematic review of English, Portuguese, and Spanish studies using the EBSCOhost Research and Science Direct databases (2011-2017). Additional studies were identified through reference lists. Search terms included group therapy, group psychotherapy, older adults, elderly, depressive disorder, geriatric depression, and depression in the elderly.

REVIEW METHODS

The researcher screened any study designs concerning the effects of any paradigm of group therapy on geriatric depression versus alternative interventions or no treatment. Relevant data, including indicators of risk of bias, were extracted.

DATA SYNTHESIS

Nine studies were reviewed. Reminiscence therapy and cognitive-behavioral therapy are viable group interventions for geriatric depression, and were significantly superior to most controls. Conclusions about the long-term effects were unclear. Significant improvements were obtained for different intervention durations and facilitators, and with participants of different nationalities and age. Most studies recruited participants from the community, which limited generalizability. Group therapy also resulted in improvements in other psychological variables.

CONCLUSIONS

Group therapy can significantly improve geriatric depression. Improvements were found across a variety of settings, protocols, participant characteristics, and for several psychological domains.

Depression and infrequent participation in social activities among older adults: the moderating role of high-quality familial ties

OBJECTIVES

The primary objective of this study is to investigate whether depression is associated with reduced participation in social activities among older adults. Additionally, this study assesses whether high-quality familial ties diminish the negative association between depression and social activities.

METHODS

Using cross-sectional telephone interview data from a sample of individuals 60 years of age and older in Arizona and Florida (N = 2000), this study estimates a series of linear regression models to assess the relationship between depression and social activities, and test whether this association is conditioned by high-quality familial ties using multiplicative interaction terms.

RESULTS

As expected, an inverse relationship between depression and social activities is observed. Delving deeper, the regression models reveal that the depression-inactivity association is weaker among older individuals with strong, positive ties to spouses and children. Additional tests demonstrate the mere of existence of familial bonds provides no meaningful benefit - the quality of such ties matters.

CONCLUSION

Findings support the theoretical argument that high-quality familial ties provide supportive coping resources that buffer individuals from the undesirable consequences associated with depression. Moving forward, longitudinal research on the causal links between depression and infrequent participation in social and leisure activities among older adults is warranted.

Prevalência e fatores associados ao indicativo de depressão entre idosos residentes na zona rural

O presente estudo objetivou verificar a prevalência de idosos com indicativo de depressão, segundo sexo e faixa etária, e identificar os fatores associados ao indicativo de depressão. Estudo analítico, transversal e observacional, realizado com 850 idosos residentes na zona rural de um município de Minas Gerais. Para a análise dos dados aplicou-se a fórmula de taxa de prevalência e o modelo de regressão logística (p<0,05). O Projeto foi aprovado pelo Comitê de Ética em Pesquisa com Seres Humanos. A prevalência de indicativo de depressão correspondeu a 22%, com maior ocorrência entre o sexo feminino e na faixa etária entre 60├70 anos. O sexo feminino, o maior número de comorbidades e de incapacidade funcional para o desempenho de atividades instrumentais da vida diária permaneceram associados ao indicativo de depressão. Esses resultados reforçam a necessidade de se implementarem ações de promoção de saúde e prevenção de agravos, com enfoque para a depressão.

Social functioning, polypharmacy and depression in older Chinese primary care patients

OBJECTIVE

This study aims to identify the relationship among social functioning, polypharmacy and depression among older patients in Hong Kong.

METHOD

Three out of 18 elderly health centres were selected using the cluster sampling method. 457 elders were randomly selected from all the patients aged 65 and over attending the centres, and were interviewed using the Chinese Minimum Data Set-Home Care in 1999. Of them 318 were re-assessed in 2000.

RESULTS

At follow-up, their mean age was 73.6 (SD = 5.5), of whom 51.6% were females. Besides negative emotions, respondents' increased depressive symptoms were associated with using more than four medications and decline in social functioning over time, and behavioural agitation at baseline. If there was no medication review at baseline, the impact of polypharmacy on depression was subsided.

CONCLUSION

Medication review is important in the prediction and treatment process of depression as it can moderate the impact of social functioning and polypharmacy. Therefore, medical professionals should prescribe fewer medications to eliminate adverse drug reactions and reduce depressive symptoms. However, the study reflects that older adults might feel depressed by not being able to control the result of their reviews. Thus, if the review could involve older patients, it might be more assuring and helps to restore their hope for gaining control in their treatment process.