Perhaps because negative emotions are frequently expressed in physiological reactions, psychosomatic theories have often identified Neuroticism and its component traits (including anxiety, anger, and depression) as causal influences on the development of disease. These views are apparently supported by correlations between physical symptom reports and measures of Neuroticism in males. Data from 347 adult women in the Baltimore Longitudinal Study of Aging replicate this finding for total physical complaints and for most body systems. However, analyses of mortality in the literature and in the present article show no influence of Neuroticism, suggesting that symptom reporting may be biased by Neuroticism-related styles of perceiving and reporting physiological experiences. Researchers in this area are urged to employ objective measures of medical status, and to be alert to possible biases of self-selection and selective perception in interpreting associations between Neuroticism and disease.

Neuroticism, somatic complaints, and disease: is the bark worse than the bite?

The concept of moderate consumption of ethanol (beverage alcohol) has evolved over time from considering this level of intake to be nonintoxicating and noninjurious, to encompassing levels defined as "statistically" normal in particular populations, and the public health-driven concepts that define moderate drinking as the level corresponding to the lowest overall rate of morbidity or mortality in a population. The various approaches to defining moderate consumption of ethanol provide for a range of intakes that can result in blood ethanol concentrations ranging from 5 to 6 mg/dl, to levels of over 90 mg/dl (i.e., approximately 20 mM). This review summarizes available information regarding the effects of moderate consumption of ethanol on the adult and the developing nervous systems. The metabolism of ethanol in the human is reviewed to allow for proper appreciation of the important variables that interact to influence the level of exposure of the brain to ethanol once ethanol is orally consumed. At the neurochemical level, the moderate consumption of ethanol selectively affects the function of GABA, glutamatergic, serotonergic, dopaminergic, cholinergic, and opioid neuronal systems. Ethanol can affect these systems directly, and/or the interactions between and among these systems become important in the expression of ethanol's actions. The behavioral consequences of ethanol's actions on brain neurochemistry, and the neurochemical effects themselves, are very much dose- and time-related, and the collage of ethanol's actions can change significantly even on the rising and falling phases of the blood ethanol curve. The behavioral effects of moderate ethanol intake can encompass events that the human or other animal can perceive as reinforcing through either positive (e.g., pleasurable, activating) or negative (e.g., anxiolysis, stress reduction) reinforcement mechanisms. Genetic factors and gender play an important role in the metabolism and behavioral actions of ethanol, and doses of ethanol producing pleasurable feelings, activation, and reduction of anxiety in some humans/animals can have aversive, sedative, or no effect in others. Research on the cognitive effects of acute and chronic moderate intake of ethanol is reviewed, and although a number of studies have noted a measurable diminution in neuropsychologic parameters in habitual consumers of moderate amounts of ethanol, others have not found such changes. Recent studies have also noted some positive effects of moderate ethanol consumption on cognitive performance in the aging human. The moderate consumption of ethanol by pregnant women can have significant consequences on the developing nervous system of the fetus. Consumption of ethanol during pregnancy at levels considered to be in the moderate range can generate fetal alcohol effects (behavioral, cognitive anomalies) in the offspring. A number of factors--including gestational period, the periodicity of the mother's drinking, genetic factors, etc.--play important roles in determining the effect of ethanol on the developing central nervous system. A series of recommendations for future research endeavors, at all levels, is included with this review as part of the assessment of the effects of moderate ethanol consumption on the central nervous system.

Effects of Moderate Alcohol Consumption on the Central Nervous System

Context. —Preventive health programs may mitigate against the health risks of older adulthood. Objective. —To evaluate the effectiveness of preventive occupational therapy (OT) services specifically tailored for multiethnic, independent-living older adults. Design. —A randomized controlled trial. Setting. —Two government subsidized apartment complexes for independentliving older adults. Subjects. —A total of 361 culturally diverse volunteers aged 60 years or older. Intervention. —An OT group, a social activity control group, and a nontreatment control group. The period of treatment was 9 months. Main Outcome Measures. —A battery of self-administered questionnaires designed to measure physical and social function, self-rated health, life satisfaction, and depressive symptoms. Results. —Benefit attributable to OT treatment was found for the quality of interaction scale on the Functional Status Questionnaire (P=.03), Life Satisfaction Index-Z (P=.03), Medical Outcomes Study Health Perception Survey (P=.05), and for 7 of 8 scales on the RAND 36-Item Health Status Survey, Short Form: bodily pain (P=.03), physical functioning (P=.008), role limitations attributable to health problems (P=.02), vitality (P=.004), social functioning (P=.05), role limitations attributable to emotional problems (P=.05), and general mental health (P=.02). Conclusions. —Significant benefits for the OT preventive treatment group were found across various health, function, and quality-of-life domains. Because the control groups tended to decline over the study interval, our results suggest that preventive health programs based on OT may mitigate against the health risks of older adulthood.

Occupational therapy for independent-living older adults. A randomized controlled trial

The measurement of age, age structuring, and the life course has become more problematic as the study of human lives has moved toward more detailed analyses and explanations. As we seek to better understand the course of human lives in contemporary and changing societies, the effective empirical measurement of its key concepts simultaneously becomes more pressing and more complicated. We first review the critical concepts of, and measurement strategies associated with, age and age structuring—including a discussion of different types of age, subjective age identification, age norms and age expectations, critical life events, life phases, and life review. We then discuss state-of-the-art methods for measuring the life course, especially through life history and event matrices, and we close the chapter with some comments on the organization, analysis, and modeling of data.

https://www.jstor.org/stable/pdfplus/2952551.pdf

The Measurement of Age, Age Structuring, and the Life Course

Results from a 1986 national survey (N = 3,614) show that having ever been widowed is associated with current levels of depression and that this association is greater for men than women. Some of this apparent gender difference occurs because men have been widowed for a shorter average period of time than women and the effects of widowhood appear to lessen over time. Widowhood also is associated with different types and amounts of life strain for men and women. The results suggest that the primary mechanism linking widowhood to depression among women is financial strain. Among men, the more critical mechanisms seem to be strains associated with household management. When specific strains occur, they appear to have different effects on respondents who have ever been widowed and those who have not. Taken together, these results suggest that what appears on the surface to be a gender difference in vulnerability to the same life event turns out upon closer examination to occur because widowhood does not affect men and women in the same way.

Widowhood and depression: explaining long-term gender differences in vulnerability.

The effects of five major life events, and of three types of resources, on the physical and social-psychological adaptation of 375 participants in a longitudinal study were examined. As expected, medical events had the most impact on physical adaptation, but they had surprisingly little impact on social-psychological adaptation. Retirement had the most negative social-psychological effects, but had little effect on physical adaptation. The other three events had even less effects, although multiple events tended to cumulate in impact. Better physical resources helped only physical adaptation, and better psychological and social resources mainly helped satisfaction. It appears that most of these potential stressors have less serious long-term outcomes than the crisis orientation would suggest.

Stress and adaptation in later life.

Data from a 20-year longitudinal study of persons over 60 were analyzed by step-wise multiple regression to test for declines in function with age, for terminal decline (linear relationship to time before death), and for terminal drop (curvilinear relationship to time before death). There were no substanial terminal drop effects. All health measures had substantial declines with age, and the physician's physical function rating, as well as the individual's self-rating, showed additional terminal decline. Intelligence had a substantial decline with age and a small terminal decline. Most activities declined with age but had no significant terminal decline. Despite these declines in health, intelligence, and activities, there was little or no decline in satisfaction or adjustment.

Aging, Terminal Decline, and Terminal Drop

Age and low doses of alcohol had a synergistic deleterious effect on subjects' performance on a continuous tracking task.

Effects of age and alcohol on psychomotor performance of men.

The effects of alcohol on performance were investigated in 10 men and 10 women. On 4 psychomotor tasks minor gender-related effects of alcohol were found.

Effects of alcohol on psychomotor performance of men and women.

A technique was devised to estimate age specific remarriage probabilities for newly widowed persons utilizing North Carolina marriage certificates plus informatiom from the 1970 U. S. Census. Remarriage probabilities are very high for persons widowed before age 35. Remarriage probabilities decrease faster for widows than widowers. Less than one-fourth of men widowed after age 65 ever remarry. Less than 5% of women widowed after age 55 ever remarry. Age specific intervals to remarriage were also calculated. Men remarry more quickly than women. The median interval to remarriage was 1.7 years for men and 3.5 years for women.

William P. Cleveland

Papers

Stress and adaptation in later life.

Aging, Terminal Decline, and Terminal Drop

Effects of age and alcohol on psychomotor performance of men.

Effects of alcohol on psychomotor performance of men and women.

Remarriage Probability After Widowhood: A Retrospective Method