Cet ouvrage nous aide à mieux comprendre les relations complexes entre la santé physique et la dépression au sein de la population âgée. Les parties les plus intéressantes du livre s'attachent à discuter de l'influence de variables potentiellement responsables de la médiation des liens bidirectionnels entre la santé physique et la dépression chez les aîné(e)s, et des implications de ces découvertes pour une meilleure identification et des traitements plus adéquats de la dépression parmi les patient(e)s médicaux(ales) âgé(e)s. Malgré une organisation des chapitres qui laisse à désirer une perspective nettement médicale sur le sujet, cet ouvrage représente une contribution importante à notre compréhension de la dépression à l'âge adulte avancé.

This study examines the importance of variables from the Theory of Planned Behaviour (i.e.,attitudes toward behaviour, subjective norms, and perceived control) for the prediction of consumption of anxiolytic and sedative-hypnotic (ASH) medications in a sample of older persons, aged 69 years on average, 62 consumers and 92 non-consumers. A favourable attitude toward ASH and a sense of having less control regarding these drugs predict both current usage and intention to continue. Perceived control predicts intention to start consumption of ASH in current non-consumers. This study underlines the importance of considering the role of the older person’s decisional power in the consumption of these medications.

As an initial step in the improvement of interventions for the depressed elderly, the present study attempts to identify the strategies they spontaneously use to cope with depressive feelings. Fifty two older persons answered two questionnaires, one measuring the intensity of depressive symptomatology, the other dealing with coping strategies and their usefulness. Results suggest that, as a whole, coping strategies used by the elderly do not fundamentally differ from the ones advocated by younger individuals, in that they favor strategies involving goal-oriented action. The subjects who reported the most depressive feelings differed from the others on two points: they less frequently relied on the strategy of problem solving and they considered general activity as less useful in their struggle against depressive feelings. Implications for the development of services for the elderly, in particular the secondary prevention of depression, are drawn.

Post-traumatic stress disorder refers to the aftermath of highly traumatic events involving death, serious injury, or threat to one's physical integrity in circumstances out of the ordinary, such as war, natural disasters, rape, or torture. Four chapters of this book specifically address post-traumatic stress disorder, as a late-onset or reactivated condition, in World War II veterans and older adults who survived a natural disaster. These contributions, from American and Dutch researchers, bring first-hand information on the prevalence and course of the disorder and they constitute the originality of the book. Two chapters, on the maltreatment of older adults and on the stressful impact of ordinary negative events on older adults, expand the coverage of stress in late adulthood. Starting and finishing with a discussion of general issues in stress and post-traumatic stress research, the book also contains two chapters of a more general nature on the effects of age on physiological responses to stress in both laboratory animals and human beings. Contributions providing a theoretical context for integration and drawing the therapeutic implications of the research findings would have been useful. Still, this book constitutes a unique source of information and a basic reading, given the paucity of research in the area of post-traumatic stress disorder in older adults.

Ce livre, qui traite des origines, de l'évaluation et du traitement des problèmes émotionnels de la personne âgée, se présente comme un livre pratique de référence à l'usage des cliniciens. En plus de sujets habituellement couverts dans des ouvrages de ce genre, comme la dépression et les problèmes associés aux maladies physiques, cet ouvrage aborde les problèmes de communication et de collaboration avec la personne âgée et sa famille, ainsi que les interventions susceptibles de favoriser l'épanouissement psychologique et physique à l'âge adulte avancé. Clairement organisé et rédigé, cet ouvrage se caractérise par la concision. Comme tel, il satisfera mieux le clinicien désireux de trouver rapidement une information pratique que le chercheur soucieux d'approfondir une question. Cet ouvrage constitue néanmoins un choix intéressant de manuel pour un cours avancé de premier cycle dans les disciplines qui s'occupent de santé mentale.

This volume published in 1991 contains the contributions of specialists in the field of geriatric psychiatry who met in 1989 to discuss the state of knowledge on the pathology of anxiety in the elderly. Written from a medical perspective, it contains 16 relatively short chapters divided into five sections which cover topics related to diagnosis, epidemiology, comorbidity, neurobiology, pharmacology, and pharmacological and psychotherapeutical treatments. The major weaknesses of the book reside in its atheoretical stance and its exclusive medical focus. We learn very little on the phenomenology and etiology of anxiety in the elderly, and on therapeutic interventions other than anxiolytics. Still it may be worth reading simply because there is such a derth of literature on anxiety in the elderly. Readers interested in the psychological research on this topic may consult the additional references cited.

Reminiscence is the process of thinking or telling about past experiences. The goal of this study was to investigate which functions young adults attribute to their own reminiscences, and to the reminiscences of older persons. The views of young adults on the reminiscences of older adults were also compared with the self-reports of older persons on their reminiscences. We used the Reminiscence Functions Scale (Webster, 1993,1997), which measures eight functions: Boredom Reduction, Death Preparation, Identity, Problem-Solving, Conversation, Intimacy Maintenance, Bitterness Revival, and Teach/Inform. Seventy-six undergraduate students reported on their own uses of reminiscences. A few weeks later, they gave their views regarding the functions for older persons on the same scale. Eighty-three adults over the age of 65 completed the scale regarding their own uses. Age-appropriate higher uses of the functions of Boredom Reduction, Identity and Problem-Solving characterized the young adults. Older adults most characteristically used reminiscence for Teach/ Inform, i.e. for transmission of life experiences. Compared to themselves, young adults believed that older adults reminisced more for practically all functions, which reflects the stereotypical view. When these beliefs were checked against the reports of older adults, it became clear that young adults overestimated almost all uses, especially Boredom Reduction, Death Preparation, and Teach/Inform. These findings reflect the prevalence of ageist assumptions regarding the uses of reminiscence by older persons.

There is great interest in identifying psychological and social variables associated with depressive symptoms in older adults. The goal of this article is to review the literature on the relationship between social support and depressive symptoms in the elderly and to identify the mechanisms involved in this relationship. The review indicates that both structural and functional dimensions of social support are inversely related to depressive symptoms in elderly persons. In addition, there is evidence supporting both the main effect model and the buffering effect model of social support. It is unclear, however, whether observation of these effects depends on the type of measure used to assess social support. A better understanding of the relationship between social support and depression requires the consideration of more precise dimensions of social support as well as the nature of the Stressors experienced by older people.

Available research supports the therapeutic usefulness of cognitive therapy for depressed older adults. Few studies have addressed the issue of response prediction. This research investigates the associations between several pre-intervention characteristics of subjects and therapy outcomes in the context of a group intervention. The characteristics under study were severity of depressive symptommatology, endogenous depression profile, subjective health status, perceived social support, and frequency of cognitive depressive symptoms representing a negative view of oneself. A more severe depressive symptomatology and a more negative health perception were associated with a less favourable outcome of therapy. Although the majority of endogenous patients benefitted from the intervention, only a minority reached the level of symptom remission at the end of treatment. A more pronounced cluster of symptoms characterized by negative thoughts about oneself tended to be associated with a worse outcome. Perceived social support was unrelated to therapy outcome.

This study was devised to determine the effectiveness of a pretherapy training procedure in enhancing group cognitive therapy for depressed older adults. Twenty-nine subjects were randomly assigned to a pretherapy training condition or an attention-placebo control condition. Subjects were 65 years of age or older, had a score of 14 or higher on the Beck Depression Inventory or on the Geriatric Depression Scale, and had no previous experience in psychotherapy. The pretherapy training procedure was based on Bandura's social cognitive theory and included verbal persuasion, vicarious experience, and performance accomplishment. The pretherapy training improved knowledge about psychotherapy and promoted the development of a problem-oriented focus in therapy. However it was unsuccessful in significantly reducing dropouts, increasing attendance, modifying role expectancies in the expected direction, and differentially affecting the outcome of cognitive therapy. For the experimental and control conditions taken together, 53.7 per cent of the subjects demonstrated clinically significant improvement at the end of therapy. Implications for research and clinical practice are discussed.

The study focuses on perceived control and coping strategies regarding activity restriction due to osteoarthritis in a sample of older women. Using a cross-sectional design, it examines how these variables, separately and in combination, predict anxious symptoms and depressive symptoms. Perceived control did not predict anxious symptoms, while approach-type coping strategies did. Perceived control and approach-type coping strategies individually predicted depressive symptoms. Higher perceived control in interaction with avoidant-type coping strategies significantly predicted lower depressive symptoms. Overall, the findings suggest that perceived control and coping strategies with regard to activity restriction relate in different ways to anxious symptoms and to depressive symptoms.

The goodness-of-fit hypothesis contends that distress results due to incongruence between choice of coping strategies and perceived ability to change stressful stimuli. Goal-directed or active coping responses are believed to be most efficacious when the individual believes s/he can change or control perceived threats (i.e., problem-focused coping). Instances in which stressors must be accepted, however, would dictate reliance upon strategies to regulate distress (i.e., emotion-focused coping). Inconsistent support for this facet of Lazarus and Folkman's cognitive phenomenological model was obtained in this study of spouses of suspected dementia patients. The distinction between emotion- and problem-focused coping appears less germane than overall coping efforts relative to perceived control and caregiver burden. In addition, perceived ability to control dementia-related stressors appears to be somewhat independent of coping by caregivers. These findings are discussed in terms of the unique and chronic demands faced by spouses of persons with dementia.

Activation of a depressogenic schema by a negative life event is said to be more likely when the life event corresponds to the same domain of vulnerability (congruency hypothesis). Specifically, this refers to a negative interpersonal event for the sociotropy/dependency schema, and an obstacle or a failure in achieving a goal for the autonomy/accomplishment or self-criticism schema. This study examines the congruency hypothesis for the prediction of relapse. Older patients were followed for 6 months after remission from major depression. Life events were rated as interpersonal or autonomous in nature. Their subjective impact on social relations and on autonomous functioning was also assessed. Congruency between dependency schema and interpersonal events, but only when the subjective impact of event was taken into consideration, predicted relapse. Non-congruency between an autonomous schema and an event rated as impacting the social domain also predicted relapse. However, in both analyses of dependency and autonomy schemas, impact of event on social relations on its own predicted relapse. These findings support the cognitive vulnerability theory of depressive relapse, underlining the importance of considering how the person views the influence of life events and the determining impact of stressful life events on social relations.