Richard A. Zweig

The Relation Between Cognitive Functioning and Self-Reported Sleep Complaints in Nondemented Older Adults: Results From the Bronx Aging Study

Abstract Self-reported sleep complaints and current cognitive functioning were assessed in 375 nondemented participants ages 75 to 85 years (134 men and 241 women) as part of enrollment in the Bronx aging study, an ongoing longitudinal community-based study of cognitive aging. This study only reports on the baseline data collected from 1980 to 1983. Sleep complaints were common, occurring in about 25% of the sample. Furthermore, after controlling for depression, use of hypnotic medication, physical morbidity, age, and education, participants who reported longer sleep onset latencies performed significantly worse on measures of verbal knowledge, long-term memory and fund of information, and visuospatial reasoning. Participants who reported longer sleep durations did significantly worse on a measure of verbal short-term memory. These results suggest that perceived sleep is related to select objective cognitive abilities even when accounting for commonly recognized mediating variables, such as depression, medical comorbidity, age, or use of hypnotic medication. Given the restricted range of this nondemented sample, these results may underestimate the relation between cognitive abilities and sleep.

Medical and Psychology Students' Knowledge and Attitudes regarding Aging and Sexuality.

The current study surveys medical and doctoral psychology students (N = 100) from an urban northeastern university regarding knowledge and attitudes toward elderly sexuality and aging using the Facts on Aging Quiz, the Aging Sexuality Knowledge and Attitudes Scale, and measures of interest in gerontology, academic/clinical exposure to aging and sexuality, and contact with elders. The current study found that psychology students demonstrated greater aging knowledge than medical students; however, both groups showed gaps in knowledge about sexuality. Married students had greater academic/clinical exposure and greater knowledge about aging but less permissive attitudes toward elderly sexuality. Generally, knowledge about aging was the strongest correlate of knowledge about sexuality. Level of knowledge about sexuality was not associated with attitudes. Attitudes toward sexuality and aging may be more strongly tied to demographic variables reflective of religious beliefs or adherence to sociocultural norms.

The social adjustment scale-self-report: psychometric properties for older adults.

To assess the reliability and validity of the Social Adjustment Scale-Self-Report for older adults, 129 community dwelling elderly ranging in age from 63 to 87 years (M = 72.3 yr., SD = 5.0) were surveyed using a modified version of the scale. The average internal consistency of subscales was satisfactory (mean coefficient alpha = .62). Overall social functioning impairment (total score) was associated with measures of depression (Beck Depression Inventory, r = .58) and global psychiatric symptoms (Brief Symptom Inventory, r = .55). Older adults scored higher on Marital role, Family Unit role, and overall social functioning impairment compared to mixed-age adults assessed in previous research, and higher on marital role impairment but similarly on overall social functioning when compared with a mixed-age sample from primary care. The modified Social Adjustment Scale–Self-Report has acceptable psychometric characteristics for research use with older adults, and select subscales may account for findings of age-related differences.

Doctoral Clinical Geropsychology Training in a Primary Care Setting.

Abstract Most older adults diagnosed with a mental disorder receive treatment in primary care settings that lack personnel skilled in geropsychological diagnosis and treatment. The Ferkauf Older Adult Program of Yeshiva University endeavors to bridge this gap by providing training in geriatric psychology, through coursework and diverse clinical practica, to clinical psychology doctoral students within a large urban professional psychology program. In an innovative effort to provide the most disadvantaged elderly with comprehensive mental health treatment and maximize trainee exposure to an interdisciplinary treatment model, the program also pairs selected doctoral psychology trainees with medical residents to optimize integrated mental health service delivery for primary care elderly. The program has the following core objectives: (1) Infuse the mental health and aging knowledge base into the regular graduate curriculum; (2) Provide interdisciplinary training in geropsychological diagnostic and consultative services within an urban primary care setting; (3) Provide interdisciplinary training in the practice of psychological and neuropsychological evaluation of elderly; (4) Provide training in geropsychological psychotherapeutic intervention, including individual, couples/family, and brief/psycho-educational therapies with outpatient older adults. These objectives are achieved by pooling the resources of a graduate school of psychology, a local public hospital, and an academic medical center to achieve educational and clinical service goals.

Doctoral Gero-Psychology Training in Primary Care: Preliminary Findings from a Clinical Training Project

This article provides descriptive information and preliminary program evaluation data regarding a University based doctoral training program with a special focus on gero-psychology training in a primary care setting. The program sought to combine the resources of a University, an urban public hospital, and an academic medical center to develop geropsychology didactic and clinical training experiences, and specifically direct services to minority elders. Preliminary program findings suggest that educational and service objectives may be simultaneously achieved. A relatively modest increment in didactic training resulted in measurable gains in knowledge and interest. While the integration of geropsychology into primary care medicine presents some formidable challenges, preliminary data suggest great potential for further expansion of training and geropsychological services in primary care to meet the burgeoning mental health needs of older adults.

Psychotherapy Termination Practices with Older Adults: Impact of Patient and Therapist Characteristics

ABSTRACT Objectives: The aims of this study were to survey clinicians’ opinions regarding psychotherapy practices in mutual termination with a specified population (depressed older adult outpatients) and to examine the patient and therapist characteristics that may influence such practices. Methods: We surveyed psychologists’ (N = 96) psychotherapy termination practices, using a hypothetical depressed older adult as a referent, to assess consensus on the appropriateness of various guidelines to termination and to examine whether these differ as a function of patient and therapist characteristics. Results: Several practices were generally agreed to be “extremely appropriate” when terminating psychotherapy with older adults, including collaborating to determine the end date of treatment and discussing patient growth. Data also indicate that patient factors, such as personality pathology, and therapist factors, such as having an Integrative theoretical orientation were associated with differential endorsement of termination practices. Identification as a geropsychologist or working regularly with older adults were associated with a more cautious approach to termination. Conclusions: There is substantial consensus regarding many approaches to termination, but modifications might be appropriate depending on patient characteristics. Clinical Implications: Clinicians agree on a set of fundamental termination practices when working with older adults, but modify these based on orientation and diagnosis.