Human Behavior and the Social Environment I Part XI Chapter 27 Psychosocial Development in Middle Adulthood

Chapter 27 Psychosocial Development in Middle Adulthood Explain the controversy surrounding the concept of a midlife crisis Explain the sources of stress confronting adults in midlife and the strategies to cope Summarize seventh psychosocial task of stagnation Describe the relationships adults have with their children , parents , and other family members Describe singlehood , marriage , divorce , and at midlife Describe the contemporary roles of grandparents Describe friendships at midlife Explain how women are uniquely affected at midlife Describe friendships at midlife Explain how women are uniquely affected at midlife Explain the role of religion at midlife 1064 Chapter 27 Psychosocial Development in Middle Adulthood

There are many changes that occur in how aged adults perceive themselves . While people in their early may emphasize how old they are to gain respect or to be viewed as experienced , by the time people reach their they tend to emphasize how young they are . For instance , a few cut each other down for being so young stating You only 43 ?

48 ! A previous focus on the future gives way to an emphasis on the present . 1968 ) notes that in midlife , people no longer think of their lives in terms of how long they have lived . Rather , life is thought of in terms of how many years are left . Midlife Crisis ?

In 1978 Daniel published a book entitled The Seasons of a Life in which he presented a theory of development in adulthood . work was based on interviews with 40 men between the ages of . 1978 ) indicated that adults go through stages and have an image of the future that motivates them . This image is called the dream and for the men interviewed , it was a dream of how their career paths would progress and where they would be at midlife . According to the midlife transition ( was a time of reevaluating previous commitments making dramatic changes if necessary giving expression to previously ignored talents or aspirations , and feeling more of a sense of urgency about life and its meaning . By the time the men entered middle adulthood ( they believed they committed to the new choices made and placed one energies into these commitments . believed that a midlife crisis was a normal part of development as the person is more aware of how much time has gone by and how much time is left . The future focus of early adulthood gives way to an emphasis on the present in midlife , and Chapter 27 Psychosocial Development in Middle Adulthood 1065

the men interviewed had difficulty reconciling the dream they held about the future with the reality they experienced . Consequently , they felt impatient and were no longer willing to postpone the things they had always wanted to do . Although believed his research demonstrated the existence of a midlife crisis , his study has been criticized for his research methods , including small sample size , similar ages , and concerns about a cohort effect . In fact , other research does not support his theory of the midlife crisis . 2012 ) believed that it was the design of study that led to the erroneous conclusion of an inevitable midlife crisis . Instead , he believed that longitudinal studies of an individual entire life were needed to determine the factors associated with optimum health and potential . was one of the main researchers in the Harvard Study of Adult Development , and he considered a midlife crisis to be a rare occurrence among the participants ( 1977 ) Additional findings of this longitudinal study will be discussed in the next chapter in late adulthood . Most research suggests that most people in the United States today do not experience a midlife crisis . Results of a study conducted by the MacArthur Foundation Research Network on Successful Midlife Development , based on telephone interviews with over midlife adults , suggest that the years between 40 and 60 are ones marked by a sense of . Only 23 of the participants reported experiencing a midlife crisis . The crisis tended to occur among the highly educated and was triggered by a major life event rather than out of fear of aging ( Research Network on Successful Midlife Development , 2007 ) 1066 Chapter 27 Psychosocial Development in Middle Adulthood

Stress Figure Are you Stressed ?

We all know that stress plays a major role in our mental and physical health , but what exactly is stress ?

The term stress is as a pattern of physical and psychological responses in an organism after it perceives a threatening event that disturbs its homeostasis and taxes its abilities to cope with the event ( Hooker Pressman , 2016 ) Stress was originally derived from the field of mechanics where it is used to describe materials under pressure . The word was first used in a psychological manner by researcher Hans , who was examining the effect of an ovarian hormone that he thought caused sickness in a sample of rats . Surprisingly , he noticed that almost any injected hormone produced this same sickness . He smartly realized that it was not the hormone under investigation that was causing these problems , but instead , the aversive experience of being handled and injected by researchers led to high physiological arousal , and eventually to health problems like ulcers . 1946 ) coined the term stressor to label a stimulus that had this effect on the body ( that is , causing stress ) He developed a model of the stress response called the General Adaptation Syndrome , which is a model of stress , which includes a mobilization of Chapter 27 Psychosocial Development in Middle Adulthood 1067

physiological resources phase , a coping phase , and an exhaustion phase ( when an to cope with the stress adequately and depletes its resources ) Figure illustrates the General Adaptation Syndrome . Figure Syndrome sun . I suge Alarm I Psychologists have studied stress in a myriad of ways , and it is not just a major life stressor ( a family death , a natural disaster ) that increases the likelihood of getting sick . Stress can result from negative events , chronically difficult situations , a biological response , and as clinical illness , such as stress disorder ( Even small daily hassles , like getting stuck in traffic or fighting with your friend , can raise your blood pressure , alter your stress hormones , and even suppress your immune system function ( Lazarus , 1988 , 81 van , 1999 ) Stress continues to be one of the most 1068 Chapter 27 Psychosocial Development in Middle Adulthood

important and psychological correlates of illness because excessive stress causes potentially damaging wear and tear on the body and can influence almost any disease process . Dispositions and Stress Negative dispositions and personality traits have been strongly tied to an array of health risks . One of the earliest negative connections was discovered in the by two cardiologists . They made the interesting discovery that there were common behavioral and psychological patterns among their heart patients that were not present in other patient samples . This pattern included being competitive , impatient , hostile , and time urgent . They labeled it Type A Behavior . Importantly , it was found to be associated with double the risk of heart disease as compared with Type Behavior ( absence of Type A behaviors ) 1959 ) Since the , researchers have discovered that it is the hostility and competitiveness components of Type A that are especially harmful to heart health ( et , 2000 Matthews , Glass , 1977 Miller , Smith , Turner , 1996 ) Hostile individuals are quick to get upset , and this angry arousal can damage the arteries of the heart . In addition , given their negative personality style , hostile people often lack a supportive social network . Social Relationships and Stress Research has shown that the impact of social isolation on our risk for disease and death is similar in magnitude to the risk associated with smoking regularly ( Smith , 2010 House , Landis , 1988 ) In fact , the importance of social relationships for our health is so significant that some scientists believe our body has developed a physiological system that encourages us to seek out our relationships , especially in times of stress ( Taylor et , 2000 ) Social integration is the concept used to describe the number of social roles that you have ( Cohen Willis , 1985 ) For example , you might be a daughter , a basketball team member , a Humane Society volunteer , a coworker , and a student . Maintaining these different roles can improve your health via encouragement from those around you to Chapter 27 Psychosocial Development in Middle Adulthood 1069

maintain a healthy lifestyle . Those in your social network might also provide you with social support ( when you are under stress ) This support might include emotional help ( a hug when you need it ) tangible help ( lending you money ) or advice . By helping to improve health behaviors and reduce stress , social relationships can have a powerful , protective impact on health , and in some cases , might even help people with serious illnesses stay alive longer ( Spiegel , Bloom , 1989 ) Figure support II for handling stress and Stress A disabled child , spouse , parent , or other family member is part of the lives of some midlife adults . According to the National Alliance for ( 2015 ) 40 million Americans provide unpaid . The typical caregiver is a female currently caring for a female who needs care because of a physical condition . Looking more closely at the age of the recipient of , the typical caregiver for those years of age is a female ( 61 ) caring mostly for her own child ( 32 ) followed by a spouse or partner ( 17 ) When looking at older 1070 Chapter 27 Psychosocial Development in Middle Adulthood

recipients ( who receive care , the typical caregiver is female ( 60 ) caring for a parent ( 47 ) or spouse ( 10 ) places enormous stress on the caregiver . for a young or adult child with special needs was associated with poorer global health and more physical symptoms among both fathers and mothers ( Seltzer , Floyd , Song , Hong , 2011 ) Marital relationships are also a factor in how caring affects stress and chronic conditions . Fathers who were caregivers identified more chronic health conditions than fathers , regardless of marital quality . In contrast , mothers reported higher levels of chronic conditions when they reported a high level of marital strain ( Kang Marks , 2014 ) Age can also make a difference in how one is affected by the stress of caring for a child with special needs . Using data from the Study of Midlife in the United States , Ha , Seltzer , and ( 2008 ) found that older parents were significantly less likely to experience the negative effects of having a disabled child than younger parents . They concluded that an weakening of the stress occurred over time . This follows with the greater emotional stability noted at midlife . Currently , 25 of adult children , mainly baby boomers , provide personal or financial care to a parent ( 2011 ) Daughters are more likely to provide basic care and sons are more likely to provide financial assistance . Adult children who work and provide care to a parent are more likely to have fair or poor health when compared to those who do not provide care . Some adult children choose to leave the workforce , however , the cost of leaving the workforce early to care for a parent is high . For females , lost wages and social security benefits equal , while for men it equals ( 2011 ) This loss can jeopardize the adult child financial future . Consequently , there is a need for greater workplace flexibility for working caregivers . Spousal Care Certainly , caring for a disabled spouse would be a difficult experience that could negatively affect one health . Chapter 27 Psychosocial Development in Middle Adulthood 1071

However , research indicates that there can be a positive health effect on caring for a disabled spouse . Beach , Yee , and Jackson ( 2000 ) evaluated outcomes in four groups Spouses with no needed ( Group ) living with a disabled spouse but not providing care ( Group ) living with a disabled spouse and providing care ( Group ) and helping a disabled spouse while reporting caregiver strain , including elevated levels of emotional and physical stress ( Group ) Not surprisingly , the participants in Group were the least healthy and identified poorer perceived health , an increase in behaviors , and an increase in anxiety and depression symptoms . However , those in Group who provided care for a spouse , but did not identify caregiver strain , actually identified decreased levels of anxiety and depression compared to Group and were actually similar to those in Group . It appears that greater involvement was related to better mental health as long as the spouse did not feel the strain . The beneficial effects of helping identified by the participants were consistent with previous research ( Baker , 1992 et , 1997 ) When caring for a disabled spouse , gender differences have also been identified . Female caregivers of a spouse with dementia experienced more burden , had poorer mental and physical health , exhibited increased depressive symptomatology , took part in fewer activities , and received fewer hours of help than male caregivers ( Gibbons et , 2014 ) This study was consistent with previous research findings that women experience more burden than men , despite similar situations ( Reed , 2004 Yeager , Hobbs , 2010 ) Explanations for why women do not use more external support , which may alleviate some of the burdens , include women expectations that they should assume roles ( et al , 2004 ) and their concerns with the opinions of others ( 2000 ) Also contributing to women poorer outcomes is that disabled males are more aggressive than females , especially males 1072 Chapter 27 Psychosocial Development in Middle Adulthood

with dementia who display more physical and sexual aggression toward their caregivers ( 1997 , de , 2009 ) Female caregivers are certainly at risk for negative consequences of , and greater support needs to be available to them . Figure for females is with greater stress Stress Management On a scale from to 10 , those Americans aged rated their stress at , and those aged rated their stress at ( American Psychological Association , 2017 ) The most common sources of stress included the future of our nation , money , work , current political climate , and violence and crime . Given that these sources of our stress are often difficult to change , a number of interventions have been designed to help reduce the aversive responses to duress , especially related to health . For example , relaxation activities and forms of meditation are techniques that allow individuals to reduce their stress via breathing exercises , muscle relaxation , and mental imagery . Physiological arousal from stress can also be reduced via biofeedback , a technique where the individual is shown bodily information that is not normally available to them ( heart rate ) and then taught strategies to alter this signal . This type of intervention has even shown promise in reducing heart and hypertension risk , as well as other serious conditions ( 2008 Patel , Marmot , Terry , 1981 ) Reducing stress does not have Chapter 27 Psychosocial Development in Middle Adulthood 1073

to be complicated . For example , exercise is a great stress reduction activity ( Salmon , 2001 ) that has a myriad of health benefits . Coping Strategies Coping is often classified into two categories coping or coping ( Carver , 1989 ) coping is thought of as actively addressing the event that is causing stress in an effort to solve the issue at hand . For example , say you have an important exam coming up next week . A strategy might be to spend additional time over the weekend studying to make sure you understand all of the material . coping , on the other hand , regulates the emotions that come with stress . In the above examination example , this might mean watching a funny movie to take your mind off the anxiety you are feeling . In the short term , coping might reduce feelings of stress , but coping seems to have the greatest impact on mental wellness ( Billings Moos , 1981 , 1995 ) That being said , when events are uncontrollable ( the death of a loved one ) coping directed at managing your feelings , at first , might be the better strategy . Therefore , it is always important to consider the match of the stressor to the coping strategy when evaluating its plausible benefits . Figure How do you cope with stress when mick in ?

1074 Chapter 27 Psychosocial Development in Middle Adulthood Stagnation According to ( 1950 , 1982 ) encompasses , productivity , and creativity . This stage includes the generation of new beings , new products , and new ideas , as well as concerned with further identity development . believed that the stage of , during which one established a family and career , was the longest of all the stages . Individuals at midlife are primarily concerned with leaving a positive legacy of themselves , and parenthood is the primary generative type . understood that work and family relationships may be in conflict due to the obligations and responsibilities of each , but he believed it was overall a positive developmental time . In addition to being parents and working , also described individuals being involved in the community during this stage . A sense of stagnation occurs when one is not active in generative matters , however , stagnation can motive a person to redirect energies into more meaningful activities . identified virtues for each of his eight stages , and the virtue emerging when one achieves is Care . believed that those in middle adulthood should take care of the persons , the products , and the ideas one has learned to care for ( 1982 , 67 ) Further , believed that the strengths gained from the six earlier stages are essential for the generational task of cultivating strength in the next generation . further argued that occurred best after the individual had resolved issues of identity and intimacy ( Peterson Duncan , 2007 ) Research has demonstrated that generative adults possess many positive characteristics , including good cultural knowledge and healthy adaptation to the world ( Peterson Duncan , 2007 ) Using the Big personality traits , generative women and men scored high on conscientiousness , extraversion , agreeableness , openness to experience , and low on neuroticism ( de , 1995 Peterson , Wentworth , 1997 ) Additionally , women scoring Chapter 27 Psychosocial Development in Middle Adulthood 1075

high in at age 52 , were rated high in positive personality characteristics , satisfaction with marriage and motherhood , and successful aging at age 62 ( Peterson Duncan , 2007 ) Similarly , men rated higher in at midlife were associated with stronger global cognitive functioning ( memory , attention , calculation ) stronger executive functioning ( response inhibition , abstract thinking , cognitive flexibility ) and lower levels of depression in late adulthood ( Malone , Liu , 81 , 2016 ) 1982 ) indicated that at the end of this demanding stage , individuals may withdraw as is no longer expected in late adulthood . This releases elders from the task of caretaking or working . However , not feeling needed or challenged may result in stagnation , and consequently one should not fully withdraw from generative tasks as they enter last stage in late adulthood . Midlife Relationships The sandwich generation refers to adults who have at least one parent age 65 or older and are either raising their own children or providing support for their grown children . According to a recent 1076 Chapter 27 Psychosocial Development in Middle Adulthood

Pew Research survey , 47 of adults are part of this sandwich generation ( Parker Patten , 2013 ) In addition , 15 of adults are providing financial support to an older parent while raising or supporting their own children ( see Figure ) According to the same survey , almost half ( 48 ) of aged adults , have supported their adult children in the past year , and 27 are the primary source of support for their grown children . Figure ( Aging Parents and Kids om . I 2005 Hue i oven 659 and are . grow ! sunny ?

in Harem 559 and am out In Um ! I I percent of the sandwich generation is age , 19 were younger than 40 , and 10 were 60 or older . Hispanics are more likely to find themselves supporting two generations 31 have parents 65 or older and a dependent child , compared with 24 of whites and 21 of blacks ( Parker Patten , 2013 ) Women are more likely to take on the role of care provider for older parents in the and Germany ( Pew Research , 2015 ) About 20 of women say they have helped with personal care , such as getting dressed or bathing , of aging parents in the past year , compared with of men in the Chapter 27 Psychosocial Development in Middle Adulthood 1077

US . and in Germany . In contrast , in Italy men are just as likely ( 25 ) as women ( 26 ) to have provided personal care . The Pew survey found that almost 33 of the generation adults were more likely to say they always feel rushed , while only 23 of other adults said this . However , the survey suggests that those who were supporting both parents and children reported being just as happy as those adults who did not find themselves in the sandwich generation ( Parker Patten , 2013 ) Adults who are supporting both parents and children did report greater financial strain ( see Figure 831 ) Only 28 reported that they were living comfortably versus 41 of those who were not also supporting their parents . Almost 33 were just making ends meet , compared with 17 of those who did not have the additional financial burden of aging parents . 1078 Chapter 27 Psychosocial Development in Middle Adulthood

Financial Stress and the Sandwich Generation Hour would you describe your household ?

sandwich Generation No ! 33333 . comfortably 28 41 Mac ! with a little over 30 31 Just meet basic expenses 30 17 Don ! have enough to meet basic expenses ( ENTER . At midlife adults may find themselves as . In all families , there is a person or persons who keep the family connected and who promote solidarity and continuity in the family ( Brown , 2010 ) Who in your own family do you count on to organize family gatherings ?

Who knows the history of your family ?

Who do people turn to in your family for advice and support ?

Who works to strengthen the bonds between members of your family ?

These are your family kin keepers , and they are usually women ( Leach , 1996 Brown , 2010 ) Leach and found that 86 of their respondents named a woman Chapter 27 Psychosocial Development in Middle Adulthood 1079 as their family , and Brown and found that mothers , maternal grandmothers , and paternal grandmothers were more likely to be a family than were fathers , young adult children , and grandfathers combined . Brown and also found that among young adults , women were more likely to be a than were young adult men . can be a source of distress when it interferes with other obligations ( Gallagher , 1993 ) and Gallagher found that on average , kin keepers provide almost a full week of work each month to ( almost 34 hours ) They also found that the more activities the took on , and the more kin they helped the more stress and higher the levels of depression a experienced . However , unlike other studies on , and Gallagher also included a number of activities that would be considered more , such as providing transportation , making repairs , providing meals , etc . in addition to the usual activities of . Empty nest The empty nest or period refers to the time period when children are grown up and have left home ( Dudley Guthrie , 2002 ) For most parents , this occurs during midlife . This time is recognized as a normative event as parents are aware that their children will become adults and eventually leave home ( Mitchell , 2009 ) The empty nest creates complex emotions , both positive and negative , for many parents . Some theorists suggest this is a time of role loss for parents , others suggest it is one of role strain relief ( 2013 ) The role loss hypothesis predicts that when people lose an important role in their life they experience a decrease in emotional . It is from this perspective that the concept of the empty nest syndrome emerged , which refers to great emotional distress experienced by parents , typically mothers , after children have left home . The empty nest syndrome is linked to the absence of alternative roles for the parent in which they could establish their identity ( 1982 ) In ( 2013 ) review of the research , 1080 Chapter 27 Psychosocial Development in Middle Adulthood

she found that few parents reported loneliness or a big sense of loss once all their children had left home . In contrast , the role stress relief hypothesis suggests that the empty nest period should lead to more positive changes for parents , as the responsibility of raising children has been lifted . The role strain relief hypothesis was supported by many studies in ( 2013 ) review . A consistent finding throughout the research literature is that raising children has a negative impact on the quality of marital relationships ( 2009 , 2013 ) Most studies have reported that marital satisfaction often increases during the launching phase of the empty nest period and that this satisfaction endures long after the last child has left home ( John , 2008 ) However , most of the research on the period has been with American parents . A number of studies in China suggest that , especially in more rural areas of China , report greater loneliness and depression than their counterparts with children still at home ( Wu et , 2010 ) Family support for the elderly by their children is a cherished Chinese tradition ( Wong Leung , 2012 ) With children moving from the rural communities to the larger cities for education and employment this may explain the more pessimistic reaction of Chinese parents than in American samples . The loss of an adult child in a rural region may mean a loss of family income for aging parents . in urban regions of China did not report the same degree of distress ( Su et , 2012 ) suggesting that it not so much the event of children leaving , but the additional hardships this may place on aging parents . Boomerang Kids As you read in Chapter , young adults are living with their parents for a longer duration and in greater numbers than previous generations . In addition to those in early adulthood who are not leaving the home of their parents , there are also young who dire returning after having lived independently outside the home , and these are called boomerang kids . Figure shows the number of American young people who were living at home based Chapter 27 Psychosocial Development in Middle Adulthood 1081

on their generation ( Fry , 2017 ) Figure 833 shows that more young adults in Europe are also living with their parents ( Desilver , 2016 ) Many of the same financial reasons that are influencing young people decisions to delay exit from the home of their parents are underlying their decisions to return home . In addition , to financial reasons , some boomerang kids are returning because of emotional distress , such as mental health issues ( Snyder , Jang , 2015 ) 1082 Chapter 27 Psychosocial Development in Middle Adulthood

! I ' hi nu . mun What is the effect on parents when their adult children return Chapter 27 Psychosocial Development in Middle Adulthood 1083 home ?

Certainly , there is considerable research that shows that the stress of raising children can have a negative impact on parents and that when children leave home many couples experience less stress and greater life satisfaction ( see the section on the empty nest ) Early research in the and supported the notion that boomerang children , along with those who were failing to exit the home , placed greater financial hardship on the parents , and the parents reported more negative perceptions of this living arrangement ( Aquilino , 1991 ) Recent surveys suggest that today parents are more tolerant of this , perhaps because this is becoming a more normative experience than in the past . Moreover , children who return are more likely to have had good relationships with their parents growing up , so there may be less stress between parents and their adult children who return ( et , 2015 ) Parents of young adults who have moved back home because of economic reasons report that they are just as satisfied with their life as are parents whose adult children are still living independently ( Parker , 2012 ) Parker found that adult children age 25 and older are more likely to contribute financially to the family or complete chores and other household duties . Parker also found that living in a household may be acting as an economic safety net for young adults . In comparison to young adults who were living outside of the home , those living with their parents were less likely to be living in poverty ( 17 versus 10 ) So far , we have considered the impact that adult children who have returned home or have yet to leave the nest have on the lives of parents . What about the effect on parents who have adult children dealing with personal problems , such as alcoholism , chronic health concerns , mental health issues , trouble with the law , poor social relationships , or academic or problems , even if they are not living at home ?

The life course perspective proposes the idea of linked lives ( Marks , 2006 ) The notion that people in important relationships , such as children and parents , mutually influence each other developmental pathways . In previous 1084 Chapter 27 Psychosocial Development in Middle Adulthood

chapters , you have read about the effects that parents have on their children development , but this relationship is bidirectional . The problems faced by children , even when those children are adults , influence the lives of their parents . and Marks found in their study of parents and their adult children , those parents whose children were dealing with personal problems reported more negative affect , lower , poorer interactions , and more family relationship stress . The more problems the adult children were facing , the worse the lives and emotional health of their parents , with single parents faring the worst . Chapter 27 Psychosocial Development in Middle Adulthood 1085

. yaw up mu . sou Middle Adult Lifestyles Singlehood According to a Pew Research study , 16 per adults age 45 to 54 and per 1000 age 55 and over have never married in 1086 Chapter 27 Psychosocial Development in Middle Adulthood the ( Wang Parker , 2014 ) However , some of them may be living with a partner . In addition , some singles at midlife may be single through divorce or widowhood . 2014 ) has challenged the idea that singles , especially the always single , fair worse emotionally and in health when compared to those married . suggests there is a bias in how studies examine the benefits of marriage . Most studies focus on comparisons between married versus not married , which do not include a separate comparison between those always single , and those who are single because of divorce or widowhood . Her research has found that those who are married may be more satisfied with life than the divorced or widowed , but there is little difference between married and always single , especially when comparing those who are recently married with those who have been married for four or more years . It appears that once the initial blush of the honeymoon wears off , those who are wedded are no happier or healthier than those who remained single . This might also suggest that there may be problems with how the married category is also seen as one homogeneous group . Online Dating ( 2003 ) surveyed over singles aged , and almost half of the participants reported their most important reason for dating was to have someone to talk to or do things with . Additionally , sexual fulfillment was also identified as an important goal for many . 2013 ) reviewed online personal ads for men and women over age 40 and found that romantic activities and sexual interests were mentioned at similar rates among the and age groups , but less for the age group . Marriage As you read in Chapter , there has been a number of changes in the marriage rate as more people are cohabitating , more are deciding to stay single , and more are getting married at a later age . As you can see in Figure , 48 of adults age are married either in their first marriage ( 22 ) or have remarried ( 26 ) This makes marriage the most common relationship status for adults in the United States . Marital satisfaction Chapter 27 Psychosocial Development in Middle Adulthood 1087

tends to increase for many couples in midlife as children are leaving home ( 81 , 2005 ) Not all researchers agree . They suggest that those who are unhappy with their marriage are likely to have gotten divorced by now , making the quality of marriages later in life only look more satisfactory ( Williams , Powers , Chen , Campbell , 2005 ) Figure by Composition . by ! Status . 45 nu , as . In . twin Divorce ( 2014 ) found that 27 of adults age 45 to 54 were divorced ( see Figure ) Additionally , 57 of divorced adults were women . This reflects the fact that men are more likely to remarry than are women . of divorces are initiated by women ( 2009 ) Most divorces take place within the first to 10 years of marriage . This timeline reflects people initial attempts to salvage the relationship . After a few years of limited success , the couple may decide to end the marriage . It used to be that divorce after having been married for 20 or more years was rare , but in 1088 Chapter 27 Psychosocial Development in Middle Adulthood

recent years the divorce rate among more marriages has been increasing . Brown and Lin ( 2013 ) note that while the divorce rate in the US . has declined since the , the rate among those 50 and older has doubled . They suggest several reasons for the graying of divorce . There is less stigma attached to divorce today than in the past . Some older women are their spouses , and thus may be more financially capable of supporting themselves , especially as most of their children have grown . Finally , given increases in human longevity , the prospect of living several more years or decades with an incompatible spouse may prompt aged and older adults to leave the marriage . and ( 2000 ) found that the divorces in early adulthood were angrier and , with each partner blaming the other for the failures in the marriage . In contrast , they found that at midlife divorces tended to be more about having grown apart or cooling off of the relationship . A survey by ( 2009 ) found that men and women had diverse motivations for getting a divorce . Women reported concerns about the verbal and physical abusiveness of their partner ( 23 ) abuse ( 18 ) and infidelity ( 17 ) In contrast , men mentioned they had simply fallen out of love ( 17 ) no longer shared interests or values ( 14 ) and infidelity ( 14 ) Both genders felt their marriage had been over long before the decision to divorce was made , with many of the aged adults in the survey reporting that they stayed together because they were still raising children . Females also indicated that they remained in their marriage due to financial concerns , including the loss of health care ( 2015 ) However , only in adults regretted their decision to divorce . The effects of divorce are varied . Overall , young adults struggle more with the consequences of divorce than do those at midlife , as they have a higher risk of depression or other signs of problems with psychological adjustment ( 2013 ) Divorce at midlife is more stressful for women . In the ( 2009 ) survey , 44 of women mentioned financial problems after Chapter 27 Psychosocial Development in Middle Adulthood 1089

divorcing their spouse , in comparison only 11 of men reported such difficulties . However , a number of women who divorce in midlife report that they felt a great release from their sense of unhappiness . and Kelly ( 2002 ) found that among the divorce enhancers , those who had used the experience to better themselves and seek more productive intimate relationships , and the competent loners , those who used their divorce experience to grow emotionally , but who choose to stay single , the overwhelming majority were women . Dating Most divorced adults have dated by one year after filing for divorce ( Anderson et , 2004 Anderson Greene , 2011 ) One in four recent report having been in or were currently in a serious relationship , and over half were in a serious relationship by one year after filing for divorce . Not surprisingly , younger adults were more likely to be dating than were or older adults , no doubt due to the larger pool of potential partners from which they could to draw . Of course , these relationships will not all end in marriage . 2008 ) found that more than of women under the age of 45 had with a partnership between their first and second marriages . Dating for adults with children can be more of a challenge . are shorter in remarriage than in first marriages . When couples are dating , there is less going out and more time spent in activities at home or with the children . So the couple gets less time together to focus on their relationship . Anxiety or memories of past relationships can also get in the way . As one scholar suggests when a divorced man marries a divorced woman , four go to bed . Warner , 2004 ) parents , that is , they regulate the of information about their new romantic partner to their children , in an attempt to balance their own needs for romance with consideration regarding the needs and reactions of their children . Anderson et al . 2004 ) found that almost half ( 47 ) of dating parents gradually introduce their children to their dating partner , giving both their romantic partner and children time to adjust and get to know each 1090 Chapter 27 Psychosocial Development in Middle Adulthood

other . Many parents who use this approach do so to avoid their children having to keep meeting someone new until it becomes clearer that this relationship might be more than casual . It might also help if the adult relationship is on the firmer ground so it can weather any initial push back from children when it is revealed . Forty percent are open and transparent about the new relationship at the outset with their children . Thirteen percent do not reveal the relationship until it is clear that cohabitation and or remarriage is likely . Anderson and colleagues suggest that practical matters influence which method parents may use . Parents may be able to successfully shield their children from a parade of suitors if there is reliable childcare available . The age and temperament of the child , along with concerns about the reaction of the , may also influence when parents reveal their romantic relationships to their children . Rates of remarriage The rate for remarriage , like the rate for marriage , has been declining overall . In 2013 the remarriage rate was approximately 28 per adults 18 and older . This represents a 44 decline since 1990 and a 16 decline since 2008 ( Payne , 2015 ) Brown and Lin ( 2013 ) found that the rate of remarriage dropped more for younger adults than and older adults , and ( 2014 ) found that as we age we are more likely to have remarried ( see Figure ) This is not surprising as it takes some time to marry , divorce , and then find someone else to marry . However , found that unlike those younger than 55 , those 55 and up are remarrying at a higher rate than in the past . In 2013 , 67 of adults and 50 of adults 65 and older had remarried , up from 55 and 34 in 1960 , respectively . Chapter 27 Psychosocial Development in Middle Adulthood 1091

Figure ! 509 married remarried KI CENT ! Men have a higher rate of remarriage at every age group starting at age 25 ( Payne , 2015 ) 2014 ) reported that in 2013 , 64 of divorced or widowed men compared with 52 of divorced or widowed women had remarried . However , this gender gap has narrowed over time . Even though more men still remarry , they are remarrying at a slower rate . In contrast , women are remarrying today more than they did in 1980 . This gender gap has closed mostly among young and adults but still persists among those 65 and older . In 2012 , Whites who were previously married were more likely to 1092 Chapter 27 Psychosocial Development in Middle Adulthood

remarry than were other racial and ethnic groups ( 2014 ) Moreover , the rate of remarriage has increased among Whites , while the rate of remarriage has declined for other racial and ethnic groups . This increase is driven by White women , whose rate of remarriage has increased , while the rate for White males has declined . Success of Remarriage Reviews are mixed as to the happiness and success of . While some are more successful , especially if the divorce motivated the adult to engage in and personal growth ( Kelly , 2002 ) a number of divorced adults end up in very similar marriages the second or third time around ( Kelly , 2002 ) have challenges that are not found in first marriages that may create additional stress in the marital relationship . There can often be a general lack of clarity in family roles and expectations when trying to incorporate new kin into the family structure , even determining the appropriate terms for this kin , along with their roles can be a challenge . Partners may have to navigate carefully their role when dealing with their partners children . All of this may lead to greater dissatisfaction and even resentment among family members . Even though remarried couples tend to have more realistic expectations for marriage , they tend to be less willing to stay in unhappy situations . The rate of divorce among is higher than among first marriages ( Payne , 2015 ) which can add additional burdens , especially when children are involved . Children Influence on Does having children affect whether a parent remarries ?

and ( 2006 ) found children residing with their mothers reduces the mothers likelihood of marriage , only with respect to marrying a man without children . Further , having children in the home appears to increase single men likelihood of marrying a woman with children ( Stewart , Manning , Smock , 2003 ) There is also some evidence that individuals who participated in a while growing up may Chapter 27 Psychosocial Development in Middle Adulthood 1093

feel better prepared for living as adults . and ( 2006 ) found that having experienced amily divorce as a child is associated with a greater willingness to marry a partner with children . Figure When children are present after divorce , one of the challenges the adults encounter is how much influence the child will have when selecting a new partner . Greene , Anderson , and ( 2003 ) identified two types of parents . The parent allows the child views , reactions , and needs to influence the partnering . In contrast , the parent expects that their child can adapt and should accommodate to parental wishes . Anderson and Greene ( 2011 ) found that divorced custodial mothers identified as more tended to be older , more educated , employed , and more likely to have been married longer . Additionally , mothers reported having less rapport with their children , spent less time in joint activities with their children , and the child reported lower rapport with their mothers . Lastly , when the child and partner were resisting one another , mothers responded more to the concerns of the partner , while the mothers responded more to the concerns of the child . Understanding the 1094 Chapter 27 Psychosocial Development in Middle Adulthood

implications of these two different perspectives can assist parents in their attempts to partner . Grandparents In addition to maintaining relationships with their children and aging parents , many people in middle adulthood take on yet another role , becoming a grandparent . The role of grandparents varies around the world . In households , grandparents may play a greater role in the activities of their grandchildren . While this family dynamic is more common in Latin America , Asia , and Africa , it has been on the increase in the ( Pew Research Center , 2010 ) The degree of grandparent involvement also depends on the proximity of the grandparents home to their grandchildren . In developed nations , the greater mobility of society can mean that grandparents may live long distances from their grandchildren . Technology has brought grandparents and their more distant grandchildren together . and Cooper ( 2010 ) found that many of the grandfathers they interviewed would text , email , or Skype with their grandchildren in order to stay in touch . Chapter 27 Psychosocial Development in Middle Adulthood 1095

and ( 1986 ) described three styles of grandparents . Thirty percent of grandparents were remote as they rarely saw their grandchildren . Usually , they lived far away from their grandchildren but may also have had a distant relationship . Contact was typically made on special occasions , such as holidays or birthdays . percent of grandparents were described as companionate as they did things with their grandchildren but had little authority or control over them . They preferred to spend time with them without interfering in parenting . They were more like friends to their grandchildren . Fifteen percent of grandparents were described as involved as they took a very active role in their grandchild life . The involved grandparent had frequent contact with and authority over the grandchild , and their grandchildren might even have lived with them . Grandmothers , more so than grandfathers , played this role . In contrast , more grandfathers than grandmothers saw their role as a family historian and family advisor ( and , 1964 ) 2001 ) suggests that grandparents adopt different styles with different grandchildren , and over time may change styles as circumstances in the family change . Today more grandparents are the sole care providers for grandchildren or may step in at times of crisis . With these changes , grandparents are redefining how they see their role in the family with fewer adopting a more formal role ( Henderson Shore , 2003 ) Early research on grandparents has routinely focused on grandmothers , with grandfathers often becoming invisible members of the family ( Cooper , 2010 ) Yet , grandfathers stress the importance of their relationships with their grandchildren as strongly as do grandmothers ( et , 1999 ) For some men , this may provide them with the opportunity to engage in activities that their occupations , as well as their generation views of fatherhood and masculinity , kept them from engaging in with their own children ( Cooper , 2010 ) Many of the grandfathers in and Cooper study felt that being a grandfather was easier and a lot more enjoyable . Even 1096 Chapter 27 Psychosocial Development in Middle Adulthood

among grandfathers that took on a more involved role , there was still a greater sense that they could be more and flexible in their interactions with their grandchildren . Many grandfathers reported that they were more openly affectionate with their grandchildren than they had been with their own children . Friendships Adults of all ages who reported having a confidante or close friend with whom they could share personal feelings and concerns believed these friends contributed to a sense of belonging , security , and overall wellbeing ( Dune ' 2007 ) Having a close friend is a factor in significantly lower odds of psychiatric morbidity including depression and anxiety ( Harrison , Barrow , Creed , 1999 Newton et , 2008 ) The availability of a close friend has also been shown to lessen the adverse effects of stress on health ( 81 , 1998 et , 2008 Tower . 1995 ) Additionally , poor social connectedness in adulthood is associated with a larger risk of premature mortality than cigarette smoking , obesity , and excessive alcohol use ( Smith , 2010 ) re Chapter 27 Psychosocial Development in Middle Adulthood 1097

Female friendships and social support networks at midlife contribute significantly to a womans feeling of life satisfaction and ( Kennedy , 2009 ) and Myers ( 2006 ) found that women who have supportive people in their life experience greater life satisfaction than do those who live a more solitary life . A friendship network or the presence of a confidant have both been identified for their importance to women mental health ( Baruch , 1984 ) Unfortunately , with numerous caretaking responsibilities at home , it may be difficult for women to find time and energy to enhance the friendships that provide an increased sense of life satisfaction ( et , 2009 ) Hunt , and Lyons ( 2013 ) found that for men in midlife , the shared consumption of alcohol was important to creating and maintaining male friends . Drinking with friends was justified as a way for men to talk to each other , provide social support , relax , and improve mood . Although the social support provided when men drink together can be helpful , the role of alcohol in male friendships can lead to damaging behavior from excessive drinking . The importance of social relationships begins in early by laying down a foundation for strong social connectedness facilitating comfort with intimacy ( 1959 ) To determine the impact of the quantity and quality of social relationships in young adulthood on middle adulthood , Reis , and ( 2015 ) assessed individuals at age 50 on measures of connection ( types of relationships and friendship quality ) psychological outcomes ( loneliness , depression , psychological being ) Results indicated that the number of social interactions at age 20 and the quality , not quantity , of social interaction at age 30 predicted midlife social interactions . Those individuals who hac high levels of social information seeking ( quantity ) at age 20 followed by less quantity in social relationships but greater emotional closeness ( quality ) resulted in positive adjustment at midlife . 1098 Chapter 27 Psychosocial Development in Middle Adulthood

Continuing to socialize widely in one 1505 appeared to negatively affect the development of intimacy , and consequently resulted in worse psychological outcomes at age 50 . Internet Friendships What influence does the Internet have on friendships ?

It is not surprising that people use the Internet with the goal of meeting and making new friends ( 2008 , 2008 ) Researchers have wondered if the issue of not being reduces the authenticity of relationships , or if the Internet really allows people to develop deep , meaningful connections . Interestingly , research has demonstrated that virtual relationships are often as intimate as relationships in fact , Bargh and colleagues found that online relationships are sometimes more intimate ( Bargh , 2002 ) This can be especially true for those individuals who are more socially anxious and lonely as such individuals are more likely to turn to the Internet to find new and meaningful relationships ( Green , 2002 ) and colleagues suggest that for people who have a hard time meeting and maintaining relationships , due to shyness , anxiety , or lack of social skills , the Internet provides a safe , nonthreatening place to develop and maintain relationships . Similarly , 2008 ) found that for autistic individuals , the Internet facilitated communication and relationship development with others , which would have been more difficult in , leading to the conclusion that Internet communication could be empowering for those who feel frustrated when communicating face to face . Workplace Friendships Friendships often take root in the workplace , due to the fact that people are spending as much , or more , time at work than they are with their family and friends ( 2003 ) Often , it is through these relationships that people receive mentoring and obtain social support and resources , but they can also experience conflicts and the potential for misinterpretation when sexual attraction is an issue . Indeed , and ( 2006 ) found that many workers Chapter 27 Psychosocial Development in Middle Adulthood 1099

reported that friendships grew out of collaborative work projects , and these friendships made their days more pleasant . Figure 839 Source In addition to those benefits , and ( 1995 ) found that people who worked in an environment where friendships could develop and be maintained were more likely to report higher levels of job satisfaction , job involvement , and organizational commitment , and they were less likely to leave that job . Similarly , a poll revealed that employees who had close friends at work were almost 50 more satisfied with their jobs than those who did not ( Armour , 2007 ) Women in Midlife In Western society , aging for women is much more stressful than for men as society emphasizes youthful beauty and attractiveness ( 2010 ) The description that aging men are viewed as distinguished and aging women are viewed as old is referred 1100 Chapter 27 Psychosocial Development in Middle Adulthood

to as the double standard of aging ( 2006 ) Since women have traditionally been valued for their reproductive capabilities , they may be considered old once they are . In contrast , men have traditionally been valued for their achievements , competence , and power , and therefore are not considered old until they are physically unable to work ( Carroll , 2016 ) Consequently , women experience more fear , anxiety , and concern about their identity as they age , and may feel pressure to prove themselves as productive and valuable members of society ( Chang , 2013 ) Attitudes about aging , however , do vary by race , culture , and sexual orientation . In some cultures , aging women gain greater social status . For example , as Asian women age , they attain greater respect and have greater authority in the household ( Fung , 2013 ) Compared to white women , Black and Latina women possess fewer stereotypes about aging ( et , 2008 ) Lesbians are also more positive about aging and looking older than heterosexual women ( 2010 ) The impact of media certainly plays a role in how women view aging by selling products and supporting cosmetic surgeries to look younger ( 2000 ) Religion and Spirituality and ( 2004 ) found that in addition to personal health behaviors , such as regular exercise , healthy weight , and not smoking , social behaviors , including involvement in related activities , have been shown to be positively related to optimal health . However , it is not only those who are involved in a specific religion that benefit , but so too do those identified as being spiritual . According to , and Marks ( 2009 ) religiosity refers to engaging with a formal religious groups doctrines , values , traditions , and . In contrast , Chapter 27 Psychosocial Development in Middle Adulthood 1101

spirituality refers to an individuals sense of connection with something transcendent ( that which exists apart from and not limited by the material universe ) and the subsequent feelings of awe , gratitude , compassion , and forgiveness . Research has demonstrated a strong relationship between spirituality and psychological being , irrespective of an individual religious participation ( 2008 ) Additionally , Chiu ( 2005 ) found that spirituality was related to a higher quality of life for both individuals and societies . Figure Based on reports from the 2005 National Survey of Midlife in the United States , et al . 2009 ) found that higher levels of spirituality were associated with lower levels of negative affect and higher levels of positive affect , personal growth , purpose in life , positive relationships with others , environmental mastery , and autonomy . In contrast , formal religious participation was only associated with higher levels of purpose in life and personal growth among just older adults and lower levels of autonomy . In summary , it appears that formal religious participation 1102 Chapter 27 Psychosocial Development in Middle Adulthood

and spirituality relate differently to an individual overall psychological . Age Older individuals identify as being more important in their lives than those younger ( Argyle , 1998 ) This age difference has been explained by several factors including that religion and spirituality assist older individuals in coping with losses , provide opportunities for socialization and social support in later life , and demonstrate a cohort effect in that older individuals were socialized more to be religious and spiritual than those younger ( et , 2009 ) Gender In the United States , women report identifying as being more religious and spiritual than men do ( de , 1987 ) According to the Pew Research Center ( 2016 ) women in the United States are more likely to say religion is very important in their lives than men ( 60 47 ) American women also are more likely than American men to say they pray daily ( 64 47 ) and attend religious services at least once a week ( 40 32 ) Theories to explain this gender difference include that women may benefit more from the aspects of spirituality because social relationships more strongly influence women mental health . Additionally , women have been socialized to internalize the behaviors linked with religious values , such as cooperation and , more than males ( et , 2009 ) Worldwide To measure the religious beliefs and practices of men and women around the world , the Pew Research Center ( 2016 ) conducted surveys of the general population in 84 countries between 2008 and 2015 . Overall , an estimated 83 of women worldwide identified with religion compared with 80 of men . This equaled 97 million more women than men identifying with a religion . There were no countries in which men were more religious than women by percentage points or more . Among Christians , women reported higher rates of weekly church attendance and higher rates of daily prayer . In contrast , Muslim women and Muslim men showed similar levels of religiousness , except the frequency of Chapter 27 Psychosocial Development in Middle Adulthood 1103

attendance at worship services . Because of religious norms , Muslim men worshiped at a mosque more often than Muslim women . Similarly , Jewish men attended a synagogue more often than Jewish women . In Orthodox Judaism , communal worship services can not take place unless a minyan , or quorum of at least 10 Jewish men , is present , thus ensuring that men will have high rates of attendance . Only in Israel , where roughly 22 of all Jewish adults as Orthodox , did a higher percentage of men than women report engaging in daily prayer . Figure References . 2009 ) The divorce experience A study of divorce at midlife and beyond . Washington , 81 , A . 2009 ) Perception of marital quality by parents with small children A study when the firstborn is years old . Journal of Family Nursing , 15 , A . 2013 ) Relationship goals of , and Internet An analysis of online personal ads . Journal of Aging Studies , 27 , American Association of Community Colleges ( 2016 ) Plus 50 1104 Chapter 27 Psychosocial Development in Middle Adulthood

community colleges Ageless learning . Retrieved from Pages American Cancer Society . 2019 ) Cancer Facts and Figures 2019 . Retrieved from content dam org research res 2019 . American Diabetes Association ( 2016 ) Standards of medical care in diabetes . Diabetes Care . 39 ( American Heart Association ( 2016 ) Saturated fats . Retrieved from Nutrition Fats 301110 American Psychological Association ( 2017 ) Stress in America The state of our nation . Retrieved from ima es American Psychological Association ( 2016 ) By the numbers Hearing loss and mental health . Monitor on Psychology , 47 ( Anderson , Greene , 2011 ) My child and are a package deal Balancing adult and child concerns in after divorce . Journal of Family Psychology , 25 ( Anderson , Greene , Walker , 2004 ) Ready to take a chance again Transitions into dating among divorced parents . Journal of Divorce and Remarriage , 40 , Aquilino , 1991 ) Predicting parents experiences with coresidence adult children . Journal of Family Issues , 12 ( 2000 ) Undue concern for others opinions deters caregivers of impaired elderly from using public services in rural Japan . International Journal of Geriatric Psychiatry , 15 ( 10 ) 968 . Armour , 2007 , August ) Friendships and work A good or bad partnership ?

USA Today . Retrieved from monev workplace , Crawford , 2001 ) Is there a menopausal Chapter 27 Psychosocial Development in Middle Adulthood 1105 syndrome ?

Menopausal status and symptoms across ethnic groups . Social Science and Medicine , 52 ( 1999 ) Lifespan Psychology Theory and Application to Intellectual Functioning . Annual Review of Psychology , 50 , Bargh , A , 2002 ) Can you see the real me ?

Activation and expression of the true self on the Internet . Journal of Social Issues , 58 , Ryan , 2009 ) The glass ceiling in the century Understanding the barriers to gender equality . Washington , American Psychological Association . Baruch , 1984 ) Women in midlife . New York Plenum . Beach , Yee , Jackson , 2000 ) Negative and positive health effects of caring for a disabled spouse Longitudinal findings from the caregiver health effects study . Psychology and Aging , 15 ( Argyle , 1998 ) Religious behavior , belief , and experience . New York . 2001 ) Families , relationships , and in midlife . In ( Author ) Ed . Handbook of midlife development ( New York Wiley . Oliver , Matthews , DELTA Investigators . 1999 ) subpopulation patterns in response to reductions in dietary total and saturated fat intakes in healthy subjects . American Journal of Clinical Nutrition , 70 , Berkeley Wellness . 2011 ) The lowdown on low testosterone . Retrieved from , care article , Brown , 2013 ) Job characteristics , core , 1106 Chapter 27 Psychosocial Development in Middle Adulthood

and job satisfaction . International Journal of Aging Human Development , 76 ( Billings , Moos , 1981 ) The role of coping responses and social resources in attenuating the stress of life events . Journal of Behavioral Medicine , 2012 ) Till death do us part and implications of marriage , divorce , and remarriage across adulthood . Research in Human Development , 1982 ) A cohort analysis approach to the syndrome among three ethnic groups of women A theoretical position . Journal of Marriage and the Family , 44 , Kennedy , 2009 ) Life satisfaction , and subjective age in women across the life span . Journal , 2013 ) How do parents reaction when their children leave home An integrative review . Journal of Adult Development , 21 , Chang , 2013 ) Does risk for anxiety increase during the menopausal transition ?

Study of Womens Health Across the Nation ( SWAN ) Menopause , 20 ( Brown , 2010 ) The connection Continuity , crisis and consensus . Journal of Relationships , Brown , Lin , 2013 ) The gray divorce revolution Rising divorce among middle aged and older adults . National Center for Family Marriage Research Working Paper Series . Bowling Green State University . dam sciences documents Lin Bureau of Labor Statistics . 2019 ) The employment 2019 . Retrieved from , 1969 ) Theories of aging . In . Pfeiffer Chapter 27 Psychosocial Development in Middle Adulthood 1107

( Behavior and adaptation in later life ( Boston , MA Little Brown . Reis , 2015 ) In your it quantity , in your it quality The prognostic value of social activity across 30 years of adulthood . Psychology and Aging , 30 ( Carroll , 2016 ) Sexuality now Embracing diversity ( Boston , MA Learning . Carver , 1989 ) Assessing coping strategies A theoretically based approach . Journal of Personality and Social Psychology , 56 , Center for Sexual Health Promotion . 2010 ) National survey of sexual health and behavior . Retrieved from Centers for Disease Control ( About high blood pressure . Retrieved from ( Centers for Disease Control and Prevention . Behaviors that increase the risk for high blood pressure . Retrieved from Centers for Disease Control and Prevention . 20140 ) Measuring high blood pressure . Retrieved from . ov Centers for Disease Control and Prevention . National diabetes statistics report , 2014 . Retrieved from diabetes pubs Centers for Disease Control and Prevention . Diagnoses of HIV infection among adults aged 50 years and older in the United States and dependent areas . HIV surveillance report , 21 ( Retrieved from re ) surveillance . Centers for Disease Control and Prevention . 2015 ) Facts about high 1108 Chapter 27 Psychosocial Development in Middle Adulthood

cholesterol . Retrieved from Centers for Disease Control and Prevention . 2016 ) The National Center for Health Statistics . Retrieved from 1335 Centers for Disease Control and Prevention . 2017 ) National diabetes statistics report , 2017 . Retrieved from diabetes data statistics Chang , An , Wong , 2016 ) Midlife adiposity predicts earlier onset of dementia , neuropathology and presymptomatic cerebral amyloid accumulation . Molecular Psychiatry , 21 ( 2006 ) Aging and expertise . In , Handbook of expertise and expert performance . Cambridge , United Kingdom Cambridge University Press . A . 1986 ) The new American grandparent A place in the family , a life apart . New York Basic Books . Cohen , Wills , A . 1985 ) Stress , social support , and the buffering hypothesis . Psychological Bulletin , 98 , Crawford , 2002 ) Dissociation between performance on abstract tests of executive function and problem solving in real life type situations in normal aging . Aging and Mental Health , Champagne , Lien , Zhang , Young , 2012 ) Influence of change in aerobic fitness and weight on prevalence of metabolic syndrome . Preventing Chronic Disease doi , Gabriel , 2011 ) The lifetime risk of rheumatoid arthritis and other inflammatory Chapter 27 Psychosocial Development in Middle Adulthood 1109

autoimmune rheumatic diseases . Arthritis and Rheumatism , 63 ( doi . 1990 ) Flow The psychology of optimal experience . New York Harper Perennial Modern Classics . 1996 ) Creativity Flow and the psychology of discovery and invention . New York Harper Collins . Dawes , Bishop , 2014 ) Vision impairment and dual sensory problems in middle age . Ophthalmic Physiological Optics , 34 , doi , Myers , 2006 ) Women at midlife An exploration of chronological age , subjective age , wellness , and life satisfaction , Journal , Lazarus , 1988 ) The impact of daily stress on health and mood Psychological and social resources as mediators . Journal of Personality and Social Psychology , 54 , Dudley , Guthrie , 2002 ) Empty nest or revolving door ?

A prospective study of women quality of life in midlife during the phase of children leaving and the home . Psychological Medicine , 32 , 2014 ) A singles studies perspective on mount marriage . Psychological Inquiry , 25 ( doi Desilver , 2016 ) In the and abroad , more young adults are living with their parents . Retrieved from 2016 24 parents de , Adams , 1995 ) The relation of generative concern and generative action to personality traits , happiness with life and ego development . Journal of Adult Development , 1110 Chapter 27 Psychosocial Development in Middle Adulthood

De , I . 1987 ) Gender differences in religion A test of the structural location theory . American Sociological Review , 52 , Dew , Hoch , Monk , Reynolds , 2003 ) Healthy older adults sleep predicts mortality at to 19 years of . Psychosomatic Medicine , 65 ( A . 2004 ) Intimate relationships and sexual attitudes of older African American men and women . The , 44 , Drake , 2013 ) Another gender gap Men spend more time in leisure activities . Pew Research Center . Retrieved from 2013 10 , 2007 ) The roles and functions of the informal support networks of older people who receive formal support A Swedish qualitative study . Ageing Society , 27 , A . 2006 ) Life cycle happiness and its sources Intersections of psychology , economics , and demography . Journal of Economic Psychology , 27 , 1997 ) Prevalence and correlates of aggressive behaviors occurring in patients with disease . International Journal of Geriatric Psychiatry , 12 , A . 2006 ) The glass partition Obstacles to friendships at work . Human Relations , 59 ( Hunt , Lyons , A . 2013 . The role of alcohol in forging and maintaining friendships amongst Scottish men in midlife . Health Psychology , 32 ( 10 , 2006 ) Studies of expertise from psychological perspectives . In , Cambridge Handbook of expertise and expert performance . Cambridge , UK Cambridge University Press . 1950 ) Childhood and society . New York Norton Chapter 27 Psychosocial Development in Middle Adulthood 1111

Company . 1959 ) Identity and the life cycle . New York Norton Company . 1982 ) The life cycle completed . New York Norton Company . 2008 ) Friendship formation . In , Wenzel , Harvey ( Handbook of Relationship Initiation ( New York , NY Psychology Press . Miller , Marmot , 2007 ) A prospective study of change in sleep duration Associations with mortality in the Whitehall cohort . Sleep , 30 ( 12 ) 1659 . Ford , Li , Zhao , 2010 ) Prevalence and correlates of metabolic syndrome based on a harmonious definition among adults in the US . Journal of Diabetes , 1959 ) Association of specific overt behaviour pattern with blood and cardiovascular findings . Journal of the American Medical Association , 169 , Fry , 2017 ) Its becoming more common for young adults to live at for longer stretches . Retrieved from 2017 05 05 , Moore , Stone , A . 2015 ) differences in speech identification despite matched audio metrically normal hearing contributions from auditory temporal processing and cognition . Frontiers in Aging Neuroscience , Fung , 2013 ) Aging in culture . 53 ( Gallagher , 1993 ) and distress Gender , recipients of care , and conflict . Journal of Marriage and the Family , 55 , Gibbons , Creese , Tran , Brazil , Chambers , Weaver , 2014 ) The psychological and health consequences of caring for a spouse with dementia A critical comparison of husbands and wives . Journal of Women Aging , 26 , 1112 Chapter 27 Psychosocial Development in Middle Adulthood

, Higgs , 2000 ) Cultures of aging Self , citizen and the body . Upper Saddle River , Prentice Hall Publishers . 2006 ) Willingness to stepparent Attitudes about partners who already have children . Journal of Family Issues , 27 , 1415 1436 . 2006 ) Creating Integrating children into the study of union formation . Journal of Marriage and Family , 68 , 275 291 . John , 2008 ) change in marital satisfaction during middle age . Psychological Science , 19 , 2000 ) The timing of divorce Predicting when a couple will divorce over a period . Journal of Marriage the Family , 62 , Greene , Anderson , 2003 ) Risk and resilience after divorce . In Walsh ( Ed . Normal family processes Growing diversity and complexity ( New York Press . Marks , 2006 ) Linked lives Adult problems and their parents psychological and relational being . Journal of Marriage and Family , 68 , Marks , 2009 ) Do formal religious participation and spiritual perceptions have independent linkages with diverse dimensions of psychological ?

Journal of Health and Social Behavior , 50 , 2007 ) Television and the European public sphere . European Journal of Communication , 22 , 2004 ) Toward health promotion Physical and social behaviors in complete health . Journal of Health Behavior , 28 ( Ha , Hong , Seltzer , 2008 ) Age and gender differences in the of midlife and aging parents with children with mental health or developmental problems Report of a national study . Journal of Health and Social Behavior , 49 , Chapter 27 Psychosocial Development in Middle Adulthood 1113

Harrison , Barrow , Creed , 1999 ) Social of score by postal survey . Journal of Public Health Medicine , 21 , Hughes , 2008 ) From social structural factors to perceptions of relationship quality and loneliness The Chicago health , aging , and marital status transitions and health outcomes social relations study . The Journals of Gerontology Series Psychological Sciences and Social Sciences , 63 , Henderson , Shore , 2003 ) The Structure of Grandparental Role Meaning . Journal of Adult Development , 10 ( 2002 ) Tacit knowledge and practical intelligence Understanding the lessons of experience . Retrieved from , au awe ari tacit , 1995 ) Approach and coping Implications for adolescent mental health . Journal of Youth and Adolescence , 24 , Kelly , 2002 ) For better or worse Divorce reconsidered . New York , NY Norton . Holland , 2014 ) Why America campuses are going gray . Retrieved from 2014 28 , Smith , 2010 ) Social relationships and mortality risk a review . Medicine , Hooker , Pressman , 2016 ) The healthy life . Retrieved from modules Horn , 1981 ) Apprehension , memory , and intelligence decline in adulthood . Research on Aging , House , Landis , 1988 ) Social relationships and health . Science , 241 , 1114 Chapter 27 Psychosocial Development in Middle Adulthood

Hu , Qiao , 2004 ) Prevalence of metabolic syndrome and its relation to and cardiovascular mortality in European men and women . Archives of Internal Medicine , 164 ( 10 ) Huang , 2007 ) Hormones and female sexuality . In Owens ( Sexual Health , Vol Physical Foundations ( 2010 ) Measures of hearing threshold and temporal processing across the adult lifespan . Hearing Research , 264 ( International Labour Organization . 2011 ) Global Employment Trends 2011 . Retrieved from public documents , Sidney , Liu , Matthews , 2000 ) Association of hostility with coronary artery calcification in young adults . Journal of the American Medical Association , 283 , Jackson , 2000 ) Scotopic sensitivity during adulthood . Vision Research , 40 ( 18 ) 00 Jones , 2013 ) In , 40 Get Less than Recommended Amount of Sleep . Retrieved from 166553 amount ?

202013 cam , Wu , 2002 ) Comparison of the menopause and midlife transition between Japanese American and European American women . Medical Anthropology Quarterly , 16 ( Kang , Marks , 2014 ) Parental for a child with special needs , marital strain , and physical health Evidence Chapter 27 Psychosocial Development in Middle Adulthood 1115

from National Survey of Midlife in the 2005 . Contemporary Perspectives in Family Research , 209 . Nair , 2005 ) of aging and its metabolic impact . Current Topics in Developmental Biology , 68 , 2015 ) Why you only need hours of sleep . American Academy of Sleep Medicine . Retrieved from news 2015 06 03 , 2003 . The economics of labor markets ( Mason , OH . 2016 ) How to cultivate creativity . Scientific American Mind , 27 ( Singh , A . 2004 ) How menopause affects the lives of women in suburban , India . Climacteric , Knowles , A . 1998 ) The adult learner A neglected species . Houston Gulf , Book Division . Murphy , Xu , Arias , 2019 ) Deaths Final data for 2017 . National Vital Statistics Reports , 68 ( 1998 ) Absence of social networks , social support , and health services utilization . Psychological Medicine , 28 , Baker , 1992 ) Providing support to others and in later life . Journal of Gerontology Psychological Sciences , 47 , 2011 ) How long do you benefit from vacation ?

A closer look at the vacation effects . Journal of Organizational Behavior , 32 , 2005 ) Sleep deprivation basic science , physiology , and behavior . London , England Informal Healthcare . 2004 ) Development in midlife . Annual Review of Psychology , 55 ( doi 1116 Chapter 27 Psychosocial Development in Middle Adulthood

, 2005 ) A quantitative and qualitative approach to social relationships and in the United States and Japan . Journal of Comparative Family Studies , 36 , Leach , 1996 ) A binding tie Supportive communication of family . Journal of Applied Communication Research , 24 , Lee , Chang , 2015 ) physical activity moderates the longitudinal associations between spillover and physical health . Journal of Leisure Research , 47 ( 1978 ) The seasons of a mans life . New York . 2014 ) Four in ten couples are saying I do again . In Chapter . The differing demographic profiles of marries , remarried and divorced adults . Pew Research Center . Retrieved from . 2014 11 14 Madden , St , Kelly ( 2010 ) First Nations women knowledge of menopause Experiences and perspectives . Canadian Family Physician , 56 ( Malik , 2004 ) Impact of the metabolic syndrome on mortality from coronary heart disease , cardiovascular disease , and all causes in United States adults . Circulation , 110 ( 10 ) Malone , Liu , 2016 ) Midlife psychosocial development Setting the stage for cognitive and emotional health . Developmental Psychology , 52 ( Marketing Charts Staff . 2014 ) Are young people watching less ?

Retrieved from television Martin , 2014 ) Aging changes in hair and nails . National Library of Medicine . Retrieved from Matthews , Glass , Chapter 27 Psychosocial Development in Middle Adulthood 1117 ( 1977 ) Competitive drive , pattern A , and coronary heart disease A further analysis of some data from the Western Collaborative Group Study . Journal of Chronic Diseases , 30 , Mayo Clinic . Heart disease . Retrieved from disease basics ( definition ( Mayo Clinic . Metabolism and weight loss How you burn calories . Retrieved from lifestyle metabolism , A . 2008 ) MySpace or your place Relationship initiation and development in the wired and wireless world . In , Wenzel , Harvey ( Handbook of relationship initiation ( New York , NY Psychology Press . Green , 2002 ) Relationship formation on the Internet Whats the big attraction ?

Journal of Social Issues , 58 , 2011 ) study of costs to working caregivers Double jeopardy for baby boomers caring for their parents . Retrieved from ivin uploads 2011 06 , Au , Fletcher , 2012 ) Effects of systolic blood pressure on matter integrity in young adults in the Farmington Heart Study A study . The Lancet Neurology , 11 ( Miller , Smith , Turner , 1996 ) review of research on hostility and physical health . Psychological Bulletin , 119 , Mitchell , 2009 ) The empty nest syndrome in midlife families A exploration of parental gender differences and cultural dynamics . Journal of Family Issues , 30 , 2003 ) Lifestyles , dating , and romance A study of midlife singles . Washington , 1118 Chapter 27 Psychosocial Development in Middle Adulthood

Monthly Labor Review . 2013 ) Percentage of the institutionalized civilian workforce employed by gender age . Retrieved from , 2008 ) Biofeedback therapy in cardiovascular disease rationale and research overview . Cleveland Clinic Journal of Medicine , 75 , 2006 ) Precedence of the shift of distribution over the change in body composition after menopause . Journal of Obstetrics and Gynecology , 32 , Mayer , Nair , 2001 ) Journal of Laboratory and Clinical Medicine , 137 ( 2014 ) Wrinkles . National Library of Medicine . Retrieved from article ( Nakamura , 2002 ) The concept of flow . In Snyder Lopez ( Handbook of positive psychology ( New York Oxford University Press . Rector , Hammond , JA . 2015 ) Pathogenesis and prevention of hepatic steatosis . Gastroenterology Hepatology , 11 ( National Alliance for . 2015 ) in the 2015 . Retrieved from . National Eye Institute . 2009 ) Facts about . Department of Health and Human Services . Retrieved from National Eye Institute . 2013 ) Facts about dry eye . Department of Health and Human Services . Retrieved from health National Eye Institute . 2015 ) Facts about diabetic eye disease . Retrieved from health diabetic National Eye Institute . 2016 ) Facts about presbyopia . Department of Chapter 27 Psychosocial Development in Middle Adulthood 1119

Health and Human Services . Retrieved from health errors ia National Institutes of Health . 2007 ) Menopause Medical Encyclopedia . Retrieved from National Institutes of Health . 2013 ) Gallstones . US . Department of Health and Human Services . Retrieved from National Institutes of Health . The and diabetes . Retrieved from information topics Pages National Institutes of Health ( Age changes in the lungs . Retrieved from article National Institutes of Health ( 20140 ) Sweet stuff How sugars and sweeteners affect your health . Retrieved from issue National Institutes of Health . What is atherosclerosis ?

Retrieved from health topics National Institutes of Health . 2015 ) Cancer . Retrieved from understanding National Institutes of Health . Facts about diabetes . Retrieved from topics Diabetes Pages National Institutes of Health ( Handout on Health Rheumatoid Arthritis . Retrieved from . ov health rheumatic National Institutes of Health . 20160 ) Older drivers How health affects driving . Retrieved from National Sleep Foundation . 2015 ) 2015 Sleep in America poll finds pain a significant challenge when it comes to Americans sleep . 1120 I Chapter 27 Psychosocial Development in Middle Adulthood

National Sleep Foundation . Retrieved from National Sleep Foundation . 2016 ) Menopause and Insomnia . National Sleep Foundation . Retrieved from slee ert , Besing , 81 , 2015 ) The Effect of Background Babble on Working Memory in Young and Adults . Journal of the American Academy of Audiology , 26 ( 1968 ) The awareness of middle aging . In ( Ed . Middle age and aging ( Chicago University of Chicago Press . 81 , 1964 ) The changing American grandparent . Journal of Marriage and the Family , 26 , Newton , Buckley , Mitchell , Shaw , 2008 ) Lack of a close confidant Prevalence and correlates in a medically underserved primary care sample . Psychology , Health Medicine , 13 , 13548500701405491 Nimrod , 2012 ) Leisure in coping with depression . Journal of Leisure Research , 44 ( Norman , 2005 ) Research in clinical reasoning Past history and current trends . Medical Education , 39 , North American Menopause Society . 2016 ) Menopause Understanding the symptoms . Retrieved from ) Yoon , Burt , 81 Gu , 2013 ) Hypertension among adults in the US National Health and Nutrition Examination Survey , Data Brief , No . 133 . Chapter 27 Psychosocial Development in Middle Adulthood 1121

National Center for Health Statistics , Centers for Disease Control and Prevention , US Dept of Health and Human Services . Office of Disease Prevention and Health Promotion . 2008 ) The physical activity guidelines for Americans . Retrieved from a ?

Organisation for Economic Cooperation and Development . 2016 ) Average annual hours actually worked per worker . Stat . Retrieved from ?

Henderson , 2010 ) Age of menopause and impact of climacteric symptoms by geographical region . 13 ( Parker , Patten , 2013 ) The sandwich generation Rising financial burdens for Americans . Pew Research Center . Retrieved from . 2013 01 30 Patel , Marmot , Terry , 1981 ) Controlled trial of behavioural methods in reducing mild hypertension . British Medical Journal ( Clinical research ed . 282 , 2015 ) Sleep deficit . Experience . Retrieved from article Payne , 2015 ) The remarriage rate Geographic variation , 2013 . National Center for Family Marriage Research . Retrieved from resources Peterson , Duncan , 2007 ) Midlife women and authoritarianism Marriage , motherhood , and 10 years of aging . Psychology and Aging , 22 ( Peterson , Wentworth , A . 1997 ) and authoritarianism Implications for personality , political involvement , and parenting . Journal of Personality and Social Psychology , 72 , Pew Research Center . 2010 ) The return of the 1122 Chapter 27 Psychosocial Development in Middle Adulthood

family household . Retrieved from 2010 03 18 Pew Research Center . How the great recession has changed life in America . Retrieved from 2010106130 Pew Research Center . Section Generations and the great recession . Retrieved from 11 03 Pew Research Center . 2015 ) Caring for aging parents . Family support in graying societies . Retrieved from 21 Pew Research Center . 2016 ) The Gender gap in religion around the world . Retrieved from . 2016 03 22 Phillips , 2011 ) The mind at midlife . American Psychological Association . Retrieved from ( 04 ( Proctor , Nair , 1998 ) in humans is associated with reduced synthetic rates of specific muscle proteins . Journal of Nutrition , 128 ( Project ( 2016 ) The state of American vacation How vacation became a casualty of our work culture . Retrieved from research Qian , Almeida , 2013 ) Does leisure time as a stress coping source increase affective complexity ?

Applying the Dynamic Model of Affect ( Journal of Leisure Research , 45 ( Ray , 2013 ) nation revisited . Chapter 27 Psychosocial Development in Middle Adulthood 1123 Center for Economic Policy Research . Retrieved from publications reports Ray , 2007 ) No vacation nation USA A comparison of leave and holiday in countries . Retrieved from programs papers No Research Network on Successful Midlife Development . 2007 , February ) Midlife Research Website . Retrieved from , 1995 ) The opportunity for friendship in the workplace An construct . Journal of Business and Psychology , 10 , Rossi , 2004 ) The menopausal transition and aging process . In How healthy are we A national study of health in midlife . Chicago University of Chicago Press . Rubin , Williams , Douglas , 2018 ) Older women , deeper learning , and greater satisfaction at university Age and gender predict university students learning approach and degree satisfaction . Diversity in Higher Education , 11 ( 2014 ) The 40 hour work week is actually longer by hours . Gallop . Retrieved from 175286 Salmon , 2001 ) Effects of physical exercise on anxiety , depression , and sensitivity to stress A unifying theory . Clinical Psychology Review , 21 ( Salthouse , A . 2004 ) What and when of cognitive aging . Current Directions in Psychological Science , 13 , Jang , 2015 ) Exiting and returning to the parental home for boomerang kids . Journal of Marriage and Family , 77 , Chiu , 2005 ) A of the relationship between spirituality and quality of life . Social Indicators Research , 72 , 1124 Chapter 27 Psychosocial Development in Middle Adulthood

, 2005 ) Developmental influences on adult intelligence the Seattle longitudinal study . Oxford Oxford University Press . 2009 ) New territories of Positive Lifespan Development Wisdom and Life Longings . In Snyder Lopez ( Oxford handbook of Positive Psychology ( New York Oxford University Press . Reece , Sanders , Dodge , 2010 ) Sexual behaviors , condom use , and sexual health of Americans over 50 Implications or sexual health promotion for older adults . Journal of Sexual Medicine , 111161 , Vinci , Roy , Evans , 2008 ) perceptions and body mass index of older African American and European American women . Journal of Gerontology , 23 ( Burton , 1997 ) Health effects of The caregiver health effects study . Annals of Behavioral Medicine , 19 , Warner , 2004 ) Marriages and families Relationships in social context . Belmont , CA Learning . Seltzer , Floyd , Song , Hong , 2011 ) Midlife and aging parents of adults with intellectual and developmental disabilities Impacts of lifelong parenting . American Association on Intellectual and Developmental Disability , 116 , 1946 ) The general adaptation syndrome and the diseases of adaptation . Journal of Clinical Endocrinology , 230 . Shure , 1998 , September 10 ) Launch an exercise program today , say Aging Institute , Senator John Glenn . National Institute on Aging . Retrieved from , 2010 ) If I had lots of money have a body makeover Managing the aging body . Social Forces , 88 ( Cooper , 2010 ) Reshaping the family man A Chapter 27 Psychosocial Development in Middle Adulthood 1125

grounded theory study of the meaning of grandfatherhood . Journal of Men Studies , 18 ( Spiegel , Bloom , 1989 ) Effect of psychosocial treatment on survival of patients with metastatic breast cancer . The Lancet , 334 , Stern , 2009 ) Physical Leisure activities and their role in preventing dementia A systematic review . International Journal of Healthcare , Stewart , Manning , Smock , 2003 ) Union formation among men in the US Does having prior children matter ?

Journal of Marriage and Family , 65 , 90 104 . Su , Wu , Zhang , Li , Zhang , Zhou , 2012 ) Depression and social support between China rural and urban elderly . Archives of Gerontology and Geriatrics , 55 , 2015 ) Erectile Dysfunction . Retrieved from , Thomas , 2003 ) Prediction of satisfaction among African American women . Journal of Adult Development , 10 , Matthews , Harlow , Hall , 2016 ) Bedtime variability and metabolic health in midlife women the SWAN Sleep Study . SLEEP , 39 ( Klein , Lewis , A . 2000 ) responses to stress in females , not . Psychological Review , 107 , 2008 ) Complex life course patterns and the risk of divorce in second marriages . Journal of Marriage and Family , 70 , 294 305 . 2006 ) Reconsidering the double standard of aging Effects of gender and sexual orientation on 1126 Chapter 27 Psychosocial Development in Middle Adulthood

facial attractiveness ratings . Personality and Individual Differences , 42 ( 2005 ) An ecological model for understanding culture as a determinant of womens health . Critical Public Health , 15 ( Reed , A . 2004 ) A multinational review of recent trends and reports in dementia caregiver burden . Disease and Associated Disorders , 18 ( Tower , 1995 ) Depressive symptoms across older spouses and the moderating effect of marital closeness . Psychology and Aging , 10 , van , 1999 ) Changes in daily hassles and life events and the relationship with coronary heart disease risk factors A longitudinal study in males and females . Journal of Psychosomatic Research , 46 , Ando , 2003 ) Prevalence of auditory problems and their relation to audiometric thresholds in a to elderly population . Acta , 123 ( 618 . Williams , I ( Powers , Chen , Campbell , A . 2005 ) As good as it gets ?

A life course perspective on marital quality . Social Forces , 81 , United Health Foundation . 2016 ) New report finds health concerns loom for seniors in coming years . Retrieved from News Articles Feeds 2016 , US . Bureau of Labor Statistics ( 2016 ) American time use survey 2015 . Retrieved from . ov US . Department of Health and Human Services and US . Department of Agriculture . 2015 ) Dietary Guidelines for Americans . Edition . Retrieved from 2015 guidelines Chapter 27 Psychosocial Development in Middle Adulthood 1127

Department of Labor ( 2016 ) Vacation Leave . Retrieved from general topic vacation leave Government Accountability Office . 2012 ) Unemployed older workers Many experience challenges regaining employment and face reduced retirement security . Retrieved from products , 1977 ) Adaptation of life . Boston , MA Little , Brown , 2008 ) Spiritual evolution A scientific defense of faith . New York Broadway . 2012 ) Triumphs of experience . Cambridge , MA Harvard University Press . Weber , Herald , Cooper , 1999 ) Wisdom and life experience How grandfathers mentor their grandchildren . Journal of Aging and Identity , Wang , Parker , 2014 ) Record share of Americans have never married As values , economics and gender patterns change . Retrieved from 2014 09 24 . 2016 ) Erectile Dysfunction Testosterone Replacement Therapy . Retrieved from guide therapy ?

Willis , 1999 ) Intellectual functioning in midlife . In Willis . Reid ( Life in the Middle Psychological and Social Development in Middle Age ( San Diego Academic . Wong , Leung , 2012 ) care in China Issues and prospects . Journal of Social Work , 55 , World Health Organization . 2018 ) Top 10 causes of death . Retrieved from burden disease causes death top 10 eng World Health Organization . 2019 ) an occupational phenomenon International Classification of Diseases . Retrieved from mental health evidence 1128 Chapter 27 Psychosocial Development in Middle Adulthood

Wu , Sun , Sun , Zhang , Tao , Cui , 2010 ) Correlation between loneliness and social relationship among empty nest elderly in rural area , China . Aging and Mental Health , 14 , Yeager , Hobbs , 2010 ) disease and vascular dementia The complex relationship between diagnosis and caregiver burden . Issues in Mental Health Nursing , 31 ( A . 2013 ) Meanings of menopause Cultural considerations . Retrieved from ?

de , 2009 ) of symptoms in nursing home patients Influence of gender and dementia severity . International Journal of Geriatric Psychiatry , 24 ( 10 ) Attribution Adapted from Chapter from Lifespan Development A Perspective Second Edition by Martha Lally and Suzanne under the Creative Commons Alike license . Chapter 27 Psychosocial Development in Middle Adulthood 1129