Gains and Losses in Middle Adulthood

One of the major themes associated with middle adulthood is the balance of gains and losses. How do people cope with and try to minimize the losses associated with aging that become apparent during this phase? And what gains are made as brains start to accommodate for this decline, and social, work and family roles change?  Many of the developmental milestones reached in this age, such as the onset of chronic illness; the peak of cognitive and physical functioning; and assuming the role of caregiver for older generations are all characterized by losses but also have opportunities for gains.
Throughout our research, we felt that dividing topics into categories (i.e. physical health or relationships) was artificial as all the subjects overlap. Continued research on issues of middle adulthood should focus on the interplay of various aspects, such as the affects of physical health on relationships.
One idea for future research we have is to examine what motivates people in middle adulthood to make life-style choices that are protective against aging and chronic illness. Are interventions most effective when proposed by medical professionals, peers, family members or some other group? What forms of accountability work best? The best intervention programs would come in adolescence and young adulthood and seek to prevent negative life-style choices, but it is also important to understand how to work with people in middle adulthood to mitigate consequences of previous choices.
Another research question is how an individual’s physical and cognitive status affects their generativity and role in the sandwich generation. Are people who are in better health more or less likely to be motivated to contribute to future generations or care directly for older generations. Would these findings be true cross-culturally, i.e. would health status affect an Asian-American’s willingness to care for a parent differently than an African-American’s?
We suspect that as life-expectancy increases, the experience of people in middle-age will change and we think this should be continuously examined and the definition of Middle-Adulthood redefined if necessary.
More specific topic related ideas for future research are below.

THEORIES

Erik Erikson is one of the primary contributors of theories throughout life stages.  No one stage can be studied in isolation as Erikson has categorized each period in his Psychosocial Stages of Life.  To better utilize Erikson’s Psychological Stages, it is important to be cognizant of the various life courses and trajectories in life and it is more useful to look at patterns of stability and change as opposed to clearly defined stages that middle adults go through.  Additionally, there are several types of trajectories that individuals pass through including family life, health and work trajectories which do not pertain to any one stage of life as such trajectories are a continuum of the life line. In analyzing Carl Roger’s Actualizing Tendency, it is important to remember that not all individuals are born with the innate desire to live up to their fullest potentials.  Arguably this tendency would not pertain to those individuals in life who chose to remain stagnant or change their life course.  Rollo May’s Stages of Development seem to be more applicable to a wider range of individuals as there are no clear-cut age ranges of development and people experience different issues at different points in life.  Lastly, John Kotre asserts that generative impulses may serve evil purposes as well as good purposes, which seems to be more plausible as some individuals do have ulterior motives in life.One interesting method for research in this age group would be a longitudinal study on the theory that Middle Adulthood is really based off of stagnation vs. generativity. It would be interesting to see trends in the types of activities that individuals feel most generative participating in. Additionally, it would be useful to know in what ways individuals validate themselves throughout life as Rollo May asserts that individuals must realize they are on their own and not depend on the validation from other people. Some potential areas for study could be activities that provide the most validity to individuals and how males and females search for validity in differentiating ways. John Kotre asserts that there are several types of generativity and some potential studies could include whether an individual acts for the good of society or for selfish purposes or what types of generativity are most common (communal, agentic, etc.).

CHRONIC ILLNESS IN MIDDLE AGE

One major theme that is associated with becoming middle aged is that the aging process begins to visibly start to show. An example of this would be the wrinkling of the skin. One developmental milestone of this age range is the onset of chronic illnesses and diseases. Both can be associated with lifestyle and life choices that start to take their toll on the human anatomy. Future studies of how to prevent and minimize the use of substances over the lifespan could help with stemming the tide of developing chronic diseases at middle adulthood. Also examining non-substance related factors by learning the percentages of non-smokers and drinkers who have eaten properly, exercised on a regular basis and still were diagnosed with a chronic condition will help us understand other risk factors. The ultimate goal of this research is to learn how we reduce the 70% of all deaths in the United States due to the different chronic illnesses.

 “The Aging Process” of Middle Adulthood

A reflective analysis of the biological changes that occur during the aging process of the lifespan period known as “middle adulthood” presents the following universal developments: visible aging in physical appearance, varied loss of body mobility, and periodic changes in reproductive/sexual functioning. Research and discussions conducted by our group investigation into this human developmental stage concluded that individuals amongst the ages of 45-60 will experience a rate of physical decline relating to the effects of the aging process.
A critical examination of these processes revealed that the individual rates of change in these different body systems vary significantly from one middle adult to the next and may be significantly influenced by environmental/social factors. Our team identified three major areas for further examination: psychological factors such as stress and activity, sociological factors such as cultural perceptions of aging, and spiritual factors such as generative practices of fulfillment.

An interview with a recently graduated medical doctor referenced how the psychological health of an individual in middle adulthood, specifically related to chronic stress, can have a critical impact on the aging process. Research connected to this concept found that the overproduction of the stress hormone cortisol has been shown to deteriorate telomere lengths leading to accelerated aging on a cellular level. The practice of meditation and mindfulness presents one method addressed by our research that has demonstrated a minimization of the effects of chronic stress on the aging of middle adults. Much of the current treatment for stress-related care revolves around the psychiatric prescription of medication, a resource that many
socioeconomically challenged demographics do not have access to. Future studies could address alternative or more universally accessible means of minimizing the harmful effects of stress i.e diet, exercise, improving environmental conditions.

Research indicated that the various effects of aging on skin and bone density vary amongst different races and ethnicities once they reach middle adulthood. Additionally, different regional cultures outside of the pervasive western worldview present more positive or deferential considerations of developmental milestones exhibited during middle adulthood such as the perception of menopause as a liberating spiritual process. Future studies could conduct examinations of whether or not these ethnocultural differences stem more from inherent genetics or external practices/beliefs (a nature vs. nurture comparison). More specific research could also examine the rates of aging for various racial/ethnic demographics residing here in America
compared to populations living in countries of origin.

The theme of spiritual fulfillment through generativity existed as an overlapping concept in a few of our specific research areas. Conducting studies that examine the more subtle spiritual practices of middle adults, specifically related to what activities or beliefs they consider sacred and transcendent, could inform how the notions of fulfillment and generative purpose influence the experience of middle adulthood. This future research could help expand the conception of spirituality while identifying potential trends or relative impacts on quality of life in middle adulthood.

PSYCHOLOGICAL FACTORS, MENTAL ILLNESS AND SUICIDE IN MIDDLE ADULTHOOD

There are two main definitions of middle adulthood. One is referred to as a period of peaks and new goal setting (Freund & Ritter, 2011, p.583). The other interpretation of middle adulthood is a period of difficult transitions and losses (Freund & Ritter, 2011, p.583). Middle adulthood is most commonly referred to ages 40 to 64. According to Freund and Ritter (2011), 92% of middle adults believe there is a midlife crisis and 71% of middle adults know someone who has experienced a midlife crisis (p.583). A midlife crisis is defined as personality change where an individual loses a sense of identity, values, roles, and association to groups (Freund & Ritter, 2011, p.584). A major criticism of midlife crisis is that gains and losses are believed to be normal occurrences throughout a lifespan. Moreover, inability to adapt to changes that are experienced is defined as a crisis that may happen at any age (Freund & Ritter, 2011, p.586)

The ultimate goal during middle adulthood is to sustain healthy well-being. Well-being in middle adulthood is categorized among six categories including self-acceptance, positive relationships, autonomy, and mastery over challenges. Like Lachman, Willis and Martin (2005), stated that psychological well-being is conceptualized as life satisfaction, purpose, mastery and future expectations (p.147). Recommendations to achieve healthy well-being and preventing the sense of a midlife crisis in middle adulthood are reframing and age-normative shift (Lachman, 2001).

If adaptive strategies, such as reframing or age-normative shift are not accomplished then the mental health of middle adults may be compromised. The common mental health illness among middle adulthood is depression (Willis & Marin, 2005, p.222). A research study estimated that 3,000 middle aged adults displayed depressive symptoms (Willis & Marin, 2005). Depression can lead to substance abuse or suicide if untreated. Adults aged 40 to 54 had the highest risk of death by suicide during 1999-2007 (Daniel & Goldston, 292). According to Substance Abuse and Mental Health Services Administration (2009), half of 2.2 million adults aged 50 and older used marijuana, 28 percent used only prescription drugs, and 17 percent used cocaine (Blank, p.2). It is imperative for middle adults to redefine personal goals and not allow losses to determine their well-being.

INTELLECTUAL AND PERSONALITY CHANGES

Studies have consistently shown that middle adulthood is not a time of significant change in intellectual functioning or personality for most individuals. Gains and loses are for the most part balanced in these areas. Despite the research indicating stability in theses areas, there is still a perception of cognitive decline in middle age and the concept of the midlife crisis persists.

Several risk and protective factors can influence the degree of cognitive change for middle adults. When working with this age group, it is important to be aware of these factors and ways to enhance capacities and mitigate risks. Two of the protective capacities, level of education and cognitive challenge at work, may be less accessible to lower income individuals and future research should examine other ways for people with less access to education and a variety of jobs to protect against decline. Additionally, many of the risk factors for decline are related to physical health, so individuals without access to medical care will likely be more affected by these. Because of these issues, socioeconomic status may play a role in the level of cognitive change at this age. Work to understand disparities based on demographics and cross culturally will enhance understanding and perhaps lead to findings of more varied protective factors.

During middle adulthood the function of the brain changes in two main ways. First, the process of bilateralization, or using two hemispheres to accomplish the same cognitive task previously completed by one hemisphere, starts to occur. Secondly, changes in the function of the amygdala occur so that the ability to regulate emotions is increased. The result of these two changes can lead to better decision-making, more optimism and creative solving problems. Bilateralization compensates for loss of function in other areas of the brain so that a person can continue to maintain his current level of cognitive performance. Scientists do not yet understand why bilateralization occurs in some individuals and not others, only that people who experience the phenomenon perform better on tests of cognitive function. Discovering the root of these differences may lead to the ability to trigger or enhance bilateralization in all middle adults.

Cross cultural studies show that personality in middle adulthood tends to remain stable. The concept of a midlife crisis persists in American culture and there are adjustments in midlife that can be viewed as losses, such as change in physical appearance, family role and work life. Researchers identify that some people are better able to cope with these changes, while others do experience more distress in the transition to middle adulthood. All the risk factors for a negative experience in this transition are not yet understood. Discovering what traits help a person cope and maintain a balanced identity during middle adulthood will help in work with individuals who struggle with the transition. Understanding the cultural attachment to the idea of a midlife crisis despite research that it is not a common part of middle adulthood would also be an interesting area for social researchers to explore.

THE SANDWICH GENERATION AND GRAY DIVORCE

Through the research gathered on middle adulthood and the Gray Divorce phenomenon, a major factor in the shift in the norms for middle aged couples is the increase in life expectancy. Underlying aspects of longer life expectancy are what essentially seem to be affecting the shift in the marital structures of the middle aged. For instance, late-life divorce, is primarily an effect of developmental issues associated with personal growth in old age. The ideal of lifelong marriage is becoming obsolete, because the demand for receiving personal gratification through marriage appears incompatible with single, lifelong marriages. Basically people are constantly changing, and with more time to grow and change, there is more opportunity to shift away from the ideals of your younger years and those of your partner. Lifelong marriage was a viable expectation in an era when life expectancy was comparatively short and marriages were based on economic interdependence. Without the financial interdependence in middle aged years, there are few, if any, legitimate reason to stay together. Children are typically grown and both partners working.  More than prolonged life itself, a more accurate reading of contributing factors of Gray Divorce would be, the effects of prolonged life. Future studies that developed and tested how prolonged life affected not only marriage, but the emotional and mental psyche of the elderly would shed more light on the reasons for phenomenons such as the Gray Divorce Revolution.

The Sandwich Generation seems to be caused by a multitude of codependent factors. Like the Gray Divorce Revolution, prolonged life expectancy is a major one, but as is delayed childbirth. Prolonged life and late childbirth has caused an overlapping of generations. Middle aged adults are taking care of elderly parents and their children. The literature does not give conclusive reasons as to why families have taken on the responsibility of the direct day to day needs of caring for an elderly parent, but one can infer that there has been a shift in cultural norms and expectations across all ethnicities. The literature shows that regardless of economic means, Asians, Blacks, Whites, and Hispanics have a vested interest and hand in the care of their elder family members. It could be that there are more elderly so it is a more prominent phenomenon or there has been a legitimate shift in social expectations. Deciphering between the two possibilities would be an interesting angle to study and test.

SOCIAL, INTIMATE, AND WORK RELATIONSHIPS

In Middle Adulthood, social life, employment, and intimacy levels in relationships are vital components of life. These particular relationships bring a sense of life to middle adults, also allowing time for self-reflection for past and future life choices they have made. It is during midlife where adults tend to have larger members in their social circles than young adults, but report having fewer important friendships (Hutchinson et al., 2011). Friendships appear to have a great impact on the lives of middle-age adults as they can provide great benefactors such as healthy physical fitness for me and overall satisfaction for women (Hutchinson et al., 2011). Hutchinson et al., (2011) also found that the importance of friends do vary by race, sexual orientation, and marital status. Friends also serve as a chosen family for middle adults. Employment plays an important role for midlife adults in many parts of the world for men and women alike (Dittman-Kohli, 2005; Kin & Moen, 2001). Work status during this time begins to change drastically due to earlier periods of retirement, shifts in career paths due to midlife crisis, shifts in familial patterns, and re-entry into the educational system. It is imperative that middle adults remain active, even during retirement, to keep steady pace and greater overall satisfaction with life once moving into late adulthood. Research has indicated that loss of work in middle adulthood is a very critical life event that has negative consequences for emotional well-being. Also among companions, it is during middle adulthood where intimacy is a very important determinant in the overall sexual satisfaction. Marriage during this age period is like a roller coaster. Marital satisfaction decreases during childbearing years, and increases from middle to late adulthood. As age increases, people usually have less sexual intercourse with their partner and many biological factors begin to occur in men and women such as erectile dysfunction and vaginal dryness. However, “foreplay” becomes widely accepted during this period because the sexual desire does not decrease. Hormones are still highly functioning (with the exemption of women suffering from menopause), and these adults still have sexual needs to be met. It is during this development stage where intimacy is just as important as physical health in regards to overall sexual satisfaction among middle-aged adults. 

It was extremely surprising to see how vast relationships affect the lives of middle-ages adults. The research gathered studied the various stages of each type of relationship; however, future studies may want to examine the extent of  which relationships that have a direct effect on the level of intimacy issues experienced. This information may reveal how different middle-aged adults view the importance of relationships in their everyday lives. Social workers examine all types of relationships and their correlation to the lives of their clients.