Hostname: page-component-586b7cd67f-rcrh6 Total loading time: 0 Render date: 2024-11-25T04:13:55.002Z Has data issue: false hasContentIssue false

Emotion regulation processes as mediators of the impact of past life events on older adults’ psychological distress

Published online by Cambridge University Press:  23 January 2020

Virginia Fernández-Fernández*
Affiliation:
Department of Psychology of the Personality, Evaluation and Psychological Treatment, Universidad Nacional de Educación a Distancia (UNED), Madrid, Spain
Andrés Losada-Baltar
Affiliation:
Department of Psychology, Universidad Rey Juan Carlos, Madrid, Spain
María Márquez-González
Affiliation:
Department of Biological and Health Psychology, Universidad Autónoma de Madrid, Madrid, Spain
Teresa Paniagua-Granados
Affiliation:
Faculty of Education and Psychology, Universidad Francisco de Vitoria, Madrid, Spain
Carlos Vara-García
Affiliation:
Department of Psychology, Universidad Rey Juan Carlos, Madrid, Spain
Octavio Luque-Reca
Affiliation:
Department of Psychology, Universidad Rey Juan Carlos, Madrid, Spain
*
Correspondence should be addressed to: Virginia Fernández-Fernández, Department of Psychology of the Personality, Evaluation and Psychological Treatment, Universidad Nacional de Educación a Distancia (UNED), Madrid 28040, Spain. Phone: +34913986292. Email: [email protected].

Abstract

Objective:

Although it is known that certain emotion regulation processes produce a buffering effect on the relationship between life events and well-being, this issue has been poorly studied in the elderly population. Thus, the aim of the present study is to test and confirm a comprehensive model of the impact that past life events have on older adults’ psychological distress, exploring the possible mediating roles of emotion regulation processes. These include rumination, experiential avoidance, and personal growth.

Methods:

In this cross-sectional study, 387 people over 60 years old residing in the community were assessed on life events, physical functioning, emotion regulation variables, psychological well-being, as well as symptoms of anxiety and depression.

Results:

The structural model tested achieved a satisfactory fit to the data, explaining 73% of the variance of older adults’ psychological distress. In addition, the main results suggest possible mediation effects of both the physical functioning and the emotional variables: rumination, experiential avoidance, and personal growth in the face of hardship.

Conclusions:

These findings confirm the importance of emotion regulation processes in the final stages of life. They reveal the various adaptive and maladaptive mechanisms that underlie the relationship between life events and psychological distress. The findings suggest – both in the explanatory models of psychological well-being and in psychotherapeutic interventions – the importance of emotion regulation in the elderly population’s health.

Type
Original Research Article
Copyright
© International Psychogeriatric Association 2020 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Abramson, L.Y., Metalsky, G.I., and Alloy, L.B. (1989). Hopelessness depression: a theory-based subtype of depression. Psychological Review, 96, 358372. doi: 10.1037/0033-295x.96.2.358 CrossRefGoogle Scholar
Abravanel, B.T. and Sinha, R. (2015). Emotion dysregulation mediates the relationship between lifetime cumulative adversity and depressive symptomatology. Journal of Psychiatric Research, 61, 8996. doi: 10.1016/j.jpsychires.2014.11.012 CrossRefGoogle ScholarPubMed
Aldao, A. and Nolen-Hoeksema, S. (2012). When are adaptive strategies most predictive of psychopathology? Journal of Abnormal Psychology, 121, 276281. doi: 10.1037/a0023598 CrossRefGoogle ScholarPubMed
Alonso, J., Prieto, L., and Antó, J.M. (1995). La versión española del SF-36 Health Survey (Cuestionario de Salud SF!36): Un instrumento para la medida de los resultados clínicos. Medicina clínica, 104, 771776.Google Scholar
Baltes, P.B., Lindenberger, U., and Staudinger, U.M. (1998). Life-span theory in developmental psychology. In: Lerner, R.M. (Ed.) Handbook of Child Psychology (pp. 10291143). Nueva York: Wiley & Sons.Google Scholar
Bardeen, J.R. and Fergus, T.A. (2016). The interactive effect of cognitive fusion and experiential avoidance on anxiety, depression, stress and posttraumatic stress symptoms. Journal of Contextual Behavioral Science, 5, 16. doi: 10.1016/j.jcbs.2016.02.002 CrossRefGoogle Scholar
Barraca, J. (2004). Spanish adaptation of the Acceptance and Action Questionnaire (AAQ). International Journal of Psychology and Psychological Therapy, 4, 505515.Google Scholar
Berghoff, C.R. et al. (2017). The role of experiential avoidance in the relation between anxiety disorder diagnoses and future physical health symptoms in a community sample of young adult women. Journal of Contextual Behavioral Science, 6, 2934. doi: 10.1016/j.jcbs.2016.11.002 CrossRefGoogle Scholar
Bernstein, K., Park, S.Y., and Nokes, K.M. (2017). Resilience and depressive symptoms among Korean Americans with history of traumatic life experience. Community Mental Health Journal, 53, 593801. doi: 10.1007/s10597-017-0142-7 CrossRefGoogle ScholarPubMed
Blonski, S.C. et al. (2016). Associations between negative and positive life events and the course of depression: A detailed repeated-assessments study. The Journal of Nervous and Mental Disease, 204, 175180. doi: 10.1097/NMD.0000000000000445 CrossRefGoogle ScholarPubMed
Bollen, K.A. (1987). Total, direct, and indirect effects in structural equation models. Sociological Methodology, 17, 3769. doi: 10.2307/271028 CrossRefGoogle Scholar
Bonanno, G.A., Westphal, M., and Mancini, A.D. (2011). Resilience to loss and potential trauma. Annual Review of Clinical Psychology, 7, 511535. doi: 10.1146/annurev-clinpsy-032210-104526 CrossRefGoogle ScholarPubMed
Browne, M.W. and Cudeck, R. (1993). Alternative ways of assessing model fit. In: Bollen, K.A. and Long, J.S. (Eds.), Testing Structural Equation Models (pp. 136162). Beverly Hills, CA: Sage.Google Scholar
Buunk, B.P., Gibbons, F.X., and Buunk, A. (2013). Health, Coping, and Wellbeing: Perspectives from Social Comparison Theory. New York: Psychology Press.CrossRefGoogle Scholar
Calhoun, L.G. and Tedeschi, R.G. (2014). Handbook of Posttraumatic Growth: Research and Practice. New York: Routledge.CrossRefGoogle Scholar
Chou, W.P., Yen, C.F., and Liu, T.L. (2018). Predicting effects of psychological inflexibility/experiential avoidance and stress coping strategies for internet addiction, significant depression, and suicidality in college students: a prospective study. International Journal of Environmental Research and Public Health, 15, 788. doi: 10.3390/ijerph15040788 CrossRefGoogle ScholarPubMed
Cohen, J. (1988). Statistical Power Analysis for the Behavioral Sciences (2nd ed.). Hillsdale, NJ: Lawrence Erlbaum Associates.Google Scholar
Cohen, S., Murphy, M.L.M., and Prather, A.A. (2018). Ten surprising facts about stressful life events and disease risk. Annual Review of Psychology, 70, doi: 10.1146/annurev-psych-010418-102857 Google ScholarPubMed
Connolly, S.L. and Alloy, L.B. (2018). Negative event recall as a vulnerability for depression: relationship between momentary stress-reactive rumination and memory for daily life stress. Clinical Psychological Science, 6, 3247. doi: 10.1177/2167702617729487 CrossRefGoogle ScholarPubMed
Cutrona, C., Russell, D., and Rose, J. (1986). Social support and adaptation to stress by the elderly. Psychology and Aging, 1, 4754. doi: 10.1037/0882-7974.1.1.47 CrossRefGoogle ScholarPubMed
Dekel, S., Ein-Dor, T., and Solomon, Z. (2012). Posttraumatic growth and posttraumatic distress: a longitudinal study. Psychological Trauma: Theory, Research, Practice, and Policy, 4, 94. doi: 10.1037/a0021865 CrossRefGoogle Scholar
Díaz, D. et al. (2006). Adaptación española de las escalas de bienestar psicológico de Ryff. Psicothema, 18, 572577.Google Scholar
Dulin, P. and Passmore, T. (2010). Avoidance of traumatic material mediates the relationship between accumulated lifetime trauma and late life depression and anxiety. Journal of Traumatic Stress, 23, 296300. doi: 10.1002/jts.20512 Google Scholar
Eisma, M.C. et al. (2017). Does worry affect adjustment to bereavement? A longitudinal investigation. Anxiety, Stress and Coping, 30, 243252. doi: 10.1080/10615806.2016.1229464 CrossRefGoogle ScholarPubMed
Faber, P. (2015). Active Ageing: A Policy Framework in Response to the Longevity Revolution. Rio de Janeiro: International Longevity Centre Brazil.Google Scholar
Ferguson, S.J., Taylor, A.J., and McMahon, C. (2017). Hope for the future and avoidance of the present: associations with well-being in older adults. Journal of Happiness Studies, 18, 14851506. doi: 10.1007/s10902-016-9787-0 CrossRefGoogle Scholar
Fernández-Fernández, V. et al. (2013). Diseño y validación de las escalas de evaluación del impacto psicológico de sucesos vitales pasados: el papel del pensamiento rumiativo y el crecimiento personal. Revista Española de Geriatría y Gerontología, 48, 161170. doi: 10.1016/j.regg.2013.03.006 CrossRefGoogle Scholar
Folkman, S. (2008). The case for positive emotions in the stress process. Anxiety, Stress, and Coping, 21, 314. doi: 10.1080/10615800701740457 CrossRefGoogle ScholarPubMed
Garson, G.D. (2012). Structural Equation Modeling. Asheboro, NC: Statistical Associates Publishers.Google Scholar
Graham, J.W. (2009). Missing data analysis: making it work in the real world. Annual Review of Psychology, 60, 549576. doi: 10.1146/annurev.psych.58.110405.085530 CrossRefGoogle ScholarPubMed
Hayes, S.C. et al. (2000). Psychometric Properties of the Acceptance and Action Questionnaire (AAQ). Unpublished manuscript.Google Scholar
Hayes, S.C. et al. (2004). Measuring experiential avoidance: a preliminary test of a working model. The Psychological Record, 54, 553578. doi: 10.1007/BF03395492 CrossRefGoogle Scholar
Hooper, D., Coughlan, J., and Mullen, M. (2008). Structural equation modelling: guidelines for determining model fit. Electronic Journal of Business Research Methods, 6, 5360.Google Scholar
Jackson, B. and Nolen-Hoeksema, S. (1998). The Emotion-Focused Coping Questionnaire. Unpublished manuscript, University of Michigan.Google Scholar
Jöreskog, K.G. (1993). Testing structural equation models. In: Bollen, K.A., and Long, J.S. (Eds.), Testing Structural Equation Models (pp. 294316). Thousand Oaks, CA: Sage.Google Scholar
Kleiman, E.M., Riskind, J.H., and Schaefer, K.E. (2014). Social support and positive events as suicide resiliency factors: examination of synergistic buffering effects. Archives of Suicide Research, 18, 144155. doi: 10.1080/13811118.2013.826155 CrossRefGoogle ScholarPubMed
Kline, R.B. (2015). The mediation myth. Basic and Applied Social Psychology, 37, 202213. doi: 10.1080/01973533.2015.1049349 CrossRefGoogle Scholar
Krause, N., Shaw, B.A., and Cairney, J. (2004). A descriptive epidemiology of lifetime trauma and the physical health status of older adults. Psychology and Aging, 19, 637648. doi: 10.1037/0882-7974.19.4.637 CrossRefGoogle ScholarPubMed
Laloyaux, J. et al. (2016). Maladaptive emotion regulation strategies and stress sensitivity mediate the relation between adverse life events and attenuated positive psychotic symptoms. Cognitive Neuropsychiatry, 21, 116129. doi: 10.1080/13546805.2015.1137213 CrossRefGoogle ScholarPubMed
Lazarus, R.S. and Folkman, S. (1984). Stress, Appraisal, and Coping. New York: Springer.Google Scholar
Lee, J. et al. (2018). An exploration of posttraumatic growth, loneliness, depression, resilience, and social capital among survivors of Hurricane Katrina and the Deepwater Horizon Oil Spill. Journal of Community Psychology. doi: 10.1002/jcop.22125 Google ScholarPubMed
Lerebours, E. et al. (2007). Stressful life events as a risk factor for inflammatory bowel disease onset: a population-based case–control study. The American Journal of Gastroenterology, 102, 122131. doi: 10.1111/j.1572-0241.2006.00931.x CrossRefGoogle ScholarPubMed
Luhmann, M. et al. (2012). Subjective well-being and adaptation to life events: a meta-analysis. Journal of Personality and Social Psychology, 102, 592. doi: 10.1037/a0025948 CrossRefGoogle ScholarPubMed
Márquez-González, M. et al. (2012). Psychometric properties of the Spanish version of the Geriatric Anxiety Inventory. International Psychogeriatrics, 24, 137144. doi: 10.1017/S1041610211001505 CrossRefGoogle ScholarPubMed
McCarthy, M.J. et al. (2016). Age, subjective stress, and depression after ischemic stroke. Journal of Behavioral Medicine, 39, 5564. doi: 10.1007/s10865-015-9663-0 CrossRefGoogle ScholarPubMed
Michl, L.C. et al. (2013). Rumination as a mechanism linking stressful life events to symptoms of depression and anxiety: longitudinal evidence in early adolescents and adults. Journal of Abnormal Psychology, 122, 339. doi: 10.1037/a0031994 CrossRefGoogle ScholarPubMed
Moberly, N.J. and Watkins, E.R. (2008). Ruminative self-focus, negative life events, and negative affect. Behavioral Research Therapy, 46, 1034–39. doi: 10.1016/j.brat.2008.06.004 CrossRefGoogle ScholarPubMed
Monserud, M.A. and Markides, K.S. (2017). Changes in depressive symptoms during widowhood among older Mexican Americans: the role of financial strain, social support, and church attendance. Aging and Mental Health, 21, 586594. doi: 10.1080/13607863.2015.1132676 CrossRefGoogle ScholarPubMed
Nam, I. (2016). Suicide bereavement and complicated grief: experiential avoidance as a mediating mechanism. Journal of Loss and Trauma, 21, 325334. doi: 10.1080/15325024.2015.1067099 CrossRefGoogle Scholar
Nolen-Hoeksema, S., Wisco, B.E., and Lyubomirsky, S. (2008). Rethinking rumination. Perspectives on Psychological Science, 3, 400424. doi: 10.1111/j.1745-6924.2008.00088.x CrossRefGoogle ScholarPubMed
Pachana, N.A., Byrne, G.J., Siddle, H., Koloski, N., Harley, E., and Arnold, E. (2006). Development and validation of the Geriatric Anxiety Inventory. International Psychogeriatrics, 19, 103114. doi: 10.1017/s1041610206003504 CrossRefGoogle Scholar
Petkus, A., Gum, A., and Wetherell, J.L. (2012). Thought suppression is associated with psychological distress in homebound older adults. Depression and Anxiety, 29, 219225. doi: 10.1002/da.20912 CrossRefGoogle ScholarPubMed
Podsakoff, P.M. et al. (2003). Common method biases in behavioral research: a critical review of the literature and recommended remedies. Journal of Applied Psychology, 88, 879903. doi: 10.1037/0021-9010.88.5.879 CrossRefGoogle ScholarPubMed
Pruchno, R., Heid, A.R., and Wilson-Genderson, M. (2017). The Great Recession, life events, and mental health of older adults. The International Journal of Aging and Human Development, 84, 294312. doi: 10.1177/0091415016671722 CrossRefGoogle ScholarPubMed
Radloff, L. S. (1977). The CES-D Scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385401. doi: 10.1177/014662167700100306 CrossRefGoogle Scholar
Rebok, G.W., Parisi, J.M., and Kueider, A.M. (2014). Stressors and vulnerabilities in middle and old age: opportunities for prevention. In Defining Prevention Science (pp. 113133). Springer, Boston, MA.CrossRefGoogle Scholar
Reed, R.G. and Raison, C.L. (2016). Stress and the immune system. In: Esser, C. (Ed.), Environmental Influences on the Immune System (pp. 97126). Vienna: Springer.CrossRefGoogle Scholar
Ruscio, A.M. et al. (2015). Rumination predicts heightened responding to stressful life events in major depressive disorder and generalized anxiety disorder. Journal of Abnormal Psychology, 124, 1726. doi: 10.1037/abn0000025 CrossRefGoogle ScholarPubMed
Ryff, C.D. (1989). Happiness is everything, or is it? Explorations on the meaning of psychological well-being. Journal of Personality and Social Psychology, 57, 10691081. doi: 10.1037/0022-3514.57.6.1069 CrossRefGoogle Scholar
Segerstrom, S.C. et al. (2015). Repetitive thought dimensions, psychological well-being, and perceived growth in older adults: a multilevel, prospective study. Anxiety, Stress, and Coping, 28, 287302. doi: 10.1080/10615806.2014.947285 CrossRefGoogle ScholarPubMed
Shrira, A., Shmotkin, D., and Litwin, H. (2012). Potentially traumatic events at different points in the life span and mental health: findings from SHARE-Israel. American Journal of Orthopsychiatry, 82, 251259. doi: 10.1111/j.1939-0025.2012.01149.x CrossRefGoogle ScholarPubMed
Stange, J.P. et al. (2016). Inflexible cognition predicts first onset of major depressive episodes in adolescence. Depression and Anxiety, 33, 10051012. doi: 10.1002/da.22513 CrossRefGoogle ScholarPubMed
Sun, X.J. et al. (2017). Gender, negative life events and coping on different stages of depression severity: a cross-sectional study among Chinese university students. Journal of Affective Disorders, 209, 177181. doi: 10.1016/j.jad.2016.11.025 CrossRefGoogle ScholarPubMed
Tak, L.M. et al. (2015). Age- and sex-specific associations between adverse life events and functional bodily symptoms in the general population. Journal of Psychosomatic Research, 79, 112116. doi: 10.1016/j.jpsychores.2015.05.013 CrossRefGoogle ScholarPubMed
Thoits, P.A. (2010). Stress and health: Major findings and policy implications. Journal of Health and Social Behavior, 51, S41S53. doi: 10.1177/0022146510383499 CrossRefGoogle ScholarPubMed
Topper, M. et al. (2017). Prevention of anxiety disorders and depression by targeting excessive worry and rumination in adolescents and young adults: a randomized controlled trial. Behaviour Research and Therapy, 9, 123136. doi: 10.1016/j.brat.2016.12.015 CrossRefGoogle Scholar
Triplett, K.N. et al. (2012). Posttraumatic growth, meaning in life, and life satisfaction in response to trauma. Psychological Trauma: Theory, Research, Practice, and Policy, 4, 400. doi: 10.1037/a0024204 CrossRefGoogle Scholar
Ullman, J.B. (2006). Structural equation modeling. In: Tabachnick, B.G. and Fidell, L.S. (Eds.), Using Multivariate Statistics (5th ed., pp. 653771). Boston: Allyn & Bacon.Google Scholar
Vanderhasselt, M.-A., Brose, A., Koster, E.H.W., and De Raedt, R. (2016). Co-variation between stressful events and rumination predicts depressive symptoms: an eighteen months prospective design in undergraduates. Behaviour Research and Therapy, 87, 128133. doi: 10.1016/j.brat.2016.09.003 CrossRefGoogle ScholarPubMed
Verkuil, B. et al. (2010). When worries make you sick: a review of perseverative cognition, the default stress response and somatic health. Journal of Experimental Psychopathology, 1, 87118. doi: 10.5127/jep.009110 CrossRefGoogle Scholar
Vogelzangs, N. et al. (2007). Psychosocial risk factors and the metabolic syndrome in elderly persons: findings from the Health, Aging and Body Composition study. The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, 62, 563569. doi: 10.1093/gerona/62.5.563 CrossRefGoogle ScholarPubMed
Ware, J.E. and Sherbourne, C.D. (1992). The MOS 36-ltem Short-Form Health Survey (SF-36). Medical Care, 30, 473483. doi: 10.1097/00005650-199206000-00002 CrossRefGoogle Scholar
Watkins, E.R. et al. (2011). Rumination-focused cognitive-behavioural therapy for residual depression: phase II randomised controlled trial. British Journal of Psychiatry, 199, 317322. doi: 10.1192/bjp.bp.110.090282 CrossRefGoogle ScholarPubMed
Wong, J.S. and Waite, L.J. (2016). Elder mistreatment predicts later physical and psychological health: results from a national longitudinal study. Journal of Elder Abuse and Neglect, 29, 1542. doi: 10.1080/08946566.2016.1235521 CrossRefGoogle Scholar
World Health Organization (2015). World Report on Ageing and Health. Luxembourg: World Health Organization.Google Scholar
Yoshiuchi, K. et al. (2010). Stressful life events and habitual physical activity in older adults: 1-year accelerometer data from the Nakanojo Study. Mental Health and Physical Activity, 3, 2325. doi: 10.1016/j.mhpa.2010.02.001 CrossRefGoogle Scholar