‘Growing Down’

· Chapter 13 Broderick & Blewitt: Chapter 13

Middle Adulthood: Cognitive, Personality, and Social Development

Amanda and Anthony, an African American couple, are both 50. They have been married for 20 years, and they agree that their relationship is strong and loving. Amanda, who did not attend college, currently works as an administrative assistant for the CEO of a small company. When their children were younger she worked as a classroom aide in the local elementary school so that she would have a shorter working day. Anthony is the security supervisor at a large university hospital, and he enjoys the work. His career was interrupted once when the rural hospital where he had his first security job closed. He was out of work for five months, and the family was forced to move to a larger urban area in order for him to find another position. Anthony feels valued in his current job, although he works very hard, putting in long hours at times, to keep it that way. The couple has three children, ages 12, 13, and 15. Through the years of their marriage, Amanda and Anthony have had similar ideas about child rearing, presenting a united front on matters of discipline and sharing the many responsibilities of child care. They have also shared household chores, albeit in somewhat stereotypical ways: Amanda does most of the meal prep and house cleaning, they both have grocery shopping and laundry duties, and Anthony takes care of their small yard and all house and car repairs. There are two “bones of contention” that create recurring friction between them. First, they have different ideas about how conservative they need to be in their spending, with Anthony often buying impulsively (like an expensive new fishing rod or other gear for his hobbies) without consulting Amanda, who worries about saving for the kids’ education and for retirement (and, heaven forbid, another employment setback). Second, the way they split their household duties was established when Amanda had shorter working hours and less responsibility at work. Now she works long days, and her boss, who appreciates her organizational skills, counts on her more and more to keep his busy office running smoothly. She finds the job (and her boss’s respect and recognition) quite gratifying, but she wants Anthony to take on more of the house cleaning to help balance the longer hours. She also argues that clipping hedges or changing the car’s oil occasionally are way less taxing than the day-to-day need to keep bathrooms clean and dishes washed. Anthony feels that he needs time to unwind and pursue his hobbies, so that he can work as effectively as possible at his job. And, after all, he points out, he does earn the higher income. Unfortunately, the strain of their intensified disagreement about this issue comes at a time when the children are all moving into adolescence and presenting their parents with the many challenges their stage of development brings.

What is the nature of development at midlife? This is a perplexing question because adult lives are complex and multifaceted. Adults seek out jobs, select them, and sometimes ascend to positions of responsibility in their fields of work. Adults also change employment voluntarily to work in other settings or in other careers. Some adults lose their jobs and may experience unemployment or underemployment. Some work at multiple jobs. Adults take on leadership, executive, or mentoring roles in their communities. Adults move from one location to another, historically now more than ever before. They marry, cohabitate, divorce, date, and often go on to marry again. Some adults have children and grandchildren; others are childless. Adults may have responsibilities for the care of their own aging parents. Those who are parents or stepparents have to deal with the ever-changing developmental needs of their children. Adults are also affected by the close relationships they share with partners or friends. They may experience financial difficulties. They may sustain illness themselves or experience the illness or loss of loved ones. Some adults experience catastrophic events, such as wars, accidents, or natural disasters. Many more deal with chronic adversities such as discrimination of one sort or another, mental problems such as depression, or simply the gradual physical changes involved in the aging process. Moreover, many of these events occur simultaneously.

The complexity of people’s experience and functioning is what is most striking about middle adulthood. How are we to make sense of all the variables operating in adult lives? Is there some coherent scheme that helpers can use to understand development in the adult years? In Chapter 1, we examined some of the many theoretical approaches that explain developmental processes, including stage models, such as Erikson’s or Piaget’s, and incremental models, such as learning and information processing accounts. As we have seen throughout this book, these approaches to development can be quite helpful in understanding some aspects of psychological functioning, but modern theorists typically turn to multidimensional models, which are focused on the complexity of interrelated causal processes in development. Recall in Bronfenbrenner’s multidimensional model, for example, the description of proximal processes in development—reciprocal interactions between an “active, evolving biopsychological human organism and the persons, objects, and symbols in its immediate environment” (Bronfenbrenner & Morris, 1998, p. 996). These proximal processes are modified by more distal processes, some within the organism, such as genes, and some outside the organism, such as the family, the workplace, the community, the broader economic and political context, and other aspects of the culture. As we saw in Chapter 1, multidimensional theories of adult development, called life span developmental theories or models, address all the fundamental questions of development, including the role of heredity and environment in adulthood and the extent to which adult characteristics are continuous with previous traits and propensities versus how much genuine change there is in adult behavior. Life span developmental models (e.g., Baltes, Lindenberger, & Staudinger, 2006) make one fundamental assumption in addressing such questions—that from birth to death, adaptation continues. The development of psychological functioning does not end or become fixed when adulthood is reached, but goes on until death. The reciprocal interaction of many biological and environmental factors forms an ever-changing “architecture” or scaffolding that supports the development of behavioral and mental functioning (e.g., Baltes et al., 2006). Thus, middle adulthood is not some kind of holding pattern before the slide into death. An adult’s cognitive and socioemotional functioning continues to evolve through her 30s, 40s, 50s, and beyond.

Life Span Developmental Theory

Life span developmental theory provides an overarching framework for understanding how middle adult life is linked to the childhood years, on one hand, and to old age, on the other. It can be construed as a kind of macrotheory under whose umbrella all the processes of ontogeny, or the development of organisms, fall into place. This orientation offers a clear benefit to those in the helping professions. First, it provides a way of organizing developmental processes across the life cycle. Think of the multiplicity of challenges and possibilities in adult life, some of which we mentioned at the beginning of this chapter. Rather than viewing them as disconnected parts of a life story, helpers can interpret the choices people make and the ways they adapt as reflecting some degree of lawful continuity. Second, life span developmental theory emphasizes the importance of learning about successful or effective development. Thus, this perspective fits well with therapeutic or psychoeducational goals. Let’s now consider some of the elements of life span developmental theory.

Gains and Losses in Development: The Changing Architecture of Biology and Culture

Natural selection through many generations has created a biological trajectory that tends to optimize development in most typical environments, allowing the majority of individuals to grow up and become fully functioning adults who can contribute to the success of the species by reproducing. Of course, basic cultural supports—adequate parenting, nutrition, education, protection from environmental hazards, and so on—are fundamental for the success of this process as well. As individuals move through adulthood, the biological supports for life weaken because the reproductive process is complete, and the selection pressure that the need for reproductive success creates for a species is no longer operative. Thus, biological dysfunctions are more likely. “Evolution and biology are not good friends of old age” (Baltes, 1997, p. 368). During middle adulthood (defined here as ages 30 to 55), people begin to depend more and more on cultural supports for adequate functioning. Indeed, “old age” exists primarily because of modern culture. Advances in economics, nutrition, general knowledge, technology, and medicine have compensated for the weakening of the biological supports for life. As a result, from 1900 to 1995, the average life span increased in Western societies from about 45 years to around 75 years! For the U.S. population, life expectancy at birth increased to 76.6 (males) and 81.2 (females) by 2015, with some notable racial disparities. For example, Hispanic males (79.3) and females (84.3) have the longest life expectancies, and Black males (71.8) and females (78.1) the shortest, although ethnic/racial gaps have been narrowing in recent decades (National Center for Health Statistics, 2017).

Viewing development as a life span process makes clear that development or change in functioning with age involves both gains and losses for the individual. Gains are most obvious early in life; losses are more obvious later. But once we are sensitized to the fact that development involves both, we begin to notice that gains and losses characterize change throughout life. Thus, children, not just adults, experience some losses in the normal course of development. One familiar illustration is characteristic of language development. As an infant, you were capable of hearing and producing all of the kinds of sound distinctions that are used across all human languages. But as you learned your native language, you became less adept at discriminating and producing sounds that were not part of that language. If you were introduced to a second language after the preschool years, you probably had trouble producing sounds that were not part of your native tongue, and so you probably speak the second language with a “foreign accent.” Another example, suggested by Baltes (1997), is that as adolescents strive for personal autonomy, their relationships with their parents are often strained, as we have seen. The intimacy of the parent–child relationship is diminished for both partners as the adolescent struggles to achieve an adult identity.

Of course, loss is more obvious to us in adulthood as biological declines occur. We saw in Chapter 11, for example, that our biological systems, like our sensory abilities and our immune functions, all reach peak potential between ages 18 and 30. Many of these systems begin to decline soon after (see below). But the increase in losses through adulthood should not mask the fact that the gains also continue. For example, in Chapter 11 we discussed the gains in postformal thinking that seem to characterize some people as they move into middle adulthood. Other examples of gains will become clear throughout this chapter. However, the relative balance of gains and losses clearly shifts across the life span, until eventually losses outstrip gains for most people in old age (see Figure 13.1).

Development as Growth, Maintenance, and Regulation of Loss

Life span developmental theory defines development as a process of adapting to the constant flux of influences in our lives (Baltes, 1997; Baltes et al., 2006). One kind of adaptation is growth. We grow when we add new characteristics, understandings, skills, and so on to our behavioral repertoire. So, for example, an adult might grow by becoming more expert at some task at work, or she might acquire a more balanced and thus empathic perspective on her relationship with her parents. Another kind of adaptive functioning is maintenance or resilience, finding ways to continue functioning at the same level in the face of challenges or restoring our functioning after suffering some loss. For example, an adult might maintain the concept of herself as a poet—despite repeated rejections of her work—by persistently revising and resubmitting her work until eventually a piece is published. Or despite the death of a partner, she might eventually reestablish intimacy in her life by returning to social circulation and finding a new partner. A third kind of adaptation is regulation of loss. Like maintenance, this form of adaptation involves reorganizing the way we behave. But unlike maintenance, regulation of loss involves adjusting our expectations and accepting a lower level of functioning. Suppose that a woman who prides herself on her ability to remember names, faces, and telephone numbers suffers a reduction in learning ability as she ages. She adapts by using strategies that include writing down essential information that she previously would have recalled. She accepts that she will never have at her fingertips the breadth of information that she had before, but by using her new strategies she ensures that she will remember what is really necessary. According to life span developmental theory, all three adaptive processes—growth, maintenance, and regulation of loss—are part of development from infancy through old age. What changes is the relative probability of each. Growth is much more characteristic of children than it is of the elderly, and regulation of loss is much more characteristic of the elderly (see Figure 13.2). The middle adult years appear to be a time when the balance is shifting among the three adaptive processes. All three processes occur across the life span. Children experience the need to compensate for loss through maintenance or regulation, and adults of all ages experience growth. However, knowing the relative proportions of each, given a client’s stage of life, may provide professionals with a frame for understanding presenting problems. We will have more to say about how these processes affect coping with stress in Chapter 14.

Defining Successful Development at Any Age

As adulthood proceeds, the more physical and psychological resources an individual has, the greater her likelihood of adapting well. Consider the nature of developmental success at different times in the life of Emma, now a 91-year-old woman. Emma never married or had children, which she experienced as a loss. In her young adulthood, she compensated for her childlessness by dedicating her considerable talents to teaching poor urban children in public schools. In middle adulthood, she became an administrator, developing innovative programs for young children and mentoring teachers in the public school system. In her early old age, the physical demands of a daily work schedule became too great, so she retired. This change diminished her power to influence the lives of young children in the public schools. But she managed the loss, maintaining her view of herself as a child advocate, by serving on the governing boards of nonprofit organizations that provide services for children. Now, Emma suffers from a number of biological losses—poor vision, breathing problems, and general frailty—and she has confined her living space to her small apartment. A good deal of her functioning involves regulating her biological losses by living a quiet, sedentary life in her small space and depending on some outside help, which she has the means to pay for as a result of careful financial planning. But she also continues to grow: She has learned to use a computer, and she has begun to write for her own enjoyment. She also maintains her contacts with friends through e-mail, video chats, phone calls, and visits.

At each stage of her life, Emma found ways to manage losses through maintenance or regulation and to continue to grow. The balance of losses and gains in her life has now clearly shifted so that much of her adaptive energy is dedicated to managing losses. With the help of technological supports, such as the computer, Emma has minimized the overwhelming losses of her late life and has continued to maximize her gains, to the extent possible. She provides an example of successful development even in old age.

Our description of successful development will sound familiar to most helpers because it is clearly continuous with what we think of as healthy coping. The life span developmental view helps us see that healthy coping evolves and changes throughout life. What is adaptive coping at one stage of life may be less adaptive at another. In the following sections, we will consider some relatively stable influences on adult life as well as the sources of change. As we look at these influences, we will begin to identify what resources the mature individual brings to the task of development and which of these resources might most effectively contribute to success. In Chapters 14 and 15, we examine additional aspects of the adaptive developmental process that characterizes adult life.

Influences on Adult Development: Sources of Stability

Personality

The popular Up! series of films produced by the British Broadcasting Company (BBC) documented the lives of several men and women at 7-year intervals, from the time they were 7 years old to age 56. The series set out to investigate the truth of the proverb: Give me a child until he is 7, and I’ll show you the man. The eight documentaries clearly depict many changes that occur over the intervening 49 years. Yet they also illuminate the thread of stability that runs through these individual lives. For example, Nick, who at age 7 expressed the desire “to find out all about the moon,” became a professor of science in adulthood. Sue, who was a vibrant, independent youngster, is now a fun-loving, independent woman. What kind of continuity is typical of people in general? What are the sources of relative stability in development from childhood through adulthood?

Longitudinal studies have found substantial stability in personality characteristics across the life span (McAdams & Olson, 2010; Roberts, Walton, & Viechtbauer, 2006). In much of this research, personality is construed as a set of traits that may be likened to the temperament characteristics of infants (see Chapter 4). Perhaps the most influential—and well supported—trait theory of personality has been developed by McCrae and Costa (2008; Costa & McCrae, 2017) who specifically assume that traits are biologically based, inherent tendencies that persistently influence thoughts, feelings, and behavior throughout life.

What are these traits that appear to be so stable? In the 1980s, researchers recognized that the thousands of words referring to personality characteristics could be reliably boiled down to five, which McCrae and Costa called the Five Factor or Big 5 model of personality (Costa & McCrae, 2017; McCrae & Costa, 2008). These five traits represent the most basic dimensions of personality: neuroticism (N) or emotional stability, extraversion (E), openness (O), agreeableness (A), and conscientiousness (C). Each trait or dimension is actually a cluster of characteristics or qualities that are correlated – they tend to go together. Table 13.1 provides additional detail on these dimensions, describing some of the qualities of individuals at the “high” end of each dimension. For example, “energy level” and “talkativeness” tend to go together: If someone is very energetic, she is also likely to be very talkative, and vice versa. Both characteristics are part of the same personality trait or dimension, extraversion. It is also worth noting that the characteristics making up different traits are usually not correlated with each other. So, for example, “warmth” (part of the agreeableness trait) is not correlated with “outgoing” (part of the extraversion trait). That means that someone who is high on warmth is no more likely to be an extravert (high on extraversion) than she is to be an introvert (low on extraversion).

Across many cultures and subcultures, characteristics cluster into the same five personality traits (DeBolle et al., 2016; Ispas, Iliescu, Ilie, & Johnson, 2014; McCrae & Terracciano, 2005; Rollock & Lui, 2016). There are, however, cultural differences in how people typically score on each dimension or trait. For example, in a summary of cross-cultural findings, Putman and Gartstein (2017) report that Europeans and people from the United States are characterized by somewhat higher levels of extraversion and openness than people from Asian and African cultures. Northern Europeans tend to score higher than Southern Europeans on neuroticism and conscientiousness.

Regardless of country or culture, there are some typical shifts in these traits with age. First, as people get older, they usually increase in social maturity. That means they become more agreeable, more conscientious, and less neurotic (that is, more emotionally stable) (Bleidorn, 2015; Roberts, Wood, & Caspi, 2008). This normative trend is considered quite positive, given that more socially mature personality traits predict more positive life outcomes, such as greater economic success, better relationships, better health, and greater longevity (Roberts et al., 2017). This pattern of increasing social maturity may be in part a matter of genetic unfolding (McCrae et al., 2000), but there is also evidence that typical experiences in early adulthood, such as needing to take on adult responsibilities, contribute to this process. For example, cross-cultural comparisons show that personalities mature earlier in cultures where young people have to take on adult role responsibilities early (Bleidorn et al., 2013).

Second, there is more relative change in personality traits early in development than later (Briley & Tucker-Drob, 2014). In other words, individual differences in personality tend to stabilize with age, usually by about age 30. This means that a person’s ranking on personality traits, relative to other people the same age, is more likely to change earlier rather than later in development. Suppose Amanda (from the introduction to this chapter) was average on conscientiousness compared to her age mates at age 12. Her ranking (relative to others in her cohort) could have gone up or down during adolescence and young adulthood. Let’s suppose that it went up, so that by age 30 Amanda actually scored higher on conscientiousness than most of her cohort. After age 30, if Amanda is like most people, her relative conscientiousness probably didn’t change much—it stabilized. She and the rest of her cohort probably continued to grow more conscientious, but her ranking on conscientiousness stayed the same as it was at 30.

Given that personality traits usually change with age, albeit only a little, is it possible to encourage changes? Helping professionals often hope that their interventions will advance at least some aspects of social maturity—agreeableness, conscientiousness, and neuroticism/emotional stability. Do therapeutic and educational efforts actually change people’s personality traits? Roberts and his colleagues (2017) addressed this question by doing a meta-analysis of a wide range of studies that examined the outcomes of both clinical and nonclinical interventions. Few of these interventions were intended to change specific personality traits. But each of them included outcome measures that assessed at least some characteristics that are aspects of personality traits, such as sympathy and warmth (agreeableness) or anxiety and anger (neuroticism/emotional stability). Also, aspects of every Big 5 trait were measured in at least some studies (from 44 studies that measured characteristics of openness to 199 studies that measured aspects of neuroticism). There were two critical findings. First, scores on measures of trait characteristics did change in a positive direction on the average, particularly for neuroticism and extraversion characteristics. Second, these positive changes were evident as early as 2 to 4 weeks into most interventions. So, even though most longitudinal studies find only small typical changes in personality over relatively long periods of time, Roberts and colleague demonstrated that active therapeutic and educational efforts can bring about positive personality changes and can do so relatively quickly.

The Link to Temperament

Where do individual differences in adult personality traits come from? You may recall from Chapter 4 that infants and young children show early individual differences in behavioral tendencies that together are referred to as a child’s temperament. As with adult personality, some behavioral tendencies are correlated with each other even in infancy, clustering into overarching traits or dimensions. Although not all researchers agree about the number or composition of the clusters, three that are commonly identified are: emotionality (quality and intensity of mood, especially negative mood and soothability), control or self-regulatory tendencies (such as attentional control/persistence, comfort with low intensity activities), and surgency (activity level, approach vs. avoidance, pleasure in anticipating reward or in high intensity activities, sociability) (Rothbart, 2011; Shiner et al., 2012). Like personality traits, these early characteristics are assumed to be biologically based reactivity patterns, and evidence is accumulating for the importance of genetic and epigenetic contributions to the physiological processes involved (Beekman et al., 2015; Saudino & Micalizzi, 2012; see Chapter 4).

Do early temperament traits contribute to later personality? One possibility is that early tendencies differentiate and integrate over time into more mature self-systems (Rothbart, 2011). So, for example, early manifestations of positive approach, such as smiling and laughing, could be precursors of more mature forms, such as social extraversion. Early persistence might contribute to later effortful control and conscientiousness. Infant tendencies toward irritability and problems soothing might predict higher neuroticism in adulthood. If we measure temperament traits and personality characteristics in adolescents or adults we find exactly these kinds of correlations (Shiner, 2015; Shiner & DeYoung, 2013).

However, the most convincing evidence comes from longitudinal studies, some of them focusing on a short-term period, comparing infant temperament to personality characteristics in later childhood, for example. There are also a few much longer term studies, beginning in infancy or early childhood and following participants well into adulthood. Quite consistently, these studies find that earlier temperament traits predict some later personality characteristics (Shiner, 2015; Shiner & DeYoung, 2013; Slobodskaya & Kozlova, 2016).

For example, Caspi (2000; Caspi et al., 2003; Schaefer et al., 2017; Slutske, Moffitt, Poulton, & Caspi, 2012) investigated the continuity of temperament in a cohort of New Zealanders from age 3 onward. The sample for this study consisted of all children born in Dunedin, New Zealand, between April 1972 and March 1973. Temperamental characteristics were assessed at various points by means of parent report, clinical examiner ratings, and self-report. Data on home environment, school, employment, and social history were also gathered. The assessment measures reflected the typologies, developed by Chess and Thomas, that were available in 1972 (Chess & Thomas, 1987; see Chapter 4): undercontrolled or difficult (impulsive, restless, negative), inhibited or slow-to-warm-up (introverted, fearful), and well-adjusted or easy (see Chapter 4).

The results paint a picture of moderate personality stability over time. At age 21 and again at age 32, the 10% of children identified at age 3 as undercontrolled were more likely than other groups to be aggressive, sensation seeking, impulsive, and prone to gambling and troubles with the law. They also tended to experience higher levels of interpersonal conflict in family and romantic relationships. Even if the surface features of behavior changed over time, these undercontrolled children were more likely to grow up to be adults whose behavior reflected a similar lack of control and problematic adjustment. The inhibited children (8% of the sample) at 21 were more likely than the other participants to have suffered from depression. As adults, they were more shy, fearful, and nonassertive, and less connected to sources of social support.

Several possible explanations might account for trait stability over time. First, genes probably play a role in stability of personality. Studies of twins indicate that identical twins are more similar in personality than other siblings, and that about 40% of that similarity seems to be attributable to shared genes (Vukasović & Bratko, 2015). Remember, however, that we do not inherit trait patterns per se. As multidimensional models of development predict, personality features are also shaped by both biological and socio-contextual circumstances. The transactional interplay between individual and context is what sculpts personality.

Viewed from this perspective, personality or trait consistency will be highest if other variables, in addition to biology, provide support or scaffolding for that consistency. For example, the individual’s environment should remain consistent. A classic study by Helson and Roberts (1994) is illustrative here. Eighty-one women from Mills College were followed from ages 21 to 52. Those women whose level of ego development showed no change or whose level of ego development even slightly decreased over the years of the study were the least likely to have experienced disruptive experiences or high levels of responsibility. They seemed to have found comfortable niches for themselves that required little accommodation or change. Personality could remain fairly consistent over time, because these women appeared to have selected environments that suited their personalities in the first place. Or they may have behaved in ways that communicated their reluctance to change, thus eliciting compliance from others.

Yet another possible explanation for continuity is that certain kinds of personality styles show more consistency than others. Hampson (2008) reports that high levels of conscientiousness in childhood tend to predict well-being in adulthood, and she speculates that conscientious individuals may “gravitate to niches that are compatible with their attributes, including relatively safe environments for work and leisure . . . and are likely to evoke positive reactions in other people, which will serve over time to sustain these traits and related behaviors” (p. 265). These conclusions have been supported in other studies as well (Burt & Paysnick, 2012; Schaefer et al., 2017). Generally, people who possess resilient characteristics tend to be more stable and consistent throughout life.

Influences on Adult Development: Sources of Change

Although personality characteristics can be a relatively stable set of influences on the adult’s development, there are many changes to which an adult must adapt. Some changes may be strongly age determined or age graded, such as physical changes that come more or less inevitably with time. Some changes are more a function of historical circumstance and are called history-graded changes. These include events that we share with our whole cohort, like living through the Great Depression or the Iraq War. Some circumstances that affect people’s lives can be unique to cultural groups. Finally, there are changes that apply specifically to our own lives. These are nonnormative changes, often accidents of fate, like being in a train wreck or winning the lottery.

Age-Graded Changes

We will consider three kinds of age-graded changes. The first two are the physical and cognitive changes that have been documented as a function of aging in adulthood. The last concerns shifts in the relative importance of various life tasks that seem to occur with age. These shifts in life tasks, described by theorists such as Erik Erikson and Daniel Levinson, are generally thought to be a product of one’s psychological response to reaching adulthood and facing the typical burdens and challenges that life presents to all of us. All three kinds of change represent challenges to our adaptive functioning as we get older.

Physical Changes in Adulthood

Bodily changes may be the most obvious ones in adult life. By about age 30, as people enter middle adulthood, there begins a shift from adolescing, or growing up, to senescing, or “growing down” (Levinson, 1986). Although there are physical declines that most people are aware of fairly early in this process, such as some skin wrinkling or hair loss, most declines are much more subtle, such as a decrease in the effectiveness of immune processes or in cardiovascular functioning. For the most part, people continue to feel that they are at peak or near peak levels of physical functioning until they are 40 or older. In their 40s and 50s, most people become more aware of physical losses. In the United States, the majority of middle adults enjoy good health, but this period is one in which many individuals, especially those in lower socioeconomic groups, begin to deal with chronic illnesses and other health problems that can limit their activities. In the 40s, 7% of adults have some kind of disability; by the early 60s, 30% do (Lachman, 2004).

Most sensory systems decline in sensitivity or acuity, although there is considerable variation among the systems and among individuals. The aging of the visual and auditory systems is probably best understood (Li-Korotky, 2012; Owsley, 2011). Visual acuity declines with age but is maintained at near peak levels until about age 40 and then it noticeably wanes. Individuals who never before wore glasses or contact lenses are likely to need them now, and those who required some visual correction in the past begin to experience more frequent prescription changes, or they now need bifocals or trifocals. Middle adults also begin to notice that they need more light than their younger friends in order to see well, and they may begin to notice that it takes longer to adapt to lighting changes than it used to. They are most likely to be bothered when there is a sudden change in lighting: coming out of a dark movie theater into daylight or encountering the headlights of an oncoming car on a dark road. Changes in the neurons of the retina, as well as changes in the cornea and lens of the eye, all contribute to these growing problems.

Similar declines in hearing or auditory sensitivity begin in the 30s. Sensitivity to high-frequency (high-pitched) sounds declines earlier and more rapidly, and the losses are usually greater in men than in women. Note that women’s voices are therefore more difficult to hear in the later years than are men’s, so that men are more likely to have difficulty hearing women than vice versa. There is much individual variation in the degree and kind of hearing loss, but most individuals find their lives somewhat affected by the end of middle age (Frisina, 2009; Humes, 2015). A national survey in the United States indicated that 15% of 50- to 59-year-olds and 31% of 60- to 69-year-olds suffered from at least mild hearing impairment (Bainbridge & Wallhagen, 2014). Impairment is more common in Whites and Hispanics than in Blacks, and in men than in women. And, as with many physical disabilities, impairment is more common among lower than higher SES groups (Anderson et al., 2017).

Among the functional systems that show developmental changes sometime in middle adulthood is the reproductive system. As with the sensory systems, noticeable changes tend to begin in the 40s and 50s. The menstrual cycle usually begins to shorten and becomes somewhat more erratic by the time a woman is in her late 30s. The female climacteric, the gradual reduction of reproductive ability, ending in menopause, the cessation of menstruation, usually begins in the 40s and continues for at least 10 years (Clayton & Harsh, 2016; Foxcroft, 2009). The climacteric is largely a function of a reduction in circulating estradiol, a form of the primary female hormone, and estrogen, produced by the ovaries. Having less estradiol eventually influences many other changes: the thinning and coarsening of pubic hair, the thinning and wrinkling of the labia, and changes in vaginal chemistry that can cause dryness and a greater likelihood of vaginal infections. Women commonly experience other physical symptoms as well, such as fatigue, headaches, insomnia, nightsweats, and hot flashes—sudden sensations of intense heat along with sweating that can last for as long as a half an hour. One reason for such symptoms is that lowered estrogen triggers the release of other hormones and these have widespread effects on the body, such as altering its temperature control mechanisms.

Despite these changes, and despite a general slowing of sexual response times, sexual functioning and sexual pleasure seem to be affected very little for most women (Avis, Stellato, Crawford, Johannes, & Longcope, 2000; Stroope, McFarland, & Uecker, 2015). Many researchers have found only small declines, if any, in the frequency of female sexual activity in middle age (see Table 13.2). Women report less sexual activity than men at every age. A key ingredient for maintaining an active sex life is having a sexual partner, and women are more likely than men to be without a partner (DeLamater & Koepsel, 2015). They are more likely to be widowed than men, and they are less likely to re-partner after either the death of a spouse or a divorce. In one large U.S. study, 89% of 57- to 64-year-old men reported having a sexual partner, compared to 74% of women. Although 78% of men ages 75 to 85 still had partners, only 40% of women did (Waite, Laumann, Das, & Schumm, 2009).

For men in the middle years, changes in the production of testosterone, the primary male hormone, are not as dramatic. Some controversy has existed over whether testosterone production declines at all in healthy men, but longitudinal studies in recent years confirm that small average declines do occur, starting as early as the 20s, a process referred to as andropause (Ammini, Somsundaram, & Goswami, 2017). Men with health problems, such as cardiovascular disease and overweight, are likely to show a larger drop in testosterone. Lower testosterone levels are thought to contribute to some aspects of physical aging in men, such as loss of muscle mass and bone density. Some erectile dysfunction is also experienced by about 50% of men between 40 and 70 years old, but this seems to be more related to changes in the circulatory system than to hormones. Healthy men remain fertile through old age, even though reproductive structures like For men in the middle years, changes in the production of testosterone, the primary male hormone, are not as dramatic. Some controversy has existed over whether testosterone production declines at all in healthy men, but longitudinal studies in recent years confirm that small average declines do occur, starting as early as the 20s, a process referred to as andropause (Ammini, Somsundaram, & Goswami, 2017). Men with health problems, such as cardiovascular disease and overweight, are likely to show a larger drop in testosterone. Lower testosterone levels are thought to contribute to some aspects of physical aging in men, such as loss of muscle mass and bone density. Some erectile dysfunction is also experienced by about 50% of men between 40 and 70 years old, but this seems to be more related to changes in the circulatory system than to hormones. Healthy men remain fertile through old age, even though reproductive structures like the testes, seminal vesicles, and prostate gland do undergo some changes. These changes have little effect on sperm production, but they result in reduced amounts of seminal fluid by the 40s and 50s and a steady decline in the volume and force of ejaculations. Yet, as with women, whereas sexual response times begin to increase in middle age, sexual functioning and sexual pleasure can be maintained (see Table 13.2). For a man with an available sexual partner, how sexually active he will be in his older years is closely correlated with how strong his sex drive was in his younger years (Kellett, 2000) and with his general physical health (Lee, Nazroo, O’Connor, Blake, & Pendleton, 2016). For both men and women, understanding that sexual activity need not be derailed by the normal changes in sexual function that come with age (e.g., slower responses, erectile changes, vaginal dryness, and so on) can be key to maintaining a satisfying sex life (DeLamater & Koepsel, 2015).

In today’s popular culture, personal worth is linked to physical beauty, defined in part as a youthful, fit appearance. In such a climate, the most problematic physical changes of middle adulthood for some people can be the wrinkling and sagging of the skin and an increase in body fat (Bessenoff & Del Priore, 2007). Weight gain is not inevitable in middle adulthood, but rather is directly linked to overeating, poor nutrition, or inadequate exercise. Chronic stress and inadequate sleep have also been related to weight gain (McEwen & Karatsoreos, 2015; Roberts, Campbell, & Troop, 2014). Unfortunately, the typical habits of many Americans result in their gaining weight throughout middle adulthood, mostly around the waist and hips. Among the factors contributing to the wrinkling and sagging process are changes in the layers of the skin. For example, elastin, a substance in the cells of the dermis, or middle layer of skin, allows the skin to stretch and contract as we move. After age 30, elastin gradually becomes more brittle, reducing skin elasticity. Areas of the body containing fat, such as the arms, legs, torso, and breasts, usually begin to sag by the 40s and 50s.

Cognitive Changes in Adulthood

Age-graded changes in cognitive functioning are experienced throughout adulthood. An enormous research literature exists on adult cognitive change. We humans, including developmental researchers, seem to worry a great deal about what kinds of intellectual declines we can expect as we get older and how we might avoid them. Early findings from cross-sectional studies (Schaie, 1994) showed that most intellectual skills declined fairly steadily after age 25. But in such cross-sectional studies, different ages are represented by people from different cohorts. Many factors contribute to what appear to be age decrements. This is so because different cohorts are often different in breadth of educational, economic, and cultural opportunities (Flynn, 2012; Gerstorf, Ram, Hoppmann, Willis, & Schaie, 2011). Prospective or longitudinal research, which follows people over time, suggests a more complex picture of intellectual change in adulthood. Although some abilities begin to decline early, many cognitive capacities seem to show improvements with age and indicate only small average declines after ages 55 to 60.

One way to make sense of the mixed pattern of improvement and decline through adulthood is to categorize cognitive skills with regard to how heavily they depend on two kinds of underlying intellectual resources: fluid and crystallized intelligence (Horn & Cattell, 1966). Fluid intelligence is also called the mechanics of intelligence (Baltes et al., 2006), and refers to basic operational characteristics that seem to directly reflect how well the “hardware” of the nervous system is working, affecting the efficiency of processes like reasoning. Fluid, or mechanical, functions include such things as processing speed and inhibitory mechanisms. They are the most likely kinds of intellectual processes to show declines sometime in middle adulthood. For example, information processing speed may begin to slow down as early as age 30 and it declines fairly rapidly after age 40, so that we are slower to take in information as we get older and slower to respond to it (Kievit et al., 2016; Tucker-Drob, 2011). Inhibitory mechanisms show decrements by about age 40, so that in some tasks, older adults are more easily distracted by irrelevant stimulation than younger adults (Dey, Sommers, & Hasher, 2017).

Executive functions (EFs) are closely linked to fluid intelligence. EFs—working memory, self-regulation (inhibitory control), and cognitive flexibility—are recruited when we effortfully pursue goals, rather than when we function more automatically or intuitively. You have seen in earlier chapters the importance of EFs for the development of skills that support children’s and adolescents’ academic success. They are important for adult functioning as well, including job success, good quality of life, and even marital harmony (Diamond, 2013). EFs involve activation of the prefrontal cortex, and they affect strategic planning and problem solving, creative thinking, maintaining attention on what is important in a situation, adapting to changing circumstances, avoiding impulsive actions, and so on. EFs show some declines in middle adulthood. These declines are related to changes in fluid intelligence, especially changes in processing speed and ability to gate out irrelevant stimuli.

Working memory provides a good example here. You know that working memory stores information that we are thinking about or working with at the present moment. It has a limited capacity, so that only a restricted number of information units can be retained there at one time, and usually only for 15 to 30 seconds, unless we actually keep working with them, that is, unless we make an effort to pay attention to the information. To put it a different way, working memory is the active, attentive part of the mind, where we consciously think and learn. In late middle adulthood, working memory capacity seems to decline. Fewer pieces of information can be attended to at one time, and either problem solving or learning or both can be somewhat affected as a result. Imagine a situation in which you look up and dial a 10-digit phone number, and then you immediately attempt to redial the number. Suppose that at age 30, you could remember about 6 of the digits when you redialed. At age 50, given the same kind of memory task, you would probably remember only 5 of the digits. Clearly, what we are describing here are not catastrophic losses. The modest change is more a nuisance factor than anything else. Most people, by about age 50, notice that they have a little more difficulty than they used to recalling the name of a new acquaintance or solving a complex problem that requires attending to several pieces of information at once. Declines in fluid intelligence seem to make the difference. Slower processing speed may make it harder to keep as many pieces of information in mind simultaneously as we once could or make it difficult to work our way through to the end of a problem before some of the information that we need has disappeared from short-term storage (Mella, Fagot, Lecerf, & de Ribaupierre, 2015). Reduced inhibitory control is also important. For example, we might experience at times “a kind of ‘mental clutter’ in which extraneous thoughts and plans can interfere with, and possibly crowd out, goal-relevant thoughts and plans” (Zacks, Hasher, & Li, 2000, p. 297).

Another intellectual resource is called crystallized intelligence or the pragmatics of intelligence (Baltes et al., 2006). It is the compilation of skills and information we have acquired in the course of our lives. Crystallized intelligence, or pragmatics, is a little like the pile of software programs that most of us accumulate for our computers. Our knowledge of language, of how to do a job or to play an instrument, the strategies we have learned for memorizing information or solving problems—all forms of declarative and procedural knowledge (see Chapter 6)—are included. Crystallized intelligence is less likely than fluid intelligence to show declines with age and, for some individuals, can increase even into old age. For most people in middle adulthood, and for most abilities, declining fluid resources are usually balanced or outweighed by continuing steady increases in crystallized resources (Baltes et al., 2006). It is only after about age 60 that losses in fluid intelligence may be great enough to contribute to overall declines in intellectual functioning.

Problem solving in middle adulthood provides a good illustration of the interactive influences of mechanics and pragmatics in overall functioning. As you have just seen, working memory is disrupted by mechanical declines with age. Working memory is where we solve problems, but age-related declines in working memory affect problem solving most when either the information that is relevant to the solution or the problem-solving situation is new. When middle adults are solving familiar, everyday problems or problems in areas of their own expertise, the crystallized resources at their disposal often help them to be more effective than younger adults (Salthouse, 2012).

Learning and long-term storage of information also reveal the complex interrelations of mechanics and pragmatics with age. Although the limitations of working memory make it more difficult to get new information into long-term memory, we nonetheless do continue to learn in middle and late adulthood, storing new information from our experiences despite our reduced efficiency. Thus, both younger and older adults add new information to episodic memory—memory for personal experiences—but younger subjects typically learn more with greater ease (Addis, Wong, & Schacter, 2008; Vidal-Piñeiro et al., 2017). To put it differently, we are somewhat less likely, as we get older, to remember specific daily experiences, such as where we parked the car at the shopping mall. However, information already learned appears to be maintained as well as in our younger years. In fact, an older person’s semantic memory, her store of factual information, seems to have a richer network of interrelationships as a result of her greater experience, allowing her to retrieve information through many more routes than a younger person can (Salthouse, 2012). As Pak and Stronge (2008) point out, younger adults may have the edge in games that require speedy responding (e.g., a video game), but older adults often outperform younger ones on memory games (e.g., Trivial Pursuit™ and Jeopardy™).

Charness and Bosman (1990) describe an interesting example of the differential effects of age changes in fluid and crystallized intelligence on performance in adulthood. They describe two kinds of chess competitions. In tournament chess, participants make their moves quickly, after deliberating for about 3 minutes. In correspondence chess, the participants can have 3 days to make a move. Clearly, tournament chess makes greater demands on processing speed, whereas correspondence chess seems to draw much more completely on one’s knowledge and experience. Not surprisingly, then, top performers win their first world championship in tournament chess at much younger ages, about age 30 on average, than they do in correspondence chess, where the average first-time champion is 46! It is not unusual for middle-aged chess devotees to adapt to declines in fluid intelligence by shifting their focus from tournament chess to correspondence chess as they get older.

In Chapter 15 we will look more closely at cognitive changes in late adulthood, focusing especially on how older adults compensate for losses in fluid intelligence and on the debate over the growth of wisdom.

Life-Task or Life-Course Changes in Adulthood

People experience another kind of age-graded change as they move through adulthood. Life-course changes, brought on by shifts in the life tasks that seem most important to us at different times of our lives, have been described by many different theorists. Although each of these theorists tends to emphasize somewhat different aspects of the life experience, you will see commonalities in their observations as we briefly summarize a sampling of these descriptions.

You may recall that Schaie (1977–1978; Schaie & Willis, 2000; see also Chapter 11) proposed a series of stages in adult life, each of which requires the development of new ways to apply and use one’s intellectual resources. These changes are directly related to shifts in family roles and in the life tasks that we face as we grow older. In the achieving stage of young adulthood, individuals must learn to use logical thinking skills to plan the achievement of long-term goals. In the responsible stage of middle adulthood, individuals must learn to use problem-solving skills not only to achieve their own goals but also to help coordinate their needs with those of others for whom they are responsible at home, at work, and in the community. In the reorganizational stage of one’s elder years, the focus narrows again to reaching personal, practical, day-to-day goals as an adult, devoting thinking skills to managing losses. Finally, in late adulthood, people move into the reintegrative stage, when their goals are primarily to conserve energy, and perhaps into a legacy-leaving stage, when they use their cognitive resources to help them leave behind a written or oral account of their experience or wisdom.

Schaie emphasizes the shifting allocation of intellectual skills across adulthood, as people confront different kinds of problems related to their age and stage of life. Most other theorists emphasize changes in personality. They do not focus on personality traits, which, as we have seen, are relatively stable in middle adulthood and beyond, but rather they describe structural changes in self-concept and in self-expression. Perhaps the best-known theory of life-course changes in self-concept is Erik Erikson’s, by now quite familiar to you. Erikson (e.g., 1950/1963) describes three stages in self-development in adulthood, based on the kinds of life tasks that become most important to people as they find themselves fully matured and facing the fact that this is the one life that they have to live. Very briefly, in young adulthood, intimacy (vs. isolation) is one’s quest: finding a way to validate and expand one’s own sense of self by committing to a shared life with others. In middle adulthood, generativity (vs. stagnation) becomes most important, giving one’s own life purpose by producing and building for the next generation, through work, community service, or child rearing. By old age, establishing ego integrity (vs. despair) becomes life’s task. Ideally, a process of life review helps the elderly adult to develop a sense that her own life is “something that had to be,” that she has lived a life that has order, meaning, and dignity (see Chapter 1, especially Table 1.2). Erikson argued that different concerns reach ascendancy in different age periods. Vaillant (1993; 2012) suggested that two more adult life stages should be added to Erikson’s scheme, reflecting that forming deep bonds, becoming productive, and finding meaning in one’s life are recurring themes throughout adulthood. In one’s mid-20s, career consolidation (vs. self-absorption) is a key focus of self-development. In this phase of life, in addition to ongoing intimacy concerns, making a commitment to work that brings personal satisfaction, regardless of its other rewards, rather than just having a job, becomes important. The most positive development for this period is that such a commitment emerges as an important part of one’s identity.

Vaillant also described a stage that comes near the end of Erikson’s generativity stage, in late middle adulthood. This he called the keeper of meaning (vs. rigidity) stage, when the adult expands her generative concerns beyond just making a productive contribution, in order to actually preserve something that is part of the culture. In this sense, adults seek ways to establish the meaningfulness of the work or contributions they have made. For example, Tien, a woman who worked as an aide at her children’s day care center, might move on after her own children are grown to join a child care advocacy group in her community, hoping to ensure that future generations of children in her region will have access to the high-quality child care she was able to provide her own children.

As we saw in Chapter 12, research indicates that both intimacy and generativity are central to the lives of young adults. Later in this chapter we will discuss research on how these concerns tend to play out in the arenas of marriage, family life, parenting, and work during the middle years of adulthood.

Several other theorists have proposed stages in adult personality development that repeat many of the themes we see in Erikson’s work. They all emphasize that people have fundamental concerns or needs that shift in importance from one adult stage to another. We will briefly describe Levinson’s theory here; some additional theories (e.g., Gould, 1978; Loevinger, 1976) are included in schematic comparison in Table 13.3.

In Levinson’s account (Levinson, 1986; Levinson & Levinson, 1996), a person’s life has structure at any given time. One’s life structure is a pattern of relationships between the self and the external world, such as relationships to one’s “spouse, lover, family, occupation, religion, leisure, and so on” (Levinson, 1986). There may be many components to the life structure, but Levinson found that at any one time there are usually only one or two really significant, defining components for the self, usually marriage-family and/or occupational components. Levinson identified three major adult stages, or eras: early, middle, and late adulthood. Each of these eras begins with a 5-year transitional period and is marked by a smaller mid-era transition, when the life structure’s effectiveness for serving the person’s goals is reexamined and may be altered.

Whereas Erikson and Vaillant suggest that certain life tasks occur in a relatively predictable sequence (e.g., first, intimacy needs are greater, then generativity needs), Levinson (1986) argues that life events unfold in many ways depending on a particular individual’s life circumstances, gender, and culture and that specific concerns are not necessarily more important in one era than in another. What is predictable, he argues, is the sequence of age periods for building and changing first one life structure and then another. The experience of life changes from one era to the next. Put a different way, what is inevitable in adulthood is that a person will establish and then revise her life structure at particular times as she ages.

In sum, many theorists have identified life-course changes affecting self-concept or self-expression during adulthood. There is by no means complete agreement among these theorists on the character of these changes. For example, following Jung (1963), Levinson (1986) and Gould (1978) describe the midlife transition as a frequently tumultuous time, a period of major upheaval and self-evaluation, not unlike adolescence. You may have heard it referred to as a “midlife crisis.” Their research, consisting of longitudinal interview studies of relatively small and somewhat selective samples of adults, tends to support these claims (Gould, 1978; Levinson & Levinson, 1996). But in much larger interview and questionnaire studies, many researchers have found little evidence of widespread midlife distress, although they have found indications of shifting concerns at midlife (Bell, 2014; Lachman, Teshale, & Agrigoroaei, 2015). Crisis-level distress seems most likely to occur as a function of major life events, like financial problems or job loss, which can happen at any time. Individuals who score high on the personality trait of neuroticism are particularly likely to suffer acute distress.

Regardless of such disagreements, there is some similarity among the theoretical descriptions of adult life-course changes. The available empirical work supports the general idea of such change. Some longitudinal research also indicates that major aspects of self, such as intimacy, may be reworked with every major life change, rather than being fully resolved at specific times in the life course (Whitbourne, Sneed, & Sayer, 2009).

Studies of how social networks change over time illustrate this point (Carmichael, Reis, & Duberstein, 2015; Wrzis, Hänel, Wagner, & Neyer, 2013). As we have seen in previous chapters, networks of friends increase in size during adolescence and young adulthood, providing a source of information and support in the quest for adult identity and intimacy. But as adults experience key life events, such as the transition to parenthood and job entry, social networks contract. Friends are fewer, but they are also closer. It appears then that adults rework and intensify their capacity for intimacy in response to such normative life events.

Despite the enormous variation in the immediate details of adult lives—from culture to culture, from cohort to cohort, from family to family, and from individual to individual—there appear to be some life changes that are widely experienced. These changes lead each of us to reformulate, or at least reevaluate, ourselves and our lives periodically. Much more research is needed to establish the specifics of these changes and whom they do and do not affect.

For professionals, awareness of potential stage changes can help enrich our understanding of clients. For example, suppose a 45-year-old woman comes to a counselor looking for help with marital problems she has tolerated for 20 years. We might be inclined to wonder why she is coming now and how likely it is that change can be effected after so many years of entrenched behavior patterns. The answers to both questions may be partly a function of life stage. Many theorists see the 40s as a time when reassessment of one’s life structure is very likely and when willingness to act on the basis of one’s individual propensities, rather than strictly in adherence with social expectations, increases (see Table 13.3). Vaillant (1977) suggests that generativity needs are likely to reorganize, so that direct caregiving to one’s spouse or children is less likely to meet an individual’s needs than opportunities to seek broader meaning in life by finding ways to preserve the culture. Thus, not only is it a likely time for this woman to reassess her life, but also it may be a time when she will be open to trying new ways of meeting her needs.

History-Graded Changes

The historical events that affect our whole cohort are another source of change in adult lives. People are partly a product of the historical context in which they develop. Imagine that you were a young adult parent trying to support your children during the Great Depression in the 1930s or the Great Recession of the late 2000s. You would take a job wherever you found one, no matter how difficult the work, and you would probably be grateful for it. What effect might years of deprivation and struggle have on your tendency toward conscientiousness? Or, think about moving through early adulthood during the social upheavals and sexual revolution of the 1960s. Do you think this experience might have some effect on your openness to experience? History-graded events, also called cohort effects, provide a context for development and also influence it directly (Kiang, Tseng, & Yip, 2016).

The year of your birth marks your entry into a cohort of peers who accompany you through age-graded developmental changes (toddlerhood, puberty, and so on) within the context of a specific set of historical events (wars, technological shifts, etc.). The effect of history is particularly linked to a person’s age and stage of life (such as coming of age in a time of war, when you could be drafted into military service). In addition to age-graded and history-graded changes, we also progress through stages of the family life cycle as child, parent, grandparent, and so on. Researchers who take a life-course perspective remind us that development is influenced by the intersection of chronological age (life time), family-related roles (family time), and membership in a birth cohort (historical time; Elder, Shanahan, & Jennings, 2015). If society experiences an economic recession that results in a lengthy period of corporate downsizing, a young father who has just completed a training program in computer repair might see his chances of getting a well-paying job shrink. He may have to wait to buy a first house, ultimately limiting the lifetime equity he can accrue. Because his family must continue to reside in a low-cost apartment, his preschool son might also be affected because of missed educational opportunities that would have been available with a move to a more advantaged school district. Note that despite the important implications of the economic downturn for this young parent life, his own grandparents, who are retired and receiving a fixed pension, would not be much affected.

Twenge (2000) provides an example of how sociocultural and historical context influences the personality development of cohorts of individuals. She reviewed published reports of child and adolescent anxiety from 1952 to 1993 to see if levels had changed over these years. Her distressing finding showed that the average child in America during the 1980s scored higher on anxiety than child psychiatric patients from the 1950s. Further analysis allowed her to demonstrate that these increases were associated with the breakdown of social connections and with increases in physical and psychological threats. Economic recessions were not related to the increase in anxiety. Twenge’s results imply that recent cohorts are living in a world that is less favorable to their positive development than the world in which their own parents grew up. A context that provides for fewer or weaker social bonds at the same time that threats are expanding heightens the sense of vulnerability for these young people, who are truly growing up in an “age of anxiety.” Twenge and her colleagues (2014) did a similar analysis of trends from 1972 to 2012 in U.S. adults’ “trust in others,” defined as belief in the ability, reliability, and honesty of other people. For every generation sampled (the post–World War II “baby boom” generation, “genXers,” and “millennials”), there was a steady decline in trust that was linked to a specific economic change: the rise in income inequality, that is, the widening gap between rich and poor. This historical change appears to be corroding adults’ fundamental beliefs about other people.

The Social Gradient and Life-Course Development

What has been absent from some formulations of history-graded effects is the role of culture. Sociocultural effects on development are not restricted to time-limited incidents, nor do they necessarily exert the same influence on all members of a generation. Developmental change also results from structural features of society. For individuals and families, one’s place on the rungs of society’s status and economic ladders has long-term consequences. Lower status contributes to poorer life outcomes on a number of measures, especially to disturbingly higher rates of illness as people age (see Figure 13.3). Socioeconomic status (SES) is a complex concept that has typically been assessed using indicators like education, income, and zip code. Historically, researchers often considered it a nuisance variable that needed to be statistically controlled so that the “real” differences could emerge. Nuisance variables are hypothesized to be extraneous to the effects researchers intend to investigate. More contemporary views recognize that SES effects are real, direct, and powerful. Increasingly, researchers are adopting the term socioeconomic position (SEP), instead of SES, because it reflects a more systems-centered approach and recognizes the contributions of societal stratification on development. Because the most common impulse within society is to organize itself in a hierarchical fashion, those at the bottom usually end up with restricted access to resources and opportunities. This step-wise top-to-bottom phenomenon is called the social gradient. Marmot and Wilkinson (2009) explain how SEP impacts life chances: Social organization also structures advantage and disadvantage longitudinally. Advantage or disadvantage in one phase of the life course is likely to have been preceded by, and to be succeeded by, similar advantage or disadvantage in the other phases of life. A child raised in an affluent home is likely to succeed educationally, which will favour entry to the more privileged sectors of the labour market, where an occupational pension scheme will provide financial security in old age. At the other extreme, a child from a disadvantaged home is likely to achieve few educational qualifications and, leaving school at the minimum age, to enter the unskilled labour market where low pay and hazardous work combine with no occupational pension, which ensures reliance on welfare payments in old age. (p. 41)

Life at the bottom of the social ladder is not easy. Across the world, the poor suffer most in terms of morbidity and mortality compared to their more advantaged peers (Anderson et al., 2017). Figure 13.3 depicts the linear increase in incidence rates for disease by SES level.

The study of SEP represents an example of a multidimensional, life-course approach to development that incorporates societal/cultural considerations. The impact of socially embedded influences can be studied at the individual or group level, at sensitive periods of development, and longitudinally across the life span. Neuroscientific research is also targeting the processes through which SEP becomes embodied via brain pathways that mediate its effects (Gianaros & Manuck, 2010). Figure 13.4 presents potential ways to measure SEP at different stages of the life span.

For the most part, life circumstances associated with low SEP include economic hardship (not having necessary resources like food and shelter), loss of job, income, housing or material possessions, debt, evictions, and insecurity. Now, consider the effects of systematic discrimination. What might membership in a socially devalued group add to the list of hardships? Would it matter if the individuals felt they had adequate resources to cope with discrimination? Life course researchers are also beginning to examine the long-term impact of racial discrimination on life span development, especially in health-related areas. Just as the sociocultural influences of one’s era may create an “age of anxiety,” so too might they affect disease processes. The disparities in health among different racial and ethnic groups have been well documented (National Academies of Science, Engineering, and Medicine, 2017). Effects of race frequently co-vary with socioeconomic status, but the particular contribution of racial discrimination appears to increase the damaging effects. Reliable data have shown that for certain historically disadvantaged groups, especially African Americans, the health disparities are stark. Heart disease, diabetes, strokes, hypertension, and obesity occur at much higher rates for African Americans than for all other major racial/ethnic groups (Zonderman, Mode, Ejiogu, & Evans, 2016). The search is on for a comprehensive understanding of how poverty and racism “gets under the skin” by altering physiological reactivity to result, ultimately, in these dramatic health disparities (McEwen, 2012). A clearer understanding of the mechanisms will increase our repertoire of effective prevention strategies (Braveman & Gottlieb, 2014).

Nonnormative Changes

Just as history-graded changes can significantly affect the development of a whole cohort, individual lives are also changed by unexpected events. These events are called nonnormative events, “bolt from the blue” experiences that we don’t anticipate, yet that can have powerful developmental effects. Crises such as traumatic illnesses, accidents, imprisonment, the untimely death of a loved one, or even positive events such as winning a lottery can be considered nonnormative. They create new sets of circumstances for people, and these have the potential to alter developmental trajectories (Boyce, Wood, Daly, & Sedikides, 2015; Leikas & Salmela-Aro, 2015).

Imagine a woman at age 45 who has worked hard as a parent and homemaker and looks forward to seeing each of her children move into adult independence. A car accident suddenly leaves her 19-year-old son a quadriplegic. The financial resources she and her husband had carefully saved for their retirement and their children’s college years are soon gone, and the mother’s dreams of opening a small craft shop are dashed. She is a somewhat introverted woman, but the special needs of her son create circumstances that move her to take initiative with lawyers, insurance companies, and government agencies. Literally, her personality and the whole course of her life begin to move in a new direction. So middle age, like the “ages” before it, is both continuous and changing. Stable personality traits are influenced by age, life stage, history, and unplanned events as people continue to adapt to life.

Key Developmental Tasks of Midlife: The Continuing Pursuit of Intimacy and Generativity

In middle adulthood, as in young adulthood, loving relationships and productive, meaningful work continue to be critical elements in the construction of a satisfying life. As you know, Erikson saw intimacy—broadly defined as sharing oneself with another—as a more prominent concern in young adulthood and generativity—defined as the need to create and produce—as a more central focus of middle adulthood. However, it is clear from available research that although the relative balance between these two concerns may shift (see Chapters 12 and 14), both remain important in middle adulthood and beyond. In the following sections we will further explore intimacy issues by examining how marital relationships form, develop, and sometimes fail during adulthood. We will continue our discussion of generativity by considering the parental role from the adult’s perspective, and we will touch on other generativity issues in the middle years, having to do with work and community.

Intimacy: Marriage and Other Primary Relationships

One of the most valuable adaptations we humans can make is to establish and maintain close interpersonal relationships. In adulthood, close ties take on a variety of forms, and the number and diversity of forms is increasing. Marriage has provided the traditional structure within which such relationships exist. Approximately 49% of the U.S. population were married in 2016, a figure down from 62% in 1990 (U.S. Bureau of the Census, 2018; see Figure 13.5). More than one third of all households in the United States were single-person households. Cohabitation was also on the rise. Although there has been a steep rise in the number of people living alone or as unmarried partners, a large majority of the population is likely to marry at least once.

The definition of “family” has indeed become more inclusive in the 21st century and refers to more than the traditional nuclear family with its own biological children. Particularly since the social changes initiated in the 1960s, people have felt more free to meet their needs for intimacy and connection in a variety of ways. Extended, multigenerational families, adoptive and foster families, same-sex unions, remarried or blended families, single-parent families, and “families” composed of several people living together without legal ties are all examples of new trends in family formation (e.g., Pew Research Center, 2017). To illustrate, one third of the children adopted in the United States in 2001 went to single women (Coontz, 2005). Some individuals will be part of several different kinds of families as they progress through their lives.

Clearly, psychological wellness does not depend upon any one specific relationship configuration. It is important for helping professionals to expand their definition of family and to work towards ways of promoting optimal functioning for each of these forms. As Coontz (2005) has argued, “moving in lockstep through a series of predictable transitions is no longer a route to personal security. Each man and woman must put together a highly individualized sequence of transitions . . . a ‘do-it-yourself’ biography” (p. 277). Regardless of whether people are married, helpers must offer resources that promote healthy relationships and, where children are involved, to improve parenting.

Despite greater social acceptance of alternative family styles, researchers have discovered that good marriages or primary relationships confer a number of physical and psychological benefits that other states may not provide (Perelli-Harris & Styrc, 2018). When researchers compare married to unmarried adults, they typically find that married people report higher levels of sexual and emotional satisfaction and happiness and lower rates of mental illness, drug or alcohol abuse, and physical illness (Hoppmann, Gerstorf, Willis, & Schaie, 2011; Robles, 2014; Waite & Joyner, 2001).

Do cohabiting partners accrue the same benefits? Some studies find more depressive symptoms, poorer relationship quality, or less overall satisfaction in cohabiting than in married couples. But other studies have found similar patterns of well-being in both cohabiting and married couples (Musick & Bumpass, 2012; Perrelli-Harris & Styrc, 2018). It seems likely that many benefits are similar, such as the day-to-day economic and social support that comes with having a partner. On the other hand, whereas marriage is seen by many as a lifetime commitment, for many couples cohabitation is not; it is more of a “trial run.” Therefore, cohabitation is accompanied by more uncertainty about the future than marriage. In addition, there are long-term economic benefits to marriage in the United States that may be less available to cohabiting partners, such as assurance of retirement income for surviving spouses. In one study, single mothers who were the sole support for their children for a period of 10 years or more during their lifetimes were 55% more likely to live in poverty at ages 65 to 75, regardless of their current marital status (Johnson & Favreault, 2004).

Tolerance for alternative family arrangements is growing, and as this cultural shift progresses, the benefits of cohabitation and marriage may be coming more and more into alignment. More research is needed to understand how alternative relationship forms affect well-being in a changing world. One thing that is clear at this point is that many factors mediate and moderate the benefits of marriage and other intimate partnerships. One factor is gender. For example, women overall are likely to be less satisfied with their marriages over time than men. Two thirds of divorces filed after age 40 are initiated by women (Hacker, 2003). Another factor is socioeconomic status or position. Consistent with the generally more negative outcomes of lower SEP, for example, women without high school degrees are more likely to divorce (60% rate) than women with college degrees (33% rate) (Coontz, 2005).

Although we use marriage as the prototypical vehicle to illustrate the development of intimacy over the adult life span, we acknowledge that this is not the only road, nor even the best one, for many people. We do not underestimate the importance of friendships nor devalue single status in adulthood. However, as you have seen, demographics show that most people, male and female, heterosexual and nonheterosexual, will marry or participate in some kind of committed relationship for at least some period of time in their lives. (See Box 13.1.) In some Latin American cultures, there is a historical acceptance of long-term consensual unions (Landale & Fennelly, 1992) even though couples are not formally wed. After divorce, people tend to find new partners. Kreider (2006) estimated that in the United States over half of individuals are likely to remarry within 5 years. Between 2008 and 2012, about 17% of U.S. adults were in second or later marriages (Lewis & Kreider, 2015). Although the traditional marital and family life cycle may not be the best descriptive fit for everyone, there are aspects of its stages that can help us understand many kinds of close adult relationships. The nature of intimate relationships, inside or outside marriage, is defined by mutual sharing of joys and sorrows, reaching compromises and working out problems, and developing a sense of “we-ness.”

Box 13.1: Changing Families: Gay and Lesbian Couples and Their Children

In 2002, Steve Lofton and Roger Croteau, residents of Florida, achieved media fame when they tried to adopt a 10-year-old boy who had been their foster child since infancy. These men were surrogate parents to five foster children at the time, including several with special needs, but state law prohibited adoption of minor children by gay adults. Lofton and Croteau eventually lost their court challenge to Florida’s adoption laws, and the child they had raised was put up for adoption by strangers, despite the child’s wish to stay with his foster parents (Patterson, 2004).

Lofton and Croteau are among a growing cohort of gay and lesbian adults who head households, form families, and raise children. They have challenged both custom and law by asking for the opportunity to marry and/or to raise their biological or adopted children. In 2015, the U.S. Supreme Court ended decades of state-by-state battles for marriage rights by declaring same-sex marriage legal throughout the country. It is now also possible for nonheterosexual adults to petition for adoption in all 50 states. Families with nonheterosexual individuals or same-sex couples at the helm are increasing in number throughout the Western world. What are the developmental consequences of these newly constituted families, both for the adults and for the children they raise?

Characteristics of Committed Relationships Between Gay and Lesbian Adults

Although media images of gay and lesbian relationships often suggest they are unstable and dysfunctional, “research has documented that many contemporary lesbians and gay men establish enduring intimate relationships” (Peplau & Fingerhut, 2007, p. 418). In a review of existing literature, Herek (2006) found that across many studies, 40% to 70% of gay men and 45% to 80% of lesbian women were in committed relationships, many of which had lasted for at least a decade (see also Herek, Norton, Allen, & Sims, 2010). By 2017, approximately 61% of cohabiting gay and lesbian couples were married, up from about 38% just prior to the Supreme Court decision of 2015 (Jones, 2017).

Same-sex couples appear to be similar to heterosexual couples in many ways. Clearly, they face some different stresses, such as continuing social stigma associated with their sexuality (Gates, 2016). But on the whole, the stability of their relationships depends on the same factors as the stability of heterosexual relationships: “positive attraction forces, such as love and satisfaction, the availability of alternatives, and barriers to leaving a relationship, such as psychological, emotional and financial costs” (Peplau & Fingerhut, 2007, p. 412). In a five-year study that controlled for factors such as age and education, relationship satisfaction was the same for married heterosexual and cohabiting homosexual couples at the start of the study, and for both types of couple, satisfaction declined somewhat over time, at similar rates (Kurdek, 1998). More recent cross-sectional comparisons also find greater similarities than differences between same-sex and different-sex couples on a wide range of measures indicating marital satisfaction and mental health (e.g., Ellis & Davis, 2017; Kornblith, Green, Casey, & Tiet, 2016).

Social support from family and friends is an important ingredient in the health and well-being of couples, especially couples with children, whether married or cohabiting, and whether same-sex or different-sex. In 2004, Kurdek found that same-sex couples generally received less support from relatives than heterosexual couples, and they were more likely to rely on friendship networks. But in newer studies, consistent with substantial increases in public acceptance of same-sex unions (McCarthy, 2015), same- and different-sex couples who are adoptive parents have reported similar levels of support from their families and friends (Sumontha, Farr, & Patterson, 2016). It also seems that when partners make legal commitments to one another, via civil unions or marriage, families tend to be more supportive, although it is difficult to say whether couples with supportive families are more likely to legalize their relationships or whether families become more supportive once couples legalize their relationships (Balsam et al., 2008).

There are some differences between same-sex and heterosexual couples. Same-sex couples, especially lesbian couples, are more likely to endorse equal power in their relationships, and they tend to be more egalitarian in the way they divide household chores, decision making, and child rearing duties (Herek, 2006; Farr & Patterson, 2013). It may help that partners in same-sex couples have been socialized into the same gender roles, making their communication styles more similar (Garanzini et al., 2017). There are some differences in exclusivity and frequency of sexual relations as well (Peplau & Fingerhut, 2007; Whitton, Weitbrecht, & Kuryluk, 2015). Gay men are less likely to restrict sex to their primary partner than lesbian or heterosexual women or heterosexual men, and male couples are more likely to openly agree to be non-exclusive than female couples or male-female couples. For all types of couple, the frequency of sexual relations is quite variable, usually declining over time. However, on the average, gay couples have more frequent sex than heterosexual couples, who have more frequent sex than lesbian couples (Peplau & Fingerhut, 2007). In a longitudinal study, Balsam et al. (2008) found that for lesbian couples, having more sex was an important predictor of relationship quality, more so than for gay or heterosexual couples. The authors suggest that it may be especially important for lesbian couples to overcome whatever problems they face in maintaining a good sexual relationship.

he Children of Gay and Lesbian Parents

Many gay and lesbian adults have biological children from prior heterosexual relationships. Others use artificial insemination, surrogacy, or some combination of modern technologies in order to have biological children. And many others adopt. As you have seen, adoption is now legal for same-sex couples across the United States, although obstacles remain. For example, at this writing, in 7 U.S. states, child welfare agencies can refuse services or placement to nonheterosexual individuals or to same-sex couples if such placements conflict with their religious beliefs (Movement Advancement Project, 2018).

Are there any special risks or protective factors that affect children raised by same-sex couples? A growing body of research, some of it longitudinal, some of it using large representative samples, compares outcomes for children reared by homosexual and heterosexual couples. Many more studies include lesbian than gay couples, but both groups are represented in the literature. In general, the findings are quite consistent: The risk of problematic outcomes is no greater for children of homosexual parents than for children reared by heterosexual couples (see reviews by Gates, 2015; Goldberg & Gartrell, 2014; Meezan & Rauch, 2005; Patterson, 2017). Meezan and Rauch (2005) summarize four key findings:

The parenting styles of homosexual parents are like those of heterosexual parents, although gay and lesbian parents are somewhat more likely to report using strategies consistent with an authoritative parenting style (high levels of warmth and control). Despite the stereotypic concern that gay fathers might be more likely to sexually abuse their children, gay men are no more likely than heterosexual men to sexually abuse children (Patterson, 2004). Children of lesbian and gay parents do not seem more confused about their gender identities than children of heterosexual parents (Bos & Sandfort, 2010). Some studies (but not all) find that they engage in less gender stereotypic toy play than children reared by heterosexual parents, perhaps because their parents are likely to be more liberal in their attitudes toward gender nonconformity (Goldberg & Gartrell, 2014). The vast majority of children grow up to be heterosexual, regardless of their parents’ sexual orientation, and it appears that base rates of homosexuality are about the same for children of homosexual and heterosexual parents. Daughters in lesbian-headed households are more willing to accept others’ alternative sexual identities, more likely to have homosexual friends, and more willing to say that they would consider same-sex relationships. Both boys and girls in lesbian-headed households are also more likely as children to express concern that they might become homosexual, a concern that disappears in adolescence. The teenage children of lesbian couples are no more likely to engage in same-sex sexual exploration than the children of heterosexual couples (Goldberg & Gartrell, 2014).

 No differences have been found in the cognitive abilities, self-esteem, and social or emotional development of children reared by homosexual parents.

·  The majority of studies find no difficulties with peers related to the social stigma of having homosexual parents, although parents worry that their children will be ridiculed, and children sometimes engage in behaviors that keep their families’ characteristics hidden. But often, children of same-sex parents rely more on direct confrontation, such as telling the other party that their comments are unacceptable or seeking support from teachers or peers, strategies that are recommended for managing bullying in general (see Chapter 7; Goldberg & Gartrell, 2014). Rivers, Poteat, and Noret (2008) also found that children of same-sex couples report using fewer school-based supports than children of heterosexual couples. Apparently, school staff are unlikely to acknowledge alternative family structures, and children often feel that school-based supports are not really intended for them. However, such practices may be changing as public acceptance of nonheterosexuality increases.

Overall, gay and lesbian parents appear to be as successful at child rearing as heterosexual parents. Consider one study that included lesbian and heterosexual couples and their children. The children were all conceived through artificial insemination arranged through the same sperm bank, so that one parent was biologically related to the child and one was not. When children averaged 7 years old, both parents and children were assessed using a variety of scales. The results did not depend on the parents’ sexual orientation but on the same risk and protective factors that appear to affect all parents and their children. “Family process variables such as parental adjustment and couple adjustment were more strongly related to children’s outcomes than were family structural variables such as parental sexual orientation or relationship status” (Fulcher, Sutfin, Chan, Scheib, & Patterson, 2005, p. 294).

The Family Life Cycle

Marriages (and other primary relationships) change as partners age and the demands of family life ebb and flow. The family life cycle, a normative, stagelike sequence of traditional family development in intact marriages, has been described in several ways. For example, Duvall (1971) described a historically typical sequence of stages, from early marriage, to early childbearing, to parenting children through various age periods, to launching children, becoming “empty-nesters,” and subsequently facing old age. Carter and McGoldrick (1999) developed a similar description and specified the tasks that accompany each stage (see Table 13.4). In the next section, we borrow from this latter description to highlight some important transitions and challenges facing families. Then we take a closer look at marriage itself and address theories of marital satisfaction and dysfunction.

Stages of the Family Life Cycle

Finding a mate is a task that typically involves a relatively lengthy period of experimentation, especially in Western cultures. Mate selection has been likened to a “winnowing process” by which people go through the step-by-step elimination of ineligible candidates until they settle on a partner (Blackwell & Lichter, 2004). According to this view, people initially select potential dates on the basis of physical attractiveness and personality characteristics from a pool of available, eligible candidates. Further sorting or filtering out follows on the basis of homogamy, or similarity to oneself in religion, SES, race, education, and so on (Horwitz et al., 2016; Luo, 2017). We saw in Chapter 12 that similarity in attachment style is also likely to increase attraction, especially for secure individuals, although insecure individuals are more likely to maintain relationships with individuals who have complementary styles of attachment.

What about love? In the United States, most people believe that love is the most important consideration when choosing a mate (Sprecher & Hatfield, 2017). You might be surprised to learn that this belief is not universal. For example, a cross-cultural study by Buss (1989) found that people from various cultures considered other factors to be more important. Males in South Africa saw maturity and ability to keep house as more significant than love in choosing a partner. And Chinese women valued emotional stability and the desire for a family as important criteria for mate selection.

Sternberg’s (1986, 2006) view of love, composed of the three elements of passion, intimacy, and commitment, which were introduced in Chapter 12, may help us understand these differences. The romantic ideal of love portrayed in many movies and songs embodies the element of passion. This is the aspect of love most closely associated with sexuality and romance. Love that includes passion without intimacy or commitment is called infatuation. Intimacy refers to feelings of attachment or emotional closeness. It characterizes one’s willingness to trust another, to value her support, and to care about her well-being. (Note that Sternberg defines “intimacy” differently from Erikson, who defines it more broadly.) According to Sternberg, when intimacy is present in a relationship without the other elements, a state of liking exists, which is similar to friendship.

The third element, commitment, is present when partners agree to love each other or make a commitment to sustain that love. Maintaining a commitment without intimacy or passion results in the state of “empty love.” Sternberg proposed that any of the three elements can be either present or absent in a relationship, accounting for eight different kinds of love (see Table 13.5). He has expanded on these ideas by suggesting that people hold implicit narratives for love or “love stories,” which direct their choice of a mate and the course of their relationships (Sternberg, 2006). Sternberg posits that those who have matching scripts, or similar implicit narratives, stand the best chance of having a compatible relationship. Each script emphasizes certain elements, such as emotional maturity or the commitment factor, as more important than others, and “love scripts” are heavily influenced by cultural values. In contemporary U.S. culture, elements of romance and sexual passion are typically central to the definition of love and are considered very important for relationship satisfaction and mate selection. Love, it seems, is a social construction and we are strongly influenced by the conceptions of love that are taught by our culture.

Once the members of a couple make a commitment to each other, they begin to develop a new marital or relationship system that is a creative synthesis of the couple’s original family systems. Marriages, then, are more than the joining of two individuals. The couple must develop a sense of “we-ness” that is not so rigid that it isolates them from their original family systems nor so weak that it dissolves under pressure from them.

With time, the couple may become parents, creating a new rung on the generational ladder and reaching a new stage in the family life cycle. Caretaking responsibilities then must be integrated into the marital relationship, and each partner needs to adjust to the new parental role. As children move through the adolescent period, the family needs to adapt to children’s increasing demands for independence. They must learn how to provide the stability and flexibility that characterize authoritative parenting for adolescents.

Next, a couple must deal with the transition of launching their children and renegotiating the marital relationship. Adult children need to balance the attachments they have with parents with those they form outside the family. Parents need to strive for acceptance of their adult children’s extrafamilial attachments as well as of their careers and other personal choices. Overall, all generations need to work toward two goals: tolerance of independence and maintenance of connections. Among families in later life, the transitions involved in grandparenthood, loss of spouse, and physical decline produce further challenges that must be dealt with flexibly.

Marriage and Its Discontents

Recall that the great majority of individuals marry at least once during their lifetimes. Clearly, many of these unions do not last “till death do us part.” People still divorce in record numbers despite a modest decline in the divorce rate since 1979. It is surprisingly difficult to determine accurately the likelihood that a marriage will end in divorce, but common estimates based on census data in the United States are that 40% to 50% of first marriages and up to 60% of remarriages end in divorce. These rates do not account for the number of unions that break up without benefit of legal divorce.

Women typically experience a 45% drop in standard of living following a divorce. Each year approximately one million children witness the dissolution of their parents’ marriages and subsequently often share in their mothers’ reduced circumstances. Yet divorce wreaks more than financial hardship for children. Researchers have documented increased emotional and behavioral problems, such as underachievement, antisocial behavior, and depression in children and adolescents after divorce (Gahler & Palmtag, 2015; see Box 13.2). Given that divorce is sometimes the best or the only alternative to a troubled marriage and that not every child of divorce suffers dire consequences, we should nonetheless consider how to help prevent what is so often a powerfully negative event in people’s lives.

Box 13.2: When Parents Divorce

Georgia and Jim, an affluent White couple, were married for 12 years. Georgia had an impairment that made it impossible for her to drive, although she competently handled most aspects of child rearing and homemaking. She felt isolated in a suburban neighborhood without public transportation, living far from her extended family. Jim brushed aside Georgia’s frustrations. He felt that suburban environments were best for children. He believed that he was more than generous with his time as the family “chauffeur,” and that Georgia was dismissive of the benefits of his successful career. Jim made lots of time for his family, somewhat enjoying his power as transportation guru, and he was jealous of his relationship with the beautiful and gregarious Georgia. He feared what “too much freedom” might bring. Georgia defied Jim’s controlling strategies in a variety of ways. Vitriolic battles ensued, with mutual accusations of disloyalty, brutality, and unfaithfulness.

The couple’s children, ages 3, 5, and 9, were caught in the headlights as their parents’ fears and frustrations drove a once vital marital relationship into a brick wall. Divorce proceedings were marked by repeated custody and financial court battles. Eventually Georgia moved the children to an urban condominium; Jim found a house with some acreage two hours away. The oldest child, Emily, was continually torn by conflicting loyalties, as both parents treated her as a confidante and ally in their battles. At the worst of times, Emily, still a pre-adolescent, was often in charge of her younger siblings overnight, while their mother explored her newfound freedom. Emily was strictly enjoined not to reveal this arrangement to anyone, especially her father. Her father was not much more responsible: At times he insisted on extensive visits from his children, during which he pumped them for information about their mother, and at other times he “punished” their mother by refusing to see the children or to send support payments.

Although this family’s story has unique features, it also has many characteristics that are relatively common to the divorce experiences of children: longstanding parental conflict that continues after divorce and to which the children are witnesses and unwitting pawns; parents so stressed and absorbed by their problems that their parenting breaks down in critical ways; dramatic changes in the living arrangements of the children. Although not true in this case, many custodial mothers experience a substantial decline in their standard of living; it is not unusual for mothers and children to slip into poverty. It is not surprising that “children often report their parents’ marital transitions to be their most painful life experience” (Hetherington, Bridges, & Insabella, 1998, p.170).

Are There Any Consistent Developmental Consequences for Children of Divorce?

Overall, children whose parents divorce (or divorce and remarry) have higher rates of behavioral, emotional, and cognitive problems than children whose parents maintain a stable marriage (the “continuously married”). As we review some of these outcomes, however, keep in mind that the impact of divorce on children in specific cases depends on multiple characteristics of the children, the parents, the family, and the community, which all interact in complex ways. Understanding the impact of divorce requires a multidimensional or systems perspective. Individual studies of the consequences of divorce sometimes yield inconsistent results, some finding serious, long-term consequences for children, and others suggesting only temporary problems. Fortunately, meta-analyses and reviews of large numbers of studies have begun to clarify not only what problems tend to occur, but also how the complex blending of risk and protective factors contributes either to sustaining these problems or to mitigating them. The following summary is primarily based on large-scale longitudinal studies (such as Amato & Anthony, 2014; Anthony, DiPerna, & Amato, 2014; Gahler & Palmtag, 2015; Weaver & Schofield, 2015), and on meta-analyses and reviews (Amato, 2001, 2005; Greene et al., 2012; Hetherington et al., 1998; Hetherington & Kelly, 2002; Lansford, 2009).

What Are the Most Likely Problems for Children of Divorce?

Compared to children of continuously married parents, the children of divorce tend to have lower grades and achievement test scores. They are more likely to display externalizing problems (e.g., conduct problems) and/or internalizing problems (e.g., depression). They are likely to have fewer friends and less peer support, and their self-esteem is likely to suffer. As children get older, new problems may emerge. Adolescents and young adults can have more difficulty establishing and maintaining intimate relationships. They are more likely to be sexually active at earlier ages and to have out-of-wedlock children. Dropping out of school, trouble finding and maintaining employment, illicit drug use, and other forms of delinquency are all more common for youth from divorced families, regardless of ethnicity. In adulthood, children of divorce have more trouble staying married, partly because of other outcomes of divorce (like early child bearing) and partly, it appears, because their marital interactions are more likely to involve negative exchanges, such as criticism and contempt. Divorce rates tend to be higher for adults who experienced their parents’ divorce during childhood. Intergenerational transmission of marital strife and divorce even extends to the third generation, with the children of the children of divorce more likely to divorce (Amato & Patterson, 2017).

How Common Are These Problems and Why Do They Occur?

It appears that 20% to 25% of children whose parents divorce have one or more of these problematic outcomes, while only about 10% of children of continuously married parents have them (Hetherington et al., 1998). The increased risk for children of divorce is clear, but it is also clear that the majority of children of divorce are able to overcome the difficulties that their parents’ marital changes create for them. Children who have adjustment problems in the first year or two after a divorce often show improvements thereafter, although new developmental challenges, such as becoming an adolescent, can precipitate new problems. Among the risk and protective factors that contribute to differential outcomes are individual factors, like parents’ personalities and children’s temperaments, and family factors, like how much conflict children witness as well as the post-divorce financial arrangements and re-marriages of their parents.

For example, children’s characteristics matter. An intelligent child with an easy temperament and good social relationships is likely to weather the storm of divorce, even in very difficult circumstances, more effectively than a child with a difficult temperament or one with a history of cognitive or social problems. Both boys and girls are negatively affected by divorce, but some girls show remarkable resilience, rising to the challenge of increased responsibility, especially in a mother-headed household. Boys are less likely to do so. Yet boys adjust better to a mother’s remarriage, apparently benefiting from a stepfather in the home, whereas girls tend not to adjust well to living in stepfamilies (Hetherington et al., 1998; Weaver & Schofield, 2015).

Another important factor is children’s exposure to parental conflict both during the marriage and after a divorce. Children whose married parents are chronically in conflict, creating a hostile household environment, often do better if their parents divorce, especially if they are less exposed to conflict after the divorce and their parents’ distress is reduced (Amato, 2005). Conflict, whether before or after divorce, in which children are “caught in the middle” because their parents fight about them, communicate through them, or denigrate each other to the children is especially harmful (Davidson, O’Hara, & Beck, 2014). Parental conflict appears to have direct consequences. It increases children’s anger, sadness, fear, and insecurity (e.g., Davies & Woitach, 2008), and these negative emotions are related to later behavior problems (e.g., Crockenberg & Langrock, 2001). But perhaps more important are the indirect consequences. Parents in conflict tend to interact with their children less effectively. They behave more negatively and less sensitively toward their children than other parents (Cox, Paley, & Harter, 2001). Even infants suffer the effects: Their attachments are less secure and their emotion regulation is less adequate when their parents frequently argue (Crockenberg, Leerkes, & Lekka, 2007). In a 30-year study of personality development, Block and Block (2006) found that boys who were going to experience their parents’ divorce in their future tended to be undercontrolled (e.g., aggressive) before the divorce, suggesting that for some children, family dysfunction begins to take its toll well before divorce.

Many risk factors seem to have effects by influencing the quality of the parenting children receive. Divorced or divorcing parents tend to be less sensitive and responsive to their children’s needs and less likely to control and monitor their children than continuously married parents (Hetherington & Kelly, 2002). Responding to children’s increased distress and insecurity can be a challenge that parents are ill equipped to handle when they themselves are highly stressed. We have seen that one risk factor, parent conflict, affects children partly by reducing parenting quality. Parents’ emotional distress also puts children at risk (e.g., chronic anger, anxiety, depression, loneliness, and so on) at least in part by affecting the quality of parent–child interactions.

Another risk factor for children is parental remarriage. Children’s adjustment problems tend to increase, and some of this increase is due to declines in parenting quality associated with remarriage. Even though parents may experience emotional and material benefits from repartnering, their own stress often increases as they face new challenges, such as managing new financial arrangements, new relationships and new family roles (e.g., step-parenting). It is not unusual for step-parents to assume disciplinary authority too quickly, before children have had a sufficient opportunity to build the kinds of ties that make discipline effective (e.g., warm, affectional, trusting bonds) (Browning & Bray, 2009).

Another risk factor, separation from the noncustodial parent (usually the father), seems to be a problem more because of changes in the quality of the parent–child relationship than because parent and child spend less time together. The noncustodial parent is likely to find his or her new role quite difficult to navigate, often failing to appropriately enforce controls in order to avoid alienation from the child. Studies of divorced fathers and their children indicate that fathers with more education are more likely to remain highly involved with their children than less educated fathers, and that if mothers are employed, fathers are more likely to stay involved (Kalmijn, 2015). If noncustodial parents maintain an authoritative style with their children, despite having less time with them, children are protected (DeGarmo, 2010). “Competent, supportive, authoritative noncustodial parents can have beneficial effects for children, and these effects are most marked for . . . parents and children of the same sex” (Hetherington et al., 1998, p. 173). Even if parents are in conflict and one parent provides poor quality care, good quality parenting by the other parent serves as a protective factor against negative child outcomes (Mahrer et al., 2016).

Clearly, parenting quality and consistency are not all that is important for long-term child outcomes after divorce. Some factors—such as the temperament of the child, the child’s intelligence, and the problems of moving into poverty—have direct or moderating influences on outcomes. But parenting quality turns out to be a critical mediator of many of the effects of parents’ marital transitions on children’s outcomes. Fortunately, it is a factor that is amenable to intervention (Symons, 2010). Many family courts now offer or require mediation and/or education that is aimed at highlighting to parents the importance of understanding the needs of their children and making those needs a priority in their divorce agreements. At least one comprehensive court related intervention, “The Collaborative Divorce Project” (Pruett, Insabella, & Gustafson, 2005), has demonstrated significant benefits. Compared to controls, intervention parents were more accepting of each others’ importance in parenting their children, parents’ conflict and distress were reduced, fathers’ involvement was increased, fathers were more reliable in making child support payments, and teacher ratings of children’s cognitive functioning was improved. If Georgia and Jim had been required to participate in such a program, perhaps Emily and her siblings would have been protected from some of the negative consequences of their parents’ divorce.

What Makes a Marriage Fail?

In the United States, the legal grounds for divorce are usually “irreconcilable differences.” What makes a difference irreconcilable? How do some people manage to reconcile their conflicts whereas others do not? Are the differences due to the nature of the conflicts or to something about the individuals themselves? These are some of the questions that marital and family researchers have attempted to answer. Increasingly, researchers have relied upon longitudinal studies to describe the course of marriage and to help them identify predictors of distress and divorce as they develop over time. On a more fine-grained level, they have also explored the nature of distressed and nondistressed couples’ interactions so that therapeutic recommendations can be made. We will focus on some important research findings in both of these areas to give helpers a framework for understanding the life of a marriage, the behaviors that lead to successful outcomes, and the behaviors that may foreshadow divorce.

Let’s begin by considering what happens to relationship quality over time. Early studies of marital satisfaction—how partners perceive the quality of their relationship and how happy they are with it—indicated consistent U-shaped patterns. Couples’ satisfaction declined shortly after the marriage, stabilized or reached a low point when children were adolescents, and recovered initial levels of satisfaction when children were launched (Burr, 1970; Rollins & Feldman, 1970). This description is often repeated and tends to be popular and compelling with the public. But it appears to be an artifact of the cross-sectional designs of the early studies. The marriages of the older cohorts in those studies were the ones that had survived, and they were therefore probably among the more satisfying, whereas many less satisfying unions had dissolved. Longitudinal studies consistently paint a very different picture (Karney, 2015). For example, Vaillant and Vaillant (1993) followed a sample of Harvard graduates and their spouses over 40 years. Average ratings of satisfaction gradually declined over the entire course of the marriage for both partners, with somewhat greater declines in women’s ratings. Interestingly, when the couples were asked to recollect the course, their marriage had taken over time, they described their marital satisfaction as following a U-shaped function, declining after their first child was born and improving after the children had left home. But their actual ratings through the years showed that fluctuations in the family life cycle did not predict changes in overall marital satisfaction.

The average declines in marital satisfaction that researchers have found actually mask the fact that if we look closely at patterns for individual couples, there is a great deal of variability. All studies that have looked for individual differences have found several trajectories. For the largest proportion of couples in these studies, satisfaction begins high and actually stays fairly steady or declines only slightly over time. For about one quarter to one third of couples, declines in satisfaction are quite steep, and these couples account for most of the overall average decline. These couples are usually less satisfied with their marriages from the start. These are the couples who are at most risk of divorce, although couples within every trajectory are at some risk (Anderson, Van Ryzin, & Doherty, 2010; James, 2015; Lavner & Bradbury, 2010, 2012; Lorber, Erlanger, Heyman, & O’Leary, 2015). Partners from low-income and minority groups are somewhat more likely than middle- or upper-middle-class Whites to be among those who begin marriage with lower levels of satisfaction and show substantial declines over time (James, 2015; Karney, 2015), perhaps because day-to-day stressors are often greater for these groups.

Why, at least for some, does marital satisfaction decline? Let us consider three contemporary hypotheses about marital success and breakdown for some possible answers. Imagine three hypothetical newlywed couples, the Grays, the Browns, and the Greens. Mr. and Mrs. Gray are very much in love. Even when they are in the presence of other people, they behave as if they see only each other. They are highly affectionate and romantic, and their courtship was a whirlwind of exciting events. The Grays believe that they are each other’s soul mate, possessing few, if any, negative characteristics. They have no doubts about the happiness that awaits them in marriage.

The Browns are also an affectionate couple. Their view of each other, however, is not quite as rosy as that of the Grays. Their engagement period was a long one because both husband and wife worked to save up enough money to buy a house. Shortly after the wedding, Mrs. Brown noticed that her husband was becoming less willing to part with any of his income for furniture or other items for the house that she considered important. This has already become a source of tension in the marriage.

The Greens met each other through an online dating website because each was having difficulty meeting eligible romantic partners. Mrs. Green was very insecure in social situations and worried constantly that she would never find a husband. Mr. Green did not want to get married so soon, but he consented because he was afraid that he might lose his chance. Their courtship was a rocky one from the start.

As you read about each of these couples, did you think one or more of them would be more likely to divorce than another? If so, why? Your answers might illustrate popular hypotheses about why marriages succeed or fail. Those who espouse the disillusionment model might choose the hypothetical Grays as the couple most likely to experience marital breakdown. This view posits that overly romantic idealizations of marriage and blissfully optimistic views of one’s partner set people up for eventual disappointment. Such fantasies cannot coexist for long with the reality of married life (Casad, Salazar, & Macina, 2015). The rise in divorce rates and incidence of cohabitation might be partially attributable to the fact that young adults today have high (Balestrino, Ciardi, & Mammitti, 2013). However, another possibility is that the Grays are not especially likely candidates for divorce because they will work hard to maintain their favorable beliefs about each other, despite the inevitable challenges of marriage. Their positive illusions are supportive of the relationship; thus they may be reluctant to abandon them to face reality. This perspective is called the maintenance hypothesis (Karney & Bradbury, 1997). A number of studies have found that people do sometimes use cognitive strategies to help them maintain positive views of their partners despite negative experiences (Karney, 2015). One strategy is to discount the importance of specific problem domains (e.g., “he’s always late”), and to elevate the importance of positive domains (e.g., “he gives me such thoughtful gifts”). Another strategy is to interpret specific negative behaviors as due to special circumstances rather than as indicative of a more general problem. For example, in a study using partners’ daily diary reports, most people described specific partner behaviors that they evaluated negatively (Neff & Karney, 2009). But for many, those evaluations did not affect their global assessment of the partner. Instead, they made causal attributions for specific transgressions that helped them “make allowances” and be forgiving.

Perhaps you thought that the Browns were the most likely couple to divorce because of the growing tension in the marriage. Another perspective on marital breakdown, built on social exchange and behavioral theories, proposes that increasing problems and mounting conflicts gradually escalate to overwhelm the originally positive perceptions spouses held for each other (Karney, 2015). Over time, partners who experience chronic conflict and who fail to negotiate it adequately may begin to see each others’ characteristics, even their strengths, as having significant costs, draining energy and causing the conflicts (Kashdan et al., 2017).

In truth, no marriage escapes conflict. Recall Amanda and Anthony from the introduction to this chapter. Despite the strength of their relationship, they have conflicts over managing money and household tasks, which are rather common areas of disagreement. For most couples, the steepest slide in marital satisfaction is likely to occur during the early period (Gottman & Levinson, 2000). Approximately half of all divorces occur within the first seven years of marriage. In these early years, couples must adjust to each other, work out routines for household tasks, pool resources, and if they have children, take care of them. Several studies have implicated the transition to parenthood as the culprit in the loss of marital satisfaction. For example, many new parents experience a sharp drop in positive interactions and a dramatic increase in conflict as well as a decrease in marital satisfaction following the birth of the first child (Belsky & Kelly, 1994; van Scheppingen, Denissen, Tambs, Chung, & Bleidorn, 2017). But even couples who remain childless report declines in satisfaction in the early years of marriage. Several prospective studies of young couples’ marriages have found much higher rates of divorce among childless couples than among those with children (Cowan & Cowan, 1992; Shapiro, Gottman, & Carrere, 2000). Thus, the existence of conflict in a marriage is simply not a good predictor of its prognosis, but the way couples handle it may be, as we will see later on.

Finally, let’s consider the Greens. You may have predicted this couple’s marital demise because they seem to bring more personal problems into the marriage in the first place. Intrapersonal models, which draw on theories of attachment or personality, emphasize the contribution of one’s personal history or temperament to the success or failure of relationships. In some studies, intrapersonal variables like a person’s tendency to make positive or negative attributions about her partner and her expectations about the future of the relationship have been found to affect relationship quality over time (McNulty & Karney, 2004). Other important factors are how quickly an individual recovers from conflict and her emotion regulation abilities (Salvatore, Kuo, Steele, Simpson, & Collins, 2011). Personality traits are also important. One particularly robust finding from many investigations of marriages is that higher neuroticism is related to lower levels of marital satisfaction and higher levels of relationship dissolution (Mund, Finn, Hagemeyer, & Neyer, 2016). More neurotic individuals may be easily overwhelmed by the conflicts that are inherent in family life and, therefore, more prone to marital distress. Higher levels of extraversion, agreeableness, and conscientiousness are linked to better marital outcomes (Mund et al., 2016).

Keeping Love Alive

Although the models we have described all may contribute something to our understanding of marriage, each by itself is inadequate to explain its complexity. The marital trajectory seems to be affected by intrapersonal (traits, expectations), interpersonal (problem-solving skills), situational (life stresses, environmental conditions), and developmental (transitions, role change) factors (Karney, 2015). A comprehensive, multidimensional theory of marriage or other committed relationships has yet to be developed. Nevertheless, we can learn a great deal from the research that has been done, particularly during the last decade, to help us improve the relationships of our clients.

Some of the most helper-friendly information comes from the “love-lab” of John Gottman, who has a unique approach to the study of marital dynamics. Gottman and his colleagues have spent years observing and videotaping couples interacting with each other to understand, from the inside out, what makes marriages work or fail. Gottman (1993, 1999; Gottman & Gottman, 2015) used this descriptive approach as a step toward building a theory of marital stability and dissolution that can be closely tied to clinical application.

Three fundamental ideas are important in understanding Gottman’s research. First, he conceptualizes marriage or any primary relationship as a new system that represents a synthesis of the pre-existing elements of each partner’s personal history and temperament. Second, he draws upon systems theory to describe marriage as a relational system that seeks a stable or homeostatic steady state (von Bertalanffy, 1968). This steady state is maintained over time by the couple’s unique balance of positive and negative elements in areas of interactive behavior, perception, and physiology. Behavior refers here to a couple’s interactions and accompanying affect; perception refers to self-perceptions and attributions directed to partners; and physiology refers to the autonomic, endocrine, and immune system functioning of the partners. Third, he premises his approach on research done in the last few decades, which consistently documents a ratio of high negative to low positive behaviors in distressed/divorcing couples as opposed to nondistressed/stable couples.

Thinking about a marital relationship as a ratio of positive and negative factors is somewhat like considering the relationship to have a typical kind of “weather,” for example, sunny, calm, cloudy, stormy, and so forth. The marital climate or stable steady state is made up of uninfluenced (intrapersonal elements like neuroticism) and influenced (couple’s interaction) elements. From a systems perspective, a marital union tends towards stability in its positivity to negativity ratio over time. Obviously, contextual features and crises also play a part in the nature of relationships, but these factors are not emphasized because they are less predictable.

Gottman and his colleagues developed ways to measure levels of positivity and negativity in couples’ behavioral interactions, in their perceptions of each other, and in their physiological states, such as arousal or calmness, using observational coding systems, measures of physiological responding, and questionnaire and interview data. Over several extensive longitudinal studies, they set out to predict which couples would divorce and which would remain together. Moreover, they sought to determine whether particular elements were associated with marital breakup or success (see Gottman, 1994a; Gottman & Levenson, 2000).

In general, making this kind of marital “weather report” has surprising predictive ability. Assessments done at the beginning of a marriage, including those made from videotapes of the first three minutes of a newlywed marital conflict discussion, predicted later outcomes with a high degree of accuracy (Carrere & Gottman, 1999; Carrere, Buehlman, Gottman, Coan, & Ruckstuhl, 2000; Gottman & Levenson, 2000). What turns out to predict marital dissolution best? A high level of negative affect reciprocity is a distinguishing feature. This construct refers to the likelihood that negative emotions in one partner will follow from the other partner’s negativity. You may think of it as the likelihood that partners will bring out the worst in each other. This is accomplished through the combined influences of information processing biases (e.g., seeing the other’s qualities as negative), heightened physiological arousal (e.g., interpreting arousal as anger), negative behavioral interactions (e.g., being critical and defensive), and failing to respond to a partner’s bids for attention.

But a number of fine points bear mentioning. As it turns out, conflict and angry feelings are part of all intimate relationships, so simply trying to avoid conflict won’t help. Furthermore, not all negative affect is equally deleterious to relationships. Anger can play a constructive function when it is a justifiable reaction to a partner’s behavior or reflects airing of grievances (Gottman, 1994b). The trick is to distinguish between functional and dysfunctional types of negativity. Other researchers have drawn similar distinctions (e.g., Markman, Stanley, & Blumberg, 1994), but, for the sake of simplicity, we will present Gottman’s definitions here.

The four kinds of negativity that do the most damage to relationships and that are highly predictive of divorce are criticism, defensiveness, contempt, and stonewalling (see Table 13.6). The presence of these “four horsemen of the apocalypse” (Gottman, 1999), particularly contempt, can be very destructive. But suppose you recognize some of these elements in your own close relationship? Does this forecast an inevitable breakup? You may be somewhat relieved to know that Gottman found criticism, defensiveness, and stonewalling even in happy marriages. In couples headed toward divorce, however, these three behaviors were more frequent, contempt was also present, and there was much less positive affect in the relationship overall. Most important, the distressed couples he observed were not skilled in repairing the relationship after conflict occurred. Instead, prolonged periods of unrelieved distress, accompanied by heightened physiological arousal, fueled negative perceptions of the partner, overwhelmed spouses’ positive feelings for each other, and led to a state of isolation and loneliness. Over time, if negativity surpassed positivity, it contributed to the derailment of the relationship.

With the accumulation of stresses and losses that we all experience in adulthood, it makes sense that good coping skills would be an essential component of personal and interpersonal wellness. Therefore, a critical part of marriage maintenance (and probably that of any close relationship) is the capacity to repair the frayed relationship after conflict. Gottman observed that the particular type of conflict style that couples demonstrated did not matter as much as the amount of overall positivity in the relationship (humor, interest, affection, and validation) and the couples’ ability to soothe hurt or angry feelings. Some couples tended to avoid conflict and others embraced it with gusto, whereas some discussed their differences with the validating (“I hear what you are saying . . . ”) style of counselors. Surprisingly, all three types could be very happily married if the steady state ratios of positivity to negativity in their relationships were 5 to 1. In other words, if a marital climate has substantially more periods of sun than rain, the chances of long-term success are pretty good.

Generativity: Making a Mark at Midlife

Establishing generativity is the primary developmental task of middle adulthood according to Erikson (1950/1963). Generativity has been described as having several components (Hofer et al., 2016). As we saw in Chapter 12, two primary components are desire and accomplishment. Desire refers to wanting to be creative, productive, or giving, and accomplishment means actually feeling that you are creative, productive, or giving. Generative desire is more characteristic of young adults, but generative accomplishment is more typical of middle adults.

The Experience of Child Rearing

For many people, raising children is a significant part of adult life. Parents experience more stress than nonparents, but they usually view their parenting role as a generative process (Marks, Bumpass, & Jun, 2003). The nature and quality of the parenting experience, including the parent’s feelings of generativity, change substantially as both children and parents grow older.

Each major period or stage of a child’s life creates new challenges for a parent, challenges that the parent is more or less prepared to face depending on her age and stage of life, her personality and coping skills, her socioeconomic status, and the available support systems. For example, the gratifications of parenthood and marriage are usually greater for older rather than younger first-time parents. Older parents tend to have a more fully developed self-concept and greater self-esteem, are more advanced in their careers, have more money, and are more likely to find balancing work and family responsibilities easier to negotiate. Older fathers spend more time caring for their children than younger fathers, a factor that not only increases satisfaction with parenting but also improves satisfaction for both partners. Older dads also tend to be less physical with their young children (e.g., less tickling and chasing), and to engage their children in more cognitively stimulating activities than younger dads (Parke, 2002). Research on mothers indicates that age is not a factor in how likely mothers are to meet their infants’ health, safety, and survival needs; younger mothers are as effective as older mothers in feeding, holding, and establishing positive emotional bonds. Yet older mothers tend to have more basic knowledge about children and parenting than younger mothers (Bornstein, 2015). Older mothers are likely to use fewer punitive measures to control their children’s behavior, and their children have fewer behavioral and emotional problems than other children, at least until the teen years (Trillingsgaard & Sommer, 2016). Even with social class controlled, older moms provide more cognitive stimulation to their infants. They talk to them more and use more diverse vocabulary, and they provide more exploratory opportunities (Bornstein, Putnick, Suwalsky, & Gini, 2006).

Not surprisingly, very young first-time parents (under 20) are at greater risk than other groups to find that the stress of parenting outweighs its satisfactions. They typically complete fewer years of education than older parents and have lower incomes. They are more likely to divorce than other groups, and their children are more likely to experience developmental problems (Bornstein, 2015; Mollborn, 2016). We should note that some of the problems of teen parenthood are a function of the social disadvantage that many teen parents experience before they become parents. Fortunately, the teen birth rate has declined dramatically in Western countries in recent years, especially in the United States, where the rate decreased by 50% between 1995 and 2013 (Mollborn, 2016).

Although late-life child bearing is associated with many positives, as you have seen, there are risks as well. For example, the children of older parents are more likely to be born with chromosomal abnormalities or other genetic anomalies (Kong et al., 2012; National Down Syndrome Society, 2018). Clearly, the impacts of parenting on parents and children, like all other developmental outcomes, are a function of many interacting risk and protective factors.

The normative experience of parents as they move through each stage of parenting is that the challenges bring both intense new stresses and delightful new pleasures (Nelson, Kushlev, & Lyubomirsky, 2014). For example, in the newborn period, first-time parents often feel distressed and overwhelmed and are likely to experience a decline in marital satisfaction (van Scheppingen et al., 2017). Caring for an infant is far more demanding than most people expect it to be. Distress is linked to insufficient sleep; money worries; anxieties about the baby’s dependency and vulnerability; feelings of uncertainty about one’s caretaking skill; difficulty balancing the needs of self, partner, and baby; and disillusionment with the “yucky” side of infant care (such as mounds of laundry, endless spit-up, and baffling crying fits just when it’s time for the parents to eat dinner). Simultaneously, however, most parents of newborns report feeling like they have now truly grown up, that their lives have new purpose and meaning, and that they have a strong sense of shared joy (Nelson et al., 2014). The transition to parenting involves tasks and demands that are transformative for many first-time parents. For example, gender role attitudes tend to become somewhat less egalitarian and more traditional as mothers and fathers attempt to adapt to their new roles (e.g., Katz-Wise, Priess, & Hyde, 2010). For both mothers and fathers, personal identity becomes somewhat less focused on work and more on family, although the shift in work salience tends to be greater for mothers.

The parent of the toddler or preschooler must begin to discipline a child who is still very dependent but who is skilled enough to need continuous supervision. Because a toddler is a proficient climber, for example, a parent can no longer put her in a crib to keep her safe while the parent takes a quick shower or talks on the phone. Parents begin to have conflicts with their children when the child, who has little capacity to take the parents’ perspective, resists their disciplinary efforts. Also, partners often find themselves in conflict about their children as they negotiate disciplinary styles, time commitments, and divisions of labor. And parents feel physically exhausted as they try to keep up with energetic, active youngsters who have little self-control. Although many parents experience this period as especially stressful, there are new pleasures as well (Edwards & Liu, 2002). Children begin to talk, to participate in organized activities, and to do things on their own, such as feeding themselves. Their temperaments are blossoming into personalities, and a new little self becomes part of the family system. Most parents experience these developments as intriguing and as a source of pride, despite the heavy dose of frustration that these advances can bring.

Up to middle childhood, parents spend a good deal of time with their children and tend to be immersed in caregiving activities (Bornstein, 2015). But when children move into middle childhood, parents spend less time with them and the family waters are often somewhat becalmed. If there is a honeymoon period between parents and children, this is it. The child’s thinking is more logical, she has a growing capacity to take another’s perspective, and she can in many situations keep herself safe, so that supervision can be reduced. At the same time, the child does not yet feel much ambivalence about her dependence on her parents, and parents still enjoy the role of preferred companion. There are plenty of challenges in this period, of course. Outside factors—such as peers, teachers, and the media—are increasingly influential. Helping children learn to interpret and negotiate the outside world and to deal with the stress it creates can be difficult (e.g., Collins, Madsen, & Susman-Stillman, 2002).

Parenting usually becomes more demanding when children reach adolescence (Bornstein, 2015). Mothers with early adolescent children (middle school age) report greater feelings of stress and lower life satisfaction than at other times in their children’s life cycle (Luthar & Ciciolla, 2016). The child’s push for independence, parental worries about the child’s risk taking and sexual maturity, and the child’s often critical and rejecting attitudes are tough to bear, even when parents are well versed in the needs of adolescents. Many parents reach their 40s and 50s when their children are reaching adolescence, so that they are beginning to confront their own physical aging and perhaps engaging in a “midlife review” at the same time. Steinberg and Silk (2002) report that adolescent development and parental distress about midlife are interacting factors. For example, parents whose teens are actively dating and involved in mixed-sex activities are more likely to express midlife concerns and to feel less satisfaction with their lives than parents whose teens are not yet dating. Parent and adolescent bickering over mundane matters and adolescents’ de-idealization of parents can also take a toll on parents’ well-being.

The launching period, when emerging adults begin to move away and become more self-sufficient, brings some new challenges. On the whole, by the time adult children are in their 20s, parents begin to feel the benefits of fewer parental responsibilities—less stress and greater feelings of well-being—and their relationships with their children improve. We often hear about how sad parents are, especially mothers, when their young adult children depart, leaving an “empty nest.” In a summary of decades of data, Bouchard (2014) reported that although parents often anticipate that the transition will be difficult for them, only a small proportion describe especially negative feelings. These are more likely for mothers who experience a substantial drop-off in community activities without children at home. It seems that it is the absence of alternative roles that causes the transition to an “empty nest” to be difficult for mothers, rather than children’s departure per se. In fact, mothers, who typically do more of the day-to-day child rearing, are more struck by the relief they experience from those duties than fathers are. Their greater involvement may also lead them to prepare more and to do more planning for the next phase of their lives. Fathers (at least in Western cultures) are more likely to report negative feelings than mothers, especially fathers with traditional gender expectations and roles. They seem to struggle more with the concept of their adult children becoming autonomous, which modifies their role as decision maker and changes the structure of the family. For both mothers and fathers, feelings of well-being and generativity are strongly correlated with their children’s functioning. If adult children are seen as personally and socially well-adjusted, parents are likely to experience greater self-acceptance, purpose in life, and feelings of mastery (Ryff, Lee, Essex, & Schmutte, 1994).

You won’t be surprised to learn that cultural context and historical events can affect how the launching period is experienced by parents. In today’s world, Chinese empty-nesters are likely to have poorer relationships with their adult children and to report higher levels of loneliness and depression than parents whose adult children live at home. In a culture where family support for older people is a valued tradition, the migration of young adults from rural to urban areas that characterizes modern China probably contributes to these findings (Bouchard, 2014).

What happens when adult children have launched, or at least by cultural standards, should have launched, but return to live with their parents? The U.S. Bureau of the Census (2017) indicates that more young adults (ages 18 to 34) live with a parent than with a spouse today than have done so in the past. In many cases, children have moved back in with parents after attending college, cohabiting with a partner, or sharing an apartment with friends. These “boomerang children” are typically single, and about one fifth have children themselves. Many characteristics of both parents and children, such as personality traits and health status, influence the impact of co-residence on parents. One important factor is how normative the experience is seen to be. In one study, middle aged parents answered questions about their marital quality at two time points, just before the Great Recession in 2008 and five years later, when co-residing adult children had become much more common (Davis, Kim, & Fingerman, 2016). In 2008, parents of adult children who were co-residing reported lower marital quality than other parents of adult children. In 2013, when co-residence was more normative, there were no such effects on parents’ marital quality. However, if children had “boomeranged” because of serious problems, such as divorce or job loss, parents apparently were more stressed, and their marital quality was likely to suffer.

The typical parent is exiting middle age when her children are entering it. Parents whose children are over 30 years old may find the quality of their relationships changing further, such that they now tend to relate to their children more as equals. Adult children often begin to identify with their parents, appreciating more profoundly what an adult’s life is like than they ever could have before. Exchange of support seems to become more and more complementary. However, the relationship is still not likely to be completely egalitarian. Assistance and support, such as financial help, are still more likely to be provided by the older generation to the younger one (Birditt, Fingerman, & Zarit, 2010; Byers, Levy, Allore, Bruce, & Kasl, 2008).

As adults move through middle age, they sometimes find themselves in the role of kinkeeper, the person in an extended family who helps the generations maintain contact with one another (e.g., Sinardet & Mortelmans, 2009). They may also take on new family responsibilities involving care of an ailing parent or another elderly relative. Most adults in the United States enter midlife with one or both parents living, but by the end of midlife, 77% have lost both parents and many have participated in some way in their parents’ terminal care (Lachman, 2004). Women are much more likely to play these roles than men in most cultures, although many men take on some kinkeeping or caregiving responsibilities. These tasks can be particularly challenging if they coincide with the adolescence of one’s children. People who carry these double responsibilities are described as being in the sandwich generation (Bornstein, 2015; Hamill & Goldberg, 1997).

Many factors affect how stressful this position is, such as the coping style of the sandwiched individual, educational, financial, and cultural factors, and the availability of other family help, especially the support of the partner. As with the challenges of parenting, kinkeeping and elder care can put caregivers at risk for physical and mental health problems (Hsing-Yi & Chiou, 2010). Yet it can also bring emotional rewards, such as feelings of mastery and meaningfulness. See Box 15.1 in Chapter 15 for a fuller discussion.

Work and Community Involvement

Our careers begin in young adulthood, but it is in the middle adult years that people usually feel they are becoming expert in their work. The full fruits of a career are likely to be experienced in this stage of life, and for many, identity is heavily affected by work (Williams, Berdahl, & Vandello, 2016). Incomes for both men and women tend to reach their peak, and top levels of management and professional advancement are most likely to characterize people in this age period as well. Work intensity and time invested in work usually increase in the first half of middle adulthood and then begin to taper off, as many people begin to strike a balance between time spent working and time spent with family and friends and in community service. This shift seems to be motivated for some people by increased confidence in their productivity and their value in the workplace, allowing them to invest more energy and effort into other aspects of their lives. For others, the shift may be motivated by a sense that their work will not bring them the satisfactions they may have once expected or dreamed about (Levinson, 1986).

This temporal pattern, of course, varies considerably across individuals and life circumstances, such as social class and marital status. It is also linked somewhat to gender. In married couples, women who continue to work after having children generally give more priority to child rearing over career responsibilities (McElwain, Korabik, & Rosin, 2005). Men are less likely to do so, although fathers are more likely to modify the intensity of their work effort in dual-earner couples, which now represent the most typical arrangement in the American middle class. With this change has come a shift in role structures, with men becoming more active, involved parents and taking on more household responsibilities, although women still shoulder more of these burdens (Connelly, 2016). There is some evidence that for more recent cohorts of U.S. parents, self-esteem goes up for fathers who adjust their work schedules to accommodate family needs, even though they are likely to worry about negative effects on their careers. “Stay at home” dads are rapidly growing in number, but they still comprised fewer than 5% of fathers in 2015 (Chesley & Flood, 2017). And, just like mothers who choose to give up careers to care for children, “stay at home” dads tend to miss the daily adult interactions they had in the workplace (Cynkar, 2007). For mothers in recent cohorts, self-esteem tends to decline if they cut back on employment to take care of family responsibilities; older cohorts of men show a similar tendency (Carr, 2002). Note the impact of historical context on the interplay of social roles and psychological functioning.

The picture is a little different in Western versus non-Western countries. In one analysis (Chandra, 2012), work–life balance was more likely to be considered the responsibility of employers in Western countries. Employee assistance programs, flexible work schedules, and so on have become more common in the United States and Europe, and both genders share in the benefits. In Asian countries, the problem of balancing home and work was perceived to be an issue for women who retained primary responsibility for household duties. Individuals were expected to take responsibility for balancing jobs and family. In many cases, women were expected to limit their career options in the service of motherhood, which was considered their preeminent role.

Western researchers have found that participating in multiple roles (active parent, spouse, worker, caregiver to aging parents, and so on) makes middle adulthood hectic. Professionals frequently work with middle adults who are struggling to find effective ways of resolving what is called “work-life” or “work-family” conflict, meaning that responsibilities in the work and family domains are at least somewhat incompatible (Bennett, Beehr, & Ivanitsakya, 2017; Fellows, Chiu, Hill, & Hawkins, 2016). Amanda and Anthony, from the introduction to this chapter, are clearly experiencing work-family conflict, and they disagree on how to address it. Amanda’s longer work hours and the needs of their adolescent children are squeezing time that Amanda once gave to housework, and Anthony is reluctant to give up his leisure time activities to help compensate. You can see in this couple lingering and long-standing gender role influences. Women tend to see a well-kept house as a reflection on their worth; men do not (Chesley & Flood, 2017). One solution might be for Amanda and Anthony to step a little further outside of their gender roles and compromise. Perhaps Amanda can accept that less housework will be done in a week, and Anthony can reduce some of his leisure activities to contribute more to daily household tasks.

Despite the challenge of such conflicts, when couples reach mutually acceptable agreements, multiple roles can contribute to life satisfaction, to mental health, and to better relationships (ten Brummelhuis & Bakker, 2012). Generally, in dual career households, the degree to which both parents modify their work and leisure time and share child care and household duties is a significant factor in determining marital satisfaction and feelings of spousal commitment, especially for women (Shockley & Allen, 2018; Unger, Sonnentag, Niessen, & Kuonath, 2015).

One of the benefits of participating in multiple roles is role buffering: If one role is a source of psychological stress or failure experiences, success and satisfaction in another role may compensate. For example, when women interrupt their careers to take on full-time parenting, they may in midlife restart their careers or start new ones, especially after their children reach adolescence. For them, the intensity of work involvement may be greater than it would otherwise be at this stage of their lives, and it can be out of phase with their husbands’ work involvement, because they are at an earlier point in career development. Yet, the opportunity to be productive in another setting seems to provide a buffer against some of the stresses involved in parenting an adolescent (Larson & Richards, 1994).

We need to be careful not to oversimplify the impact of multiple roles on well-being, however. Social class and gender interact in complex ways to influence how multiple roles affect adult lives (Ahrens & Ryff, 2006; Perry-Jenkins, 2016; Williams et al., 2016). For example, for highly educated men with high status careers, professional role is likely to be central to their identity, and they are likely to consider very long work hours as essential (e.g., physicians and lawyers). These men tend to score better on measures of mental health when they have fewer roles. Blue-collar men more often see their jobs as “a means to an end,” allowing them to provide well for their families. They are also more likely to choose, when possible, to limit work time to allow time for family and other pursuits. These men tend to do better when they do play multiple roles (e.g., parent, community volunteer). For women, these patterns are reversed: Highly educated women often do well when they have multiple roles, but blue-collar women with multiple roles are likely to do more poorly. Clearly, income, kind of work, gender role expectations, historical context, cohort, and culture underlie and modify such trends. As always, it is important for helping professionals to be mindful of the possible differences that their clients bring to the table around the issue of work-life balance.

Money and promotion are the external markers of achievement for middle adults, but a sense of generative accomplishment appears to be more dependent on how creative and productive we feel. The latter experiences are in turn related to how challenging the work is and to the level of interest and expertise that we bring to the work (Csikszentmihalyi, 1999; Deci, Olafsen, & Ryan, 2017). McAdams (2006; Mansfield & McAdams, 1996) explains generativity as constituting both agency and communion. Agency “involves generating, creating, and producing things, ideas, people, events, and so on as powerful extensions or expressions of the self” (Mansfield & McAdams, 1996, p. 721). Agentic generativity, then, depends on self-knowledge, a sense of identity, and the opportunity to work on tasks that match our interests, values, and skills; these are all key features of successful career planning, as we saw in Chapter 12. Generativity also involves communion, expressed “in the adult’s desire to care for the next generation, even to the point of sacrificing his or her own well-being for the good of those who will follow” (pp. 721–722). Behaviors involving giving, offering, and contributing are aspects of communion. Research indicates that adults who are identified by others as “generative” tend to combine both agency and communion in the concerns that they express and in their occupational and community behaviors (Mansfield & McAdams, 1996). See Box 13.3 for a further discussion.

Box 13.3: Men, Women, and Leadership

In high school, Regina loved math and science, and as a first-year college student she signed up to be a chemistry major. Regina liked her courses, but she also loved to party, and hours in the lab, along with grinding competition with premed students in organic chemistry, were not much fun. She began to feel that she was floundering: How could she combine her sociability with her sharp, analytic intellectual style to carve out a future? To satisfy distribution requirements she signed up for an economics course her second semester, and the rest is history. Regina became a very successful economics major, and by the time she was a senior, was being wooed by several major banking institutions for their management training programs. It was the early 1970s in corporate America, and recruitment of at least some women for executive management tracks was beginning to be “politically correct.” But a foot in the door is only that. What did it take for Regina to become one of the top ranking banking executives in the United States by the time she was 50?

Early research on gender and leadership seemed to indicate that women and men have different “leadership styles.” This research often involved bringing together strangers to accomplish some goal and assigning one participant as leader. Under these conditions, gender seems to make a big difference: Men are more “task oriented,” focusing on doing whatever will get the job done, whereas women tend to be more “interpersonal,” putting more time and effort into the quality of the social interaction. But in a meta-analysis of leadership style research, Eagly and Johnson (1990) found that when actual managers who occupy the same organizational positions are compared, both women and men are characterized by task-oriented, not interpersonal, styles. They did find one sex difference in leadership style, however. Women were more likely to be democratic, whereas men were more likely to be autocratic.

Social role theory, like that of Eagly and her colleagues, paints a complex picture of what contributes to leadership development and success for women and men in today’s world (Eagly, 2007; Eagly & Heilman, 2016; Koenig & Eagly, 2014). When an individual fills a role, like a leadership role, the role itself influences their behavior. But their occupational role is only one of many social roles they are fulfilling. Another important one is their gender role, which is composed of a set of expectancies, or “shared beliefs that apply to individuals on the basis of their socially identified sex” (Eagly & Johannesen-Schmidt, 2001, p. 783). Understanding leadership behavior and its effectiveness, for men or women, requires understanding how the demands of these various roles are met within the particular organizational context.

As we saw in Chapter 8, expectancies or stereotypes about gender differences may or may not actually be real, and even when they are substantiated by empirical measures (e.g., males on average are more physically aggressive than females), average sex differences in behavior or traits tend to be small. The range of differences among individuals of the same sex is much greater than the average differences between sexes. But social role theorists argue that the importance of sex differences is not just a function of their real size but of the impact they have on people’s expectations of their own and others’ behavior, as well as on how people interpret behavior. One example comes from research on the widely held gender stereotype that women are more emotional than men, that is, that women lack emotional control (Brescoll, 2016). In a study on anger expressed in the workplace, Brescoll and Uhlmann (2008) found that in simulated job interviews, when women professionals expressed anger, their reactions were attributed to internal characteristics (e.g., “She’s an angry person” or “She is out of control”), but when males expressed anger, their reactions were attributed to external circumstances.

Two aspects of gender roles that are important in the discussion of leadership are agency, which is more strongly ascribed to men, and communion, which is seen as more characteristic of women. As you have seen in the discussion of generativity, agency is a kind of powerful “get things done” expression of self. It can be captured by descriptors like assertive, ambitious, dominant, controlling, forceful, independent, and confident. Communion involves expression of concern for others. Descriptors like affectionate, helpful, sensitive to others, sympathetic, and nurturing apply.

Social role theory predicts that how a woman or a man will behave in a managerial or other leadership position is largely constrained by the nature of the position. They do not discount the influence of individual characteristics, like personality traits, but they emphasize that regardless of the individual filling the role, certain task requirements must be met, such as supervising the work of others, planning, gathering information, and disseminating it. These responsibilities require agentic behavior, and managers tend to behave agentically regardless of gender, as the meta-analysis by Eagly and Johnson illustrates. People also adjust their agentic behavior depending on whether they are interacting with subordinates or with a boss. Moskowitz, Suh, and Desaulniers (1994) used an experience sampling method to monitor managers’ interpersonal behavior at work for 20 days. The same individuals were highly agentic with their subordinates, but less agentic with their superiors. It seems clear that managerial status predicts agentic behavior. But in the Moskowitz et al. study, the same participants’ communal behavior was affected by their gender role, not by their managerial status: Women behaved more communally than men, especially with other women.

It appears, then, that women and men may tend to display different leadership styles, not with regard to whether they are task oriented or agentic, but with regard to how they treat people in the process. In other words, although their agentic behavior is constrained by their managerial role, their communal behavior is constrained by their own or others’ expectations with regard to gender. Eagly and her colleagues propose that an important reason for this gender difference is that when women are leaders, there is an incongruity in role expectations that does not hold for men. Agency is important for leadership and is also expected of men. Therefore, people are likely to accept a domineering, even autocratic, management approach from men. Women must be agentic as leaders because the role requires it, but agency is incongruent with the female gender role and may tend to be perceived negatively by others as a result. In other words, many people may feel ambivalent about yielding power to women. Therefore, for many leadership positions, women will be more successful if they exercise their authority with special attention to at least some communal aspects of the process. They may have to be more democratic, inviting others to participate more in decision making, whereas men may have more freedom to be authoritarian if they choose. Fortunately, women are more likely than men to have developed skill using a collaborative, negotiating style, as we saw in Chapter 8.

Research on leadership in many cultural contexts supports this analysis (Eagly & Antonakis, 2015; Eagly, Makhijani, & Klonsky, 1992; Eagly & Johannesen-Schmidt, 2001; Wang, Chiang, Tsai, Lin, & Cheng, 2013). One meta-analysis examined a large set of studies in which participants were asked to rate others’ leadership skills (Eagly et al., 1992). In all of these studies, the behaviors of men and women leaders had been equated by the researchers. In one type of study, for example, the same behavioral descriptions were ascribed to a woman for some participants and to a man for other participants. Interestingly, participants gave significantly lower ratings to women who behaved autocratically than to men.

In a large international study of actual leaders, researchers assessed the behaviors and effectiveness of 2,874 female and 6,126 male managers, looking at ratings by subordinates, peers, superiors, and by the managers themselves (Eagly & Johannesen-Schmidt, 2001). The most effective managers of either gender were characterized by the same leadership behaviors: acknowledging good performance by followers (giving performance-based rewards), developing and mentoring their followers, attending to followers’ individual needs, and inspiring their followers’ optimism and excitement about the future as well as their respect and pride in their leader. Women managers outscored men on all of these behaviors, especially the most communal of them (e.g., attending to the individual needs of their followers). The least effective managers were those who focused on their followers’ mistakes, procrastinated in solving problems, and were absent or uninvolved at critical times. These were not common behaviors for any of these managers, but they were more common for men than for women.

Why were women leaders more likely than men to engage in the most effective managerial behaviors? Eagly and Johannesen-Schmidt (2001) offer two explanations. First, women probably have to meet a higher standard to be successful managers. “Men may have greater leeway to remain in leadership roles, despite poor performance” (p. 793). Second, the behaviors that are especially effective for leaders—for example, individualized consideration, rewarding positive performance—“may involve being attentive, considerate, and nurturing” (p. 793), communal behaviors that women may be more likely to engage in because of gender role expectations. Another meta-analysis suggests that a larger proportion of women than men in leadership positions are “transformational leaders.” Such leaders are characterized by their ability to gain the trust of employees, to innovate, and to empower others (Eagly, Johannesen-Schmidt, & van Engen, 2003).

The studies we have reviewed thus far suggest that men are less likely than women to be penalized for autocratic, domineering behavior in leadership positions. But this situation may not hold for all racial and ethnic groups, at least in the United States (Rosette, Koval, Ma, & Livingston, 2016). In one study, researchers asked participants to rate the performance of a leader who was confronting a subordinate employee (Livingston, Rosette, & Washington, 2012). The leader was presented in one of two ways: either as demanding and assertive (dominant) or as encouraging and compassionate (communal). A photograph portrayed the leader either as a Black man or woman or as a White man or woman. Participants tended to rate communal leaders more positively than dominant leaders, regardless of race or gender, consistent with the research we have just reviewed. But dominant leaders were rated differently depending on race and gender. If the leader were White, a dominant man was seen as a better leader than a dominant woman, as you might expect. But the reverse was true when the leader was portrayed as Black. A dominant woman was given much higher scores than a dominant man. Although research examining the intersection of race and gender roles in the workplace is in its infancy, this study suggests that minority group members may face very different sets of gender role expectations than Whites.

McAdams and his colleagues have developed a variety of measures of generativity. For example, on a 20-item questionnaire respondents rate the degree to which statements are true of them, such as, “I have a responsibility to improve the neighborhood in which I live” (McAdams & de St. Aubin, 1992). In a measure of generative goals, respondents are asked to describe 10 “personal strivings,” and the responses are coded for “generative imagery” (McAdams, de St. Aubin, & Logan, 1993). Using these techniques, people who rate high on generativity are more likely to use authoritative, child-centered parenting styles, and they are more actively involved in political, religious, and social reform activities. They report higher levels of self-esteem and happiness, and they experience overall better mental health than people who score low on generativity (McAdams & Guo, 2015).

One of the more interesting differences between midlife adults who score high versus low on generativity measures is in the kind of narrative they produce when asked to tell their life stories. McAdams (McAdams & Olson, 2010) argues that the narratives we create about our lives are reconstructions that are based on the real events in our lives but that they also indicate our characteristic ways of making sense of things. They contribute to and reflect our identities and our sense of well-being. Generative adults, for example, tend to tell life stories with “redemption” themes. That is, even though the individual may describe many serious difficulties, her story often progresses from describing an emotionally negative event or bad scene to an emotionally positive or good outcome. Conversely, adults low on generativity tend to include more “contamination” sequences in their life stories. These are descriptions that go from good or positive experiences to negative outcomes.

Generative adults also are more likely to describe themselves as “sensitized to others’ suffering at an early age” and as “guided by a clear and compelling ideology that remains relatively stable over time” (McAdams & Bowman, 2001, p. 14). Overall, there is a progressive structure to the generative adult’s life story that suggests a reasonably coherent sense of a self who is moving in a positive direction and who feels able and willing to make a difference. In particular, such individuals seem to be able to move on despite sometimes serious setbacks. People low in generativity by midlife, however, seem to be stuck, “unable to grow.” McAdams and Bowman (2001) describe one woman who, at 41, is still setting goals that are markedly like those she set as a young woman—“to graduate from high school” and to be “better able to take care of myself.” She tells the interviewer that she is “desperately seeking” herself. Unfortunately, her persistent expectation that what appears to be good will turn out bad—reflected in the many contamination sequences she includes in her life story narrative—seems to make her quest overwhelming.

Generativity seems to be foreshadowed in the personality characteristics that emerge in adolescence and young adulthood. Petersen and Steward (1996) found that individuals who as adolescents already had strong power and achievement needs, combined with strong needs for affiliation, were most likely to demonstrate generativity when they reached middle adulthood. The Big 5 personality traits can play a role as well. Aspects of extraversion (which is somewhat agentic) and agreeableness (especially altruism, which is strongly communal) are correlated with generativity (Cox, Wilt, Olson, & McAdams, 2012). Finally, as we pointed out above, identity development contributes to generativity. For example, self-knowledge can help a person make choices, such as career and community activities that provide a good match to her skills and interests, so that she can maintain her intrinsic motivation to produce and create.

Applications

The middle years are a challenging period of life. Adults have to contend with jobs, children, partners, and themselves, as well as the unexpected crises that occur. They bring very different experiences and dreams into adulthood. It is impossible to establish a life-stage trajectory that could take into account all this diversity with any level of precision. However, there do seem to be powerful themes, such as the quest for intimacy and generativity that characterize most adult lives.

We have seen that many theorists (e.g., Erikson, 1950/1963; Levinson, 1986; Vaillant, 1977) have attempted to specify these themes and their typical progress, though they all seem to recognize that we cannot expect every life story to unfold in some inevitable sequence of events or experiences. These same theorists have also described psychological requirements for healthy functioning as people move through adulthood. One consistent message that these authors communicate in various ways is this: Adults have to grow up. Growing up is not always easy and often not much fun, particularly in an age and in a society that heavily invests in the notion of personal satisfaction, youth, and freedom of choice. However, the very nature of the life cycle makes certain changes inevitable, and once those changes are accepted, they can be the source of great personal satisfaction and pride.

Adult Commitments

For most married people and other intimate partners, both joyous and painful experiences make up the fabric of close relationships and both wax and wane over the course of the life span. Some of these changes are predictable: when a new baby arrives, when children become adolescents, when adult children marry, when parents age and die, when partners experience age-related declines or the onset of illness. Some changes are due to unpredictable events: the sudden loss of a job or the demands of a new one, an unexpected illness, a relocation, a war or economic recession.

Professionals who work with couples can find it helpful to identify the sources of stress as coming from nonnormative or normative causes. Couples in crisis, for example, may be reeling from an unexpected and sometimes traumatic stressor that has taken its toll on the relationship. On the other hand, changes involved in predictable life events, such as steadily accumulating time demands or eroding incomes of working families with children, can affect the quality of relationships just as significantly and may not be quite as obvious to the people involved. Furthermore, changes that come with daily give and take, such as increased realization of a partner’s flaws and idiosyncrasies combined with greater awareness of personal needs and preferences, can set the stage for relationship conflict.

Various methodologies have been employed to address couple difficulties, including behavioral approaches to improving communication and problem-solving skills, cognitive techniques for changing negative thoughts, affective or emotion-focused methods for teaching partners to own and express feelings more effectively, and intrapsychic models that relate present problems to early attachment histories. Specific modalities like Behavioral Couple Therapy ([BCT], Atkins, Dimidjian, & Christensen, 2003), Integrative Behavioral Couple Therapy ([ICBT], Jacobson & Christensen, 1996), and Emotionally Focused Couples Therapy ([EFT]; Johnson, Hunsley, Greenberg, & Schindler, 1999) have demonstrated empirical support and long-term effectiveness in helping distressed couples (Johnson & Lebow, 2000).

The Science of Couple Relationships

Fortunately for helping professionals, the science of couple relationships has progressed over recent decades to reveal some “rules” about how intimate human relationships work. Certainly, researchers don’t claim to understand all the dynamics that operate for each couple, but they do offer clinicians a scientific base of information and a generic frame for viewing the individuals they see in the consulting room. Finkel, Simpson, and Eastwick (2017) recently organized years of research on couple relationships into four broad areas of interest. The results are presented in Table 13.7.

So, we can deduce that relationships are complex, interdependent, and changing. They have the power to alter working models over time and are affected by the responsiveness and conflict management style of the dyad, for better or for worse. Their trajectory and quality is impacted by partner characteristics, culture, coping, needs, and expectations. This information raises the question: With so much complexity, what can helpers hope to change? Luckily, just as our understanding of relationships has improved, so has our understanding of effective therapeutic principles. Most approaches try to accomplish some basic goals (Benson, McGinn, & Christensen, 2012).

First, it’s important to help couples shift the way they see the presenting problem. Therapists can facilitate movement from a personal/one-sided view to a systems perspective. Recall the example of Hannah from Chapter 11 who was quite upset with her boyfriend’s occasional drinking with friends. Drinking is bad, in her view, so she perceived Mike to be the source of their relational conflict. Now imagine Hannah and Mike married for 12 years, with the same conflict. Interestingly, the content of couples’ problem discussions remains remarkably stable over time. Fully 69% of the time, couples’ arguments are about a problem that has existed in the relationship for a long time (Gottman, 1999; Gottman & Silver, 2015). These “perpetual problems,” which have to do with partners’ personalities, may be expressed in the partners’ different behavioral styles or ways of approaching issues such as money, sex, or in-laws. As we have learned, there is evidence for continuity in many temperamental characteristics, and they constitute relatively stable features of individuals’ behavior and cognition throughout their life span. Based on his work, Gottman (1999) suggests that therapists “encourage couples to think of these relationship problems as inevitable, much the way we learn to deal with chronic physical ailments as we get older. The chronic back pain, the trick knee and tennis elbow or irritable bowel do not go away, but we learn to have a dialogue with these problems. We keep trying to make things a little better all the time, but we learn to live with these problems and manage our world so as to minimize them . . . . So it is in all relationships” (p. 57).

The second goal, across modalities, is to help couples reduce the amount of emotional distress and negativity in their relationships, especially when there is conflict. Perhaps Hannah still becomes extremely upset when Mike occasionally stops to meet his friends for a drink after work. She accuses him of hurting her and betraying his moral principles as soon as he returns home, prompting a familiar cycle of blaming (Hannah) and withdrawing (Mike). Emotions such as anger are highly arousing and can escalate into a cascade of negative feelings that shut down real communication. Gottman (1994b) describes in precise detail how these escalating emotions affect interaction:

From the data gathered in our lab, we’ve seen how quickly discussions fall apart as soon as one spouse’s heart rate begins to soar. Because physical responses are such an accurate barometer of your ability to communicate at a particular moment, tracking your arousal level during intense conversation will help keep your discussions on track as well. (p. 176)

This requires that each person be aware of his or her own physiological and emotional reactions. This as a multi-step process in actual practice: becoming aware of one’s reactivity and taking steps towards regulating it effectively. Awareness can be fostered by helping clients learn to take their pulse rate as a measure of physiological arousal, to learn to ask for and take time-outs, and to engage in relaxation activities in order to return to baseline levels of arousal, a process that takes an average of 20 minutes after becoming aroused. Gottman notes that this is a particularly important step for males who typically get physiologically “flooded” with emotion more quickly than women and who take longer to return to baseline (Levenson & Gottman, 1985). Higher levels of physiological arousal during conflict is associated predictively with more unhappiness, so soothing and restoring methods are very important. Partners who are agitated during conflict, with accelerated heart rates, sweating palms, and rapid breathing secrete more adrenalin and other chemical mediators of the stress system, making listening and showing empathy, let alone some humor, virtually impossible. Fight or flight mode gives us tunnel vision and fosters a perception that we are “under attack” by our partner (Gottman & Gottman, 2017).

Couples who live under conditions of sustained interpersonal stress, marital conflict, and dissatisfaction are at risk for mental and physical illness. Significantly, intimate relationships affect partners’ health synergistically, as a function of shared experiences, interactions, and transmission of emotional states. Poor marital quality has been related to depression, sleep disorders, metabolic syndrome, and diabetes (Kiecolt-Glaser & Wilson, 2017). Thus, efforts to improve couples’ relationship quality has long-term public health benefits.

Next, therapists across modalities help clients manage, understand, and express emotions. Emotional suppression intensifies problematic interaction patterns, and over-reactivity can lead to aggression. Partners can become trapped in destructive patterns of relating that create persistent distress. In the demand–withdraw pattern (Eldridge & Christensen, 2002), a very common communication pattern, one partner withdraws to escape the demands of the other and, as a result, demands escalate and withdrawal is reinforced. Mike might be helped to express his disappointment with the couple’s communication in the safety of the therapy setting. Hannah might be helped to learn self-soothing techniques for managing her anxiety about the dire consequences of Mike’s occasional drinking. The target of therapist intervention will undoubtedly depend upon the nature of the problem as well as the therapist’s orientation. However, most couple therapists, regardless of orientation, know to set clear limits on hostile and aggressive displays in therapy sessions to guard against further erosion of the partnership. Counselors are often called upon to help couples work on empathy-building, particularly when their attachment relationship is weakened due to neglect, injury, or prolonged conflict. Sometimes old wounds reemerge in the present and need to be readdressed. Success in relationships often depends upon “the wounded partner being able to express deep hurts and losses and the other partner staying emotionally engaged and actively responding to these emotions with compassion and comfort” (Johnson, 2003, p. 373). Browning’s (1998) empathy-expansion procedure helps partners address a long-standing relationship hurt through a specific process facilitated by the therapist. Through a sequence of steps, the counselor coaches one partner to recognize and apologize for the injury that has been causing the impasse. The goal is to enhance empathic responding and to give the aggrieved partner real validation for his or her pain. Clearly, this is most appropriate for couples who are motivated to put past hurts behind them and who are willing to “do whatever it takes” to mend the relationship.

Gottman and Gottman (2017) have found that for unhappy couples, conflict opens the door to a negative state of mind that is hard to escape. The authors describe it as “stepping into a quicksand bog. No matter how hard they tried, they only sank deeper and deeper into negativity, eventually escalating to the Four Horsemen” (p. 14). Contributing to a couple’s positive “bank account” in non-conflictual times through giving validation, providing assurances, showing interest, and sharing humor and affection can strengthen the emotional connection that provides some insurance against intermittent negativity. In particular, a husband’s playfulness and enthusiasm were related to his wife’s willingness to be more affectionate when the couple did experience a conflict.

Improving couple communication is the fourth principle. Both Mike and Hannah can also learn communication skills that will help them deal with conflicts more effectively in the future. The emphasis on improving communication has a long-established history in marital therapy and in relationship education (Halford, Markman, Kline, & Stanley, 2003). The goal of such interventions is generally to help individuals express their feelings and disagreements in ways their partner can understand. What is critical here appears to be reducing the tendency to come out swinging when conflicts arise. Called “harsh startups” by Gottman and Silver (1999), a conversation about a problem that starts with criticism, contempt, or sarcasm is likely to become an argument that deteriorates quickly. This speedy buildup of emotional negativity results in feelings of being flooded and can lead one or both partners to protect themselves by stonewalling. Taking a “softer” approach when addressing potentially difficult issues can reduce defensive responding and maintain a more positive state.

Teaching couples to focus on positive aspects of the relationship and to practice relationship maintenance skills on a regular basis is the final goal. Relationship maintenance refers to those actions and interactions that sustain the desired quality of relationship or repair a relationship once there is a rupture. Mike can learn ways to verbalize his commitment and show affection to Hannah, and both partners can talk more openly about shared goals. Simply stated, relationships tend to flourish when the psychological atmosphere is positive, and they tend to deteriorate when it becomes negative. Because stress and disagreements are an inevitable part of all long-term relationships, successful therapies appear to blend skills of conflict management with those of positive relationship enhancement. Among the Zulu, a person is traditionally greeted with a word that is roughly translated to mean “I see you.” The response to this greeting is “I am here.” Notice the direction of this interchange: Until you see me, I am not here. We are psychologically “here” because we are seen and known by intimate others, much in the way Cooley describes the looking-glass phenomenon. In the intimate world of close relationships, individuals do not need so much for their partners to solve their problems as for their partners to see and validate what they’re going through. It appears that relationship satisfaction is related not only to how conflicts are resolved but also to the quality of the emotional connection constructed bit by bit though the mundane interchanges that fill couples’ lives. These aspects of a relationship appear to be amenable to therapeutic intervention, whereas many of the cultural, contextual, historical, and personality variables we have discussed are not amenable to intervention. Maintenance skills, however, offer couples the possibility of relationship change.

The Importance of Work

Generativity is not only manifested in building relationships and caregiving. It also is shown in one’s efforts to contribute something to society through work. Most adults find work to be an important expression of their talents and abilities. Our working lives are deeply connected to our sense of personal identity. The experience of nonnormative work-related events, like job loss, can affect well-being and, in some cases, permanently alter one’s life course. Job loss represents a particular challenge to the normative expectations that most adults hold about their lives: to provide for themselves and their loved ones consistently and independently. When workers lose their jobs, a singular expression of their generative capacity is compromised (see Fouad & Bynner, 2008). A longitudinal study of more than 24,000 German respondents over 15 years found that for people who experienced episodes of unemployment, their lives were never quite the same (Lucas, Clark, Georgellis, & Diener, 2004). Workers experienced a decline in overall life satisfaction following job loss and a trending upward towards pre-unemployment levels of satisfaction after reemployment. Nevertheless, their sense of life satisfaction did not return to baseline, even many years after being reemployed.

Job loss and unemployment are related to mental and physical health problems (Daly & Delaney, 2013; Paul & Moser, 2009; Wege, Angerer, & Li, 2017). Individuals who were unemployed in young adulthood reported greater weight gain, smoking, decreased physical activity, and poorer overall health than those who had been consistently employed (van der Noordt, Ijzelenberg, Droomers, & Proper, 2014). Unfortunately, the effects of job loss or gaps in employment do not necessarily remit after some time but contribute to declines in mental and physical health around retirement age (von Bonsdorff, Kuh, von Bonsdorff, & Cooper, 2016). Although financial strain is the most significant reason for depression following job loss, Price, Choi, and Vinokur (2002) have shown that the effects on physical and mental health are mediated by the erosion of a sense of personal control that accompanies the reduction of financial resources. Furthermore, these elements operate transactionally. As the authors indicate, “While job loss and financial strain may influence depression, depression, in turn, may reduce access to opportunities to reduce financial strain through reemployment. Thus, chains of adversity are clearly complex and may contain spirals of disadvantage that reduce the life chances of vulnerable individuals still further” (2002, p. 310). The ripples extend to children, as well, who suffer from more behavioral and academic problems when their parents are under financial strain (Conger, Ge, Elder, Lorenz, & Simons, 1994).

Helpers who work with people experiencing job loss need to take into account such psychological consequences, namely increased stress, anxiety, and feelings of hopelessness, as well as physical problems that may arise, as they help clients deal with this stressful event. Sometimes, individuals might try to cope through behaviors like excessive use of drugs or alcohol. Prevention programs offer some demonstrated success in curtailing the downward spiral of disadvantage following job loss. Self-efficacy skill training appears to play an important part in effective programs. Participants in the JOBS project (Akkermans, Brenninkmeijer, Schaufeli, & Blonk, 2015; Vinokur, Schul, Vuori, & Price, 2000) as well as in Cognitive-Behavioral programs that help alter negative thinking and bolster regulatory self-efficacy (Rose et al., 2012) showed success in finding reemployment, demonstrated fewer symptoms of depression, and reflected better overall adjustment than nonparticipants. There are three main elements to the JOBS program: (1) building skills for the job search, such as improving resume writing, learning to “think like” the employer, networking, and contacting potential employers; (2) increasing participants’ sense of self-efficacy through graded exposure exercises, role-modeling, and reinforcement of effective behavior; and (3) inoculating participants against setbacks that they might encounter in the job search process by identifying possible barriers while practicing the skills needed to overcome the obstacles (Price & Vinokur, 1995).

Although the ultimate goal of counseling may be to find new employment, it is important to remember that the clients’ confidence may be badly bruised and in need of shoring up. This might help explain why some clients do not pursue reemployment in active ways like sending out resumes or going on job interviews. It may be their way of avoiding further damage to self-esteem (Price, 1992). It also suggests why fostering self-efficacy is so important (Lagerveld, Brenninkmeijer, Blonk, Twisk, & Schaufeli, 2017).

Creative interventions, not as task-specific as job searching, may also ameliorate the downstream physical and mental health effects of job loss, discontinuity, or strain that persist into later life. Professionals are fortunate to be able to draw on the rapidly growing body of research in integrative health. As we will discuss in Chapter 14, the mind and body are not separable. Pain, fatigue, poor diet, lack of exercise, substance use, and chronic illness go hand in hand with daily stress, taking their toll in unique and cumulative ways. The challenges of shift work and non-stop responsibility can put adults at risk. Helping clients prioritize reasonable self-care can augment active job seeking steps.

Sleep, in particular, seems to be an underappreciated resource for physical and mental health and personal effectiveness. Naiman (2017) reports on the epidemic of sleep deprivation in the United States that is raising alarms from health professionals. Lack of sleep, particularly the critically important REM (rapid-eye movement) phase of sleep associated with dreaming, contributes to problems with memory, immunity, weight control, and mood. Associations have also been reported between REM sleep deprivation and cardiovascular problems, diabetes, Parkinson’s disease, and dementia. Causes for this widespread problem have been identified as increased substance use (alcohol, marijuana), sleep medications that privilege light sleep over deep REM sleep, anti-depressants and other medications, the ubiquity of artificial light at night, and insufficient time devoted to sleep. Helpers might explore sleep issues with adults and provide information about good sleep hygiene as an important foundation for personal well-being and ability to care for others.

Off-Time

Adulthood is a time when individuals may have to contend with the realization that events or accomplishments that they once wished for have not been achieved. Individuals of all ages may feel distressed by a sense that they did not meet their developmental goals or expectations “on-time.” Feeling “off-time,” as it relates to such things as getting married, having children, reaching career goals, or other normative achievements, reflects the fact that we all have a set of age-related expectations for the appropriate timing of major life events. This phenomenon is called the social clock. Clinicians should be sensitive to this particular source of distress in the lives of their clients to help them cope more effectively. Certainly helpers can support client strivings to find outlets for generative needs that might be met in flexible ways. Even the strains of caring for children or older relatives can be reframed as valuable contributions. For clients without such responsibilities, other outlets might be explored.

Couples may voluntarily choose not to have children or may find themselves childless involuntarily. Although societies are becoming increasingly accepting of personal decision in this area, sometimes subtle and not-so-subtle biases arise that communicate pressure and/or judgment about a child-free life. One way of therapeutically helping those individuals or couples who feel distressed is to recreate narratives that reflect alternative paths to generativity. These may consist of other, more accessible, forms of caring and creative expression as well as deepening of existing relationships (Moore, Allbright-Campos, & Strick, 2017).

Becoming generative can be viewed as a way of growing up, by taking and accepting responsibility for oneself and for dependents, by forgiving past generations for what they may have done, and by working to leave a legacy. As we have learned, flexibility and adaptability in the face of life’s demands support this process. One developmental task involves the shift in expectations that may occur gradually over this time from adolescent idealism to mature acceptance of reality (Gould, 1978).

Focus on Developmental Psychopathology

Post-Traumatic Stress Disorder

Human beings are born with the capacity to experience fear, one of our primary emotions. Fearfulness has evolutionary significance and is necessary for survival. Imagine how long our ancestors would have survived had they not become attuned to the signs of predators and other threats. But is there a difference between fear and anxiety? And when does anxiety become an anxiety disorder? Fear may be considered a hard-wired response to an immediate threatening stimulus, the kind that makes your palms sweat, your heart race, and your stomach tie itself into a knot. Fear triggers the “fight or flight” changes of the body-mind first proposed by Walter Cannon (Bracha, Ralston, Matsukawa, Williams, & Bracha, 2004; Cannon, 1929). Anxiety has been viewed as that uneasy sense of imminent danger. In other words, we get anxious about the possibility of something fearful happening.

In learning theory terms, both classical and operant conditioning processes are in play. Stimuli that actually cause fear or pain, such as loud noises or electric shock, can become associated with other neutral stimuli. In the end, these classically conditioned stimuli elicit the same physiological fear response as the original stimuli because of powerful learned associations. Termination of aversive stimuli results in escape learning, and escape behaviors are reinforced by virtue of their power to provide relief. Ultimately, avoidance conditioning patterns develop whereby individuals tend to avoid settings or situations that may cause distress because they have learned a set of anticipatory cues. Avoidance is strengthened through the process of negative reinforcement. Consider a woman who, as a result of early experiences of punishment or love withdrawal for expressing anger towards parents or others, has learned to suppress these threatening feelings. Such early aversive consequences can result in long-term patterns of conflict avoidance as well as avoidance of her own subjective angry feelings. The process is a maladaptive turn of events. What was once adaptive, avoiding pain and discomfort, becomes a generalized operating principle in circumstances that may not be particularly threatening. The maladaptive result, called “experiential avoidance,” or anxious apprehension and avoidance of one’s own real experience, can be quite problematic (Hayes, 2004). The harmful effects of emotional avoidance and suppression have increasingly been recognized (Hayes, 2016). Opportunities to become more assertive and less anxious in social situations are effectively shut down through avoidance patterns.

When fear and anxiety become overwhelming, individuals can develop anxiety disorders, which cause significant restriction in their lives and persistent intrusion into their states of mind. Unfortunately, anxiety disorders are very common. Across the world, estimates of anxiety disorders range from approximately 4% to 25% (Remes, Brayne, van der Linde, & Lafortune, 2016), with certain groups more affected than others: women, young adults, chronic illness sufferers, and people in North American, North African, Middle Eastern, and European regions. Anxiety also accompanies many other mental illnesses, including depression, schizophrenia, and substance abuse. Previously, anxiety disorders were defined as the class of disorders that shared the characteristic feature of anxiety. DSM-V has revised its diagnostic criteria for anxiety disorders due to better understanding of their causes. Those that remain in the anxiety disorder category include panic, phobia, and generalized anxiety disorders. Post-traumatic stress disorder (PTSD) is now in a class of disorders called Stressor and Trauma-Related Disorders, given its clear association with traumatic events (APA, 2013).

PTSD reflects an extreme, persistent, and pathological expression of human stress system physiology (Bernardy & Friedman, 2015). PTSD, together with dementia and substance-induced disorders, is one of the very few diagnostic categories in the DSM whose onset has a clearly identifiable cause, namely the experience of a traumatic event. However, as we shall see, not everyone who is exposed to trauma develops PTSD. From a developmental perspective, it is a good example of the interaction of genetic and environmental influences on psychopathology.

The scientific study of trauma and its effects is a relatively recent phenomenon. Perhaps the incidence of horrific events around the globe, such as wars, abuse, terrorist attacks, and natural disasters, as well as a more refined appreciation of the effects of stress on biopsychosocial processes have sharpened our awareness of the sequelae of such traumas. When PTSD was introduced into the DSM-III in 1980, it was criticized as a conglomeration of symptoms that were patched together to constitute a mental illness in order to procure needed treatment and benefits for Vietnam veterans (Kirk & Kutchins, 1997). Critics of the diagnosis claimed that it was one more example of the psychiatric establishment creating a mental illness out of a normal human response to unusually terrifying events. Researchers have sought to test the charge that PTSD is a Western social construction and have found that individuals throughout the world who have been exposed to traumatic incidents express the symptoms of PTSD (Keane, Marshall, & Taft, 2006). In a population survey across 24 countries, 70% of individuals reported experiencing at least one traumatic event in their lifetimes (Benjet et al., 2016). Although not everyone will go on to suffer from PTSD, cross-national estimates indicate approximately 6% of the trauma-exposed sample meet diagnostic criteria for this disorder (Koenen et al., 2017). Cultural differences in symptom expression, coping style, and stressor profiles (e.g., discrimination) may present unique risks for PTSD development in racial and ethnic minority subgroups. Unfortunately, the suffering caused by PTSD tends to endure. Schnurr and colleagues (2000) found that complete PTSD symptomology continued to plague 32% of soldiers exposed to mustard gas a full 50 years after their exposure in World War II.

Diagnostic Features

For diagnosis of PTSD, a person must have experienced, witnessed, or been confronted with an event so traumatizing that it results in symptoms of re-experiencing, hyperarousal, cognitive alterations, and avoidance. Such events could include the experience of war, torture, rape, or physical/sexual abuse, to name a few. Some suggest that witnessing such events or being a relative or helper of trauma victims is also sufficient for traumatization, a phenomenon called secondary or vicarious traumatization (McCann & Pearlman, 1990). Symptoms of re-experiencing might be manifested by the presence of flashbacks, recurrent dreams, or heightened fear and anxiety when exposed to internal or external trauma-related cues. Symptoms of hyperarousal might include irritability, lack of concentration, hypervigilance, sleep problems, or heightened startle response. Symptoms of avoidance include behaviors that serve to allow victims to avoid people, places, or things that could trigger an association with the trauma. Avoidance tactics may also extend to avoiding thoughts and feelings that elicit memories of trauma, possibly in an attempt to down-regulate the intensity of re-experiencing. Symptoms also include altered cognition and mood related to the traumatic event.

Who Develops PTSD?

Let’s consider the interesting question of who develops PTSD. Researchers suggest that the development of this disorder rests upon a combination of factors: biological vulnerability, psychological vulnerability, and the experience of trauma. Binder et al. (2008) found that an early history of childhood trauma/abuse in addition to certain genetic variants was important in predicting the later PTSD symptomatology. We should be cautious, however, about interpreting genetic findings to imply a determinative relationship between certain genes, trauma, and later PTSD. Consistent with the principal of multifinality, twin studies show that genes found to be related to PTSD were also associated with anxiety, depressive, and substance abuse disorders (IOM, 2012).

As we have discussed in earlier chapters, patterns of cortisol receptors are shaped in the developing brain by early experience, and the experience of abuse may make individuals’ neurophysiology more sensitive to the effects of stress over time. This understanding appears to be supported by evidence from combat veterans who served in Afghanistan. Berntsen and colleagues (2012) found that the experience of adversity in childhood was a better predictor of which soldiers developed PTSD than the trauma experienced in deployment.

Difficulties in executive functions, low intelligence, and education level prior to a traumatic incident have also been associated with the risk of developing PTSD (IOM, 2012). Executive functions involve the capacity to inhibit distractions and voluntarily direct attention to certain objects of attention. Some research suggests that compromised ability to disengage attention from stimuli that are highly salient can make it difficult to disengage from later traumatic memories, exacerbating symptoms of PTSD (Aupperle, Melrose, Stein, & Paulus, 2012). Early anxiety and depression, patterns of antisocial behavior in childhood, lack of social support, sexual victimization (especially for women), and sexual minority status are particular pre-existing features that also confer greater risk (Sayed, Iacoviello, & Charney, 2015).

It is reasonable to think that more numerous and more serious experiences of trauma would predict PTSD with greater precision. However, research results on this issue have been inconsistent. Therefore, other variables that might moderate the impact of trauma on survivors have been the subject of investigation. One possibility is sleep quality/insomnia, because sleep disturbances make it difficult to regulate emotions, consolidate memory, and control stress reactivity; all are important functions that are disturbed in PTSD. Evidence in support of sleep’s moderating role was found by researchers who studied veterans from Iraq (Cox, McIntyre, & Olatunji, 2017). Veterans with the most combat exposure and the most severe insomnia reported the highest frequency of re-experiencing symptoms. Low levels of insomnia did not predict re-experiencing despite the level of trauma. These results suggest that amount of trauma exposure alone does not predict symptoms. Rather, insomnia may function like prolonged stress exposure and impede the adaptive consolidation of traumatic memories that could inhibit recovery (Cox, Tuck, & Olatunji, 2017). Current research attention on sleep as an underappreciated risk factor is timely, not only for PTSD, but also for suicidal behaviors and other mental health disorders (Ribeiro et al., 2012).

Features of Treatment

Just as we are discovering what causes PTSD to develop in certain individuals, some consensus is developing around which therapeutic elements are helpful in public health and clinical interventions for PTSD (Lee, Schnitzlein, Wolf, Vythilingam, Rasmusson, & Hoge, 2016; Hobfoll et al., 2007). The first element is to address safety. This means providing a safe place for victims, promulgating media messages of safety and resilience rather than those of continuing threat, limiting exposure to media that evoke threatening cues, restricting the amount of talk about traumatic events to reduce hyperarousal, and using techniques to ground individuals in their immediate, safer reality, once they are out of imminent danger.

Another element is calming. Victims should receive prompt, practical assistance for their most pressing needs (e.g., food, shelter, etc.) and accurate information about the well-being of their loved ones. Psycho-education about the effects of stress and trauma, relaxation training with imagery, cognitive restructuring, cognitive diffusion, and mindfulness practices and coping skills training might be employed. These interventions are useful in helping individuals better regulate stress physiology and interrupt the development of avoidance behaviors, which, as we have already noted, can seriously impair functioning and integrate memories of traumatic events. One approach, psychological debriefing, is not recommended because of equivocal empirical findings and the possibility of enhancing hyperarousal for some victims by virtue of retraumatization (Sayed et al., 2015; van Emmerik, Kamphuis, Hulsbosch, & Emmelkamp, 2002). Recent research indicates that the benefits of empiricallysupported trauma-focused psychotherapies are significant and long lasting. Consequently, these are recommended as the first line treatment choice (Lee et al., 2016). It is notable that such trauma-focused therapies have been demonstrated to be more effective and to have fewer side effects than available and commonly prescribed medications for PTSD.

Efforts to support self and collective efficacy are also important. Specifically, promoting individuals’ sense of efficacy in relation to coping with trauma is important. Interventions should draw on local community supports to provide a caring network for victims. Emphasis on setting reasonable goals for rebuilding lives after trauma promotes a sense of personal control, healthy adaptation, and resilience. A closely linked principle is connectedness. Interventions and community reorganization efforts (in the case of mass trauma) should be structured to bolster connections among survivors and their social networks. Victims should be educated in how to access what they need, materially and interpersonally, through partnerships with families, social agencies, churches, and so on. Supports should be clear and reliable so as to assure trauma survivors of predictable assistance.

Finally, efforts should include the element of instilling hope. Hope counteracts the tendency of victims to perceive their future as foreshortened, to question their ability to survive, and to succumb to resignation and even despair. Approaches that help individuals deal with irrational fears and unrealistic expectations, de-catastrophize, and identify existing strengths permit hope to take hold in the midst of great suffering. However, the authors caution helpers not to encourage victims to see benefits and meaning in a traumatic event before they are ready to do so. Hobfoll, Canetti-Nisim, and Johnson (2006) found that benefit-finding as a therapeutic technique was related to increases in PTSD symptoms, greater defensiveness, and potential for retaliation, possibly because benefit-finding may be perceived as an attempt to minimize the real struggles and hardships associated with traumatic events.

Case Study

Lien is a 46-year-old Vietnamese American woman. She has two adult children, a son and a daughter, as well as one granddaughter. She lives in a small apartment near her mother, now in her late 60s. Lien visits her mother several times a week to check on her health and her emotional state. Although Lien’s mother, Mrs. Nguyen, is relatively self-sufficient, a recent medical check-up suggested some early warning signs of a neurological disorder. Lien’s mother expects attention from her daughter and will let her know when she feels she’s being neglected. Lien has always been very responsible and concerned about the well-being of her family members. Even though this takes a lot of her time, she faithfully attends to her mother’s needs without complaint. Now, with the threat of a potentially deteriorating health problem, she is more concerned than ever about her mother’s health and her own ability to cope.

Lien and her husband, who was born in Vietnam, settled with their young children in a state on the West Coast. Although Lien met and married her husband in the United States, he always wanted to go back to Vietnam, a place he considered his real home. After 10 years, he left the family to return to his home country, because he missed his extended family. He also worried that he could not make enough money to support two children. Single now for 16 years, Lien feels that she would like to meet someone with whom she could share her life. This is a new feeling for Lien. Until recently, she was too distracted with the problems of raising her children and getting her small business started to think about herself. Now she feels that she only has a limited amount of time left to pursue some of her own wishes. She can envision herself like her mother, old and alone, and that prospect disturbs her. She has started to attend social functions at her church and has accepted some social invitations from members of the close-knit local community.

Lien’s life has recently become more complicated. Her daughter, Annie, and her 2-year-old granddaughter, Emily, have moved in with her. The relationship between Annie and her husband, Dave, deteriorated after Emily’s birth, and the couple fought frequently. Annie accused Dave of spending too much of his paycheck on frivolous things and not spending enough time with her family. Dave, in response, withdrew even further, spent more time with his friends, and continued to spend money as he pleased. Annie finally took the baby and threatened not to come back.