A New Measure of Adaptive Strategies and its Relation to Late-Life Depression

University Of Pittsburgh At Pittsburgh, Pittsburgh PA

Investigators

Abstract

[unreadable] DESCRIPTION (provided by applicant): There is a pressing need to identify factors that predict optimal responses to the health challenges faced by older adults. Models of self-regulation (informed by control theory) can help us understand key motivational issues underlying effective adaptive strategies. Primary control strategies focus on changing the environment, whereas secondary control strategies focus on changing the self. Use of primary and secondary control strategies has been related to both physical health (e.g., mortality, physical functioning, hospitalization, and cortisol secretion) and mental health outcomes (e.g., depression and well-being) among both mid- and late-life adults. However, the assessment of primary and secondary control strategies has been unsystematic. Specifically, items not originally intended to assess control strategies have been combined post hoc; complex wording has limited the usefulness of items in samples with minimal education; and social desirability response bias has not been assessed. This proposal describes the development of a new self-report measure of primary and secondary control strategies in order to promote research on the influence of control strategies on physical and mental health across the lifespan. We propose two research studies: 1) an interview study of mid-life and late-life adults in order to generate an item pool, and 2) a scale development study using traditional and advanced (item response theory) psychometric methods. Both studies will include mid- and late-life subjects with a range of functional impairment. Our aims are 1) to describe the primary and secondary strategies mid- and late-life adults use to pursue health goals; 2) to use item response theory and structural equation models to develop a self-report measure of these strategies; and 3) to examine the relations between control strategies and both depression and functional impairment, particularly among older adults with depression. Better assessment of primary and secondary control strategies will help us predict which older adults are likely to experience depression in the face of health declines and which are more likely to benefit from interventions treating geriatric depression. Understanding the relations between control strategies, physical functioning, and depression will also help us to design more effective, evidence-based treatments for late-life depression. Developing a better measure of adaptive responses (primary and secondary control strategies) to health challenges is important to public health because it can be used as a screening tool. Specifically, this new measure may help us identify which older adults are at risk of becoming depressed when their health declines and which are most likely to benefit from certain treatments. Understanding the relations between adaptive responses, physical functioning, and depression may also help us design better treatments for late-life depression. [unreadable] [unreadable] [unreadable] [unreadable] [unreadable] [unreadable] [unreadable]