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11.3: Chapter 27- Psychosocial Development in Middle Adulthood

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    Chapter 27 Learning Objectives

    • Explain the controversy surrounding the concept of a midlife crisis
    • Explain the sources of stress confronting adults in midlife and the strategies to cope
    • Summarize Erikson’s seventh psychosocial task of generativity vs. stagnation
    • Describe the relationships middle-aged adults have with their children, parents, and other family members
    • Describe singlehood, marriage, divorce, and remarriage at midlife
    • Describe the contemporary roles of grandparents
    • Describe friendships at midlife
    • Explain how women are uniquely affected at midlife
    • Describe friendships at midlife
    • Explain how women are uniquely affected at midlife
    • Explain the role of religion at midlife

    Midlife Crisis?

    The Seasons of a Man’s Life in which he presented a theory of development in adulthood. Levinson’s work was based on in-depth interviews with 40 men between the ages of 35-45. Levinson (1978) indicated that adults go through stages and have an image of the future that motivates them. This image is called “the dream” and for the men interviewed, it was a dream of how their career paths would progress and where they would be at midlife. According to Levinson the midlife transition (40-45) was a time of reevaluating previous commitments; making dramatic changes if necessary; giving expression to previously ignored talents or aspirations, and feeling more of a sense of urgency about life and its meaning. By the time the men entered middle adulthood (45-50), they believed they committed to the new choices made and placed one’s energies into these commitments.

    Stress

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    stress is defined as a pattern of physical and psychological responses in an organism after it perceives a threatening event that disturbs its homeostasis and taxes its abilities to cope with the event (Hooker & Pressman, 2016). Stress was originally derived from the field of mechanics where it is used to describe materials under pressure. The word was first used in a psychological manner by researcher Hans Selye, who was examining the effect of an ovarian hormone that he thought caused sickness in a sample of rats. Surprisingly, he noticed that almost any injected hormone produced this same sickness. He smartly realized that it was not the hormone under investigation that was causing these problems, but instead, the aversive experience of being handled and injected by researchers led to high physiological arousal, and eventually to health problems like ulcers. Selye (1946) coined the term stressor to label a stimulus that had this effect on the body (that is, causing stress). He developed a model of the stress response called the General Adaptation Syndrome, which is a three-phase model of stress, which includes a mobilization of physiological resources phase, a coping phase, and an exhaustion phase (i.e., when an organism fails to cope with the stress adequately and depletes its resources). Figure 8.25 illustrates the General Adaptation Syndrome.

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    Dispositions and Stress: Negative dispositions and personality traits have been strongly tied to an array of health risks. One of the earliest negative trait-to-health connections was discovered in the 1950s by two cardiologists. They made the interesting discovery that there were common behavioral and psychological patterns among their heart patients that were not present in other patient samples. This pattern included being competitive, impatient, hostile, and time urgent. They labeled it Type A Behavior. Importantly, it was found to be associated with double the risk of heart disease as compared with Type B Behavior (absence of Type A behaviors) (Friedman & Rosenman, 1959). Since the 1950s, researchers have discovered that it is the hostility and competitiveness components of Type A that are especially harmful to heart health (Iribarren et al., 2000; Matthews, Glass, Rosenman, & Bortner, 1977; Miller, Smith, Turner, Guijarro, & Hallet, 1996). Hostile individuals are quick to get upset, and this angry arousal can damage the arteries of the heart. In addition, given their negative personality style, hostile people often lack a heath-protective supportive social network.

    Social Relationships and Stress: Research has shown that the impact of social isolation on our risk for disease and death is similar in magnitude to the risk associated with smoking regularly (Holt-Lunstad, Smith, & Layton, 2010; House, Landis, & Umberson, 1988). In fact, the importance of social relationships for our health is so significant that some scientists believe our body has developed a physiological system that encourages us to seek out our relationships, especially in times of stress (Taylor et al., 2000). Social integration is the concept used to describe the number of social roles that you have (Cohen & Willis, 1985). For example, you might be a daughter, a basketball team member, a Humane Society volunteer, a coworker, and a student. Maintaining these different roles can improve your health via encouragement from those around you to maintain a healthy lifestyle. Those in your social network might also provide you with social support (e.g., when you are under stress). This support might include emotional help (e.g., a hug when you need it), tangible help (e.g., lending you money), or advice. By helping to improve health behaviors and reduce stress, social relationships can have a powerful, protective impact on health, and in some cases, might even help people with serious illnesses stay alive longer (Spiegel, Kraemer, Bloom, & Gottheil, 1989).

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    Caregiving and Stress: A disabled child, spouse, parent, or other family member is part of the lives of some midlife adults. According to the National Alliance for Caregiving (2015), 40 million Americans provide unpaid caregiving. The typical caregiver is a 49-year-old female currently caring for a 69-year-old female who needs care because of a long-term physical condition. Looking more closely at the age of the recipient of caregiving, the typical caregiver for those 18-49 years of age is a female (61%) caring mostly for her own child (32%) followed by a spouse or partner (17%). When looking at older recipients (50+) who receive care, the typical caregiver is female (60%) caring for a parent (47%) or spouse (10%).

    difference in how one is affected by the stress of caring for a child with special needs. Using data from the Study of Midlife in the United States, Ha, Hong, Seltzer, and Greenberg (2008) found that older parents were significantly less likely to experience the negative effects of having a disabled child than younger parents. They concluded that an age-related weakening of the stress occurred over time. This follows with the greater emotional stability noted at midlife.

    Spousal Care: Certainly, caring for a disabled spouse would be a difficult experience that could negatively affect one’s health. However, research indicates that there can be a positive health effect on caring for a disabled spouse. Beach, Schulz, Yee, and Jackson (2000) evaluated health-related outcomes in four groups: Spouses with no caregiving needed (Group 1), living with a disabled spouse but not providing care (Group 2), living with a disabled spouse and providing care (Group 3), and helping a disabled spouse while reporting caregiver strain, including elevated levels of emotional and physical stress (Group 4). Not surprisingly, the participants in Group 4 were the least healthy and identified poorer perceived health, an increase in health-risk behaviors, and an increase in anxiety and depression symptoms. However, those in Group 3 who provided care for a spouse, but did not identify caregiver strain, actually identified decreased levels of anxiety and depression compared to Group 2 and were actually similar to those in Group 1. It appears that greater caregiving involvement was related to better mental health as long as the caregiving spouse did not feel the strain. The beneficial effects of helping identified by the participants were consistent with previous research (Krause, Herzog, & Baker, 1992; Schulz et al., 1997).

    concerns with the opinions of others (Arai, Sugiura, Miura, Washio, & Kudo, 2000). Also contributing to women’s poorer caregiving outcomes is that disabled males are more aggressive than females, especially males with dementia who display more physical and sexual aggression toward their caregivers (Eastley & Wilcock, 1997; Zuidema, de Jonghe, Verhey, & Koopmans, 2009). Female caregivers are certainly at risk for negative consequences of caregiving, and greater support needs to be available to them.

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    Stress Management: On a scale from 1 to 10, those Americans aged 39-52 rated their stress at 5.3, and those aged 53-71 rated their stress at 3.9 (American Psychological Association, 2017). The most common sources of stress included the future of our nation, money, work, current political climate, and violence and crime. Given that these sources of our stress are often difficult to change, a number of interventions have been designed to help reduce the aversive responses to duress, especially related to health. For example, relaxation activities and forms of meditation are techniques that allow individuals to reduce their stress via breathing exercises, muscle relaxation, and mental imagery. Physiological arousal from stress can also be reduced via biofeedback, a technique where the individual is shown bodily information that is not normally available to them (e.g., heart rate), and then taught strategies to alter this signal. This type of intervention has even shown promise in reducing heart and hypertension risk, as well as other serious conditions (Moravec, 2008; Patel, Marmot, & Terry, 1981). Reducing stress does not have to be complicated. For example, exercise is a great stress reduction activity (Salmon, 2001) that has a myriad of health benefits.

    Coping Strategies: Coping is often classified into two categories: Problem-focused coping or emotion-focused coping (Carver, Scheier, & Weintraub, 1989). Problem-focused coping is thought of as actively addressing the event that is causing stress in an effort to solve the issue at hand. For example, say you have an important exam coming up next week. A problem-focused strategy might be to spend additional time over the weekend studying to make sure you understand all of the material. Emotion-focused coping, on the other hand, regulates the emotions that come with stress. In the above examination example, this might mean watching a funny movie to take your mind off the anxiety you are feeling. In the short term, emotion-focused coping might reduce feelings of stress, but problem-focused coping seems to have the greatest impact on mental wellness (Billings & Moos, 1981; Herman-Stabl, Stemmler, & Petersen, 1995). That being said, when events are uncontrollable (e.g., the death of a loved one), emotion-focused coping directed at managing your feelings, at first, might be the better strategy. Therefore, it is always important to consider the match of the stressor to the coping strategy when evaluating its plausible benefits.

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    Erikson: Generativity vs Stagnation

    generativity encompasses procreativity, productivity, and creativity. This stage includes the generation of new beings, new products, and new ideas, as well as self-generation concerned with further identity development. Erikson believed that the stage of generativity, during which one established a family and career, was the longest of all the stages. Individuals at midlife are primarily concerned with leaving a positive legacy of themselves, and parenthood is the primary generative type. Erikson understood that work and family relationships may be in conflict due to the obligations and responsibilities of each, but he believed it was overall a positive developmental time. In addition to being parents and working, Erikson also described individuals being involved in the community during this stage. A sense of stagnation occurs when one is not active in generative matters, however, stagnation can motive a person to redirect energies into more meaningful activities.

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    Middle Adult Lifestyles

    Singlehood: According to a Pew Research study, 16 per 1,000 adults age 45 to 54 and 7 per 1000 age 55 and over have never married in the U. S. (Wang & Parker, 2014). However, some of them may be living with a partner. In addition, some singles at midlife may be single through divorce or widowhood. DePaulo (2014) has challenged the idea that singles, especially the always single, fair worse emotionally and in health when compared to those married. DePaulo suggests there is a bias in how studies examine the benefits of marriage. Most studies focus on comparisons between married versus not married, which do not include a separate comparison between those always single, and those who are single because of divorce or widowhood. Her research has found that those who are married may be more satisfied with life than the divorced or widowed, but there is little difference between married and always single, especially when comparing those who are recently married with those who have been married for four or more years. It appears that once the initial blush of the honeymoon wears off, those who are wedded are no happier or healthier than those who remained single. This might also suggest that there may be problems with how the “married” category is also seen as one homogeneous group.

    Online Dating: Montenegro (2003) surveyed over 3,000 singles aged 40–69, and almost half of the participants reported their most important reason for dating was to have someone to talk to or do things with. Additionally, sexual fulfillment was also identified as an important goal for many. Alterovitz & Mendelsohn (2013) reviewed online personal ads for men and women over age 40 and found that romantic activities and sexual interests were mentioned at similar rates among the middle-age and young-old age groups, but less for the old-old age group.

    Marriage: As you read in Chapter 7, there has been a number of changes in the marriage rate as more people are cohabitating, more are deciding to stay single, and more are getting married at a later age. As you can see in Figure 8.34, 48% of adults age 45-54 are married; either in their first marriage (22%) or have remarried (26%). This makes marriage the most common relationship status for middle-aged adults in the United States. Marital satisfaction tends to increase for many couples in midlife as children are leaving home (Landsford, Antonucci, Akiyama, & Takahashi, 2005). Not all researchers agree. They suggest that those who are unhappy with their marriage are likely to have gotten divorced by now, making the quality of marriages later in life only look more satisfactory (Umberson, Williams, Powers, Chen, & Campbell, 2005).

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    Divorce: Livingston (2014) found that 27% of adults age 45 to 54 were divorced (see Figure 8.32). Additionally, 57% of divorced adults were women. This reflects the fact that men are more likely to remarry than are women. Two-thirds of divorces are initiated by women (AARP, 2009). Most divorces take place within the first 5 to 10 years of marriage. This timeline reflects people’s initial attempts to salvage the relationship. After a few years of limited success, the couple may decide to end the marriage. It used to be that divorce after having been married for 20 or more years was rare, but in recent years the divorce rate among more long-term marriages has been increasing. Brown and Lin (2013) note that while the divorce rate in the U.S. has declined since the 1990s, the rate among those 50 and older has doubled. They suggest several reasons for the “graying of divorce”. There is less stigma attached to divorce today than in the past. Some older women are out-earning their spouses, and thus may be more financially capable of supporting themselves, especially as most of their children have grown. Finally, given increases in human longevity, the prospect of living several more years or decades with an incompatible spouse may prompt middle-aged and older adults to leave the marriage.

    enhancers, those who had used the experience to better themselves and seek more productive intimate relationships, and the competent loners, those who used their divorce experience to grow emotionally, but who choose to stay single, the overwhelming majority were women.

    Dating Post-Divorce: Most divorced adults have dated by one year after filing for divorce (Anderson et al., 2004; Anderson & Greene, 2011). One in four recent filers report having been in or were currently in a serious relationship, and over half were in a serious relationship by one year after filing for divorce. Not surprisingly, younger adults were more likely to be dating than were middle-aged or older adults, no doubt due to the larger pool of potential partners from which they could to draw. Of course, these relationships will not all end in marriage. Teachman (2008) found that more than two-thirds of women under the age of 45 had cohabited with a partnership between their first and second marriages.

    gatekeep, that is, they regulate the flow of information about their new romantic partner to their children, in an attempt to balance their own needs for romance with consideration regarding the needs and reactions of their children. Anderson et al. (2004) found that almost half (47%) of dating parents gradually introduce their children to their dating partner, giving both their romantic partner and children time to adjust and get to know each other. Many parents who use this approach do so to avoid their children having to keep meeting someone new until it becomes clearer that this relationship might be more than casual. It might also help if the adult relationship is on the firmer ground so it can weather any initial push back from children when it is revealed. Forty percent are open and transparent about the new relationship at the outset with their children. Thirteen percent do not reveal the relationship until it is clear that cohabitation and or remarriage is likely. Anderson and colleagues suggest that practical matters influence which gatekeeping method parents may use. Parents may be able to successfully shield their children from a parade of suitors if there is reliable childcare available. The age and temperament of the child, along with concerns about the reaction of the ex-spouse, may also influence when parents reveal their romantic relationships to their children.

    Rates of remarriage: The rate for remarriage, like the rate for marriage, has been declining overall. In 2013 the remarriage rate was approximately 28 per 1,000 adults 18 and older. This represents a 44% decline since 1990 and a 16% decline since 2008 (Payne, 2015). Brown and Lin (2013) found that the rate of remarriage dropped more for younger adults than middle-aged and older adults, and Livingston (2014) found that as we age we are more likely to have remarried (see Figure 8.35). This is not surprising as it takes some time to marry, divorce, and then find someone else to marry. However, Livingston found that unlike those younger than 55, those 55 and up are remarrying at a higher rate than in the past. In 2013, 67% of adults 55-64 and 50% of adults 65 and older had remarried, up from 55% and 34% in 1960, respectively.

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    Success of Remarriage: Reviews are mixed as to the happiness and success of remarriages. While some remarriages are more successful, especially if the divorce motivated the adult to engage in self-improvement and personal growth (Hetherington & Kelly, 2002), a number of divorced adults end up in very similar marriages the second or third time around (Hetherington & Kelly, 2002). Remarriages have challenges that are not found in first marriages that may create additional stress in the marital relationship. There can often be a general lack of clarity in family roles and expectations when trying to incorporate new kin into the family structure, even determining the appropriate terms for this kin, along with their roles can be a challenge.

    Children’s Influence on Repartnering: Does having children affect whether a parent remarries? Goldscheider and Sassler (2006) found children residing with their mothers reduces the mothers’ likelihood of marriage, only with respect to marrying a man without children. Further, having children in the home appears to increase single men’s likelihood of marrying a woman with children (Stewart, Manning, & Smock, 2003). There is also some evidence that individuals who participated in a stepfamily while growing up may feel better prepared for stepfamily living as adults. Goldscheider and Kaufman (2006) found that having experienced family divorce as a child is associated with a greater willingness to marry a partner with children.

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    Grandparents

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    remote as they rarely saw their grandchildren. Usually, they lived far away from their grandchildren but may also have had a distant relationship. Contact was typically made on special occasions, such as holidays or birthdays. Fifty-five percent of grandparents were described as companionate as they did things with their grandchildren but had little authority or control over them. They preferred to spend time with them without interfering in parenting. They were more like friends to their grandchildren. Fifteen percent of grandparents were described as involved as they took a very active role in their grandchild’s life. The involved grandparent had frequent contact with and authority over the grandchild, and their grandchildren might even have lived with them. Grandmothers, more so than grandfathers, played this role. In contrast, more grandfathers than grandmothers saw their role as a family historian and family advisor (Neugarten and Weinstein, 1964).

    Friendships

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    Internet Friendships: What influence does the Internet have on friendships? It is not surprising that people use the Internet with the goal of meeting and making new friends (Fehr, 2008; McKenna, 2008). Researchers have wondered if the issue of not being face-to-face reduces the authenticity of relationships, or if the Internet really allows people to develop deep, meaningful connections. Interestingly, research has demonstrated that virtual relationships are often as intimate as in-person relationships; in fact, Bargh and colleagues found that online relationships are sometimes more intimate (Bargh, McKenna, & Fitsimons, 2002). This can be especially true for those individuals who are more socially anxious and lonely as such individuals are more likely to turn to the Internet to find new and meaningful relationships (McKenna, Green, & Gleason, 2002). McKenna and colleagues suggest that for people who have a hard time meeting and maintaining relationships, due to shyness, anxiety, or lack of face-to-face social skills, the Internet provides a safe, nonthreatening place to develop and maintain relationships. Similarly, Benford (2008) found that for high-functioning autistic individuals, the Internet facilitated communication and relationship development with others, which would have been more difficult in face-to-face contexts, leading to the conclusion that Internet communication could be empowering for those who feel frustrated when communicating face to face.

    Workplace Friendships: Friendships often take root in the workplace, due to the fact that people are spending as much, or more, time at work than they are with their family and friends (Kaufman & Hotchkiss, 2003). Often, it is through these relationships that people receive mentoring and obtain social support and resources, but they can also experience conflicts and the potential for misinterpretation when sexual attraction is an issue. Indeed, Elsesser and Peplau (2006) found that many workers reported that friendships grew out of collaborative work projects, and these friendships made their days more pleasant.

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    In addition to those benefits, Riordan and Griffeth (1995) found that people who worked in an environment where friendships could develop and be maintained were more likely to report higher levels of job satisfaction, job involvement, and organizational commitment, and they were less likely to leave that job. Similarly, a Gallup poll revealed that employees who had close friends at work were almost 50% more satisfied with their jobs than those who did not (Armour, 2007).

    Women in Midlife

    Religion and Spirituality

    benefit, but so too do those identified as being spiritual. According to Greenfield, Vaillant, and Marks (2009) religiosity refers to engaging with a formal religious group’s doctrines, values, traditions, and co-members. In contrast, spirituality refers to an individual’s intrapsychic sense of connection with something transcendent (that which exists apart from and not limited by the material universe) and the subsequent feelings of awe, gratitude, compassion, and forgiveness. Research has demonstrated a strong relationship between spirituality and psychological well-being, irrespective of an individual’s religious participation (Vaillant, 2008). Additionally, Sawatzky, Ratner, & Chiu (2005) found that spirituality was related to a higher quality of life for both individuals and societies.

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    personal growth, purpose in life, positive relationships with others, self-acceptance, environmental mastery, and autonomy. In contrast, formal religious participation was only associated with higher levels of purpose in life and personal growth among just older adults and lower levels of autonomy. In summary, it appears that formal religious participation and spirituality relate differently to an individual’s overall psychological well-being.

    Age: Older individuals identify religion/spirituality as being more important in their lives than those younger (Beit-Hallahmi & Argyle, 1998). This age difference has been explained by several factors including that religion and spirituality assist older individuals in coping with age-related losses, provide opportunities for socialization and social support in later life, and demonstrate a cohort effect in that older individuals were socialized more to be religious and spiritual than those younger (Greenfield et al., 2009).

    Gender: In the United States, women report identifying as being more religious and spiritual than men do (de Vaus & McAllister, 1987). According to the Pew Research Center (2016), women in the United States are more likely to say religion is very important in their lives than men (60% vs. 47%). American women also are more likely than American men to say they pray daily (64% vs. 47%) and attend religious services at least once a week (40% vs. 32%). Theories to explain this gender difference include that women may benefit more from the social-relational aspects of religion/spirituality because social relationships more strongly influence women’s mental health. Additionally, women have been socialized to internalize the behaviors linked with religious values, such as cooperation and nurturance, more than males (Greenfield et al., 2009).

    Worldwide: To measure the religious beliefs and practices of men and women around the world, the Pew Research Center (2016) conducted surveys of the general population in 84 countries between 2008 and 2015. Overall, an estimated 83% of women worldwide identified with religion compared with 80% of men. This equaled 97 million more women than men identifying with a religion. There were no countries in which men were more religious than women by 2 percentage points or more. Among Christians, women reported higher rates of weekly church attendance and higher rates of daily prayer. In contrast, Muslim women and Muslim men showed similar levels of religiousness, except the frequency of attendance at worship services. Because of religious norms, Muslim men worshiped at a mosque more often than Muslim women. Similarly, Jewish men attended a synagogue more often than Jewish women. In Orthodox Judaism, communal worship services cannot take place unless a minyan, or quorum of at least 10 Jewish men, is present, thus ensuring that men will have high rates of attendance. Only in Israel, where roughly 22% of all Jewish adults self-identify as Orthodox, did a higher percentage of men than women report engaging in daily prayer.

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    References

    AARP. (2009). The divorce experience: A study of divorce at midlife and beyond. Washington, DC: AARP

    Ahlborg, T., Misvaer, N., & Möller, A. (2009). Perception of marital quality by parents with small children: A follow-up study when the firstborn is 4 years old. Journal of Family Nursing, 15, 237–263.

    Alterovitz, S. S., & Mendelsohn, G. A. (2013). Relationship goals of middle-aged, young-old, and old-old Internet daters: An analysis of online personal ads. Journal of Aging Studies, 27, 159–165. doi.10.1016/j.jaging.2012.12.006

    American Association of Community Colleges (2016). Plus 50 community colleges: Ageless learning. Retrieved from plus50.aacc.nche.edu/Pages/Default.aspx

    American Cancer Society. (2019). Cancer Facts and Figures 2019. Retrieved from https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/annual-cancer-facts-and-figures/2019/cancer-facts-and-figures-2019.pdf

    American Diabetes Association (2016). Standards of medical care in diabetes. Diabetes Care. 39(1), 1-112.

    American Heart Association (2016). Saturated fats. Retrieved from www.heart.org/HEARTORG/HealthyLiving/HealthyEating/Nutrition/Saturated-Fats_UCM_301110_Article.jsp

    American Psychological Association (2017). Stress in America: The state of our nation. Retrieved from www.apa.org/images/state-nation_tcm7-225609.pdf

    American Psychological Association (2016). By the numbers: Hearing loss and mental health. Monitor on Psychology, 47(4), 9.

    Anderson, E. R., & Greene, S. M. (2011). “My child and I are a package deal”: Balancing adult and child concerns in repartnering after divorce. Journal of Family Psychology, 25(5), 741-750.

    Anderson, E.R., Greene, S.M., Walker, L., Malerba, C.A., Forgatch, M.S., & DeGarmo, D.S. (2004). Ready to take a chance again: Transitions into dating among divorced parents. Journal of Divorce and Remarriage, 40, 61-75.

    Aquilino, W. (1991). Predicting parents’ experiences with coresidence adult children. Journal of Family Issues, 12(3), 323-342.

    Arai, Y., Sugiura, M., Miura, H., Washio, M., & Kudo, K. (2000). Undue concern for other’s opinions deters caregivers of impaired elderly from using public services in rural Japan. International Journal of Geriatric Psychiatry, 15(10), 961- 968.

    Armour, S. (2007, August 2). Friendships and work: A good or bad partnership? USA Today. Retrieved from http://usatoday30.usatoday.com/money/workplace/2007-08-01-work-friends_N.htm

    Avis, N. E., Stellato, R., & Crawford, S. (2001). Is there a menopausal syndrome? Menopausal status and symptoms across racial/ethnic groups. Social Science and Medicine, 52(3), 345-356.

    Baltes, P. B., Staudinger, U. M., & Lindenberger, U. (1999). Lifespan Psychology: Theory and Application to Intellectual Functioning. Annual Review of Psychology, 50, 471-507.

    Bargh, J. A., McKenna, K. Y. A, & Fitsimons, G. G. (2002). Can you see the real me? Activation and expression of the true self on the Internet. Journal of Social Issues, 58, 33–48.

    Barreto, M., Ryan, M. K., & Schmitt, M. T. (2009). The glass ceiling in the 21st century: Understanding the barriers to gender equality. Washington, DC: American Psychological Association.

    Baruch, G., & Brooks-Gunn, J. (1984). Women in midlife. New York: Plenum.

    Beach, S. R., Schulz, R., Yee, J. L., & Jackson, S. (2000). Negative and positive health effects of caring for a disabled spouse: Longitudinal findings from the caregiver health effects study. Psychology and Aging, 15(2), 259-271.

    Beit-Hallahmi, B., & Argyle, M. (1998). Religious behavior, belief, and experience. New York: Routledge.

    Bengtson, V. L. (2001). Families, intergenerational relationships, and kinkeeping in midlife. In N. M. Putney (Author) & M. E. Lachman (Ed.), Handbook of midlife development (pp. 528-579). New York: Wiley.

    Berglund, L., Oliver, E. H., Fontanez, N., Holleran, S., Matthews, K., Roheim, P. S., & DELTA Investigators. (1999). HDL- subpopulation patterns in response to reductions in dietary total and saturated fat intakes in healthy subjects. American Journal of Clinical Nutrition, 70, 992-1000.

    Berkeley Wellness. (2011). The lowdown on low testosterone. Retrieved from http://www.berkeleywellness.com/self-care/sexual-health/article/lowdown-low-testosterone

    Besen, E., Matz-Costa, C., Brown, M., Smyer, M. A., & Pitt-Catsouphers, M. (2013). Job characteristics, core self-evaluations, and job satisfaction. International Journal of Aging & Human Development, 76(4), 269-295.

    Billings, A. G., & Moos, R. H. (1981). The role of coping responses and social resources in attenuating the stress of life events. Journal of Behavioral Medicine, 4, 139–157.

    Birditt, K. S., & Antonucci, T.C. (2012). Till death do us part: Contexts and implications of marriage, divorce, and remarriage across adulthood. Research in Human Development, 9(2), 103-105.

    Borland, D. C. (1982). A cohort analysis approach to the empty-nest syndrome among three ethnic groups of women: A theoretical position. Journal of Marriage and the Family, 44, 117–129.

    Borzumato-Gainey, C., Kennedy, A., McCabe, B., & Degges-White, S. (2009). Life satisfaction, self-esteem, and subjective age in women across the life span. Adultspan Journal, 8(1), 29-42.

    Bouchard, G. (2013). How do parents reaction when their children leave home: An integrative review. Journal of Adult Development, 21, 69-79.

    Bromberger, J. T., Kravitz, H. M., & Chang, Y. (2013). Does risk for anxiety increase during the menopausal transition? Study of Women’s Health Across the Nation (SWAN). Menopause, 20(5), 488-495.

    Brown, L. H., & DeRycke, S. B. (2010). The kinkeeping connection: Continuity, crisis and consensus. Journal of Intergenerational Relationships, 8(4), 338-353, DOI: 10.1080/15350770.2010.520616

    Brown, S. L., & Lin, I. (2013). The gray divorce revolution: Rising divorce among middle aged and older adults 1990-2010. National Center for Family & Marriage Research Working Paper Series. Bowling Green State University. www.bgsu.edu/content/dam/BGSU/college-of-arts-and- sciences/NCFMR/ documents/Lin/The-Gray-Divorce.pdf

    Bureau of Labor Statistics. (2019). The employment situation-June 2019. Retrieved from: https://www.bls.gov/news.release/pdf/empsit.pdf

    Busse, E. W. (1969). Theories of aging. In E. W. Busse & E/. Pfeiffer (Eds.), Behavior and adaptation in later life (pp. 11-31). Boston, MA: Little Brown.

    Carmichael, C. L., Reis, H. T., & Duberstein, P. R. (2015). In your 20s it’s quantity, in your 30s it’s quality: The prognostic value of social activity across 30 years of adulthood. Psychology and Aging, 30(1), 95-105.

    Carroll, J. L. (2016). Sexuality now: Embracing diversity (5th ed.). Boston, MA: Cengage Learning.

    Carver, C. S., Scheier, M. F., & Weintraub, J. K. (1989). Assessing coping strategies: A theoretically based approach. Journal of Personality and Social Psychology, 56, 267–283.

    Center for Sexual Health Promotion. (2010). National survey of sexual health and behavior. Retrieved from http://www.sexualhealth.indiana.edu

    Centers for Disease Control (2014a). About high blood pressure. Retrieved from http://www.cdc.gov/bloodpressure/about.htm

    Centers for Disease Control and Prevention. (2014b). Behaviors that increase the risk for high blood pressure. Retrieved from http://www.cdc.gov/bloodpressure/behavior.htm

    Centers for Disease Control and Prevention. (2014c). Measuring high blood pressure. Retrieved from http://www.cdc.gov/bloodpressure/measure.htm

    Centers for Disease Control and Prevention. (2014d). National diabetes statistics report, 2014. Retrieved from http://www.cdc.gov/diabetes/pubs/statsreport14/national-diabetes-report-web.pdf

    Centers for Disease Control and Prevention. (2014e). Diagnoses of HIV infection among adults aged 50 years and older in the United States and dependent areas 2010–2014. HIV surveillance report, 21(2), 1-69. Retrieved from http://www.cdc.gov/hiv/pdf/library/reports/surveillance/cdc-hiv-surveillance-supplemental-report-vol-21-2.pdf

    Centers for Disease Control and Prevention. (2015). Facts about high cholesterol. Retrieved from http://www.cdc.gov/cholesterol/facts.htm

    Centers for Disease Control and Prevention. (2016). The National Center for Health Statistics. Retrieved from https://www.cdc.gov/nchs/index.htm

    Centers for Disease Control and Prevention. (2017). National diabetes statistics report, 2017. Retrieved from: https://www.cdc.gov/diabetes/pdfs/data/statistics/national-diabetes-statistics-report.pdf

    Chang, Y. F., An, Y., Bigel, M., Wong, D. F., Troncoso, J. C., O’Brien, R. J., Breitner, J. C., Ferruci, L., Resnick, S. M., & Thanbisetty, M. (2016). Midlife adiposity predicts earlier onset of Alzheimer’s dementia, neuropathology and presymptomatic cerebral amyloid accumulation. Molecular Psychiatry, 21(7), 910-915.

    Charness, N., & Krampe, R. T. (2006). Aging and expertise. In K. Ericsson, N. Charness & P. Feltovich (Eds.), Cambridge Handbook of expertise and expert performance. Cambridge, United Kingdom: Cambridge University Press.

    Cherlin, A. J., & Furstenberg, F. F. (1986). The new American grandparent: A place in the family, a life apart. New York: Basic Books.

    Cohen, S., & Wills, T. A. (1985). Stress, social support, and the buffering hypothesis. Psychological Bulletin, 98, 310–357.

    Crawford, S. & Channon, S. (2002). Dissociation between performance on abstract tests of executive function and problem solving in real life type situations in normal aging. Aging and Mental Health, 6, 12-21.

    Crist, L. A., Champagne, C. M., Corsino, L., Lien, L. F., Zhang, G., & Young, D. R. (2012). Influence of change in aerobic fitness and weight on prevalence of metabolic syndrome. Preventing Chronic Disease 9,110171. doi: http://dx.doi.org/10.5888/pcd9.110171

    Crowson, C. S., Matteson, E. L., Myasoedova, E., Michet, C. J., Ernste, F. C., Warrington, K. J., …Gabriel, S. E. (2011). The lifetime risk of adult-onset rheumatoid arthritis and other inflammatory autoimmune rheumatic diseases. Arthritis and Rheumatism, 63(3), 633-639. doi: 10.1002/art.30155.

    Csikszentmihalyi, M. (1990). Flow: The psychology of optimal experience. New York: Harper Perennial Modern Classics.

    Csikszentmihalyi, M. (1996). Creativity: Flow and the psychology of discovery and invention. New York: Harper

    Collins. Dawes, P., DicMonrokinson, C., Emsley, R., Bishop, P. N., Cruickshanks, K. J., Edmundson-Jones, M., …. Munro, K. (2014). Vision impairment and dual sensory problems in middle age. Ophthalmic Physiological Optics, 34, 479–488. doi: 10.1111/opo.12138479

    Degges-White, S., & Myers, J, E. (2006). Women at midlife: An exploration of chronological age, subjective age, wellness, and life satisfaction, Adultspan Journal, 5, 67-80.

    DeLongis, A., Folkman, S., & Lazarus, R. S. (1988). The impact of daily stress on health and mood: Psychological and social resources as mediators. Journal of Personality and Social Psychology, 54, 486–495.

    Dennerstein, L., Dudley, E., & Guthrie, J. (2002). Empty nest or revolving door? A prospective study of women’s quality of life in midlife during the phase of children leaving and re-entering the home. Psychological Medicine, 32, 545–550.

    DePaulo, B. (2014). A singles studies perspective on mount marriage. Psychological Inquiry, 25(1), 64-68. doi: 10.1080/1047840X.2014.878173

    Desilver, D. (2016). In the U. S. and abroad, more young adults are living with their parents. Retrieved from: https://www.pewresearch.org/fact-tank/2016/05/24/in-the-u-s-and-abroad-more-young-adults-are-living-with-their-parents/

    de St. Aubin, E., & Mc Adams, D. P. (1995). The relation of generative concern and generative action to personality traits, satisfaction/happiness with life and ego development. Journal of Adult Development, 2, 99-112.

    De Vaus, D. & McAllister, I. (1987). Gender differences in religion: A test of the structural location theory. American Sociological Review, 52, 472-481.

    Dew, M. A., Hoch, C. C., Buysse, D. J., Monk, T. H., Begley, A. E., Houck, P. R.,…Reynolds, C. F., III. (2003). Healthy older adults’ sleep predicts all-cause mortality at 4 to 19 years of follow-up. Psychosomatic Medicine, 65(1), 63–73.

    Dimah, K., & Dimah, A. (2004). Intimate relationships and sexual attitudes of older African American men and women. The Gerontologist, 44, 612-613.

    Drake, B. (2013). Another gender gap: Men spend more time in leisure activities. Pew Research Center. Retrieved from http://www.pewresearch.org/fact-tank/2013/06/10/another-gender-gap-men-spend-more-time-in-leisure-activities/

    Dunér, A., & Nordstrom, M. (2007). The roles and functions of the informal support networks of older people who receive formal support: A Swedish qualitative study. Ageing & Society, 27, 67– 85. doi:10.1017/ S0144686X06005344

    Easterlin, R. A. (2006). Life cycle happiness and its sources: Intersections of psychology, economics, and demography. Journal of Economic Psychology, 27, 463-482.

    Eastley, R., & Wilcock, G. K. (1997). Prevalence and correlates of aggressive behaviors occurring in patients with Alzheimer’s disease. International Journal of Geriatric Psychiatry, 12, 484-487.

    Elsesser, L., & Peplau, L. A. (2006). The glass partition: Obstacles to cross-sex friendships at work. Human Relations, 59(8), 1077–1100.

    Emslie, C., Hunt, K., & Lyons, A. (2013. The role of alcohol in forging and maintaining friendships amongst Scottish men in midlife. Health Psychology, 32(10, 33-41.

    Ericsson, K. A., Feltovich, P. J., & Prietula, M. J. (2006). Studies of expertise from psychological perspectives. In K. Ericsson, N. Charness & P. Feltovich (Eds.), Cambridge Handbook of expertise and expert performance. Cambridge, UK: Cambridge University Press.

    Erikson, E. (1950). Childhood and society. New York: Norton & Company. Erikson, E. (1959). Identity and the life cycle. New York: Norton & Company. Erikson, E. (1982). The life cycle completed. New York: Norton & Company.

    Fehr, B. (2008). Friendship formation. In S. Sprecher, A. Wenzel, & J. Harvey (Eds.), Handbook of Relationship Initiation (pp.29–54). New York, NY: Psychology Press.

    Ferrie, J. E., Shipley, M. J., Cappuccio, F. P., Brunner, E., Miller, M. A., Kumari, M., & Marmot, M. G. (2007). A prospective study of change in sleep duration: Associations with mortality in the Whitehall II cohort. Sleep, 30(12), 1659.

    Ford, E. S., Li, C., & Zhao, G. (2010). Prevalence and correlates of metabolic syndrome based on a harmonious definition among adults in the US. Journal of Diabetes, 2(3), 180-193.

    Friedman, M., & Rosenman, R. (1959). Association of specific overt behaviour pattern with blood and cardiovascular findings. Journal of the American Medical Association, 169, 1286–1296.

    Fry, R. (2017). It’s becoming more common for young adults to live at home-and for longer stretches. Retrieved from: https://www.pewresearch.org/fact-tank/2017/05/05/its-becoming-more-common-for-young-adults-to-live-at-home-and-for-longer-stretches/ft_17-05-03_livingathome_bygen2/

    Füllgrabe, C., Moore, B. C. J., & Stone, M. A. (2015). Age-group differences in speech identification despite matched audio metrically normal hearing: contributions from auditory temporal processing and cognition. Frontiers in Aging Neuroscience, 6, 1-25. doi:10.3389/fnagi.2014.00347

    Fung, H. H. (2013). Aging in culture. Gerontologist, 53(3), 369-377.

    Gerstel, N., & Gallagher, S. K. (1993). Kinkeeping and distress: Gender, recipients of care, and work–family conflict. Journal of Marriage and the Family, 55, 598–607.

    Gibbons, C., Creese, J., Tran, M., Brazil, K., Chambers, L., Weaver, B., & Bedard, M. (2014). The psychological and health consequences of caring for a spouse with dementia: A critical comparison of husbands and wives. Journal of Women & Aging, 26, 3-21.

    Gilleard, C., & Higgs, P. (2000). Cultures of aging: Self, citizen and the body. Upper Saddle River, NJ: Prentice Hall Publishers.

    Goldscheider, F., & Kaufman, G. (2006). Willingness to stepparent: Attitudes about partners who already have children. Journal of Family Issues, 27, 1415 – 1436.

    Goldscheider, F., & Sassler, S. (2006). Creating stepfamilies: Integrating children into the study of union formation. Journal of Marriage and Family, 68, 275 – 291.

    Gorchoff, S. M., John, O. P., & Helson, R. (2008). Contextualizing change in marital satisfaction during middle age. Psychological Science, 19, 1194–1200.

    Gottman, J. M., & Levenson, R. W. (2000). The timing of divorce: Predicting when a couple will divorce over a 14-year period. Journal of Marriage & the Family, 62, 737-745.

    Greene, S. M., Anderson, E. R., Hetherington, E., Forgtch, M. S., & DeGarmo, D. S. (2003). Risk and resilience after divorce. In F. Walsh (Ed.), Normal family processes: Growing diversity and complexity (3rd ed., pp. 96-120). New York: Guilford Press.

    Greenfield, E. A., & Marks, N. F. (2006). Linked lives: Adult children’s problems and their parents’ psychological and relational well-being. Journal of Marriage and Family, 68, 442-454.

    Greenfield, E. A., Vaillant, G. E., & Marks, N. F. (2009). Do formal religious participation and spiritual perceptions have independent linkages with diverse dimensions of psychological well-being? Journal of Health and Social Behavior, 50, 196-212.

    Gripsrud, J. (2007). Television and the European public sphere. European Journal of Communication, 22, 479-492.

    Grzywacz, J. G. & Keyes, C. L. (2004). Toward health promotion: Physical and social behaviors in complete health. Journal of Health Behavior, 28(2), 99-111.

    Ha, J., Hong, J., Seltzer, M. M., & Greenberg, J. S. (2008). Age and gender differences in the well-being of midlife and aging parents with children with mental health or developmental problems: Report of a national study. Journal of Health and Social Behavior, 49, 301-316.

    Harrison, J., Barrow, S., Gask, L., & Creed, F. (1999). Social determinants of GHQ score by postal survey. Journal of Public Health Medicine, 21, 283–288. doi:10.1093/pubmed/21.3.283

    Hawkley, L. C., Hughes, M. E., Waite, L. J., Masi, C. M., Thisted, R. A., & Cacioppo, J. T. (2008). From social structural factors to perceptions of relationship quality and loneliness: The Chicago health, aging, and marital status transitions and health outcomes social relations study. The Journals of Gerontology: Series B: Psychological Sciences and Social Sciences, 63, 375–384. doi:10.1093/geronb/ 63.6.S375

    Hayslip Jr., B., Henderson, C. E., & Shore, R. J. (2003). The Structure of Grandparental Role Meaning. Journal of Adult Development, 10(1), 1-13.

    Hedlund, J., Antonakis, J., & Sternberg, R. J. (2002). Tacit knowledge and practical intelligence: Understanding the lessons of experience. Retrieved from www.au.af.mil/au/awc/awcgate/army/ari_tacit_knowledge.pdf

    Herman-Stabl, M. A., Stemmler, M., & Petersen, A. C. (1995). Approach and avoidant coping: Implications for adolescent mental health. Journal of Youth and Adolescence, 24, 649–665.

    Hetherington, E. M. & Kelly, J. (2002). For better or worse: Divorce reconsidered. New York, NY: Norton.

    Holland, K. (2014). Why America’s campuses are going gray. CNBC. Retrieved from http://www.cnbc.com/2014/08/28/why-americas-campuses-are-going-gray.html

    Holt-Lunstad, J., Smith, T. B., & Layton, J. B. (2010). Social relationships and mortality risk: a meta-analytic review. PLoS Medicine, 7(7), e1000316.

    Hooker, E., & Pressman, S. (2016). The healthy life. NOBA. Retrieved from http://nobaproject.com/modules/the-healthy-life

    Horn, J. L., Donaldson, G., & Engstrom, R. (1981). Apprehension, memory, and fluid intelligence decline in adulthood. Research on Aging, 3(1), 33-84.

    House, J. S., Landis, K. R., & Umberson, D. (1988). Social relationships and health. Science, 241, 540–545

    Hu, G., Qiao, Q., Tuomilehto, J., Balkau, B., Borch, Johnsen, K., & Pyorala, K. (2004). Prevalence of metabolic syndrome and its relation to all-cause and cardiovascular mortality in non-diabetic European men and women. Archives of Internal Medicine, 164(10), 1066-1076.

    Huang, J. (2007). Hormones and female sexuality. In M. Tepper & A. F. Owens (Eds.), Sexual Health, Vol 2: Physical Foundations (pp. 43-78). Westport, CT: Praeger.

    Humes, L. E., Kewley-Port, D., Fogerty, D., & Kinney, D. (2010). Measures of hearing threshold and temporal processing across the adult lifespan. Hearing Research, 264(1/2), 30-40. doi:10.1016/j.heares.2009.09.010

    International Labour Organization. (2011). Global Employment Trends: 2011. Retrieved from http://www.ilo.org/wcmsp5/groups/public/@dgreports/@dcomm/@publ/documents/publication/wcms_150440.pdf

    Iribarren, C., Sidney, S., Bild, D. E., Liu, K., Markovitz, J. H., Roseman, J. M., & Matthews, K. (2000). Association of hostility with coronary artery calcification in young adults. Journal of the American Medical Association, 283, 2546–2551.

    Jackson, G. R. & Owsley, C. (2000). Scotopic sensitivity during adulthood. Vision Research, 40 (18), 2467-2473. doi:10.1016/S0042-6989(00)00108-5

    Jones, J. M. (2013). In U.S., 40% Get Less than Recommended Amount of Sleep. Gallup. Retrieved from http://www.gallup.com/poll/166553/less-recommended- amountsleep.aspx?g_source=sleep%202013&g_medium=search&g_campaign=tiles

    Kagawa-Singer, M., Wu, K., & Kawanishi, Y. (2002). Comparison of the menopause and midlife transition between Japanese American and European American women. Medical Anthropology Quarterly, 16(1), 64-91.

    Kang, S. W., & Marks, N. F. (2014). Parental caregiving for a child with special needs, marital strain, and physical health: Evidence from National Survey of Midlife in the U.S. 2005. Contemporary Perspectives in Family Research, 8A, 183- 209.

    Karakelides, H., & Nair, K. S. (2005). Sarcopenia of aging and its metabolic impact. Current Topics in Developmental Biology, 68, 123-148.

    Kasper, T. (2015). Why you only need 7 hours of sleep. American Academy of Sleep Medicine. Retrieved from http://sleepeducation.org/news/2015/06/03/why-you-only-need-7-hours-of-sleep

    Kaufman, B. E., & Hotchkiss, J. L. 2003. The economics of labor markets (6th ed.). Mason, OH: Thomson South-Western.

    Kaufman, S. B., & Gregoire, C. (2016). How to cultivate creativity. Scientific American Mind, 27 (1), 62-67.

    Kaur, S., Walia, I., & Singh, A. (2004). How menopause affects the lives of women in suburban Chandigarh, India. Climacteric, 7(2), 175-180.

    Knowles, M. S., Holton, E. F., & Swanson, R. A. (1998). The adult learner: A neglected species. Houston: Gulf Pub., Book Division.

    Kochanek, K. D., Murphy, S. L., Xu, J., & Arias, E. (2019). Deaths: Final data for 2017. National Vital Statistics Reports, 68(9), 1-77.

    Kouzis, A. C., & Eaton, W. W. (1998). Absence of social networks, social support, and health services utilization. Psychological Medicine, 28, 1301–1310. doi:10.1017/S0033291798007454

    Krause, N. A., Herzog, R., & Baker, E. (1992). Providing support to others and well-being in later life. Journal of Gerontology: Psychological Sciences, 47, P300-311.

    Kühnel, J., & Sonnentag, S. (2011). How long do you benefit from vacation? A closer look at the fade-out vacation effects. Journal of Organizational Behavior, 32, 125-143.

    Kushida, C. (2005). Sleep deprivation: basic science, physiology, and behavior. London, England: Informal Healthcare.

    Lachman, M. E. (2004). Development in midlife. Annual Review of Psychology, 55(1), 305-331. doi: 10.1146/annurev.psych.55.090902.141521

    Landsford, J. E., Antonucci, T.C., Akiyama, H., & Takahashi, K. (2005). A quantitative and qualitative approach to social relationships and well-being in the United States and Japan. Journal of Comparative Family Studies, 36, 1-22.

    Leach, M. S., & Braithwaite, D. O. (1996). A binding tie: Supportive communication of family kinkeepers. Journal of Applied Communication Research, 24, 200–216.

    Lee, B., Lawson, K. M., Chang, P., Neuendorf, C., Dmitrieva, N. O., & Ameida, D. H. (2015). Leisure-time physical activity moderates the longitudinal associations between work-family spillover and physical health. Journal of Leisure Research, 47(4), 444-466.

    Levinson, D. J. (1978). The seasons of a man’s life. New York: Knopf.

    Livingston, G. (2014). Four in ten couples are saying I do again. In Chapter 3. The differing demographic profiles of first-time marries, remarried and divorced adults. Pew Research Center. Retrieved from http://www.pewsocialtrends.org/2014/11/14/chapter-3-the-differing-demographic-profiles-of-first-time-married-remarried-and-divorced-adults/

    Madden, S., St Pierre-Hansen, N., & Kelly L. (2010). First Nations women’s knowledge of menopause: Experiences and perspectives. Canadian Family Physician, 56(9), e331-e337.

    Malik, S. (2004). Impact of the metabolic syndrome on mortality from coronary heart disease, cardiovascular disease, and all causes in United States adults. Circulation, 110(10), 1245-1250.

    Malone, J. C., Liu, S. R., Vaillant, G. E., Rentz, D. M., & Waldinger, R. J. (2016). Midlife Eriksonian psychosocial development: Setting the stage for late-life cognitive and emotional health. Developmental Psychology, 52(3), 496-508.

    Marketing Charts Staff. (2014). Are young people watching less TV? Retrieved from http://www.marketingcharts.com/television/are-young-people-watching-less-tv-24817/

    Martin, L. J. (2014). Aging changes in hair and nails. U.S. National Library of Medicine. Retrieved from https://www.nlm.nih.gov/medlineplus/ency/article/004005.htm

    Matthews, K. A., Glass, D. C., Rosenman, R. H., & Bortner, R. W. (1977). Competitive drive, pattern A, and coronary heart disease: A further analysis of some data from the Western Collaborative Group Study. Journal of Chronic Diseases, 30, 489–498.

    Mayo Clinic. (2014a). Heart disease. Retrieved from http://www.mayoclinic.org/diseases-conditions/heart-disease/basics/definition/con-20034056

    Mayo Clinic. (2014b). Metabolism and weight loss: How you burn calories. Retrieved from www.mayoclinic.org/healthy-lifestyle/weight-loss/in-depth/metabolism/art-20046508

    McKenna, K. A. (2008) MySpace or your place: Relationship initiation and development in the wired and wireless world. In S. Sprecher, A. Wenzel, & J. Harvey (Eds.), Handbook of relationship initiation (pp. 235–247). New York, NY: Psychology Press.

    McKenna, K. A., Green, A. S., & Gleason, M. E. J. (2002). Relationship formation on the Internet: What’s the big attraction? Journal of Social Issues, 58, 9–31.

    Metlife. (2011). Metlife study of caregiving costs to working caregivers: Double jeopardy for baby boomers caring for their parents. Retrieved from http://www.caregiving.org/wp-content/uploads/2011/06/mmi-caregiving-costs-working-caregivers.pdf

    Maillard, P., Sashardi, S., Beiser, A., Himail, J. J., Au, R., Fletcher, E., …. DeCarli, C. (2012). Effects of systolic blood pressure on white-matter integrity in young adults in the Farmington Heart Study: A cross-sectional study. The Lancet: Neurology, 11(12), 1039-1047.

    Miller, T. Q., Smith, T. W., Turner, C. W., Guijarro, M. L., & Hallet, A. J. (1996). Meta-analytic review of research on hostility and physical health. Psychological Bulletin, 119, 322–348.

    Mitchell, B. A., & Lovegreen, L. D. (2009). The empty nest syndrome in midlife families: A multimethod exploration of parental gender differences and cultural dynamics. Journal of Family Issues, 30, 1651–1670.

    Montenegro, X. P. (2003). Lifestyles, dating, and romance: A study of midlife singles. Washington, DC: AARP.

    Monthly Labor Review. (2013). Percentage of the non-institutionalized civilian workforce employed by gender & age. Retrieved from http://www.bls.gov/cps/cps_aa2013.htm

    Moravec, C. S. (2008). Biofeedback therapy in cardiovascular disease: rationale and research overview. Cleveland Clinic Journal of Medicine, 75, S35–S38.

    Morita, Y., Iwamoto, I., Mizuma, W., Kuwahata, T., Matsuo, T., Yoshinaga, M., &Douchi, T. (2006). Precedence of the shift of body-fat distribution over the change in body composition after menopause. Journal of Obstetrics and Gynecology, 32, 513-516.

    Morley, J. E., Baumgartner, R. N., Roubenoff, R., Mayer, J., & Nair, K. S. (2001). Sarcopenia. Journal of Laboratory and Clinical Medicine, 137(4), 231-243.

    Moskowitz, R. J. (2014). Wrinkles. U. S. National Library of Medicine. Retrieved from https://www.nlm.nih.gov/medlineplus/ency/article/003252.htm

    Nakamura, J., & Csikszentmihalyi, M. (2002). The concept of flow. In C. R. Snyder & S. J. Lopez (Eds.), Handbook of positive psychology (pp. 89-105). New York: Oxford University Press.

    Nassir, F., Rector, S., Hammoud, G.M., & Ibdah, J.A. (2015). Pathogenesis and prevention of hepatic steatosis. Gastroenterology & Hepatology, 11(3), 167-175.

    National Alliance for Caregiving. (2015). Caregiving in the U.S. 2015. Retrieved from www.caregiving.org/caregiving2015.

    National Eye Institute. (2009). Facts about floaters. Department of Health and Human Services. Retrieved from nei.nih.gov/health/floaters/floaters

    National Eye Institute. (2013). Facts about dry eye. Department of Health and Human Services. Retrieved from nei.nih.gov/health/dryeye/dryeye

    National Eye Institute. (2015). Facts about diabetic eye disease. Retrieved from: nei.nih.gov/health/diabetic/retinopathy

    National Eye Institute. (2016). Facts about presbyopia. Department of Health and Human Services. Retrieved from nei.nih.gov/health/errors/presbyopia

    National Institutes of Health. (2007). Menopause: MedlinePlus Medical Encyclopedia. Retrieved from http://www.nlm.nih.gov/medlineplus/ency/article/000894.htm

    National Institutes of Health. (2013). Gallstones. U.S. Department of Health and Human Services. Retrieved from www.niddk.nih.gov/health-information/health-topics/digestive-diseases/gallstones/Pages/facts.aspx

    National Institutes of Health. (2014a). The A1C and diabetes. Retrieved from www.niddk.nih.gov/health-information/health-topics/diagnostic-tests/a1c-test-diabetes/Pages/index.aspx

    National Institutes of Health (2014b). Age changes in the lungs. Retrieved from https://www.nlm.nih.gov/medlineplus/ency/article/004011.htm

    National Institutes of Health (2014c). Sweet stuff: How sugars and sweeteners affect your health. Retrieved from https://newsinhealth.nih.gov/issue/oct2014/feature1

    National Institutes of Health. (2014d). What is atherosclerosis? Retrieved from http://www.nhlbi.nih.gov/health/health-topics/topics/atherosclerosis

    National Institutes of Health. (2015). Cancer. Retrieved from https://www.cancer.gov/about-cancer/understanding/what-is-cancer

    National Institutes of Health. (2016a). Facts about diabetes. Retrieved from www.niddk.nih.gov/health-information/health-topics/Diabetes/diabetes-facts/Pages/default.aspx

    National Institutes of Health (2016b). Handout on Health: Rheumatoid Arthritis. Retrieved from http://www.niams.nih.gov/health%5Finfo/rheumatic%5Fdisease/

    National Institutes of Health. (2016c). Older drivers: How health affects driving. Retrieved from nihseniorhealth.gov/olderdrivers/howhealthaffectsdriving/01.html

    National Sleep Foundation. (2015). 2015 Sleep in America™ poll finds pain a significant challenge when it comes to Americans’ sleep. National Sleep Foundation. Retrieved from https://sleepfoundation.org/media-center/press-release/2015-sleep-america-poll

    National Sleep Foundation. (2016). Menopause and Insomnia. National Sleep Foundation. Retrieved from https://sleepfoundation.org/ask-the-expert/menopause-and-insomnia

    Neidleman, M. T., Wambacq, I., Besing, J., Spitzer, J. B., & Koehnke, J. (2015). The Effect of Background Babble on Working Memory in Young and Middle-Aged Adults. Journal of the American Academy of Audiology, 26(3), 220-228. doi:10.3766/jaaa.26.3.3

    Neugarten, B. L. (1968). The awareness of middle aging. In B. L. Neugarten (Ed.), Middle age and aging (pp. 93-98). Chicago: University of Chicago Press.

    Neugarten, B. L., & Weinstein, K. K. (1964). The changing American grandparent. Journal of Marriage and the Family, 26, 199–204.

    Newton, T., Buckley, A., Zurlage, M., Mitchell, C., Shaw, A., & Woodruff-Borden, J. (2008). Lack of a close confidant: Prevalence and correlates in a medically underserved primary care sample. Psychology, Health & Medicine, 13, 185– 192. doi:10.1080/ 13548500701405491

    Nimrod, G., Kleiber, D. A., & Berdychevesky, L. (2012). Leisure in coping with depression. Journal of Leisure Research, 44(4), 414-449.

    Norman, G. (2005). Research in clinical reasoning: Past history and current trends. Medical Education, 39, 418–427. doi:10.1111/j.1365-2929.2005.02127.x

    North American Menopause Society. (2016). Menopause FAQs: Understanding the symptoms. Retrieved from Http://www.menopause.org/for-women/expert-answers-to-frequently-asked-questions-about-menopause/menopause-faqs-understanding-the-symptoms

    Nwankwo T., Yoon S. S., Burt, V., & Gu, Q. (2013) Hypertension among adults in the US: National Health and Nutrition Examination Survey, 2011-2012. NCHS Data Brief, No. 133. Hyattsville, MD: National Center for Health Statistics, Centers for Disease Control and Prevention, US Dept of Health and Human Services.

    Office of Disease Prevention and Health Promotion. (2008). The physical activity guidelines for Americans. Retrieved from http://health.gov/paguidelines/?_ga=1.177233189.1671103883.1467228401

    Organisation for Economic Cooperation and Development. (2016). Average annual hours actually worked per worker. OECD Stat. Retrieved from stats.oecd.org/Index.aspx?DataSetCode=ANHRS

    Palacios, S., Henderson V. W., & Siseles, N. (2010). Age of menopause and impact of climacteric symptoms by geographical region. Climacteric, 13(5), 419-428.

    Parker, K. & Patten, E. (2013). The sandwich generation: Rising financial burdens for middle-aged Americans. Pew Research Center. Retrieved from http://www.pewsocialtrends.org/2013/01/30/the-sandwich-generation/

    Patel, C., Marmot, M. G., & Terry, D. J. (1981). Controlled trial of biofeedback-aided behavioural methods in reducing mild hypertension. British Medical Journal (Clinical research ed.), 282, 2005–2008.

    Pattison, K. (2015). Sleep deficit. Experience Life. Retrieved from https://experiencelife.com/article/sleep-deficit/

    Payne, K. K. (2015). The remarriage rate: Geographic variation, 2013. National Center for Family & Marriage Research. Retrieved from http://bgsu.edu/ncfmr/resources/data/family-profiles/payne-remarriage-rate-fp-15-08.html

    Peterson, B. E. & Duncan, L. E. (2007). Midlife women’s generativity and authoritarianism: Marriage, motherhood, and 10 years of aging. Psychology and Aging, 22(3), 411-419.

    Peterson, B. E., Smirles, K. A., & Wentworth, P. A. (1997). Generativity and authoritarianism: Implications for personality, political involvement, and parenting. Journal of Personality and Social Psychology, 72, 1202-1216.

    Pew Research Center. (2010). The return of the multi-generational family household. Retrieved from http://www.pewsocialtrends.org/2010/03/18/the-return-of-the-multi-generational-family-household/

    Pew Research Center. (2010a). How the great recession has changed life in America. Retrieved from http://www.pewsocialtrends.org/2010/06/30/how-the-great-recession-has-changed-life-in-america/

    Pew Research Center. (2010b). Section 5: Generations and the great recession. Retrieved from http://www.people-press.org/2011/11/03/section-5-generations-and-the-great-recession/

    Pew Research Center. (2015). Caring for aging parents. Family support in graying societies. Retrieved from http://www.pewsocialtrends.org/2015/05/21/4-caring-for-aging-parents/

    Pew Research Center. (2016). The Gender gap in religion around the world. Retrieved from http://www.pewforum.org/2016/03/22/the-gender-gap-in-religion-around-the-world/

    Phillips, M. L. (2011). The mind at midlife. American Psychological Association. Retrieved from http://www.apa.org/monitor/2011/04/mind-midlife.aspx

    Proctor, D. N., Balagopal, P., & Nair, K. S. (1998). Age-related sarcopenia in humans is associated with reduced synthetic rates of specific muscle proteins. Journal of Nutrition, 128(2 Suppl.), 351S-355S.

    Project Time-Off (2016). The state of American vacation: How vacation became a casualty of our work culture. Retrieved from www.projecttimeoff.com/research/state-american-vacation-2016

    Qian, X., Yarnal, C. M., Almeida, D. M. (2013). Does leisure time as a stress coping source increase affective complexity? Applying the Dynamic Model of Affect (DMA). Journal of Leisure Research, 45(3), 393-414.

    Ray, R., Sanes, M., & Schmitt, J. (2013). No-vacation nation revisited. Center for Economic Policy Research. Retrieved from cepr.net/publications/reports/no-vacation-nation-2013

    Ray, R., & Schmitt, J. (2007). No vacation nation USA – A comparison of leave and holiday in OECD countries. Retrieved from http://www.law.harvard.edu/programs/lwp/papers/No_Holidays.pdf

    Research Network on Successful Midlife Development. (2007, February 7). Midlife Research – MIDMAC WebSite. Retrieved from midmac.med.harvard.edu/research.html

    Riordan, C. M., & Griffeth, R. W. (1995). The opportunity for friendship in the workplace: An underexplored construct. Journal of Business and Psychology, 10, 141–154.

    Rossi, A. S. (2004). The menopausal transition and aging process. In How healthy are we: A national study of health in midlife. (pp. 550-575). Chicago: University of Chicago Press.

    Rubin, M., Scevak, J., Southgate, E., Macqueen, S., Williams, P., & Douglas, H. (2018). Older women, deeper learning, and greater satisfaction at university: Age and gender predict university students’ learning approach and degree satisfaction. Diversity in Higher Education, 11(1), 82-96.

    Saad, L. (2014). The 40 hour work week is actually longer – by 7 hours. Gallop. Retrieved from http://www.gallup.com/poll/175286/hour-workweek-actually-longer-seven-hours.aspx

    Salmon, P. (2001). Effects of physical exercise on anxiety, depression, and sensitivity to stress: A unifying theory. Clinical Psychology Review, 21(1), 33–61.

    Salthouse, T. A. (2004). What and when of cognitive aging. Current Directions in Psychological Science, 13, 140–144. Sandgerg-Thoma, S. E., Synder, A. R., & Jang, B. J. (2015). Exiting and returning to the parental home for boomerang kids. Journal of Marriage and Family, 77, 806-818. doi:10.1111/jomf.12183

    Sawatzky, R., Ratner, P. A., & Chiu, L. (2005). A meta-analysis of the relationship between spirituality and quality of life. Social Indicators Research, 72, 153-188.

    Schaie, K. W. (2005). Developmental influences on adult intelligence the Seattle longitudinal study. Oxford: Oxford University Press.

    Scheibe, S., Kunzmann, U. & Baltes, P. B. (2009). New territories of Positive Lifespan Development: Wisdom and Life Longings. In C. R. Snyder & S. J. Lopez (Eds.), Oxford handbook of Positive Psychology (2nd ed.). New York: Oxford University Press.

    Schick, V., Herbenick, D., Reece, M., Sanders, S., A., Dodge, B., Middlestadt, S. E., & Fortenberry, J. D. (2010). Sexual behaviors, condom use, and sexual health of Americans over 50: Implications for sexual health promotion for older adults. Journal of Sexual Medicine, 7(Suppl. 5), 315-329.

    Schuler, P., Vinci, D., Isosaari, R., Philipp, S., Todorovich, J., Roy, J., & Evans, R. (2008). Body-shape perceptions and body mass index of older African American and European American women. Journal of Cross-Cultural Gerontology, 23(3), 255-264.

    Schulz, R., Newsom, J., Mittelmark, M., Burton, L., Hirsch, C., & Jackson, S. (1997). Health effects of caregiving: The caregiver health effects study. Annals of Behavioral Medicine, 19, 110-116.

    Seccombe, K., & Warner, R. L. (2004). Marriages and families: Relationships in social context. Belmont, CA: Wadsworth/Thomson Learning.

    Seltzer, M. M., Floyd, F., Song, J., Greenberg, J., & Hong, J. (2011). Midlife and aging parents of adults with intellectual and developmental disabilities: Impacts of lifelong parenting. American Association on Intellectual and Developmental Disability, 116, 479-499.

    Selye, H. (1946). The general adaptation syndrome and the diseases of adaptation. Journal of Clinical Endocrinology, 6, 117– 230.

    Shure, J., & Cahan, V. (1998, September 10). Launch an exercise program today, say Aging Institute, Senator John Glenn. National Institute on Aging. Retrieved from www.nia.nih.gov/NewsAndEvents/PressReleases/PR19980910Launch.htm

    Slevin, K. F. (2010). “If I had lots of money…I’d have a body makeover”: Managing the aging body. Social Forces, 88(3), 1003-1020.

    Sorensen, P., & Cooper, N. J. (2010). Reshaping the family man: A grounded theory study of the meaning of grandfatherhood. Journal of Men’s Studies, 18(2), 117-136. doi:10.3149/jms.1802.117

    Spiegel, D., Kraemer, H., Bloom, J., & Gottheil, E. (1989). Effect of psychosocial treatment on survival of patients with metastatic breast cancer. The Lancet, 334, 888–891.

    Stern, C., & Konno, R. (2009). Physical Leisure activities and their role in preventing dementia: A systematic review. International Journal of Evidence-Based Healthcare, 7, 270-282.

    Stewart, S. D., Manning, W. D., & Smock, P. J. (2003). Union formation among men in the US: Does having prior children matter? Journal of Marriage and Family, 65, 90 – 104.

    Su, D., Wu, X., Zhang, Y., Li, H., Zhang, J., & Zhou, L. (2012). Depression and social support between China’ rural and urban empty-nest elderly. Archives of Gerontology and Geriatrics, 55, 564–569.

    Swierzewski, S. J. (2015). Erectile Dysfunction. Retrieved from http://www.healthcommunities.com/erectile-dysfunction/overview-of-impotence.shtml

    Tangri, S., Thomas, V., & Mednick, M. (2003). Prediction of satisfaction among college-educated African American women. Journal of Adult Development, 10, 113-125.

    Taylor, B. J., Matthews, K. A., Hasler, B. P., Roecklein, K. A., Kline, C. E., Buysse, D. J., Kravitz, H. M., Tiani, A. G., Harlow, S. D., & Hall, M. H. (2016). Bedtime variability and metabolic health in midlife women: the SWAN Sleep Study. SLEEP, 39(2), 457–465.

    Taylor, S. E., Klein, L. C., Lewis, B. P., Gruenewald, T. L., Gurung, R. A., & Updegraff, J. A. (2000). Biobehavioral responses to stress in females: Tend-and-befriend, not fight-or-flight. Psychological Review, 107, 411–429.

    Teachman, J. (2008). Complex life course patterns and the risk of divorce in second marriages. Journal of Marriage and Family, 70, 294 – 305.

    Teuscher, U., & Teuscher, C. (2006). Reconsidering the double standard of aging: Effects of gender and sexual orientation on facial attractiveness ratings. Personality and Individual Differences, 42(4), 631-639.

    Thurston, W. E, & Vissandjée, B. (2005). An ecological model for understanding culture as a determinant of women’s health. Critical Public Health, 15(3), 229-242.

    Torti, F. M., Gwyther, L. P., Reed, S. D., Friedman, J. Y., & Schulman, K. A. (2004). A multinational review of recent trends and reports in dementia caregiver burden. Alzheimer Disease and Associated Disorders, 18(2), 99-109.

    Tower, R. B., & Kasl, S. V. (1995). Depressive symptoms across older spouses and the moderating effect of marital closeness. Psychology and Aging, 10, 625– 638. doi:10.1037/0882-7974.10.4.625

    Twisk, J. W., Snel, J., Kemper, H. C., & van Mechelen, W. (1999). Changes in daily hassles and life events and the relationship with coronary heart disease risk factors: A 2-year longitudinal study in 27–29-year-old males and females. Journal of Psychosomatic Research, 46, 229–240.

    Uchida, Y., Nakashima, T., Ando, F., Niino, N., & Shimokata, H. (2003). Prevalence of self-perceived auditory problems and their relation to audiometric thresholds in a middle-aged to elderly population. Acta Oto-Laryngologica, 123(5), 618.

    Umberson, D., Williams, K., Powers, D., Chen, M., & Campbell, A. (2005). As good as it gets? A life course perspective on marital quality. Social Forces, 81, 493-511.

    United Health Foundation. (2016). New report finds significant health concerns loom for seniors in coming years. Retrieved from http://www.unitedhealthfoundation.org/News/Articles/Feeds/2016/052516AHRSeniorReport.aspx?r=3

    U.S. Bureau of Labor Statistics (2016). American time use survey – 2015. Retrieved from http://www.bls.gov/news.release/pdf/atus.pdf

    U.S. Department of Health and Human Services and U.S. Department of Agriculture. (2015) 2015–2020 Dietary Guidelines for Americans. 8th Edition. Retrieved from http://health.gov/dietaryguidelines/2015/guidelines/

    U.S. Department of Labor (2016). Vacation Leave. Retrieved from https://www.dol.gov/general/topic/workhours/vacation_leave

    U.S. Government Accountability Office. (2012). Unemployed older workers: Many experience challenges regaining employment and face reduced retirement security. Retrieved from http://www.gao.gov/products/GAO-12-445

    Vaillant, G. E. (1977). Adaptation of life. Boston, MA: Little, Brown

    Vaillant, G. E. (2008). Spiritual evolution: A scientific defense of faith. New York: Doubleday Broadway. Vaillant, G. E. (2012). Triumphs of experience. Cambridge, MA: Harvard University Press.

    Waldrop, D., Weber, J., Herald, S., Pruett, J., Cooper, K., & Juozapavicius, K. (1999). Wisdom and life experience: How grandfathers mentor their grandchildren. Journal of Aging and Identity, 4 (1), 33-46.

    Wang, W. & Parker, K. (2014) Record share of Americans have never married: As values, economics and gender patterns change. Retrieved from http://www.pewsocialtrends.org/2014/09/24/record-share-of-americans-have-never-married/

    WebMD. (2016). Erectile Dysfunction: Testosterone Replacement Therapy. Retrieved from http://www.webmd.com/erectile-dysfunction/guide/testosterone-replacement-therapy?page=2#3

    Willis, S. L., & Schaie, K. W. (1999). Intellectual functioning in midlife. In S. L. Willis & J. D. Reid (Eds.), Life in the Middle: Psychological and Social Development in Middle Age (pp. 233-247). San Diego: Academic.

    Wong, Y. C., & Leung, J. (2012). Long-term care in China: Issues and prospects. Journal of Gerontological Social Work, 55, 570–586.

    World Health Organization. (2018). Top 10 causes of death. Retrieved from https://www.who.int/gho/mortality_burden_disease/causes_death/top_10/en/

    World Health Organization. (2019). Burn-out an “occupational phenomenon”: International Classification of Diseases. Retrieved from: https://www.who.int/mental_health/evidence/burn-out/en/

    Wu, Z., Sun, L., Sun, Y., Zhang, X., Tao, F., & Cui, G. (2010). Correlation between loneliness and social relationship among empty nest elderly in Anhui rural area, China. Aging and Mental Health, 14, 108–112.

    Yeager, C. A., Hyer, L. A., Hobbs, B., & Coyne, A. C., (2010). Alzheimer’s disease and vascular dementia: The complex relationship between diagnosis and caregiver burden. Issues in Mental Health Nursing, 31(6), 376-384.

    Yick-Flanagan, A. (2013). Meanings of menopause: Cultural considerations. Retrieved from http://www.netce.com/coursecontent.php?courseid=976

    Zuidema, S. U., de Jonghe, J. F., Verhey, F. R., & Koopman, R. T. (2009). Predictors of neuropsychiatric symptoms in nursing home patients: Influence of gender and dementia severity. International Journal of Geriatric Psychiatry, 24(10), 1079-1086.

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