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Doctoral
Thesis: Social support
in later life: Cross-sectional and longitudinal analyses
of inter-relationships between psychosocial variables
in the Women's Health Australia study.
Supervisors: Dr
Nancy Pachana & Dr Gerard Byrne
University: School
of Psychology, Flinders University, Adelaide.
This study examined the roles of psychosocial variables
including social support and optimistic appraisal in
understanding the mental health transitions of older
Australian women. Data were drawn from a community-dwelling
sample of 9514 older Australian women aged 72-79 years,
as part of the Australian Longitudinal Study on Women's
Health (ALSWH).Cross-sectional
analyses were conducted for data collected in 1999 for
the general sample of women, as well as for subgroups
of women considered to be at greater risk of mental
health problems - those with the poorest physical health;
those having experienced higher numbers of negative
life events; and women from non-English speaking backgrounds.Results
of multiple regression analyses indicated optimism,
social satisfaction, and social interaction to be significant
predictors of mental health in all subsamples. The role
of protective factors appeared to be diminished for
women with poorer physical health.Data
for 8646 older women collected in 1999 and 2002 were
then analysed longitudinally via multinomial logistic
regression analyses. Women whose mental health had stayed
adequate over the three year period were compared to
subgroups of women whose mental health had stayed poor,
declined, or improved. SF-36 Mental Health scores, in
addition to doctor diagnosed depression and anxiety
were used as criterion variables. Comparison of means
across transition groups of women suggested these groups
represented distinct mental health trends in ageing.
Results indicated optimism, social satisfaction, and
social interaction to be significantly lower for all
groups of women, other than those with adequate ongoing
mental health. Women with poor or declining mental health
were more likely to have poorer social satisfaction
at Time 1; social interaction was seen to decline in
unison with mental health for women with chronic or
declining mental health. Physical health had little
explanatory value in predicting mental health transitions.
Data provided additional evidence for a significant
role of life events in effecting change in mental health
status over time.Public
health recommendations are outlined, including increased
research funding for the study of psychosocial variables
in healthy ageing; improved mental health education
both within public and primary care settings; and additional
resources for mental health treatment services for older
Australian women. Clinical implications of the project
are also discussed, and include the enhanced training
of clinical psychologists in the area of ageing, and
improved recruitment of psychologists into the aged
care sector; further treatment of late-life depression
and anxiety; and the use of appropriate psychological
interventions such as cognitive behaviour therapy for
late-life depression and anxiety; interpersonal therapy
is recommended for older women experiencing depressive
symptoms and relational deficits.
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