Prueba de hipótesis

There is widespread agreement that social relationships provide a fundamental resource for late-life adaptation. However, the under-lying mechanisms and health functions of social resources are not fully understood (House, Umberson, & Landis, 1988). Social support has been proposed generally to exert a direct protective effect on health or well-being, while stressor-specific support of others may operate as a buffer when adverse or stressful events occur (Cohen & Wills, 1985; Schwarzer &

Leppin, 1991). Others have proposed more complex patterns of associations in which specific types of social resourcesÐsuch as emotional, instrumental, or tangible support (Rook & Pietromonaco, 1987)Ðare expected to have specific effects on health or well-being for specific individuals in specific situations (Got-tlieb, 1983; House & Kahn, 1985; House et al., 1988; Kessler & McLeod, 1985). However, the age-specific needs and capacities of older support recipients and their social partners are often not well integrated in theoretical models of adaptivity in later life (see also Baltes

& Carstensen, 1996; Carstensen & Lang, 1997;

Staudinger, Marsiske, & Baltes, 1995). Indeed, considerable empirical evidence may serve to underscore the notion that age-specific social preferences and social belief systems (e.g., social self-efficacy; Lang, Featherman, & Nessel-roade, in press) contribute to the adaptive functions of social support and social contact in later life.

The most convincing evidence for positive effects of social support and social networks on health comes from a variety of longitudinal studies of mortality in later life. The interested reader is referred to several excellent reviews of empirical findings about associations of social resources with mortality (Atkins, Kaplan, &

Toshima, 1992; Schwarzer & Leppin, 1991), physical health (Antonucci & Jackson, 1987;

Schwarzer & Leppin, 1991), immunologic functioning (Antonucci & Jackson, 1987; Ken-nedy, Kiecolt-Glaser, & Glaser, 1990), disease course (Kriegsman, Penninx, & van Eijk, 1995), recovery from illness (Reifman, 1995), adjust-ment to cancer (Helgeson & Cohen, 1996), depression and mental health (Gotlib & Whif-fen, 1992; Schwarzer & Leppin, 1992), and well-being (Bowling, 1994; Kessler & McLeod, 1985). It should be noted, however, that some reviews have reported minimal or even no impact of social support on health or well-being (Ganster & Victor, 1988; Schulz & Rau, 1985;

Wallston, Alagna, DeVellis, & DeVellis, 1983) and some have also pointed to the potential negative effects of social relationships (Rook, 1984; Rook & Pietromonaco, 1987). In the following, health effects of social relationships are distinguished as they pertain to the relational contexts of older people, on the one hand, and as they pertain to relational beha-viors, on the other, such as older individuals' styles or strategies of relating to others, such as selecting social partners, relying on others, reciprocating support, and enhancing social relationships.

7.03.3.1 Social Relationships and Health:

Evidence for Positive Effects

Epidemiological studies in the United States and Europe have consistently found associa-tions between the individual's risk of premature mortality and social resources or social con-texts. For example, having close confidants or intimate social partners has been found repeat-edly to be associated with increased longevity (Berkman, 1985; Berkman & Syme, 1979;

Broadhead et al., 1983; Hammer, 1983; Hanson, Isacsson, Janzon, & Lindell, 1990; Orth-Gomer

& Johnson, 1987; Steinbach, 1992; Sugisawa, Liang, & Liu, 1994). In the Terman Gifted Study, having a stable long-term marriage predicted increased longevity above and beyond gender, childhood personality, and health behaviors, while the risk of premature mortality was highest among those who had experienced divorce or separation before age 40 (Friedman et al., 1995). Separation and divorce are critical non-normative life events that may affect longevity. When individuals do not develop new intimate relationships after separation or divorce, they are at greater risk of premature mortality (Tucker, Friedman, Wingard, &

Schwartz, 1996).

Furthermore, increased social network size and frequency of social contacts reduce the risk of mortality (Cohen, Teresi, & Holmes, 1986±87; Olsen, Olsen, Gunner-Svensson, &

Waldstrom, 1991). However, social resources seem to affect morbidity differentially, among men and women (Bryant & Rakowski, 1992;

Shye, Mullooly, Freeborn, & Pope, 1995). For example, while premature mortality is related to marital status among men (Berkman & Syme, 1979; Schoenbach, Kaplan, Fredman, & Klein-baum, 1986), womens' chance of survival is better determined by size of social network (Shye et al., 1995), level of social activity, and church attendance (Berkman & Syme, 1979;

House, Robbins, & Metzner, 1982).

In an Israeli five-year incidence study on adult men, high family conflict and low spousal support were related to increased risk of angina pectoris (Medalie & Goldbourt, 1976). In a Danish 14-year follow-up study of mortality, the perceived quality of social resources rather than quantitative characteristics of social net-works were associated with increased longevity (Olsen et al., 1991). Generally, there is much empirical evidence that the perceived or sub-jective quality of social support or social contact are associated more strongly with adaptive outcomes than any other aspect or measure of social support (Antonucci & Jackson, 1987;

Dunkel-Schetter & Bennett, 1990; Schwarzer &

Leppin, 1991). This further underscores the qualification that social relationships are most effective when they are congruent with the individual's competence and social preferences (Carstensen, 1987; Carstensen & Lang, 1997).

For example, in old age declines in health status are associated with receiving help and support from sources that are increasingly distant from the older person (Stoller & Pugliesi, 1988). This means that emotional or instrumental social support may often come from social partners who are not emotionally meaningful to the older person and may thus create unease or enhance feelings of dependence in the older individual.

When changes in health status occur, in-dividuals may change their apprehension of available social relationships and social support (e.g., Gotlib & Whiffen, 1992; Wilcox, Kasl, &

Berkman, 1994). When the individual's level of functioning and competence change, the in-dividual may also adjust their preferences for specific social partners and for specific functions of social interactions. However, such changes in social preferences or needs may also affect the adequacy and satisfaction with previously available social resources. Research on social support has often neglected the fact that individuals change their social preferences and social behaviors in the course of physical or mental health crises, even when examined in prospective studies, where social support can be measured before and after health changes occur (e.g., Holahan, Moos, Holahan, & Brennan, Social Relationships and Adaptation in Late Life

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1995; Wilcox, Kasl, & Berkman, 1994). In fact, the benefits and positive outcomes of receiving social support may depend on the older individual's competence to utilize social re-sources in adaptive ways (Hansson & Carpen-ter, 1994; Lang, 1996; Thomae, 1994). Findings from empirical studies of health and well-being that do not consider changes in the individual's social needs and preferences may underestimate the actual impact of social resources.

7.03.3.2 The Negative Side of Social Relationships

Since the early 1980s, the perspective of social relationships as a uniformly positive resource has been challenged by conceptual and empiri-cal work that demonstrates that positive relational outcomes can be neutralized or even reversed by negative aspects of social relation-ships, such as relational strain (Rook, 1984, 1987a), overprotective or unsolicited support (Thompson & Sobolow-Shubin, 1993a, 1993b), daily relational hassles (Bolger & Kelleher, 1993), and violence or physical abuse (Pillemer

& Finkelhor, 1988; Pillemer & Suitor, 1992).

Another, often overlooked, source of negative experience in social relationships pertains to the experience or anticipation of personal loss that is relatively common in later life (Garrett, 1987;

Lopata, 1986; Morgan, 1989).

While negative aspects of social relationships, in theory, are often exclusively discussed in respect to the social behaviors of others (Rook

& Pietromonaco, 1987), empirical studies on negative interactions have often focused exclu-sively on subjective evaluations of social support to the older individual (e.g., Schuster, Kessler, & Aseltine, 1990). Although an individual's negative relational experiences may be difficult to empirically disentangle from social (dis-)satisfaction or perceived support (in-)adequacy, this is crucial for an under-standing of the individual's role in dealing with negative contents of social interactions. How an older individual responds to a specific threat or strain in a concrete social relationship may determine the individual's satisfaction or affect as much as the negative event itself. For example, conflict or friction among spouses may be easily resolved when both partners are satisfied with their marriage but may have detrimental effects and even predict separation when marital satisfaction is low (e.g., Carsten-sen et al., 1995; Gottman & Levenson, 1992;

Levenson et al., 1993).

Most negative aspects of social relationships typical in later life may be associated with intensive emotional turmoil that demands

efficient types of affective regulation on the part of the older individual. In the following, four sources of potential negative aspects of social relationships in later life are distin-guished. They are: (i) dysfunctional social support, such as undesirable, ineffective, or excessive support; (ii) unpleasant or overde-manding social contact; (iii) violence or neglect;

and (iv) anticipation or experience of personal loss of others.

7.03.3.2.1 Dysfunctional social support

While there is convincing empirical evidence that social support does contribute to life quality and well-being in later life, there is also a growing body of empirical studies showing that social relationships not only provide gratification but also entail risks and costs for the individual (for reviews see Jung, 1990; Rook

& Pietromonaco, 1987; Shinn, Lehmann, &

Wong, 1984). Failures to provide social support have been related to a variety of characteristics of the support process such as undesirable social contact (Cutrona, Cohen, & Igram, 1990; Rose, 1993), lack of empathy and sensitivity (Wort-man & Leh(Wort-man, 1985), grudgingly given support (Coyne, 1976), interpersonal betrayal (Hansson, Jones, & Fletcher, 1990), emotional overinvolvement (Coyne, Wortman, & Leh-mann, 1988), overprotection (Thompson &

Sobolow-Shubin, 1993a, 1993b), and the re-inforcement of dependent behaviors (Baltes, 1995).

Negative aspects of social relationships have been shown consistently to operate relatively independently of personality or situational characteristics (Finch, Okun, Barrera, Zautra,

& Reich, 1989). Furthermore, empirical evi-dence suggests that negative experiences in supportive interactions are more strongly associated with well-being or mental health than perceived positive instances of social support (Finch et al., 1989; Okun, Melichar,

& Hill, 1990; Rook, 1984; Schuster et al., 1990).

However, there is no consistent evidence that detrimental effects of negative social support are enhanced dramatically in the absence of positive social support (Schuster et al.) or in the presence of negative events (Okun et al., 1990).

Typically, negative and positive social interac-tions are only mildly or not at all correlated (Finch et al.; Okun et al.; Rook, 1984; Shinn et al., 1984). It has been suggested (Schuster et al.;

Shinn et al.) that such a dissociation of positive and negative aspects may parallel findings on independence of positive and negative affect (e.g., Watson, Clark, & Tellegen, 1988). How-ever, no study, to the best of our knowledge, has examined the age-differential effects of positive

and negative supportive interactions on the experience of positive and negative affect in daily life.

Empirical studies of the experience of negative supportive interactions typically have focused on the individual's subjective experience of such negative interaction. However, it seems plau-sible that older individuals may have idiosyn-cratic responses to negative events in their close relationships and may develop individual stra-tegies of avoiding or managing negative aspects of close relationships (e.g., Carstensen et al., 1995). Moreover, many negative aspects of dysfunctional social support may also be related to the older individual's social contacts and social preferences. For example, a failure to communicate wishes or needs may be as much responsible for inefficient or inadequate social support as a social partners' lack of social abilities to ªdo the right thingº (e.g.,Query &

James, 1989). It has also been suggested that individuals do not rely on others when they cannot reciprocate received benefits in order to avoid feelings of shame or guilt (Fisher, Nadler,

& Whitcher-Alagna, 1982; Riley & Eckenrode, 1986; Shumaker & Jackson, 1979)

7.03.3.2.2 Unpleasant and demanding social contacts

Conflicts, demands, and criticism are part and parcel of even the best close social relationships and may even increase over time (Rook & Pietromonaco 1987; Antonucci, 1985).

In addition, personal relationships are not always stable and reliable but to some extent are also characterized by unpredictability and fluctuations (e.g., Lang, Featherman, & Nes-selroade, in press).

Although empirical research on unpleasant and demanding aspects of social relationships in later life remains scarce, there is some evidence that older adults may differ from younger adults in respect to how they react and deal with relational conflict or friction (e.g., Carstensen et al., 1995). Older people may be more skilled in avoiding unpleasant or overly demanding situations with social partners about whom they feel less strongly or positive. For example, it has been shown that lack of equity or reciprocity expectations in older adult's friend-ships are very likely to lead to dissatisfaction or even dissolution of the relationship (Roberto &

Scott, 1986a, 1986b).

There is some evidence that when individuals hold negative views toward others they have a greater risk of premature mortality (Barefoot et al., 1987) and are more vulnerable to depression or other form of negative affect when con-fronted with demands, criticism, or rejection

(Smith, 1992). For example, spouses of de-pressed partners are less supportive, more critical, hostile, and ambivalent towards their partners (Hautzinger, Linden, & Hoffman, 1982; Ruscher & Gotlib, 1988; for a review, see Gotlib & Hooley, 1988). Personality char-acteristics and relational styles may thus conjointly influence the way individuals react to unpleasant social encounters (Hansson &

Carpenter, 1994). However, although person-ality characteristics are relatively stable over the life course (Costa & McCrae, 1994), their impact in determining outcomes of social interactions and social adaptation may well change with age and may account for fewer outcomes in later adulthood (Lang et al., in press). In other words, older people may be at greater risk of experien-cing negative effects when confronted with unavoidable, unpleasant,or demanding social behaviors of others.

7.03.3.2.3 Violence and neglect: the relational dynamics of caregiving

Violent or neglectful behaviors are the most obvious and dramatic negative aspects of social relationships in later life. In the United States, estimates of incidence of elder abuse range from seven hundred thousand to one million people older than 65 years (Hansson & Carpenter, 1994). Violence or neglect occurs mostly in relationships with social partners who share a household (Pillemer & Finkelhor, 1988). In-deed, social contexts of caregiving children or spouses may be experienced as extremely stressful and frustrating for caregivers as well as older individuals (Franks & Stephens, 1996;

Schulz, Tompkins, & Rau, 1988; Walker, Martin, & Jones, 1992). Caregiver stress (for reviews: Pearlin, Mullan, Semple, & Skaff, 1990;

Schulz, Visintainer, & Williamson, 1990) has been reported to be associated with increased depression and emotional turmoil (Pruchno, Peters, & Burant, 1995; Townsend & Franks, 1995), social isolation, and the lack of social support (Johnson & Catalano, 1983; George &

Gwyther, 1986).

In addition, the relational dynamics of caregiving may lead to further escalation of hostility and aggression in the care receiver as well as in the caregiver. Older individuals who receive care must also come to terms with their lack of autonomy and dependence on the caregiver (Baltes & Silverberg, 1994).

7.03.3.2.4 Anticipation or experience of relational loss

Finally, experiencing the deaths of close friends and relatives is normative in late life Social Relationships and Adaptation in Late Life

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(Holmes & Rahe, 1967; Johnson & Troll, 1994).

Most individuals over 65 years have experienced losses of close friends, siblings, or of partners during late life and also struggle with the anticipatory loss of other close social partners (Garrett, 1987; Lopata, 1986; Morgan, 1989).

Despite empirical evidence for the negative impact of widowhood on the social world, however, research suggests a more differen-tiated perspective on adjustment to widowhood (e.g., Ferraro & Farmer, 1995). Prior to widowhood, many spouses endure extended periods when their partners suffer from severe illness and require considerable care (Bass &

Bowman, 1990; Bass, Bowman, & Noelker, 1991; Mullan, 1992). Subsequently, as painful as widowhood may be, it can also entail a sense of relief that the spouse's suffering has finally come to an end and the widowed spouse regains freedom to engage in more pleasant activities.

Due to women's longer life expectancy and the traditional age differences among married couples, widowhood is a normative experience among married women. It is a less common experience for married men. In addition, widowhood seems to be related to gender-differentiated demands and needs. Adjustment to widowhood is more strongly related to social compensation among widows than among widowers (Ferraro & Farmer, 1995). Typically, widows are threatened by financial losses following widowhood, whereas men are at risk if they have difficulties with keeping up an independent household (Umberson, Wortman,

& Kessler, 1992). In addition, widowhood is associated with a higher mortality risk for widowers than for widows (Bowling, 1988-89;

Bowling & Windsor, 1995).

7.03.3.3 Managing Social Resources

A review of empirical studies on differential effects of positive and negative aspects of supportive relationships on late-life adaptation suggests that positive outcomes of social resources are largely determined by the extent to which social resources actually meet the older individual's social preferences and needs.

For example, it has been reported consistently, that perceived adequacy of social support is more strongly associated with adaptive out-comes than any other aspects of social support.

However, the cognitive and behavioral strate-gies in supportive interactions that determine and influence subjective support adequacy are not well understood. Few empirical studies have examined cognitive or behavioral corre-lates of perceived social support adequacy in adulthood (e.g., Dunkel-Schetter, Folkman, &

Lazarus, 1987; RoÈhrle, 1994) or old age (Seeman & Berkman, 1988), let alone con-sidered age-related changes in motivational or emotional determinants of managing social support. Empirical evidence for changed social preferences towards greater emphasis on emotionally meaningful social contacts in late adulthood (Carstensen, 1995; Fredrickson &

Carstensen, 1990) suggests that the adequacy and impact of social contact and social support on well-being in later life depends on emotion-regulatory aspects of social relationships such as emotional closeness (Lang & Carstensen, 1994), intimacy (Babchuk & Anderson,1989), generativity (McAdams, de St. Aubin, &

Logan, 1993), functional specificity (Felton &

Berry, 1992), and trust (Holmes, 1991; Tho-mae, 1994). There is also empirical evidence that older people benefit from actively enga-ging in support-seeking behaviors (Filipp &

Aymanns, 1987), and from reciprocating support to others (Jung, 1990; Krause, Herzog,

& Baker, 1992; Lang, 1996). Others have focused on the personality characteristics of older people that were shown to be closely associated with increased levels of relational competence (Hansson & Carpenter, 1994) related to the initiation, maintenance, and enhancement of social relationships or rela-tional outcomes (Carpenter, 1993; Mariske et al., 1995). Moreover, feelings of control in salient social roles (such as spouse, parent, or grandparent) have been shown to buffer deleterious effects of stressful life events on life satisfaction (Krause, 1994).

The adaptive management of social resources in later life is also illustrated by empirical evidence for the learned dependency model developed by Baltes and her colleagues (Baltes, 1995; Baltes, Neumann, & Zank, 1994). This line of observational research has revealed that dependent behaviors of older ,nursing home residents are more often posi-tively reinforced by responsiveness and social contact than independent behaviors. Subse-quent intervention studies demonstrated that independent behaviors of residents increased when staff members and other social partners were trained to be responsive to independent behaviors (Baltes et al.). The initiation of such dependence-support scripts in nursing home settings has been conceptualized as an adaptive behavioral strategy by which older people regulate and optimize the available resources

The adaptive management of social resources in later life is also illustrated by empirical evidence for the learned dependency model developed by Baltes and her colleagues (Baltes, 1995; Baltes, Neumann, & Zank, 1994). This line of observational research has revealed that dependent behaviors of older ,nursing home residents are more often posi-tively reinforced by responsiveness and social contact than independent behaviors. Subse-quent intervention studies demonstrated that independent behaviors of residents increased when staff members and other social partners were trained to be responsive to independent behaviors (Baltes et al.). The initiation of such dependence-support scripts in nursing home settings has been conceptualized as an adaptive behavioral strategy by which older people regulate and optimize the available resources