바로가기메뉴

본문 바로가기 주메뉴 바로가기

The Korean Journal of Health Psychology

  • KOREAN
  • P-ISSN1229-070X
  • E-ISSN2713-9581
  • KCI

The Roles of Acceptance and Cognitive Reappraisal in the Relationship Between Stress, Subjective Well-Being and Depression in Older Adults

The Korean Journal of Health Psychology / The Korean Journal of Health Psychology, (P)1229-070X; (E)2713-9581
2017, v.22 no.1, pp.103-122
https://doi.org/10.17315/kjhp.2017.22.1.006


Abstract

The purpose of this study is to examine the roles of acceptance and cognitive reappraisal in the relationship between stress, subjective well-being and depression in older adults. Among various emotion regulation strategies, cognitive reappraisal, which is positively reinterpreting an event, is widely considered to improve subjective well-being and reduce depressive symptoms of the elderly. However, the role of acceptance - willingly experiencing an unpleasant thought and feeling - for successful aging is not yet clear. In this study, whether acceptance and cognitive reappraisal play a positive role on successful aging was identified by exploring the relationships among stress, subjective well-being, depression, acceptance, and cognitive reappraisal. Demographic characteristics such as gender, age, education level, and the presence of a spouse were also considered to verify whether the characteristics had an effect on elderly's subjective well-being and depression. The results showed that only education level was related to subjective well-being and depression. Acceptance was significantly related to high subjective well-being and low depression, whereas cognitive reappraisal was not. When the education level was controlled, the partial mediating effect of acceptance on the relationship between stress, subjective well-being and depression was found. From these results, it was provisionally supported that acceptance is helpful for improving elderly's subjective well-being and reducing depression, ultimately contributing to successful aging. Finally, the implications and limitations of this study and suggestions for future research were discussed.

keywords
장노년, 스트레스, 주관적 안녕감, 우울, 수용, 인지적 재평가, older adults, stress, subjective well-being, depression, acceptance, cognitive reappraisal

Reference

1.

강인 (1990). 중년기 가족스트레스와 가족대처방안에 관한 연구. 이화여자대학교 대학원 석사학위청구논문.

2.

고선규, 고영건 (2009). 노인과 청년 집단의 인지적 정서 조절 비교. 인지행동치료, 9(2), 65-85.

3.

권철, 남철현, 황해석, 정한태, 하순희, 민경진, 김순(2006). 노인의 삶의 만족도에 영향을 미치는 요인. 대한보건연구, 32, 66-74.

4.

기백석 (1996). 한국판 노인 우울 척도 단축형의 표준화예비연구. 신경정신의학, 131, 298-307.

5.

김미령 (2008). 여성노인의 삶의 만족도에 영향을 미치는성공적 노화의 구성요소. 한국노년학, 28, 33-48.

6.

김미정 (2005). 노인의 스트레스와 대처방법. 한림대학교 대학원 석사학위청구논문.

7.

김민희, 민경환 (2004). 노년기 정서경험과 정서조절의특징. 한국심리학회지: 일반, 23(2), 1-21.

8.

김희주, 주경희 (2008). 한국적 성공적 노후척도를 활용한 노인의 삶의 만족에 관한 연구. 한국노인복지학회, 41, 125-158.

9.

박은숙 (1998). 노인의 건강증진 행위 및 삶의 질에 영향을 미치는 요인. 대한간호학회지, 28(3), 638-649.

10.

배나래, 박충선 (2009). 노년기 삶의 질에 영향을 미치는 생태체계적 요인에 관한 연구. 한국노년학, 29(2), 761-779.

11.

손재민 (2005). 정서조절방략 사용에서의 개인차. 서울대학교 대학원 석사학위청구논문.

12.

신현구 (2007). 노동시장 은퇴자의 은퇴만족도 및 삶의만족도. 노동리뷰, 27, 81-93.

13.

유경 (2005). 정서최적화와 정서복잡성이 장노년기 심리적 적응에 미치는 영향. 서울대학교 대학원 박사학위청구논문.

14.

유정이 (2006). 노인의 연령에 따른 삶의 만족도에 영향을 미치는 요인: 일, 건강, 배우자 요인을 중심으로. 복지행정연구, 22, 241-254.

15.

이영자 (1999). 단독가구 노인의 스트레스와 우울감: 사회적 지지의 완충 효과를 중심으로. 성신여자대학교 대학원 박사학위청구논문.

16.

이유정 (1994). 성격특질이 기분의 수준 및 변화성에 미치는 영향. 중앙대학교 대학원 박사학위청구논문.

17.

이주영, 문재우 (2011). 노인의 정신건강이 삶의 만족도에 미치는 영향. 대한보건연구, 37, 45-57.

18.

이훈진 (2009). 수용(Acceptance)이 심리적 증상, 자존감 및 삶의 만족도에 미치는 영향. 한국인지행동치료학회, 9(1), 1-23.

19.

전수빈 (2015). 노인의 삶의 만족도에 미치는 영향요인:대전광역시 노인의 동거형태를 중심으로. 서울시립대학교 대학원 석사학위청구논문

20.

정옥분 (2000). 성인발달의 이해. 서울: 학지사.

21.

조명한, 차경호. (1998). 삶의 질에 대한 국가 간 비교. 서울: 집문당.

22.

조성자, 김병석 (2014). 노년기의 스트레스와 삶의 만족도간의 관계: 우울, 자기효능감, 마인드풀니스(mindfulness)의 매개효과. 한국노년학, 34(1), 49-71.

23.

최현석, 하정철 (2012). 노인의 생활전반 만족에 영향을미치는 요인에 관한 연구. 한국데이터정보과학지, 23(1), 131-142.

24.

통계청 (2016). 2015년 한국의 사회지표.

25.

허재홍, 최명식, 진현정 (2009). 한국어판 수용-행동 질문지 II 신뢰도 및 타당도 연구. 한국심리학회지:상담 및 심리치료, 21(4), 861-878.

26.

Ayers, C., Petkus, A., Liu, L., Patterson, T. L., & Wetherell, J. L. (2010). Negative life events and avoidant coping are associated with poorer long-term outcome in older adults treated for generalized anxiety disorder. Journal of Experimental Psychopathology, 1(1), 146-154.

27.

Baltes, P. (1997). On the incomplete architecture of human ontogeny: Selection, optimization, and compensation as foundation of developmental theory. American Psychologist, 52, 366-380.

28.

Baron, R. M., & Kenny, D. A. (1986). The moderator-mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 6, 1173-1182.

29.

Blazer, D. G. (2003). Depression in late life: review and commentary. Journal of Gerontology Series A: Biological and Medical Science, 58, 249-265.

30.

Bond, F. W., Hayes, S. C., Baer, R. A., Carpenter, K. M., Guenole, N., Orcutt, H. K., ... Zettle, R. D. (2011). Preliminary psychometric properties of the Acceptance and Action Questionnaire-II: A revised measure of psychological flexibility and experiential avoidance. Behavior Therapy, 42(4)1-38.

31.

Brenes, G. A., Guralnik, J. M., Williamson, J. D., Fried, L. P., Simpson, C., Simonsick, E. M., & Penninx, B. W. (2005). The influence of anxiety on the progression of disability. Journal of the American Geriatric Society, 53(1), 34-39.

32.

Butler, J., & Ciarrochi, J. (2007). Psychological acceptance and quality of life in the elderly. Quality Of Life Research, 16(4), 607-615.

33.

Carstensen, L. L. (2006). The influence of a sense of time on human development. Science, 312, 1913-1915.

34.

Carstensen, L. L., Pasupathy, M., Mayr, U., & Nesselroade, J. (2000). Emotional experience in everyday life across the adult life span. Journal of Personality and Social Psychology, 79, 644-655.

35.

Charles, S. T., & Carstensen, L. L. (2007). Emotion regulation and aging. In J. J. Gross (Ed.), Handbook of emotion regulation (pp. 307-327). New York: Guilford Press.

36.

Cukrowicz, K. G., Ekblad, A. G., Cheavens, J. S., Rosenthal, M. Z., & Lynch, T. R. (2008). Coping and thought suppression as predictors of suicidal ideation in depressed older adults with personality disorder. Aging and Mental Health, 12, 149-157.

37.

Diefenbach, G. J., Tolin, D. F., Gilliam, C. M., & Meunier, S. A. (2008). Extending cognitivebehavioral therapy for late-life anxiety to home care: program development and case examples. Behavior Modification, 32, 595-610.

38.

Diener, E., Emmons, R. A., Larsen, R. J., & Griffin, S. (1985). The satisfaction with life scale. Journal of Personality Assessment, 49, 71-75.

39.

Diener, E., & Suh, E. (1998). Age and subjective well-being: An international analysis. In K. W. Schaie & M. P. Lawton (Eds.), Annual review of gerontology and geriatrics: Vol. 17. Focus on emotion and adult development (pp. 304-324). New York: Springer.

40.

Dotson, V. M., Resnick, S. M., & Zonderman, A. B. (2008). Diferential association of concurrent, baseline, and average depressive symptoms with cognitive decline in older adults. American Journal of Geriatric Psychiatry, 16, 318-330.

41.

Folkman, S., Lazarus, R. S., Pimley, D., & Novacek, J. (1987). Age differences in stress and coping processes. Psychology and Aging, 2, 171-184.

42.

Freund, A. M. (2008). Successful aging as management of resources: The role of selection, optimization, and compensation. Research in Human Development, 5, 94-106.

43.

Garnefski, N., Boon, S., & Kraaij, V. (2003). Relationships between cognitive strategies of adolescents and depressive symptomatology across different types of life events. Journal of Youth and Adolescence, 32, 401-408.

44.

Garnefski, N., Kraaij, V., & Spinhoven, P. (2001). Negative life events, cognitive emotion regulation and emotional problems. Personality and Individual Differences, 30, 1311-1327.

45.

Garnefski, N., Teerds, J., Kraaij, V., Legerstee, J., & Van den Kommer, T. (2004). Cognitive emotion regulation strategies and depressive symptoms:Differences between males and females. Personality and Individual Differences, 36, 267-276.

46.

Garnefski, N., Van den Kommer, T., Kraaij, V., Teerds, J., Legerstee, J., & Onstein, E. (2002). The relationship between cognitive emotion regulation strategies and emotional problems:Comparison between a clinical and a non-clinical sample. European Journal of Personality, 16, 403-420.

47.

George, L. K. (2000). Well-being and the sense of self: What we know and what we need to know. In K. W. Schaie & J. Hendricks (Eds.), The evolution of the aging self: The societal impact on the aging process (pp.1-36). New York:Springer.

48.

Gibbons, L. E., Teri, L., Logsdon, R., McCurry, S. M., Kukull, W., Bowen, J., ... Larson, E. (2002). Anxiety symptoms as predictors of nursing home placement in patients with Alzheimer’s disease. Journal of Clinical Geropsychology, 8(4), 335-342.

49.

Gross, J. J. (Ed.). (2007). Handbook of emotion regulation. New York: Guilford Press.

50.

Gross, J. J., & John, O. P. (2003). Individual differences in two emotion regulation processes:Implications for affect, relationships, and well-being. Journal of Personality and Social Psychology, 85, 348-362.

51.

Hammarstrom, G., & Torres, S. (2012). Variations in subjective well-being when ‘aging in place’ – A matter of acceptance, predictability and control. Journal of Aging Studies, 26, 192-203.

52.

Hayes, S. C. (1994). Content, context, and the types of psychological acceptance. In S. C. Hayes, N. S. Jackson, V. M. Follette, & M. J. Doughter (Eds.), Acceptance and change: Content and context in psychotherapy (pp. 13-32). Reno, NV:Context Press.

53.

Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (1999). Acceptance and commitment therapy: An experiential approach to behavior change. New York: Guilford Press.

54.

Hayes, S. C., Strosahl, K. D., Wilson, K. G., Bissett, R. T., Pistorello, J., Toarmino, D., ... Mccurry, S. M. (2004). Measuring experiential avoidance: A preliminary test of a working model. The Psychological Record, 54, 553-578.

55.

Hayes, S. C., Wilson, K. G., Gifford, E. V., Follette, V. M., & Strosahl, K. (1996). Experiential avoidance and behavioral disorders: A functional dimensional approach to diagnosis and treatment. Journal of Consulting and Clinical Psychology, 64(6), 1152-1168.

56.

Hofmann, S. G., Heering, S., Sawyer, A. T., & Asnaani, A. (2009). How to handle anxiety: the effects of reappraisal, acceptance, and suppression strategies on anxious arousal. Behaviour Research and Therapy, 47, 389-394.

57.

Holland, J. M., Futterman, A., Thompson, L. W., Moran, C., & Gallagher-Thompson, D. (2013). Difficulties accepting the loss of a spouse: A precursor for intensified grieving among widowed older adults. Death Studies, 37, 126-144.

58.

Kennedy, Q., Mather, M., & Carstensen, L. L. (2004). The role of motivation in the age-related positivity effect in autobiographical memory. Psychological Sciences, 15, 208-215.

59.

Kogan, E., Kabacoff, R., Hersen, M., & Van Hasselt, V. (1994). Clinical cutoffs for the Beck Depression Inventory and the Geriatric Depression Scale with older adult psychiatric outpatients. Journal of Psychopathology and Behavioral Assessment, 16, 233-242.

60.

Kohl, A., Rief, W., & Glombiewski, J. A. (2012). How effective are acceptance strategies? A meta-analytic review of experimental results. Journal of Behavior Therapy and Experimental Psychiatry, 43, 988-1001.

61.

Kraaij, V., Garnefski, N., & Van Gerwen, L. (2003). Cognitive coping and anxiety symptoms among people who seek help for fear of flying. Aviation, Space, & Environmental Medicine, 74, 273-277.

62.

Kraaij, V., Pruymboom, E., & Garnefski, N. (2002). Cognitive coping and depressive symptoms in the elderly: a longitudinal study. Aging and Mental Health, 6, 275-281.

63.

Krause, N. (2007). Thought suppression and meaning in life: a longitudinal investigation. International Journal of Aging and Human Development, 64, 67-82.

64.

Lawton, M. P. (1989). Environmental proactivity and affect in older people. In S. Spacapan & S. Oskamp (Eds.), The social psychology of aging (pp. 135-163). Newbury Park: Sag.

65.

Lawton, M. P., Kleban, M. H., Rajagopal, D., & Dean, J. (1992). Dimensions of affective experience in three age groups. Psychology and Aging, 7, 171-184.

66.

Lenze, E. J., Rogers, J. C., Martire, L. M., Mulsant, B. H., Rollman, B. L., Dew, M. A., ... Reynolds, C. F. (2001). The association of late-life depression and anxiety with physical disability. American Journal of Geriatric Psychiatry, 9(2), 113-135.

67.

Martin, R. C., & Dahlen, E. R. (2005). Cognitive emotion regulation in the prediction of depression, anxiety, stress, and anger. Personality and Individual differences, 39, 1249-1260.

68.

Mather, M., & Johnson, M. K. (2000). Choicesupportive source monitoring: Do our decisions seem better to us as we age?. Psychology and Aging, 15, 596-606.

69.

McCubbin, H. I., Patterson, J. M., & Wilson, L. R. (1987). FILE: Family inventory of life events and changes. Family assessment inventories for research and practice, 81-98.

70.

Nordhus, I. H., VandenBos, G. R., Berg, S., & Fromholt, P. (2010). 임상 노년 심리학[Clinical geropsychology]. (진영선, 김영경과 박선영 역). 서울: 학지사. (원전은 1998에 출판)

71.

Nowlan, J. S., Wuthrich, V. M., & Rapee, R. M. (2015). Increasing older adults’ use of positive reappraisal coping for chronic physical illness. Clinical Gerontologist, 38(5), 428-437.

72.

Pekus, A. J., Gum, A. M., & Wetherell, J. L. (2012). Thought suppression is associated with increased anxiety and depression in homebound older adults. Depression and Anxiety, 29(3), 219-225.

73.

Pekus, A. J., & Wetherell, J. L. (2013). Acceptance and Commitment Therapy with older adults:rationale and considerations. Cognitive and Behavioral Practice, 20, 47-56.

74.

Porensky, E. K., Dew, M. A., Karp, J. F., Skidmore, E., Rollman, B. L., Shear, M. K., & Lenze, E. J. (2009). The burden of late-life generalized anxiety disorder: effects on disability, health-related quality of life and healthcare utilization. American Journal of Geriatric Psychiatry, 17(6), 473-482.

75.

Preacher, K. J., & Hayes, A. F. (2008). Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behavior Research Methods, 40(3), 879-891.

76.

Ready, R. E., Weinberger, M. I., & Jones, K. M. (2007). How happy have you felt happy? Two diary studies of emotion recall in older and younger adults. Cognition and Emotion, 21, 728-757.

77.

Sinoff, G., & Werner, P. (2003). Anxiety disorders and accompanying subjective memory loss in the elderly as a predictor of future cognitive decline. International Journal of Geriatric Psychiatry, 18, 951-959.

78.

Smith, J., & Gersdorf, D. (2004). Ageing differently:Potential and limits. In S. O. Daatland & S. Biggs (Eds.), Ageing and diversity: Multiple pathways and cultural migrations (pp. 13-28). Bristol: The Policy Press.

79.

Suri, G., & Gross, J. J. (2012). Emotion regulation and successful aging. Trends in Cognitive Sciences, 16(8), 409-410.

80.

Szasz, P. L., Szentagotai, A., & Hofmann, S. G. (2011). The effect of emotion regulation strategies on anger. Behaviour Research and Therapy, 49, 114-119.

81.

Unutzer, J., Patrick, D. L., Simon, G., Grembowski, D., Walker, E., Rutter, C., Katon, W. (1997). Depressive symptoms and the cost of health services in HMO patients aged 65 years and older: A 4-year prospective study. Journal of the American Medical Association, 277(20), 1618-1623.

82.

Vilardaga, R., Hayes, S. C., Atkins, D. C., Bresee, C., & Kambiz, A. (2013). Comparing experiential acceptance and cognitive reappraisal as predictors of functional outcome in individuals with serious mental illness. Behaviour Research and Therapy, 51, 425-433.

83.

Watson, D., Clark, L. A., & Tellegen, A. (1988). Development and validation of brief measures of positive and negative affect: The PANAS Scales. Journal of Personality and Social Psychology, 54, 1063-1070.

84.

Wetherell, J. L., Thorp, S. R., Patterson, T. L., Golshan, S., Jeste, D. V., & Gatz, M. (2004). Quality of life in geriatric generalized anxiety disorder: a preliminary investigation. Journal of Psychiatric Research, 38, 305-312.

85.

Windle, G., & Woods, R. T. (2004). Variations in subjective wellbeing: The mediating role of a psychological resource. Ageing and Society, 24, 583-602.

86.

Winecoff, A., LaBar, K. S., Madden, D. J., Cabeza, R., & Huettel, S. A. (2011). Cognitive and neural contributions to emotion regulation in aging. SCAN, 6, 165-176.

87.

Wolgast, M., Lundh, L. G., & Viborg, G. (2011). Cognitive reappraisal and acceptance: An experimental comparison of two emotion regulation strategies. Behaviour Research and Therapy, 49, 858-866.

88.

Yeung, D. Y., Wong, C. K. M., & Lok, D. P. P. (2011). Emotion regulation mediates age differences in emotions. Aging & Mental Health, 15(3), 414-418.

The Korean Journal of Health Psychology