Psychological News You Can Use - June 2008

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Can you run as fast as you could when you were a kid? Stay up as late as when you were a teenager? Fit into the same size clothes as when you were in your 20s? Probably not. What about your thinking? Do you have more trouble remembering things or concentrating? Such experiences are not necessarily signs of a serious condition, such as Alzheimer's disease or other dementias. Our bodies change with age. Like old cars, our aging bodies don't work as well as they used to. This is true for our physical functioning and our thinking, as well.

Intelligence
Psychologists have identified two kinds of intelligence that change with age: crystallized and fluid. First, the good news. "Crystallized" intelligence increases with age. This is what we might think of as "hard" knowledge, such as facts, new skills, expertise, and wisdom. All of these improve well into old age.

"Fluid" intelligence, on the other hand, gets worse with age, starting when we are in our 20s and decreasing even more quickly after we are in our 60s. Fluid intelligence skills use short-term memory, sometimes called "working memory." This is what you use to remember a phone number between looking it up in the phone book and dialing it. What happens if you get a busy signal? Sometimes you have to look the number up again, because it is no longer in your short- term memory. Multi-tasking is a good example of using fluid intelligence. You have to remember where you are in several different activities at once.

Can you remember the name of your first grade teacher but sometimes you forget the name of the person you just met? You use long-term memory to remember the name of your teacher (crystallized intelligence). Remembering the new person's name uses short-term memory (fluid intelligence). Don't worry - having more problems with short-term memory is a natural aging process.

Stress and Mood
Our stress level also affects our thinking. We all need some anxiety to motivate us to do well, but when stress is too high, we can't do tasks which aren't easy. Having to multitask all the time leads to increased stress. This leads to poorer performance, which leads to more stress. Then you most likely need more time to do the same things (anyone with a job, a home, and children knows what this is like). Having experiences like this does not mean you are developing dementia. It is just is the natural response of our brains to being "overloaded."

Sometimes depression can look like dementia. This happens most often in the elderly. In these cases, memory complaints are typical. These individuals can give examples of what they forgot and they often worry about having Alzheimer's disease. When their memory is tested by a psychologist, they might say "I don't know" and give up easily. They can't pay attention or concentrate very well, and this causes problems with short-term memory. This condition is called "pseudodementia." It can be reversed with treatment of the depression.

Medical Causes
Illnesses or infections can also cause memory problems in older people. Again, their memory gets better when they are treated. About 33% of older adults will develop "Mild Cognitive Impairment." This condition includes problems with learning and memory that are worse than what happens with normal aging. It is not as bad as dementia. They can still go about their daily lives without a major problem.

Who does get Alzheimer's disease? It occurs more often when people are much older, especially over the age of 80. Having a relative with Alzheimer's increases the risk. A head injury or stroke can also increase the risk of developing Alzheimer's.

Testing by a psychologist can tell whether or not memory changes are part of normal aging. There also are medications for persons in the early stages of dementia. These do not cure the disease or make memory better. These drugs instead allow the person to stay at the same level without getting worse for a period of time. Eventually they do get worse.

Strategies
Unfortunately, we can't avoid the natural aging process. We can't treat Mild Cognitive Impairment or Alzheimer's disease. However, there are some things we can do to keep our memory sharp and to maybe avoid getting Alzheimer's:

• Eat foods high in antioxidants (such as blueberries) and omega-3 fatty acids (fish).
• Try to keep from developing heart problems by controlling your blood pressure and keeping your cholesterol level down.
• Do your best to keep your stress levels low. " Exercise regularly.
• Be socially active with others.
• Use calendars, planners, sticky notes, and refrigerator pads to help remind you. When I can't write myself a reminder note, I move my wedding ring to my opposite hand (like tying a string around my finger). This helps me to remember to do something later in the day. Every so often I would notice the ring on my right hand and that would help me to remember what I most likely would have forgotten ("pick up milk on the way home").
• In particular, stay mentally active. Read, take a class, do crossword puzzles or sudoku, balance your checkbook. All of these actions will help keep you sharp. If your children or grandchildren own a Nintendo DS, borrow it and play Brain Age or Brain Age 2. These games have different kinds of fun activities which make you concentrate and solve problems.

We can't turn back the clock to make ourselves, and our brains, younger. The good news is, keeping our brains active and making changes in our lifestyle can help us avoid at least some of those "senior moments!"

Brooke Cannon, Ph.D. is a Professor of Psychology and Director of Clinical Training for the Psy.D. Program at Marywood University.

Pennsylvania has long been at the forefront in revolutionary treatment for psychological disorders. Psychologist Edna Foa, Ph.D., University of Pennsylvania Professor of Clinical Psychology in Psychiatry, is greatly responsible for dramatic changes in the treatment of Obsessive-Compulsive Disorder and other anxiety-related disorders. Although she has published over 250 articles and book chapters she may be known best among the general public for her transformational book, Stop Obsessing!: How to Overcome Your Obsessions and Compulsions, co-authored by Reid Wilson.

Dr. Foa introduced cognitive-behavioral techniques to the general public and specifically taught adult and adolescent patients that they could "talk back" to their obsessional thoughts and implement methods in their homes to reduce compulsive behaviors such as washing, hoarding, and checking.

Historically, Obsessive-Compulsive Disorder was quite difficult to treat. Prior to Dr. Foa's work, patients were often treated by time-consuming psychoanalysis, inpatient psychiatric hospitalization, and psychotropic medications. Dr. Foa's methods allowed for more effective treatments in shorter time periods. She taught skills that most people can easily learn and adapt regardless of their lifestyles. Over the years, Dr. Foa has expanded her treatment methods to help patients with other anxiety conditions such as Social Anxiety, Post-Traumatic Stress Disorder, and Trichotillomania.

Dr. Foa is the Founder and Director for the Treatment and Study of Anxiety at University of Pennsylvania and has been since 1979. Through her center she trains numerous mental health and medical professionals from around the world. Her books for the public are widely available through bookstores and Internet booksellers.

Parents often have a harder time coping with the summer than kids do. If you ask kids about summer they use words like "freedom," "fun," and "awesome" to describe this time of the year. If you ask parents about summer you often get the deep long sigh and a look that conveys a pleading for mercy. They use words like "boredom," "trouble," "annoying." Our children and adolescents hear a lot of complaining from the adults in their lives. One way we can help our children cope with their free time over the summer, while also helping ourselves, is to change our thinking regarding this free time. Let's start by modeling positive behavior and attitudes regarding summer break and view summer as an opportunity!

Here are a few examples of what you can do:

• DON'T: Catastrophize (exaggerate the negative meanings of an event). An example of this might be to use words like "horrible," "terrible," "awful" when it is raining outside.

  DO: Put things into perspective and challenge yourself to think about events that would really be "horrible," "awful," and "terrible." Ask yourself (and your children) "Is it really so bad?" I guarantee you will use catastrophizing language much less when you make a choice to use it when it really describes the situation.

• DON'T: Overgeneralize (Extend the negative meanings of an event beyond the situation or event and ignore the positive possibilities). Example: When it is raining outside and an activity is cancelled and we say things like, "The whole day is ruined!"

  DO: Keep things in perspective. Just because one event was altered does not mean the entire day is "ruined."

• DON'T: Jump to conclusions (Skip steps that would be necessary to justify drawing a particular, usually negative, conclusion about the meaning of an event or situation). Example: Assuming "My kids are going to be bored in the summer."

  DO: Focus on your goals for your children. You can just as easily tell yourself, "My kids are going to be productive in the summer."You have the power to affect this significantly. Use the Internet as a tool for discovering activities to make for a fruitful summer. Get your kids involved in the fight against global warming. Take at least one green idea and implement it. For example, get plain canvas bags and have your kids make creative designs for a personal touch at the grocery store.

• DON'T hold on to regret or blame or doubt, using such phrases as "Yeah but" or "If only." Example: Saying "It is nice to have the kids home BUT….."

  DO: Stop before you get to the "but," or substitute the word "and" -- it may just change your feelings and approach to the problem.

• DON'T use "should" statements, believing that things "must" go a certain way or one will be "inferior" or a "bad person" or that something bad will happen). Example: Thinking that every moment "has" to be scheduled.

  DO: Enjoy the flexibility of not having a schedule and avoid labeling yourself as a bad parent if you don't have every moment accounted for.

Here is a solid example of how changing the way we think can change the way we feel (even about something like a standardized test): It was enlightening to me when I had the experience of being involved with a school that approached the PSSAs (Pennsylvania System of School Assessment) as an opportunity rather than a burden... The teachers and administrators made it a point not to complain, displaying enthusiasm and passion in their approach to this often dreaded experience. The outcome was children who were excited and positive in their approach to the test. Astonishing, well maybe, but a more appropriate word to describe this is phenomenon is "intelligent." We have had the knowledge for a long time that one integral way children learn is from modeling. These ingenious educators utilized this knowledge and put it into practice and the results were remarkable. If we utilize this knowledge with other aspects of our children's lives the results can be equally amazing. So how do we do it? We can start by first identifying negative thoughts (the Don'ts) that can be affecting our behavior and in turn our children's behavior. If we correct such cognitive mistakes (the Do's) then our perceptions, feelings and behaviors are likely to change as well.

Remember that each new moment is an opportunity for change and to model a positive approach for our children... Once you identify the negative thoughts you may be having in relation to the upcoming summer break you can substitute a realistic or less critical thought or perception. Be positive and proactive in your approach to the summer months. Stay in the moment and enjoy it while it lasts. Your children will benefit and so will you.

Mia M. Bartoletti, Psy.D. is in private practice in Wilkes-Barre, PA.

Tip #7 -Giving Employees Feedback
We all give people feedback but how do you do it so people will listen and follow up? If I could change a word in the English language it would be feedback, I'd like to change it to feed forward. The purpose of giving anyone feedback is to have them take action in the future.

1. Create an environment that is receptive to an open exchange of information, up and down. Employees should be able to give
   mangers and executives feedback as well as executives giving employees feedback.
2. Feedback needs to be given and received as a learning and developmental process, not as punitive: the only time I hear
   anything from my boss is when something goes wrong.
3. Establish ground rules for giving feedback so the process is consistent from department to department.
4. Ensure that the feedback relates to the goals the person is working to achieve.

1. Listen to what employees need and how they feel about the job, and only then appropriately respond.
2. Encourage people to do their best and recognize what they accomplish.
3. Ensure that people have challenging jobs that promote satisfaction between them and the work they do; remember this equation: Performance equals Ability times Effort or motivation.
4. Treat employees like valued adults.

Tip #9 Mentoring
What is your organization doing to mentor the next generation of employees? Mentoring is the experienced person supporting and guiding the less experienced person to a better understanding of the workplace and life balance.

1. To effectively mentor, don't tell, but instead, listen, ask questions and guide mentees to a wider appreciation of the workplace, share experiences and discuss the mentee's career aspirations.
2. Mentoring will help your organization build the social infrastructure and develop the next generation of employees creating a succession plan.
3. The objective is to create a mentoring process to retain the right people in your organization.
4. Remember you can promote success through positive thoughts about yourself and others.

PPA secured passage of a hospital continuity of care bill that allows general hospitals to place psychologists on their professional staffs and to participate on treatment teams, and that requires the attending physician to notify the patient's psychologist upon admission and discharge.

PPA was a major advocate for Act 68 of 1998, which established basic patient protections under managed care plans. These protections include an expanded grievance and compliant process, a requirement that insurers pay clean claims promptly or suffer financial penalties, and establishing basic quality care mechanisms on utilization entities.

PPA continues to work, both on the state and federal level, for laws and regulations that would protect patients covered by managed care plans. In these efforts, PPA represents psychologists on the Alliance of Health care Providers, a group of 16 specialty health care associations which focuses on the need for patient choice of their health care professional.