Giblin, Sharon; (2001) Late-onset psychosis and adjustment to ageing. Doctoral thesis (D.Clin.Psy), UCL (University College London).

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Abstract

Little is known about the psychological factors involved in the onset and experience of psychosis that begins after age 60 (late-onset psychosis, LOP). At present, treatment methods are primarily biological. As a first step in developing a psychological intervention for LOP, this study aimed to explore the role and nature of psychological factors and the way in which they interact with the ageing process. It was hypothesised from the literature that people with LOP are made vulnerable to mental health difficulties through various psychological (personality difficulties) and environmental (life events) factors and that when age-related stressors occur, this vulnerability leads to difficulties in adjusting to ageing (as reflected in attitude to ageing, self-esteem, and use of assimilative versus accommodative coping style) and hence, psychotic breakdown. Fourteen people with LOP were interviewed about their life experiences (childhood, family, relationships, children, work and health) and asked to complete questionnaires concerning self-esteem, depression, attitude to ageing, cognitive schemas, and coping strategies. Responses were compared with a late-onset depression group (N=13) and a healthy volunteer group (N=18). As predicted, the clinical groups reported a greater number of adverse life events, and there were differences between these groups in the types of events reported. The LOP group reported higher levels of depression and maladaptive schemas, and lower levels of attitude to ageing and morale than the healthy volunteer group. The LOP group was different to the depressed participants on two schema domains. All three groups had equivalent coping styles. Therefore, there was evidence to suggest that people with LOP are made vulnerable to developing mental health difficulties through adverse life events and entrenched personality difficulties. There was some evidence that this group found adjusting to ageing difficult, but the results did not suggest that assimilative or accommodative coping strategies were adversely affected in people with LOP. These results are discussed in relation to theories of LOP, psychosis of earlier-onset and adjustment to ageing. The implications for clinical practice are also considered.

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