DEPRESSION IN OLDER PEOPLE: THE SOCIAL WORK RESPONSE

Depression in older people: The Social Work Response

Depression in older people: The Social Work Response

Chapter I: Introduction

According to attachment theory, children, adolescents, and adults benefit greatly from having a principal source of emotional security, a "primary attachment figure" to count on no matter how difficult life's circumstances. Mothers typically fulfill the role of primary attachment figure during childhood, but what about during adolescence? Social support research has consistently documented that by early to middle adolescence peers are valued as equal or greater sources companionship and intimacy (Buhrmester, 2006; Furman and Buhrmester, 2005; Hunter and Youniss, 2002; Wintre and Crowley, 2003). Yet, it is unclear if a shift in attachment also takes place during this time. This study examines the extent to which best friends, boy/girlfriends, mothers, and fathers serve as attachment figures during late adolescence. In addition, this study examines whether attachment preference for parent or peer is associated with attachment style.

Although a person typically has more than I attachment figure, a hierarchy of attachment exists such that attachment behaviors are usually directed toward a principal or primary attachment figure (Ainsworth, 2009; Bowlby. 2009/2002; Bretherton, 2000; Colin, 2006; Weiss, 2001). Attachment behaviors may be classified under 3 behavioral/affective features: proximity seeking, secure base effect, and separation protest. Proximity seeking captures the degree to which the attachment figure is sought for emotional support and accurately understands the emotional needs of the attached. The second feature, separation protest, captures the degree to which physical separation from the attachment figure produces anxiety and protest in the attached. The third attachment feature, secure base effect, captures the degree to which the attached feels confident to explore knowing the attachment figure is committed and available to provide support when needed (Bowlby, 2009/2002; Cassidy, 2009). By assessing the degree to which t hese 3 features apply to various close relationships an attachment hierarchy can be identified from a network of support figures.

A person's pattern of establishing and experiencing relatedness to significant others can be conceptualized as an attachment process. Attachment refers to the emotional bonding with a partner who is experienced as both a safe haven and a secure base (Bowlby, 2008; Shaver & Hazan, 2003). When the individual is feeling some form of distress, the partner is seen as someone who can provide comfort and support, while, at other times, it is the felt security of the relationship and the guidance of the partner that allows the individual to explore the environment more confidently and more fully. If there is a breach in the sense of felt security through an unexpected separation or through perceiving the partner as inaccessible when needed, then attachment-related separation anxiety is experienced. Attachment processing becomes primary, inhibiting the exploratory system, and the person attempts to restore a comfortable range of proximity with the partner, along with the sense of felt security.

Older rural residents are vulnerable in both health status and access to health services. This descriptive study was designed to assess the general ...