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Chapter 20: Adulthood: Biosocial Development

Terms in this set (43)

The first visible signs of age are in the skin, which becomes dryer, rougher, and less even in color.

-Collagen, the main component of the connective tissue of the body, decreases by about 1 percent per year, starting at age 20. By age 30, the skin is thinner and less flexible, the cells just beneath the surface are more variable, and wrinkles become visible, particularly around the eyes.

-Hormones and diet have an effect—fat slows down wrinkling—but aging is apparent in all four layers of the skin, with "looseness, withering, and wrinkling"
^particularly notable at about age 50 for women, as part of lower estrogen during menopause

-Wrinkles are not the only sign of skin senescence. Especially on the face (the body part most exposed to sun, rain, heat, cold, and pollution), skin becomes less firm. Age spots, tiny blood vessels, and other imperfections appear.

-In addition, veins on the legs and wrists become more prominent, and toenails and fingernails become thicker

-Hair usually becomes gray and thinner, first at the temples by age 40 and then over the rest of the scalp.

-Both men and women lose hair, but the pattern differs. Women's hair becomes thinner overall, whereas some men lose hair on the top of their heads but not on the sides.

-That is male pattern baldness. I saw a man wearing a T-shirt that read, "This is not a bald spot; it is a solar plate for a sex machine."

^It is true that male pattern baldness correlates with hormones; it also correlates with increased risk of prostate cancer

-Body hair (on the arms, legs, and pubic area) also becomes less dense over the 40 years of adulthood.
^An occasional thick, unwanted hair may appear on the chin, inside the nose, or in some other place. That has no known correlates with any disease, although many adults are distressed at this and at other signs of aging.
-Every large study finds a vast range of sexuality and sexual satisfaction, not only between men and women but between one individual and another.

-Some people are strongly heterosexual or homosexual, and others less so; some people are pansexual and others bisexual. Beyond that, sexual urges of any kind vary.

- Some adults are asexual, not interested or aroused by sex. This is apparent more in attitude than in biology (Brotto & Yule, 2011).

-On the other hand, some people think about sex almost all the time.

Very few people, male or female, ever commit a harmful sexual act (estimates vary widely), so arrest rates do not reflect normal sexuality.

-Further, correlation is not causation. Both men and women, of varying sexualities, can be sexually aroused by viewing sexual images (Spape et al., 2014).

-Many choose never to look, and some seem unable to stop looking.
^Viewing actions are related to culture and age, in that older men and women view less. This may be a sign of reduced sexual arousal, less computer expertise, or greater wisdom, in that pornography interferes, at least temporarily, with rational thinking, acute hearing, and healthy relationships

-Biology and age do not seem to be the most important factor. ^Sexual arousal, orgasm, and, as we will soon see, fertility and menopause are all connected to senescence, but the effects, and even the occurrence, are strongly influenced by the mind (Pfaus et al., 2014). As many say: "The most important human sexual organ is between the . . . ears."
-Always, culture and SES matter. This is shown dramatically in use of tobacco, considered the leading risk factor for many diseases. Rates are quite different depending on nation, SES, gender, and cohort.

-In the United States, high-SES people are less likely to smoke.

-However, in poor nations, rates of smoking increase with income, because poor people cannot afford cigarettes. Traditionally in Asia, women rarely smoked, but as their income rises, rates of smoking are increasing rapidly

-The World Health Organization calls tobacco "the single largest preventable cause of death and chronic disease in the world today," with 1 billion smoking-related deaths projected between 2010 and 2050, most in low-income nations where rates of abject poverty are declining (Blas & Kurup, 2010, p. 199).

-Cigarette smoking in the United States illustrates marked cohort and gender effects.

-During World War II (1941-1945), American soldiers (always men) were given free cigarettes. Then in 1964, the U.S. surgeon general first reported on the health risks of smoking, with many follow-up reports in the next few decades. As a result, many former soldiers quit.

-Meanwhile, some women celebrated another historical happening, women's liberation, by smoking—encouraged by cigarette advertisements. (One brand launched in 1968, Virginia Slims, used the slogan "you've come a long way baby.")

-In the 1960s, more than half of U.S. adult men and more than a third of women smoked.

-Over the next decades, as research became clearer on smoking, cancer, heart disease, and secondhand smoke, both sexes had decreased smoking. Recent data show that only 21 percent of adult men (aged 25 to 65) and 17 percent of women are smokers.

-Rates peak at about age 30 and then decrease, indicating the advantages of maturation among adults (National Center for Health Statistics, 2016). By age 60, more adults are former smokers than current smokers.

-The changes over the past decades are reflected in lung cancer deaths. A half-century ago in the United States, five times as many men as women died of lung cancer.

-More recently, rates are closer to equal, because "women who smoke like men die like men who smoke" (Schroeder, 2013, p. 389).

-In the past decades, adults of both sexes quit smoking and lung cancer was reduced by 500 percent—not primarily because of better medical care but because of wiser adults (see Figure 20.2).
The harm from cigarettes is dose-related: Each puff, each day, each breath of secondhand smoke makes cancer, heart disease, strokes, and emphysema more likely. No such linear harm results from drinking alcohol.

In fact, some alcohol may be beneficial: Adults who drink wine, beer, or spirits in moderation—never more than two drinks a day—live longer than abstainers. Some scientists consider this a misleading correlation because some of those abstainers were formerly heavy drinkers, so their death rate reflects damage done by alcohol (Chikritzhs et al., 2015; Knott et al., 2015). Whether that is true or not is debatable, but everyone agrees that excessive drinking is harmful.

To be specific, alcohol abuse destroys brain cells, is a major cause of liver damage and several cancers, contributes to osteoporosis, decreases fertility, and accompanies many suicides, homicides, and accidents—all while wreaking havoc in families. Even moderate consumption is unhealthy if it leads to smoking, overeating, casual sex, or other destructive habits.

Alcohol abuse also shows age, gender, cohort, and cultural differences. For example, the risk of accidental death while drunk is most common among young men: Law enforcement in the United States has cut their drunk-driving rate in half. However, middle-aged parents who abuse alcohol are more harmful to other people, because of their neglect and irrational rage

-In general, low-income nations have more abstainers, more abusers, and fewer moderate drinkers than more affluent nations (Blas & Kurup, 2010). In developing nations, prevention and treatment strategies for alcohol use disorder have not been established, regulation is rare, and laws are lax (Bollyky, 2012). Thus, alcohol is particularly lethal to a community as national income falls.
A measure of the reduced quality of life caused by disability.

-measures how much a person's life is hampered by a disability.

ex./ For instance, a person born with a disability that reduces functioning by about 10 percent, who then lives to age 70, would be said to have 63 DALYs because the disability is considered to have cost that person seven healthy, active years (10 percent of 70).

-Whether or not a disability impairs a person depends as much on the social context as on the specific condition. Thus, making homes and stores accessible might reduce disability.

-An analysis of DALYs in 188 nations for 306 diseases since 1990 found that the world disease burden has undergone a major shift. In 1990, the main cause of DALYs was diseases that could be passed from one person to another—diarrhea, HIV/AIDS, tuberculosis, and so on.

-In the past decades, DALYs have increased for diseases affected by each person's genes and lifestyle.

-Dramatic increases in DALYs have occurred for major depressive disorder—which does not kill people (unless they kill themselves) but destroys their daily life. Another new problem is "road rage"—now the fifth most common cause of DALYs (C. Murray et al., 2015). That indicates what national and personal measures are needed.

-A downside of this measure is that many people with various disabilities object to someone deciding how much their life is impaired because of them.

-Further, some nations object that the focus on DALYs tilts toward wealthy nations who have the luxury of making daily life better for everyone, whereas poor nations still have high rates of communicable diseases that should be eliminated.
A measure of how many years of high-quality life a person lives. This is distinct from DALYs, in that a person could have a disability and nonetheless have a high quality of life.

-One way to measure vitality is to calculate quality-adjusted life years (QALYs). If people are fully vital, their quality of life is 100 percent, which means that a year of their life equals one QALY. A healthy, happy, energetic person who lives 70 years has 70 QALYs.

-If one year included surgery and a difficult recovery, with an estimated 50 percent reduction in quality of life, then that person's QALY would be 69 and a half.

-Considering QALYs is needed to evaluate medical treatment, because simply saving a life (decreasing mortality) or reducing disability may not be a boon if the quality of life is gone.

ex./ For example, a study at many German hospitals for patients with schizophrenia, randomized to receive traditional or newer antipsychotic drugs, found significant improvement in QALYs as reported by the patients.

^The study also found slightly more adverse physiological effects from the new drugs (Gründer et al., 2016). Thus, vitality increased even as morbidity did. This information is useful in assessing any medical measure.

-People disagree about vitality. As already seen in the sections on exercise and nutrition, specific recommendations vary a great deal, in part because measuring vitality is difficult.

-Traditional physician training emphasizes morbidity and mortality; psychologists focus more on disability and vitality. Individuals disagree even more.

-Overall, doctors are concerned about adverse physiological effects; patients want to be able to do what they want to do, joyfully. Obviously, mortality, morbidity, disability, and vitality are all worthy considerations: Balancing them is difficult.

-No society spends enough to enable everyone to live life to the fullest. Without some measure of disability and vitality, the best health care goes to whomever has the most money, or whatever morbidity tugs hardest at the public's heart strings.