The Aging Personality and Self: Diversity and Health Issues


Personality may be defined as the pattern of thoughts, feelings, and behaviors that shape an individual's interface with the world, distinguish one person from another, and manifest across time and situation. Personality is impacted by biologic, cognitive, and environmental determinants, including the impact of culture and cohort. Theoretical approaches to personality are as varied as the breadth of the construct they attempt to describe and explain yet each approach, to varying degrees, emphasizes stability and change within individuals across time and situation.

The impact of personality across the adult life span touches every domain—personal, professional, spiritual, and physical. Certainly, personality characteristics have direct and indirect influences on health status, health behaviors, and behavioral interactions with health care professionals. Although no single chapter can adequately condense such rich empirical and theoretical research, we will attempt to provide a concise overview of stage models, trait theory, and social-cognitive approaches to personality. As such, we will focus on aspects of personality development among cognitively intact older adults, not personality changes that may ensue as the result of dementia.

Each section of this chapter contains four subsections. For each of the three major approaches—stage, trait, social-cognitive—we first provide an overview of classic along with the most current research on stability and maturational and environmental changes in the adult personality. Our focus will be on findings from longitudinal data. Second, we include cross-cultural comparisons of adult personality, where available. This focus provides a unique contribution to reviews of adult personality and aging. Third, we examine the health correlates of adult personality, focusing on morbidity and mortality, well-being, life satisfaction, positive and negative affect, anxiety, and depression. Finally, we discuss measurement issues and provide examples of current assessment instruments.

Personality Stages and Ego Development

Freudian Theory

The psychoanalytic approach to adult personality development has its roots in the theories of Sigmund Freud. His theories encompassed four domains—level of consciousness, personality structure, defense mechanisms, and stages of psychosexual development. Freudian theory postulates that adult personality is made up of three aspects: (1) the id, operating on the pleasure principle generally within the unconscious; (2) the ego, operating on the reality principle within the conscious realm; and (3) the superego, operating on the morality principle at all levels of consciousness. The interplay of these personality structures generates anxiety that must be reduced through various defense mechanisms. These mechanisms act to obscure the true, anxiety-laden reasons for one's behavior.

Although seminal in the expansion of our understanding of the human psyche, Freud's specific theories receive little attention in the scientific study of personality today. His theories are not easily amenable to scientific inquiry in that they frequently lead to nonspecific hypotheses, wherein failure to find expected effects may simply be a result of unknown defense mechanisms. Additionally, having postulated that personality development associated with his stages of psychosexual development essentially ends in adolescence, Freud's theories have limited applicability to the fields of gerontology and geriatric medicine.

Post-Freudian Theorists

In contrast, some post-Freudian theorists have conceptualized personality development as a continuing process focused on current interpersonal and/or family of origin issues as the source of individual distress and coping patterns. Carl Jung proposed that as individuals age, they achieve a balance between the expression of their masculine characteristics (animus) and feminine characteristics (anima). Findings regarding increased balance of gender roles with age have emerged in different cultures, lending some support to Jung's hypothesis.

Erik Erikson's stages of psychosocial development are perhaps the best known of the stage theories of adult personality. The sequence of Erikson's eight stages of development is based on the epigenetic principle, which means that personality moves through these stages in an ordered fashion at an appropriate rate. Two of the eight stages describe personality change during the adult years. Although the identity crisis is placed in adolescence, deciding “who you are” is a continual process that is reflected throughout adulthood, even in old age. In the midlife stage of generativity versus stagnation, individuals seek ways to give their talents and experiences to the next generation, moving beyond the self-concerns of identity and interpersonal concerns of intimacy. Successful resolution of this stage results in the development of a sense of trust and care for the next generation and assurance that society will continue. Unsuccessful resolution of this stage results in self-absorption.

Ego integrity versus despair is Erikson's final stage of ego development, beginning around the age of 65 years and continuing until death. In this stage, individuals become increasingly internally focused and more aware of the nearness of death. Successful resolution of this stage results in being able to look back on one's life and find meaning, developing a sense of wisdom before death. Alternatively, meaninglessness and despair can ensue if this process of life review results in focus on primarily negative outcomes.

Difficulties arising from attempts to investigate Erikson's theory empirically include the assertion that stages must be encountered in order and there is lack of specification regarding how developmental crises are resolved, so that an individual may move from one stage to the next. However, the environmental influences of culture and cohort on adult personality have been minimized. One 22-year investigation found significant age changes supportive of Erikson's theory. Middle-aged adults expressed emotions and cognitions consistent with successful completion of more psychosocial developmental crises than younger adults. In addition, Ackerman and colleagues found a stronger association between generativity in midlife compared with that in young adulthood. Some theorists have postulated that the ego integrity versus despair period initiates a process of life review.

Life Review

The concept of life review is the exception to this lack of empirical investigation regarding stage theories of adult personality. Life review can be thought of as a systematic cognitive-emotional process occurring late in life in which an individual thinks back across his or her life experiences and integrates disparate events into general themes. The portion of life review focusing on recall of primarily positive life experiences is reminiscence. Reminiscence has been linked to successful aging by contributing to sustained identity formation and self-continuity, a sense of mastery, meaning, and coherence in life, and acceptance and reconciliation of one's life. Although this approach to adult personality development can be conceptualized as a cognitive process in which identity emerges from the story of one's life, we have chosen to include it with stage models because it is most frequently described as occurring near the completion of one's life. Nevertheless, it should be acknowledged that individuals likely undergo a process of life review periodically throughout the adult years, including young adulthood and midlife.

Stage Theory

Stage Theories and Diversity

Few studies investigating stage theories of personality have focused on diverse cultural or racial and ethnic groups. Most of the stage models, such as Freud's original theories, were based on highly select samples. Only a few investigations of life review have succeeded in recruiting participants reflecting the general population of interest. Cross-cultural evidence has indicated that life review programs have improved self-esteem and life satisfaction in Taiwanese older adults, depressive symptoms in community-dwelling Chinese older adults, and depression and anxiety symptoms in Dutch older adults. Data reflecting the broader diversity of the population are needed for examining the universality of life review and generalizability of the basic assumptions.

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