1 CHAPTER 3: EARLY ADULTHOOD THE EMERGING ADULT Polka Dot Images/Thinkstock Early adulthood may be the prime of life. We are at our best physically and mentally. Our speed and strength, height, hearing, vision, and sexual drive all are at their peak during the early adult years. During this period, we achieve the status of “adult” and embark on the great adventure of building a career, a family, and a place in society. Yet it is often a troubling time for many as they seek to discover who they are, what they want to do, and the type of person they want to become. In this chapter, we look at some important physical, cognitive, and psychosocial developments that help set a young adult’s path in life.
2 REFLECT ON IT: BECOMING AN ADULT Describe what you would consider to be your first major transition into adulthood—the time when you first began to consider yourself an “adult.” • Was it when you left home for the first time? Started a committed relationship? Had children? Attended college? • Would you consider it a successful or unsuccessful transition? Why? • What would you have done differently if you could go back to that time in your life? HEALTH AND PHYSICAL DEVELOPMENT Many of the physical changes in young adults are a result of the decisions they make, rather than programmed genetic changes as in earlier years. Some of the most important decisions include drugs and alcohol, smoking, nutrition, and sexual choices. The choices we make in each of these areas have an impact on our aging. This is called secondary aging because it is not based on the passage of time (known as primary aging) but on how our bodies are affected by the health decisions we make, the diseases we get, the environmental dangers we are exposed to, and the standard of living we have. Perhaps you’ve seen old photos of coal miners, as an example. Miners constantly breathed in coal dust (environmental), which often resulted in a terrible Secondary aging factors such as work environment respiratory disease called black lung disease, and had a poor and standard of living often make coal miners appear much older than they actually are. diet (nutrition) in large part due to their low income (standard Photodisc/Thinkstock of living). Like a “perfect storm,” these factors combined with natural aging to make a 30‐year old miner look like he was 50! DEMOGRAPHIC ISSUES Psychologists have found a relationship between social, cultural, and racial differences in secondary aging, but those findings may be explained by a third factor—income and education. Research shows that African Americans, Hispanics, and those in lower social classes have more chronic diseases, poorer
3 health, and a lower life expectancy than those who are in middle‐ and upper‐income brackets. However, if African Americans and Hispanics are divided into higher‐and lower‐income brackets, the racial differences disappear; it appears that income level is the most important factor associated with health, not race (Guralnik, Land, & Blazer, 1993). In addition, educational achievement is strongly associated with income. Therefore, income and education are better predictors of secondary aging than racial variables. In the early adult years, when most people are generally healthy, there is a small difference among income groups. But as people age and become more prone to disease, the impact of income on health widens. The reasons are apparent: People with lower incomes cannot afford the same health care as their wealthier counterparts, they have less access to the latest technology and tests, they are less likely to have health insurance, and most important, they have less medical knowledge and are more prone to let problems go for too long before Access to medical care has a big impact on our health, especially as we get older. seeking treatment. Thomas Northcut/White/photolibrary Although income plays an important role in the health of young adults, they make health‐related choices, which also have a major impact on their physical development, as part of their chosen lifestyle. Even small bits of information on how to keep oneself healthy can make a big difference in early adulthood. For example, by knowing the importance of taking calcium and being able to afford it, a person is much less likely to suffer from a fracture or osteoporosis later in life. In addition, young adults do not often die of diseases. The leading causes of death for young adults 18‐ to 29‐years old are accidents, homicide, and suicide, making up 70% of the 47,000 deaths in 2005. Of those deaths, 26% were caused by motor vehicle–related injuries. Not surprisingly, half of those accidents involved alcohol (National Centers for Health Statistics, 2008a; Center for Disease Control, 2008a). SEX AND SEXUALLY TRANSMITTED INFECTIONS Women reach their peak of sexual desire in their early 30s (Schmitt et al., 2002) while men peak in their early 20s. Sex researchers have known for a long time that the most important variable in sexual desire and pleasure is the brain. A lot depends on your partner, how well you communicate, and how comfortable you are with your body. Regardless, for women and men in early adulthood, in general, orgasms are more reliable, hormone levels peak (early to mid‐30s for women; late teens to early 20s for
4 men), and the awkwardness of adolescence has given way to more confidence and better communication. Over 80% of sexually transmitted infections (STIs) occur in the under‐25 population (Centers for Disease Control, 2008c). Obviously, the choices that adolescents and young adults make regarding sex can have lifelong health consequences. The human immunodeficiency virus (HIV), which is the virus that causes AIDS, and genital herpes have lifelong effects, whereas other STIs like chlamydia, gonorrhea, and syphilis are easily cured with immediate treatment. Demographic issues often change the discussion. For instance, AIDS/HIV has dropped from the 5th to the 20th leading cause of death in the United States; but more important, AIDS/HIV is the leading cause of death among African American women between 30‐ and 39‐years‐old. No doubt the vast majority of those women contracted HIV in their teens and early 20s. Acquired immune deficiency syndrome (AIDS) is a chronic, life‐threatening disease caused by the HIV virus. The human Young adulthood is a time when many people are involved in sexual relationships. immunodeficiency virus (HIV) damages the immune system, making Joe Madeira/Stockbyte/Thinkstock it less able to fight off other illnesses and infections, including pneumonia. The virus is transmitted from one infected person to another by sexual contact (including oral sex), infected blood, sharing needles contaminated with the blood of an infected user, and even from mother to child—a tremendous problem in underdeveloped countries. HIV is not spread through ordinary contact like shaking hands, hugging, dancing, or kissing (Mayo Clinic, 2009h). Tens of millions of people worldwide carry the HIV virus. Roughly 15% of all new HIV/AIDS diagnoses in the United States are among people ages 40‐ to 44‐years‐old (Centers for Disease Control, 2008b). The incidence of HIV/AIDS deaths in the United States has remained roughly the same since 2000 and is less than half the rate in 1990. Three times as many men die of the disease as women (National Center for Health Statistics, 2008e). SMOKING Part of becoming an adult is making wise, long‐term choices for yourself and others in your life. Teens and young adults often smoke cigarettes because it seems like an adult behavior, a status they strongly desire. Twenty‐one percent of Americans smoke cigarettes. About 440,000 people in the United States die each year from various diseases caused by smoking cigarettes. One of the most dangerous choices anyone can make is to smoke. Worldwide, the death figure jumps to well over 4 million people per year
5 (Centers for Disease Control, 2009a). It is as if the entire population of Cleveland, Ohio, died every year from smoking! Smoking causes cancers of the lung, larynx, mouth, brain, esophagus, bladder, kidney, pancreas, and cervix. It sharply increases the risk of heart disease and stroke and is the leading cause of emphysema and other respiratory diseases that together are the 4th leading cause of death in the United States and 11th worldwide. Smokers are 14 times more likely to die from lung cancer than nonsmokers and twice as likely to die from a heart attack. When a pregnant woman smokes, it can cause a low–birth weight baby, stillbirth, or reduced cognitive ability in the newborn (Whalley, Fox, Deary, & Starr, 2005). Some Some decisions young adults make, such as choosing to smoke cigarettes, can have life‐long affects. studies have also found infants of smokers have a Photodisc/Thinkstock higher risk of dying from SIDS (sudden infant death syndrome). Young adults are often not aware of the dangers that their smoking poses for their children and others. Nonsmokers who breathe smoke in the air (secondhand smoke) are also at great risk. Sometimes called “passive smoking” or “environmental tobacco smoke” secondhand smoke carries over 250 toxic chemicals. Estimates on the number of nonsmokers who die each year from cancer and cardiovascular diseases related to breathing secondhand smoke range from about 26,000 to over 73,000. The U.S. Department of Health and Human Services reports that “nonsmokers who are exposed to secondhand smoke at home or work increase their heart disease risk by 25–30% and their lung cancer risk by 20–30%. There is no Nicotene gum is a popular method used to try to risk‐free level of secondhand smoke exposure. Even brief quit smoking. Stockbyte/Thinkstock exposure can be dangerous” (2006). Nevertheless, one of the clearest beneficial long‐term choices is to not smoke. Stopping smoking has major health benefits, including a greatly reduced chance of cancer, stroke, heart attack, and emphysema (U.S. Department of Health and Human Services, 2001). As all smokers know, smoking is addictive, perhaps the most difficult addiction to break (National Institute on Drug Abuse, 2008).
6 PSYCHOACTIVE SUBSTANCES Among youths who smoke cigarettes, the rate of illicit (illegal) drug use is over 9 times higher than among those who didn’t smoke. Those data do not mean that cigarette smoking leads to drug use. They simply show that the kind of person who smokes at a young age is more likely to also use drugs. Personality factors may be more important than the actual behavior of lighting up. Drugs are not just confined to illegal, potentially addicting substances or medical prescriptions. They include all legal and illegal substances that can change a person’s functioning. Drugs and alcohol are called psychoactive substances Figure 3.1 ‐ The number of people in the United States using illicit because they alter brain functioning. Substances drugs in the month preceding the survey; the numbers total more than 20.1 million due to polydrug use. (Source: Substance Abuse like caffeine, methamphetamine, Ecstasy, and and Mental Health, 2009). alcohol affect consciousness, thought, perception, mood, or behavior. Psychoactive substances are often divided into four main categories, based on the effect that they have on the central nervous system: depressants, stimulants, opiates, and hallucinogens. According to data extrapolated from the 2008 National Survey on Drug Use and Health (U.S. Department of Health and Human Services, 2008), it is estimated that over 20 million people in the United States use illicit drugs on a monthly basis, or about 8% of the over‐12 years‐of‐age population (Figure 3.1). Of those who Figure 3.2 ‐ Drug usage by age in the United States: The survey use illicit substances, marijuana was used by over shows that young adults, ages 18‐ to 25‐years‐old, are the biggest 75% of current illicit drug users; it is the only drug users of illicit substances. (Source: Substance Abuse and Mental used by 57.3% of them. Young adolescents are not Health, 2009.) the biggest users of illicit drugs, as one might think; young adults are the biggest users of illicit substances (Figure 3.2).
7 ADDICTION When researchers and doctors assess for drug and alcohol addiction, they usually throw around terms like dependence, tolerance, chemical imbalance, craving, and withdrawal. A doctor may ask you if you have tried unsuccessfully to cut back or how you feel when you don’t use the substance. Unfortunately, none of those measures are particularly objective. They are based on a medical model that dominates the addiction field, but it doesn’t explain social variables in addiction. For instance, how come construction workers are most often addicted to beer? How come the drug of choice in Japan is methamphetamine? How come Hollywood‐types have more problems with cocaine? Tens of thousands of people (mostly adolescents) seek treatment for marijuana addiction every year, but according to most medical models, it is not physically addicting. And finally, although it is good advice to stay away from psychoactive There is no definitive way to explain why some people develop addictions and others substances, there is also evidence that shows former alcohol addicts do not. can use responsibly. Jupiterimages/Polka Dot/Thinkstock However, some factors can put you at a higher risk of drug addiction, such as a family history of addiction, peer pressure, anxiety, depression, loneliness, and lack of family involvement (Mayo Clinic, 2009b). If you are worried about someone (including yourself) being addicted, a number of objective psychological factors can be used in assessment. 1. Legal issues. Has the user been in trouble with the law, for example, by driving drunk, buying illegal narcotics, or stealing to support a habit? 2. Financial problems. Is the person buying drugs or alcohol instead of paying the rent or making the car payment? Did the user lose a job because of drug or alcohol use? 3. School or work. Has the person missed work or blown off school because of a hangover or because he or she was buying drugs? Does the person get high even though it interferes with studying? 4. Relationships. Have relationships changed because of substance use? Is the person hanging out with different (or significantly fewer) people? Is there an absence of formerly close relationships with friends or family?
8 5. Health. Are veins collapsing due to heroin injections? Is the person forsaking proper nutrition or sleep while taking methamphetamine? Did the user contract an STI or become seriously injured while engaging in questionable behaviors while using? Treatment for addiction can be effective in both inpatient and outpatient settings. Withdrawal therapy (detoxification, which means to get the drugs out of the body) is often an important first step. Treatment also includes therapy sessions focusing on behavior modification to resist temptations. The most commonly used treatment for addiction is self‐help, the largest organization of which is Alcoholics Anonymous (AA). One important factor related to overcoming addiction—regardless of the type of treatment—is having a strong social support group (Vaillant, 1992). That is why counseling often involves family members so that they can learn techniques to help the addict remain clean. DEPRESSANTS As its name implies, depressants—alcohol, barbiturates (downers), and benzodiazepines—depress, or slow down, your body’s functioning. Outside of nicotine and caffeine, alcohol is the most widely used psychoactive substance in the world. Alcohol abuse is widespread among young adults, especially those away from home for the first time at college. A national survey of full time college students in 2008 found that 61% were current drinkers and 40.5% were binge drinkers. The use of alcohol is somewhat lower among those not in college (Substance Abuse and Mental Health, 2009). Binge drinking, which is defined as elevating blood alcohol levels to .08 or greater over a 2‐hour period, is especially dangerous. For men, that would be having five or more drinks in a row, and four for women. Studies show that binge‐drinking students are much more likely to miss classes, sustain injuries, drive while drunk, have unprotected sex, forget events, and be arrested (Wechsler, Davenport, & Sowdall, 1994; Verster, van Duin, & Volkerts, 2003). Alcohol use is common among young adults, especially in social situations. Jupiterimages/Goodshoot/Thinkstock Alcohol is a large contributor to the number‐one killer of young adults, accidents (National Center for Health Statistics, 2008a). In 2008, drunk driving accounted for 11,783 deaths, 32%of all traffic fatalities. Young adults ages 21‐ to 35‐years‐old make up more than half of all alcohol‐related vehicle fatalities. The percentage of adults who have alcohol problems is greatest among 18‐ to 29‐year‐old young adults (National Institute on Alcohol Abuse and Alcoholism, 2005).
9 A typical serving of alcohol is one beer, one 6‐ounce glass of wine, or one shot of “hard” liquor. Every drink contributes to a blood alcohol concentration (BAC), which is the percentage of alcohol in the blood. A level of .08 is considered drunk driving, but most people are impaired at a lower level, between .02 and .03. Every person is different though. Depending on your sex, weight, and the food in your stomach (food delays the release of alcohol, allowing the liver to break it down), three to four drinks per hour will significantly impair you and put you over the legal limit for drinking. Click here to see a BAC chart: http://alcoholprev.colostate.edu/bachart.shtml. The effects of alcohol on the body are widespread, affecting almost every organ. On a short‐term basis, alcohol depresses the inhibitory centers of the brain, allowing people to engage in behaviors they otherwise would not. The normal parts of the brain that inhibit responses are quieted. For this reason, it is sometimes called a “social lubricant.” Long‐term consequences of alcohol use include cirrhosis of the liver, a higher incidence of certain types of cancers, and an increase in heart disease and stroke. Pregnant women who drink expose their fetuses to the possibility of fetal alcohol syndrome (FAS), a devastating condition that causes damage to the developing central nervous system. FAS is almost always characterized by behavior and intellectual deficits (including low intelligence) and physical abnormalities. About 8% of pregnant women admit to drinking and 3% to binge drinking (Centers for Disease Control, 2009b), though the current recommendation by the Surgeon General of the United States is to completely abstain from alcohol during pregnancy. Excessive, long‐term drinking creates chemical changes that cause your body to crave alcohol to restore good feelings or to avoid bad feelings, known as the addictive disease of alcoholism. Alcohol abuse can have devastating Alcoholism is primarily due to heavy, long‐term drinking, but its consequences. onset can be influenced by genetics and social factors as well. iStockphoto/Thinkstock Barbiturates (“downers,” “blues”) and benzodiazepines (“bennies”) also slow your body’s functioning. They are most commonly used to treat anxiety and sleep disorders like insomnia. Unlike alcohol, the difference between a safe amount of barbiturates and a lethal dosage is quite thin. For example, the prescribed barbiturates Valium, Xanax, and Halcion and other popular street drugs can cause sleep, coma, and ultimately death. Like all “medications” someone might find in Mom or Dad’s medicine cabinet, “downers” and “bennies” are frequently used in suicide attempts. Rohypnol, or “roofies,” is a benzodiazepine that is illegal in the United States. It is commonly known as the “date‐rape” drug due to its quick‐acting sedative effect and ability to induce loss of memory. Rohypnol is most commonly ground
10 up and dropped into a drink and can leave the victim unable to remember events for hours at a time—when potential victims become vulnerable to sexual assaults. STIMULANTS Stimulants include those substances that speed your body’s functioning. They generally elevate mood, increase energy and alertness, and reduce appetite and the need for sleep. Examples include MDMA (Ecstasy), cocaine, and amphetamines such as those that are used to treat attention deficit hyperactivity disorder (ADHD). Caffeine is the most widely used psychoactive drug worldwide. Over 80% of U.S. adults consume some caffeine on a daily basis. It is found naturally in coffee and tea, and to a much smaller degree, in chocolate and coffee‐flavored products. Among college students, energy drinks like Red Bull and Monster have replaced pure caffeine supplements of the past like No‐Doze and Vivarin. The main “energy” in those drinks comes from the stimulant effect of the 80–200 milligrams (and more) of caffeine! As you are probably aware, many soft drinks also contain a fair amount of caffeine, usually between 20 and 55 mg. As Figure 3.3 shows, the caffeine content of different products varies greatly, ranging from about 9 mg for a chocolate bar to 240 mg for the largest cup of Starbucks brewed coffee. If you doubt the psychoactive nature of caffeine, try taking it away from a moderate user. Withdrawal symptoms can include depressed mood, anxiety, sleepiness, and almost always, headaches. Figure 3.3‐ Caffeine content in popular items varies greatly. (Adapted from USDA National Nutrient Database for Standard Reference, 2009; Center for Science in the Public Interest, 2007; Journal of Food Science, 2007. Retrieved April 2010 from http://www.mayoclinic.com/health/caffeine/AN01211.)
11 OPIATES Opiates belong to a class of drugs that are derived naturally from the opium poppy or synthesized to have similar properties. They have narcotic (sedative) and analgesic (pain‐killing) effects. Heroin, the best known and perhaps most feared street drug, belongs to this class. Morphine and codeine are legal opiates that are used for pain relief and as a cough suppressant. Many of you have probably been prescribed acetaminophen (Tylenol) with codeine after dental work, for instance, but morphine is usually reserved for more severe pain like a cesarean birth or a physical trauma like a car accident. In 1975 scientists discovered a built‐in human painkiller that has properties almost identical to opiates. Endorphines block pain messages from reaching the brain and allow us to persist in activities. Those of you Use of opiates such as heroin can who have experienced a “runner’s high” or an “endorphine rush” result in physical dependence. BananaStock/Thinkstock understand the euphoria and sense of well‐being that endorphines produce. HALLUCINOGENS As the name implies, hallucinogens are substances that cause hallucinations and changes in perception, thought, emotion, and awareness. Users experience things that are not based in reality but appear as if they are. Marijuana, a hallucinogen, is the most common illicit drug in the United States. The leaves of the marijuana plant are dried and smoked, eaten, or brewed into a tea. Marijuana has a negative effect on energy, attention, and memory, but it has potentially positive Because marijuana has negative effects as well as medically beneficial properties, its legalization has become a debated effects as well. Marijuana has been found to alleviate issue. nausea and vomiting and to stimulate hunger, and that Doug Menuez/Valueline/Thinkstock allows chemotherapy and AIDS patients to gain weight and remain more comfortable. It has also been shown to relieve the intraocular (inside the eye) pressure that is caused by glaucoma (see Chapter 4).
12 INHALANTS Inhalants refer to a broad range of substances that contain toxic chemicals that alter perception when inhaled, such as spray paint, adhesive products, compressed air such as DustOff, and countless cleaners, solvents, and fuels. On a basic level, inhaling toxic chemicals interferes with oxygen delivery and interferes with normal heart and brain functioning. Long‐term use typically results in permanent brain damage. PRESCRIPTION DRUGS Almost any legal substance can become illicit, depending on the way it is used and distributed. Inhalants and prescription drugs are prime examples. For instance, OxyContin (generic name: oxycodone) is a pain reliever that is often prescribed after surgery. However, when “Oxy” is sold on the street, it becomes an illicit substance that in 2010 could bring up to $80 per pill. When prescription users begin to lie or seek multiple doctors to obtain a prescription, use has become problematic. If users are doing this, they have probably also hit one or more of the five assessment measures for addiction as discussed earlier, including health. Any prescription drug can be dangerous when used incorrectly. Medioimages/Photodisc/ Thinkstock REFLECT ON IT: DECISIONS Students often make choices that are harmful to them physically and mentally, even if they don’t seem dangerous at the time. Because the pleasure centers of the brain can exert such a powerful influence on decision making, students will often disregard good reasons for avoiding dangerous behaviors. • Can you think of a decision that you’ve made where you disregarded good evidence and participated in a harmful behavior because you wanted to make the choice that gave you pleasure? • What was the outcome of that decision? Would you make the same decision again? • Based on this, why do you think young adults are particularly resistant to changing their drinking‐and‐driving behavior or experimenting with drugs, despite knowing the dangers?
13 Some of these decisions are directly related to success in school. For example, students who drink too much or use illicit drugs may find their mind does not readily remember the material they study and that their willpower to study is too weak to overcome their desire for other pleasures. You can use your answers to the above questions to prepare a way to meet future challenges to your study time. Remember that one of the most common reasons why students do not pass classes—and fail in their dream of a college degree—is their frequent choice to do something else instead of studying. Plan now to meet that challenge. COMPONENTS OF HEALTH: WEIGHT, EXERCISE, AND SLEEP WEIGHT The United States has a weight problem, and the road toward obesity often starts with the choices that we make as young adults. Thirty‐six percent of us are overweight, and another 27% of us are grossly overweight, or obese—that means about 6 out of every 10 Americans are carrying around way too much weight! Experts say this is because we eat Figure 3.4 ‐ Adults in the United States have been getting steadily heavier since too much fast food, have the mid‐1970s (Source: National Center for Health Statistics, 2008d). “supersized” portions at home and restaurants, don’t exercise enough, pick poor nutritional meals, sit too much, and pick the easy options—like an elevator or driving—over the more strenuous options like taking the stairs or walking. We eat a lot more than our grandparents did and get a lot less physical exercise (Centers for Disease Control, 2008a; Mayo Clinic, 2009c). Weight has an enormous effect on health. It impacts everything from physical illnesses like heart disease and stroke to mental issues like anxiety and depression. As you can see from Figure 3.4, both men and women have been getting steadily heavier since the mid‐1970s, although the percentage of overweight women has begun to stabilize. Roughly half of young adults are overweight (National Center for Health Statistics, 2008d). Of those who are overweight, roughly half are classified as obese. To standardize weight categories and make comparisons, researchers and health‐care professionals define overweight
14 and obese by the body mass index (BMI), which is a measure that after comparing a person’s weight and height estimates healthy or unhealthy weights by the ratio (see Figure 3.5). Figure 3.5 ‐ Body mass index table. Be advised that the BMI can misclassify, especially for muscular athletes and those who are elderly. Experts also have somewhat different opinions about healthy weight ranges, so any figures should be taken as approximations, not absolutes. (Adapted from Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults: The Evidence Report.) It is clear that many young adults are consuming more calories, which are the standard measure of food energy, than they burn. (A pound of fat has approximately 3,500 calories.) The body uses energy in two ways. First, energy is needed just to keep your autonomic nervous system (a system that is not controlled consciously) functioning: heart beating, lungs breathing, stomach digesting, maintaining body temperature, and so on. This basic functioning is called the basal metabolic rate (BMR). It normally accounts for 60–70% of all calorie requirements. When there is a calorie deficit—that is, more energy is being burned than is taken in through food and drink—the body starts burning stored fat. You can calculate your BMR by clicking this link: http://health.discovery.com/centers/heart/basal/basal.html. In addition to your BMR, you also need energy for activities—walking, reading, and even eating. These additional calories vary by the
15 amount of energy it takes to perform them. This calculator can give you an estimate of how many calories you can burn based on the type of activity and your current weight: http://health.discovery.com/tools/calculators/activity/activity.html. Because your BMR declines as you age, especially beginning in early adulthood, if you continue to eat at the same rate as you did when you were younger, you will likely gain weight. Part of that process is reflected in weight trends by age, as shown in Figure 3.6. If you want to lose weight, you must—on a daily basis—either reduce the calories coming in or expend more energy. (Before starting any plan to lose weight, it is wise to talk to your doctor.) Temporarily changing diets or increasing your physical output is not the same thing as changing your lifestyle. If you go on a crash diet or dramatically change your exercise habits over a short period of time, you are likely to revert back to your pre‐diet weight due to the body defending its set point, a mechanism that adjusts a person’s metabolism to keep weight consistent. Your body tends to burn fewer Our bodies need energy to do calories when you are dieting (to conserve energy), so your metabolism everything from pumping the heart to riding mountain bikes. slows. If you go back to your old habits, with a new (slower) metabolism, your body will take you back to your previous set point. In Jupiterimages/Photos.com/Thinkstock the meantime, that extra fuel is stored as fat. (This phenomenon is also the reason that those 10,000 calories you took in during the Thanksgiving weekend may be gone from your waistline before the next weekend—your body tries to defend the extra calories by increasing your metabolism.) If instead you reduce your calorie intake and/or increase energy use on a permanent basis (a lifestyle change), the weight will stay off. The primary cause of obesity is eating too much and eating the wrong sorts of foods, but a small genetic factor probably also makes it harder or easier to maintain one’s weight. Genes help control how efficiently your body turns food into energy, how your body burns calories, and where your extra weight is stored (e.g., waist or hips). Although researchers agree that there is at least some genetic component in weight, the strongest evidence for the absence of a large genetic role is the trend of the last 50 years or so (Mayo Clinic, 2009c). Childhood obesity has risen from less than 5% in the 1970s to 17% in 2009 (Centers for Disease Control, 2009d); among adults, the figure has risen from approximately 13% to about 36%. The percentage of overweight adults The rise of obesity is an alarming trend in the United States today. in that time (including those who are obese) has ballooned from 45 to 68%. Jupiterimages/Polka Dot/Thinkstock
16 Genetics cannot account for such a dramatic change in two generations. Weight issues run in families not only because of genetics but also because children learn bad eating habits from their parents and friends. (Recall from Chapter 2 that this is known as an environmental influence.) The Centers for Disease Control (2009d) says that, as a consequence of childhood obesity, 1 in 3 American children born in 2000 will develop diabetes. Children under 10 years of age are already developing type 2 diabetes, which in past generations had been seen virtually only in adults—and even then not usually until past the age of 40 (Centers for Disease Control, 2009c). Although most young adults are not overweight, the eating habits they create can lead to significant weight gain later when their metabolism and level of activity slows down. Though Americans continue to gain weight, more people than ever are either dieting to reduce weight or watching their calories (Kolata, 2000). The pressure that young people feel to look fit is often enormous. A fixation on weight can lead to destructive disorders like bulimia and anorexia. A lifestyle change that includes healthier food and fitness choices is the Unlike fad diets, a lifestyle that incorporates healthy key to maintaining one’s weight. Counseling and support food and exercise is the best way to keep excess groups have also shown great benefit in many cases. For more weight off over time. Max Oppenheim/Photodisc/Thinkstock severe obesity, prescription weight‐loss medications and even surgery are treatment options. Doctors warn of believing the quick‐fix pitches seen on TV and in magazines. Often the only thing you lose is your money, and these “fixes” can be dangerous. Trendy diets have shown over and over why they are simply fads: They come and go because the weight loss just doesn’t last. Consumers and health‐care professionals alike also forget that there is pleasure in food and eating. When diets take that away, they are destined to fail. Importantly, Kruger, Blanck, and Gillepse (2006) found that the most successful dieters exercised 30 minutes a day, planned their meals, and weighed themselves daily. EXERCISE Our society puts a premium on youth and attractiveness, with physical fitness being an important component of attractiveness. For most young adults, the 20s provide a double whammy of weight‐related issues. Not only does metabolism slow down, but for most of us there is also less time available for physical pursuits. Young adults are going to school, working, or taking care of a family and usually do not have the same freedom to exercise as they once did.
17 Exercise is an important component of good health. A regular exercise program reduces the danger of stroke, osteoporosis, diabetes, and some forms of cancer. It is also associated with positive mental health, especially a reduction in stress, depression, anxiety (Mayo Clinic, 2009p) and an increase in happiness. The American Heart Association (2007) reports that the fitness level of a young adult is a good predictor of whether that person will develop cardiovascular disease in middle age. Those who have a poor to Regular exercise is important for maintaining a healthy weight. What is moderate fitness level are at greater risk for your favorite way to exercise? Stockbyte/Thinkstock diabetes, high blood pressure, and heart disease, as well as reduced cognitive functions (thought to be due to less oxygen in the blood). Current recommendations by many health professionals include exercising 30 minutes a day, even if it is not continuous. It can include walking in a parking lot and taking the stairs, in addition to a daily walk during a work break. Despite the benefits, 38.5% of adults ages18‐ to 25‐years‐old do not engage in any exercise (National Center for Health Statistics, 2008a), and 80% do not exercise enough; those percentages increase with age. SLEEP It seems like an “all‐nighter” or two is a rite of passage for college students. Although those few nights of lost sleep don’t appear to have any effect other than short‐term mental, emotional, and physical fatigue, the cumulative effects of sleep deprivation may be problematic. The amount of sleep that an adult needs varies from person to person, but most sleep experts agree that you sleep enough if you are consistently alert and not drowsy during waking hours. However, for many, there is a growing sleep debt in the United States. It has been estimated that, because of electricity (especially light Figure 3.6‐ Some possible effects of sleep deprivation.
18 bulbs) and technology (especially television and the Internet), Americans on average sleep about two hours less now than they did 150 years ago. Sleep, an important part of good health, is even related to obesity in young adults. Spiegel, Knutson, and Leproult (2005) found that normal‐weight young adults who got less than 6.5 hours of sleep a night showed hormonal changes that inhibited their ability to process glucose (sugar) and a 30% increase in their levels of insulin over normal sleepers. Insulin and weight gain often go hand in hand. Figure 3.6 shows some possible health consequences of not sleeping. REFLECT ON IT: PHYSICAL HEALTH Good nutrition, exercise, and getting enough sleep are important for good health, as you have seen. And good health is important for success as a student. Poor health will rob you of the needed energy and brain functions to do well in your classes. One of your jobs as a student is to give yourself all the tools that you need to succeed. Ask yourself these questions: • Are you happy with your current exercise and nutrition regimen? Based on what you learned above, what can you do to be healthier in this aspect? • Do you feel like you get enough sleep? • How would your life be different if you were doing everything you could to promote good health? Think about what tools and support you need to start getting healthier. MENTAL HEALTH: STRESS AND DEPRESSION Moving from adolescence to adulthood can be a very traumatic experience, even in the best of circumstances. The person most often moves from a known environment where primary responsibilities are limited to an environment where the person is responsible for nearly all aspects of life—making money, paying bills, performing at work, creating a successful relationship, and even raising a child—often all within the span of a year or two. In addition, young adults have great expectations and oftentimes inflated evaluations of their skills, leading to crushing disappointments when things don’t work out as they expected them to. Early adulthood is one of the peak periods of depression. Depression is different from just being sad or unhappy. Depression is a clinical illness characterized by hopelessness, constant sadness, problems with sleep, and fatigue (Mayo Clinic, 2010). It is not just something that you can turn off, but it is treatable. You can take this free evaluation of personal depression offered by Mayo Clinic: http://www.mayoclinic.com/health/depression/MH00103_D.
19 Nearly 1 in 10 young adults reported major depression, anxiety disorders, or panic disorders during the past year. Major depression is characterized by profound sadness, loss of interest or pleasure in activities, and other symptoms that impair a person’s ability to function. These mental health problems can lead to suicide attempts, substance abuse, self‐harm, eating disorders, and other behavioral difficulties, along with health problems like heart disease (National Institute of Mental Health, 2009; National Center for Health Statistics, 2008b). Individuals suffering from depression may benefit from talking to a professional. Laurence Mouton/photolibrary Women are twice as likely as men to experience depression and anxiety disorders. Men and women deal with depression in different ways. Men are more likely to ignore symptoms and try to “tough it out” when feeling depressed. They often resort to alcohol or drugs to fight depression. Women are more likely to use their social networks of other women and are more likely to seek medical help (Mahalik, Burns, & Syzdex, 2007). Treatment for depression includes antidepressant medications and psychological counseling. Physical and social factors also can play a major role in treatment, including having the support of family and friends. Social support helps improve our sense of not being alone, improves our self‐esteem, provides a sounding board for discussing the problems, and may provide solutions or insights that are helpful. REFLECT ON IT: MENTAL HEALTH Many college students, especially those just starting out, have feelings of depression and doubt. Their lives were already full of responsibilities at work and home, and they now have to find a way to free up more hours to study, which usually means that they get less sleep and see less of their family; this can lead to depression and stress. • Do you feel stressed? If so, can you pinpoint the sources of your stress? • Has your stress caused you to feel depressed? If so, what have you tried to relieve it?
20 Students find that two key strategies for reducing stress and depression are to learn good time management skills, which do not come naturally to most people, and having the active support of your family, friends, or classmates, (You must study the techniques of time management—see the “Life Assessment” at the end of the chapter). This means that they not only accept that you have to study but also become active partners in encouraging you to study, even helping you study. Students who feel that their goal of a college degree is a shared goal to which everyone contributes in their own way have a more positive outlook than those who feel they are alone in their quest. The active and supportive partnership helps you make the right decisions about studying. COGNITIVE DEVELOPMENT There is some disagreement among psychologists over Piaget’s stage of formal operations. Traditional stage theorists believe that once adolescents reach Piaget’s final stage during adolescence, cognition does not fundamentally change again. Other stage theorists believe that cognitive changes do occur. We will examine both arguments. In addition, other models, like information processing, describe a more gradual change in thinking. JEAN PIAGET Piaget theorizes that adolescents and adults used the same basic thought processes, one of formal operations that is characterized by the use of more abstract and logical thinking. Piaget sees the difference between adolescents and adults as one of quantity of information, not style of processing or using it (Piaget, 1977). WILLIAM PERRY Others believe that substantive differences exist between adolescence and adulthood. Perry (1970, 1999) argues that adolescent thinking centers more on dualistic thinking, in terms of right/wrong or good/bad, with no middle ground. This type of absolutist thinking relies on authorities for answers: books, professors, and experts. Thinking is rigid. However, as we move into young adulthood, we become aware of relativistic thinking where there are fewer absolutes, just varying opinions and different perspectives. Perry found that this shift to reflective, relativistic thinking from the dualistic, absolutist thinking of adolescence occurs by the junior or senior year of college.
21 POSTFORMAL THOUGHT Other kinds of postformal thinking are also characterized by reflective thinking and have solutions that vary according to the situation. King and Kitchener (2004) built on Perry’s finding and suggest that postformal thought is the final stage in the development of reflective judgment. It is thought that higher order thinking develops during the final growth of the cortical regions of the brain. In the early stages of adult cognitive development, people do not understand or will not accept that knowledge may be uncertain or You may use postformal thought to make abstract decisions such as weighing all the factors involved in buying a car. contradictory and that some problems just do Thinkstock Images/Comstock not have a good solution. Beliefs need no justification because “What I believe is true” or “What the expert I trust says is true.” Later, knowledge becomes more subjective and facts vary by the situation so that people with different ideas can be right about the same question, depending on their situation. To recognize postformal thought, Sinnott (2003) proposes several criteria to judge its existence: 1. Using two different logic systems at the same time, shifting back and forth, such as between abstract reasoning and practical considerations: “It’s a logical plan, but it won’t work in real life.” 2. Categorizing the problem: “They seem to have a relationship problem, but it’s really a money problem.” 3. Deciding if the problem can be solved by applying a common solution or if it requires a unique solution: “Normally we could use that tool, but in this case we’ll have to build a special tool.” 4. Using pragmatic thinking in which multiple solutions and their pros and cons can be compared: “If we fly, we’ll save time; but if we drive, we’ll save money and see the sights.” 5. Recognizing that many problems have multiple solutions, some of which are equally good: “We could both be right about how to get this done.” 6. Recognizing that solutions aren’t perfect and that what you do might not solve the entire problem or might even create new problems: “This repair will get you back on the road, but you could end up with a radiator problem if you drive too long.”
22 REFLECT ON IT: HOW WE THINK Understanding how we think is an important part of understanding ourselves, and how we approach problems can influence our success in resolving problems. • Can you think of a situation where your thinking was rigid and you were absolutely certain that there was no other answer than yours (absolutist thinking)? • Can you think of a situation where your answer depended on a variety of factors and differing opinions (relativistic thinking)? • What type of thinking do you use most frequently in your daily life? What type of thinking do you think will make you the most successful at solving problems? LOGIC AND EMOTION Many psychologists say that being able to integrate emotion and logic is a critical step toward adult thinking (Labouvie‐Vief, 1997, 2005). Young adults, more so than adolescents, tend to analyze situations and make decisions on the basis of pragmatic, realistic, and emotional grounds, recognizing that the most practical solutions often involve compromise and a willingness to accept different thinking in different situations. ROBERT STERNBERG Unlike the stage theorists described previously, Robert Sternberg (1998) has used an information‐processing model to describe thinking. Sternberg emphasizes the importance of the initial step of encoding, or putting needed information into the system (our brain). Sternberg’s research shows that the best problem solvers are not the quickest; the quickest are the ones who take the time to gather a lot of information and then sort through it to find the most relevant pieces for the problem at hand. Novices encode a few pieces of information to draw a conclusion, whereas experts encode much more before deciding on an answer. Sternberg and Grigorenko (2000) also suggest that an important part of practical intelligence is tacit knowledge, or “know‐how” information. This is not formally taught knowledge but ways of getting things done, relating to people, and creating a positive impression, most often picked up Successful managers often have high through experience and observation. It does not correlate well with emotional intelligence. What other general intelligence, or IQ (one may be savvy without being smart), but it professions could benefit from this is highly correlated with managerial success (Sternberg, Grigorenko, & Oh, type of intelligence? iStockphoto/Thinkstock
23 2001). This association may be related to emotional intelligence (the ability to recognize and deal with feelings), both our own and those of others. Goleman (2001) found that people in major corporations who had risen to the top had a higher degree of emotional intelligence than those who had not been promoted as high, suggesting that these emotional competencies play an important role in overall evaluation of our performance. MORAL DEVELOPMENT Thinking about morality and ethical behavior is often brought to the forefront for young adults by changes in their lifestyles. When they leave home for college, jobs, or the military, they encounter new temptations and new beliefs that conflict with ideas instilled during childhood by parents, teachers, and their social network. They face new challenges in deciding what is right and wrong. As explained in Chapter 2, Kohlberg describes the late stages of moral development as an awareness that most values are relative and that laws can be changed. Universal ethical principles state that ideas about right and wrong come from within after a long period of thinking, reasoning, and integrating what we have learned about life. This last stage includes a sense of equal justice and respect for all, including empathy for the perspectives of others (Kohlberg, 1976). Kohlberg thinks that few people ever get to the last stage of moral development. Others, including Carol Gilligan, have explored these stages as they apply to adults, especially young adults. She suggests that men and women view morality in different ways (Gilligan, Sullivan, & Taylor, 1995). Men tend to define moral problems in terms of what seems right and fair, whereas women define moral problems Have you ever turned to a friend for advice in terms of caring, seeking to avoid hurting anyone. They see when faced with a moral dilemma? Jupiterimages/Comstock/Thinkstock relationships as more important than men do, so their moral perspective focuses more on maintaining those relationships and integrating oneself into “the larger human enterprise.” Men, on the other hand, see ethics and morality as a way of keeping things fair and stopping unfair aggression of the strong over the weak. This view fits with their worldview that life is about competition and seeking to gain autonomy in the face of attempts by the strongest to achieve domination. Hekman (1995, pp. 8, 11) writes that Gilligan isn’t saying one position is better than the other, just that they are different: “Gilligan claims that individuals can see moral conflicts in terms of either justice or
24 care, but not both at once. Moral problems are thus not resolved by balancing justice and care, but by taking one perspective rather than the other.” Friedman points out that in the Heinz moral dilemma (the man discussed in Chapter 2 who had to decide whether or not to steal medicine for his dying wife) it is only a dilemma if there is both a caring relationship between man and wife and a sense of unfairness about the demands of the druggist who has the medicine (Friedman, Robinson, & Friedman, 1987). This perspective suggests that care and fairness can be complementary. Her view has met resistance however, as support for differences in the moral perspectives of men and women is lacking (Pratt, Diessner, Hunsberger, & Prancer, 1991; Gilgun, 1995). REFLECT ON IT: MORALITY Almost everyone develops a sense of morality and decides what is ethical behavior for them, what they believe is right and wrong—although sometimes that decision depends on perspective. Think about the following questions to assess your view on morality • How would you describe your view of right and wrong? • Do any of the examples above seem to echo your perspective? • When you have been in an ethical conflict situation where you were torn between two actions (such as the Heinz example noted above), how did you decide what to do? EDUCATION IN EARLY ADULTHOOD Throughout most of the 20th century, it was natural to expect a college student to be between the ages of 18 and 25 years old, the years when most received their bachelor’s or master’s degrees. Late in that century, universities designed to meet the needs of adult students who wanted to return to college began to flourish, led by universities that promoted both on‐ground (“brick‐and‐mortar”) and online classes. Some traditional students go to college because it is expected of them, but many returning adult students are very goal driven. Adult students have a wide range of ages and a variety of goals. Younger adults focus on getting their college degree, whereas older adults often return for an advanced degree or specialized training to qualify for promotions. They recognize the need for a degree to open doors for employment and better salaries. They are self‐directed problem solvers who analyze The life experience of older adults often helps them to be very successful in their needs and take action to meet them. They often have an academic school. Ryan McVay/Photodisc/Thinkstock
25 advantage over younger students because their life experiences help them understand and master the academic material. They also have a strong focus on applying what they learn to their jobs, which enhances their memory for the material (Harringer, 1994). The impact of millions of better educated adults in the workforce should have a significant impact on productivity and individual opportunities for success. Adult students often fear not being able to do the work after a long layoff from school. Most often these fears are groundless, and students find that their experiences and maturity actually help them be better students. They do face additional stressful challenges as they try to juggle work and family responsibilities with the added time demands of school, so time management skills become critical. Having the support of family and friends is also important to reduce stress and provide an environment where students can study (Kirby, Biever, Martinez, & Gomez, 2004). REFLECT ON IT: YOUR EXPERIENCE AS A STUDENT • Does the above description of the motivations and challenges of being a college student reflect your own experience? • Do you think that time management skills would benefit you in your education? Click the following link for some time management strategies that you can use in your life and answer the following questions: http://collegelife.about.com/od/academiclife/a/timemanagement.htm • Which of the eight time management strategies in the link above do you currently use? Have they been successful? • Which additional strategies do you think would be helpful to you in balancing your education with your home life? Here are some additional sites that will help you think about and plan more effective time management strategies as a student: • Study Guides and Strategies (includes eye‐opening worksheets): http://www.studygs.net/timman.htm • Virginia Tech Time Management Strategies (includes online analysis of your time management now): http://www.ucc.vt.edu/lynch/TimeManagement.htm • Mind Tools (numerous helpful pages): http://www.mindtools.com/pages/main/newMN_HTE.htm
26 THINKING ABOUT THE FUTURE An important part of cognitive development in young adults revolves around developing the ability to rationally consider alternate futures for themselves. To make choices about our future plans—career, marriage, where to live—we must develop the skill of projecting ourselves into the different roles that we might occupy. What would it be like to be married to this person? What would it be like to be a nurse? What would it be like to live in San Diego? Non‐hypothetical thinking can sometimes lead to poor decision‐making. For instance, many young teens (and older women too!) romanticize child rearing. They look at only how cute little babies are and how easy they are to feed, change, and put down to nap. And they are easy—as long as you What career did you dream of as a only see them temporarily. Young mothers and fathers alike know that the child? What career would you like to reality of raising an infant—including sleepless nights, exhausting days, have now? George Doyle/Stockbyte/Thinkstock financial responsibilities, and the difficulty of simply taking a shower or running errands—is nothing like the simple projection that is sometimes discussed. Only by developing the ability for deeper reasoning and seeing the world without “rose‐colored glasses” can young adults make informed decisions about their futures. REFLECT ON IT: YOUR FUTURE Thinking realistically about your future so that you can rationally plan for it is critical. As you’ve read above, it is easy to be seduced by an unrealistic image of a job or lifestyle if you cannot think hypothetically about it. Perhaps you can think of a time (perhaps when you were a child) when you had a fantasy of what a certain career or a certain lifestyle might be like; then when you got older, you realized that it was not quite what you envisioned. It is important to get as much information as you can about the day‐to‐day experience of working in a career field, or maintaining a lifestyle, and then envisioning yourself doing it before you decide on that option. Because some young adults do not think hypothetically about their future careers or future lifestyles, the reality may not be the same as what they expected. Think about the following questions: • Can you think of a time when you were guilty of failing to use hypothetical thinking? • What career are you most interested in pursuing, either now or after you finish your degree program? • If it is a new career, what do you know about the day‐to‐day operations of that career? What do you need to learn about it to be able to project yourself into that role?
27 SOCIOEMOTIONAL DEVELOPMENT Research shows that children and adolescent socioemotional development sets the foundation for who we are as young adults. For example, one longitudinal study found that children who were highly active as toddlers were more likely to be outgoing as young adults (Franz, 1996). Another study found that children who adapted well to new experiences, had generally positive moods and emotions, and had regular eating and sleeping patterns (called “easy babies”) were more likely to be judged well adjusted as young adults (Chess and Thomas, 1987). In addition, baby boys who were emotional, irritable, cried a lot, and had irregular patterns of eating and sleeping (“difficult babies”) were more likely to drop out of school; baby girls who had this difficult temperament were more likely to later have marital problems (Wachs, 2000). Kagan (2008) found that children who had an inhibited temperament were less likely to be assertive as adults and to start full‐time work later. Individually, outcomes are dependent on gender, culture, and socioeconomic factors. However, it This baby’s temperament may offer a glimpse into what she’ll be like as an adult. does appear that our earlier years create Jupiterimages/Brand X Pictures/Thinkstock tendencies that play an important role in our psychosocial and emotional development. One of the most difficult challenges in life is becoming an adult. Recall that in Chapter 2 we discussed Erikson’s stage theory and briefly Levinson’s stage theory. Each suggested there is an underlying order of development, leading us through stages, each with its own goals and difficulties to overcome. In each stage, we must first learn what to do and how to do it; then we master those skills, making us more comfortable in that stage. DANIEL LEVINSON Levinson says that in the early adult years, we are in the novice phase of adulthood. In this stage, he suggests that as a man leaves his family and strikes out on his life adventure, he must accomplish four goals: (1) Find a dream of who he wants to become; (2) find an occupation that leads him in that direction; (3) find a mentor to help him achieve it; (4) find a love relationship (Levinson, 1979). Levinson believes that everyone goes through the same basic pattern of development, which he categorized in long periods he called eras. He likened this idea to seasons of the year (his 1979 book is titled The
28 Seasons of a Man’s Life). Each era (season) is different; there are transition periods between eras, and there is change within each era. In addition, each of the four eras contains stages (Table 3.1). Table 3.1 Levinson’s Life Stages ERA AGES STAGE AGE LIFE EVENTS Preadulthood 0–22 The formative years for physical, social, and psychological growth. Levinson was not too interested in the earlier part of this period. Transition Early adult 17–22 A developmental bridge from preadulthood to early period adulthood. The “budding” adult begins to modify transition her relationship with family and friends, seeking a place in the adult world Early 17–45 Starts with the transition period noted above. An Adulthood era of great energy and great stress. Dreams of the future are firmed up. Careers and families are made, both creating stressors that strain relationships. Entry life 22–28 A time to experiment and discover possible life structure for pathways related to career, relationships, and life early styles; a time to settle on a stable structure for life. adulthood Can be a time of great mental confusion. Age 30 28–33 A time to reappraise choices and make changes transition based on more mature goals, which are often focused on both family and career. Culminating 30–40 The period when early adulthood’s social and life psychological growth is completed and some goals structure for are achieved. We have greater self‐confidence early and purpose. We start to rely less on what others adulthood think and want and more on what we think and want. Transition Midlife 40–45 The second major life shift, this period bridges period transition young adulthood and middle adulthood. Decisions are made about what to do and who to be in middle adulthood. We’re forced to face the transition between young and old as physical
29 capabilities and health show evidence of decline. We begin to think a little about death, driven by the realization that half of life is over. We also tend to become more balanced in our masculine/feminine sides, and relationships built or discarded. It is a time to try out new ideas for a new era. Middle 40–60 The middle years of life separate the period of Adulthood youthful experimentation and the decline of old age. It can be a difficult time. Dreams of young adulthood may be achieved or let go. Relationships may flourish or die, although acceptance of “what we have” is most common. Fears about loss of jobs, loved ones, dreams and opportunities are more common. We may also become more at peace with ourselves and our place in life. Entry life 45–50 Just as we entered young adulthood with an structure for experimental stage, we enter middle adulthood middle with a time in which we let go of some parts of our adulthood youth and try out new ideas that are more realistic for middle age, including activities, relationships, career paths, spiritual thoughts, and planning for the future. This, too, can be a time of mental anxiety and uncertainty as we learn to be a middle aged adult. Age 50 50–55 This is a time when trying out new ideas gives way transition to making decisions about relationships, careers, goals, and generally how we want to live our lives, including the balance we need between work and family. This too can be a time of fear and upheaval, or of simply making modifications to improve life. The 55–60 As with the last stage of young adulthood, this is a culminating time when some of the new dreams and goals of life this era are fulfilled. Others are let go with a structure for greater acceptance of their loss than during our middle youth. Generally, a greater balance in many of life’s adulthood polarities are achieved, leading to greater