The adaptive and maladaptive faces of dependency in later life: Links to physical and psychological health outcomes

Abstract

Objectives: Negotiating the balance between reliance on others and desires for autonomy is a fundamental task of successful aging. The purpose of the present study was to replicate and extend a three-factor model of interpersonal dependency in a sample of older adults, and to examine the physical and psychological health correlates of this multifaceted construct. Methods: Data come from the third wave of a population-based study of older Americans (n = 166; mean age 80 years). We conducted an exploratory factor analysis of selected dependency items from two scales, and then conducted logistic and hierarchical linear regressions to analyze the association of dependency factors with self-reported health, use of hypertension medication, depressed affect and positive affect. Results: We found three factors closely paralleling those of Bornstein and Languirand's (Psychological Bulletin, 112(1), 3–23, 2004) measure: destructive overdependence, healthy dependency and dysfunctional detachment, as well as a fourth factor we labeled ‘healthy independence’. Healthy dependency was associated with better self-reported health. Dysfunctional detachment was related to a greater likelihood and healthy independence a lesser likelihood of taking hypertension medication. Whereas both healthy independence and healthy dependency were positively related to positive affect and negatively related to depressed affect, destructive overdependence was positively related to depressed affect. Conclusion: Understanding the complex nature of interpersonal dependency and autonomy in old age, as well as their implications for health and wellbeing, may enable practitioners to assist older adults in negotiating the task of balancing these needs.