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Final Exam Paper: Middle Adulthood
Charla E. Davis
Wayne State University
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Physical Changes
There are several notable changes that occur in the bodies of middle-aged adults and contrary to popular thought, they are not
all negative. In fact, Hutchinson says that in general, “midlife is characterized by good health (Hutchinson, 2019, p. 571).” Middle aged
adults are less likely to hurt themselves accidentally, which shifts “unintended injuries” from being a leading cause of death. A portion
of this group will also experience “important gains in their cognitive functioning” and their inductive reasoning and spatial orientation
capabilities will peak (p. 578). Middle aged adults also experience bilateralization and begin to reason with both sides of their brain,
better synthesizing and integrating processing power (Hutchinson, 2019, p. 570). The sum of these changes affords middle aged adults
better opportunity to see the forest over the trees; to think on a grander scale than material concerns or day-to-day challenges (p. 571).
On the other hand, the most significant physical change is the decline of reproductive and sexual capability. Middle aged
women are coming upon or experiencing the inability to conceive or bear children. This refers to menopause or “the permanent
cessation of menstruation” which can occur at any time from their 40s to their late 50s (Hutchinson, 2019, p. 565). In the previous life
stage, in their 30s, women will have already begun the process leading up to this, wherein the menstrual cycle does not always include
ovulation. The frequency of cycles declines alongside ovulation. Hormones like estrogen are produced at decreasing levels which
triggers perimenopause, the biological phenomenon that happens right before the onset of menopause (p. 566). This is easily detectible
due to its numerous symptoms. These include “hot flashes, night sweats, vaginal dryness, headaches, insomnia, fatigue, anxiety,
depression, irritability, memory loss, difficulty concentrating and weight gain” (p. 566). The decrease in estrogen due to these changes
can also increase the likelihood for developing osteoporosis and cardiovascular disease which, together with perimenopausal
symptoms, coincide with the health challenges associated with this age group. Lower estrogen levels can also spell trouble for a middle
aged woman’s sex life as this causes the uterus to shrink and provide less blood flow to erogenous zones such as the vagina and nipples,
which become drier and less sensitive respectively. This loss of sexual interest and capability can be a source of strain in relationships,
along with menopauses’ physical toll on the body (Hutchinson, et al., 2019).
Men encounter similar issues due to a reduction in testicular tissue and a slight (>1%) drop in testosterone each year. Some
research implies a correlation between these declining testosterone levels and “low energy, muscle and bone loss, sleep disturbance,
and decreases in motivation and self-confidence” in middle aged men (Hutchinson, 2019, p. 568). This is called andropause (p. 568).
There is more evidence of sperm-carrying tubes hardening, the onset of erectile dysfunction, and a lessening desire for sex. Sperm also
becomes less virile and can cause pregnancy complications or miscarriage for sexual partners after conception. Children who are carried
to term also face a higher risk of developing autism, schizophrenia, and bipolar disorder (pp. 567-8).
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Information on changes in brain biology is affected by the “variability” among middle aged adults (Hutchinson, 2019, p. 570).
However, the differences present in midlife have the potential to predict later brain health issues such as Alzheimer’s before they occur.
These variations are related to where and how much shrinkage occurs in an individual’s gray matter, as well as the presence of amyloid
and neurofibrillary tangles. The amount an individual is affected by these and other physical changes is dependent upon their genetic
makeup as well as their environment, overall health, and engagement in stimulating activities and exercise (570-571). Lachman &
Agrigoroaei (2011) also posit that control beliefs – sensibilities that a person has control or influence over their lives and are
able to make meaningful changes to it – can cause gains in cognitive ability and slow the onset of age-based decline.
Psychological Changes
Erik Erickson’s Stages of Pychosocial Development defines middle age as having the conflict of generativity vs. stagnation
which resonates with the duel perceptions of middle adulthood that pervade popular culture: accrual and decline. Generativity relates
to “procreation, productivity, and creativity (Hutchinson, 2019, p. 557).” This psychosocial imperative pushes middle aged adults to
altruistically use material resources, life experiences, and physical intervention to help older and younger members of their community
and is tied to a sense of personal stability and increasing ingenuity. This is internal, as well, leading to introspection and personal growth.
Erikson also noted that this “instinct” contributes to the proliferation of society (p. 557). This fullness of life, interaction, and time
utilized is linked to an increase in overall psychological well-being. Conversely, a stagnated adult who has been unable to become a
productive part of their family or community will become primarily concerned with themselves, set in their ways. They pull back from
the greater societal and multigenerational narrative and behave selfishly, showing disinterest in the well-being of others, which can lead
to the loss of social energy and relationships. There are external factors that can offset the development of generativity related to race,
class, and gender which I will address with sociocultural influences (Hutchinson, 2019, pp. 558-9).
Intrapsychic and psychosocial maturity also affect a person’s moral development as laid out by Lawrence Kohlberg (Robbins
et al., 2019, p. 298). According to him, most adults fail to develop past the conventional level which is defined in its latest stage by
authority-maintaining morality – the desire to “avoid criticism from authority figures” and as such “conform to the social order”
(Robbins et al., 2019, p. 298). This type of morality places rules and institutions themselves in high esteem and lacks flexibility or
nuance. In contrast, adults in the postconventional level experience full moral autonomy that is not tied to acceptance from authorities
or the current law of the land. This level is defined by internalized social contracts – contractual legalistic orientation – and a deep
belief in justice, compassion, equality and human dignity” (Robbins et al., 2019, p. 298). Adults with advanced moral sensibilities look
beyond the status quo to determine if there are broader opportunities for social improvement, adding to generativity.
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This moral autonomy, or the lack thereof, plays into another psychosocial challenge suggested by Daniel Levinson: finding
balance within different facets of one’s life and identity (Hutchinson, 2019, p. 560). In his view, “the underlying pattern or design of a
person’s life at [this] given time” or life structure is fashioned after reconciling periods of transition and “relative stability” within family
and work (Hutchinson, 2019, p. 561). In the case of middle adulthood, however, it is characterized by individuals striving to achieve
balance in physical and intrapsychic areas that did not get as much attention earlier in life. Levinson summarizes these reconciliations
as young versus old, creation versus destruction, feminine versus masculine, and attachment versus separation (Hutchinson, 2019).
Gail Sheehy expands on this idea of balance and reconciliation for women in her work on the “Second Adulthood” that
characterizes the pathway some women take in life (Robbins et al., 2019, p. 248). This refers to the choice to delay her own gratification,
personal interest and autonomy until after she has fully raised her children. As this is associated with menopausal women, it marks
middle age and the negatively perceived menopause as a transitional period where women had previously chosen to pour all of their
effort into the role of wife and mother and are now presented with an opportunity to shift focus back to their own achievement, which
is very empowering and an important perspective for Social Workers working with middle aged women (Robbins et al., pp. 248-249).
Sociocultural Influences
Hutchinson states that adults in middle age “generally have established a family, settled into and peaked in a career, and taken
responsibility for their children, parents, and community” Hutchinson, 2019, p. 555). And these facets of their life, or the lack of them,
are a significant influence on actions, behaviors, and mental health in this phase. In relation to gender, men tend toward generativity
much more often if they have been fathers, and women are more likely to be generative than men whether they have been mothers or
not, due in part to socialization as care takers. That said, studies have shown that positive relationships early in life increase the likelihood
of generativity for both genders by midlife, as well as stable or increasing cognitive functioning (Lachman & Agrigoroaei, 2011).
Additionally, Levinson and Jung theorized that middle aged adults may begin to shed performative gendered behaviors in favor of
those that are more natural to them, reconciling with previously “repressed” traits instead of prioritizing social conformity (Hutchinson,
2019, p. 560). This idea has been shown to have merit in a Finnish longitudinal study that took place over 30 years – women
demonstrated greater assertiveness and men exhibited less aggression. Sheehy and other theorists have conceptualized this change for
women, who may shed the status of homemaker to pursue personal interests during this period. Inability to successfully resolve
personal, interpersonal, financial, or sociocultural conflict surrounding societal ideals and gender roles has been shown to increase the
likelihood of depression in both men and women (Hutchinson, 2019).
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Further referencing Erikson, work status, education and ethnicity also have interesting correlations to behavior and perception.
Middle aged African Americans reported higher levels of generativity than their white counterparts, as well as greater participation
across a myriad of socio-political engagements. Ethnicity also plays a part in the extent to which individuals are affected by the
biological phenomena that are the hallmarks of middle age. Black and Hispanic communities are more likely to have multigenerational
households and Blacks were also most likely to have 4 generation families, though this seems to be due more so to finances than
ethnicity. Greater financial status was also linked to greater levels of generativity and overall health, which can differ wildly based on
ethnicity. For example, health deterioration has also been shown to be up to 30 years earlier for black adults, though 75% of this disparity
is attributable to socioeconomic factors in childhood and young adulthood. This is also related to how white, low-educated adults in
midlife have a higher rate of suicide than other members of their cohort due to financial issues and stagnation (Hutchinson, 2019).
Our current economic conditions make it hard for middle aged adults to achieve the stability that has been a hallmark of this
time period. They are currently subject to greater job instability, which has a greater effect on minorities and women, and are also facing
retirement uncertainty. This is causing more middle aged adults to find new work after retiring from their primary career. These 3 trends
are a source of significant stress for this age group and can have profound effects on the other areas of their lives, especially in light of
the fact that middle adults are facing longer unemployment rates during their working years (Hutchinson, 2019, p. 617).
New trends as of 1996 are showing that middle aged parents are less likely to be “both end carers” though it is still a challenge
many adults must face (Hutchinson, 2019, p. 596). Their parents are living longer and, especially in some racial communities, their
grown children and grandchildren need additional assistance due to the difficulty millennia children have becoming self-sufficient.
Overall, middle adults tend to take on the responsibility of being kinkeepers and bridging the gap between generations and providing
support, while women generally spend more time exhibiting this behavior. Despite the fact that few women are caring for children at
the same time as they are caring for their parents, it is a significant circumstance for women who do as they are often kinkeeping across
generations as well as working. It also appears to be more emotionally difficult for parents to let their children leave the nest now,
despite spousal relationships usually experiencing more happiness before and after parenting (Hutchinson, 2019, pp. 604-5).
There is more research to be done on the effects of sexual orientation on middle aged adults. Lesbians and gays of middle age
have reported a higher amount of relationship contentedness as well as less family support. For them, their social convoy or protective
network of individuals consists of intimate friendships or “found family” in middle age than blood family (Hutchinson, 2019, p. 602).
This is also the case for single middle age adults. Some midlife adults also revisit their sexual orientation and gender expression,
choosing this phase of life to disclose their sexual orientation, which can be a source of stress and subsequent isolation if unaccepted
(Hutchinson, 2019, pp. 612, 614-615).
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In terms of spirituality and religion, Wade Clark Roof suggested that the happenings of the 1960’s and 70’s have contributed
to a U curve in religiosity for baby boomers and decentralization of Christianity. However, they share a deep desire for personal meaning
in life. This cohort was also more likely to recognize multiple religions and meaning making experiences as legitimate. The presence
of children or grandchildren in the home seemed attached to a resurgence of religious affiliation. This is often compounded by culture
in the case of Black and Hispanic baby boomers (Hutchinson, 2019, pp.588-591).
Ecological/Systems Model
On a Micro level, most middle age adults are dealing with their own mental health, interacting with their spouse, have children
either within or outside the house, and are learning to parent adults. They are also transitioning into a caretaking role for their parents
and learning to balance these new relationship dynamics and financial stressors. Micro systemic relationships will hold high significance
to a person’s overall perception and actual quality of life at this stage and will influence the goals they have for themselves and their
capability to adapt to changes on each level. Meso systems, such as those of their extended family and perhaps their workplace, will
have a more secondary effect as they are at this point well established within their careers and social convoys. That is, unless they have
been laid off and have found themselves in a new career or unemployed. If they are unemployed, this level will hold even more
significance as they must make use of their family and broader community network to get by. As kinkeepers and with their social
convoy being tied in part to their work and extended relationships, they must also contend with the integration of their families within
greater multigenerational contexts. The lack of or abundance of these secondary relationships relates to latency and their ability to keep
things afloat. The macro level relates to them in terms of larger scale systems like the economy and job market, and the policies and
programs that the government has in place to protect them, like social security and healthcare. Influencing this level may require welfare
advocacy and political engagement. As social workers, it is important to understand systems in order to help clients identify areas of
dysfunction and support growth and change.
Empowerment perspective
An empowerment perspective on middle aged adults, particularly women who are transitioning from being full time parents
into the rest of their lives, is important for their continued generativity, health, and well-being. Women in this stage in their lives often
suffer from limited relationships outside of their family and, due to gender roles, feel they do not have the agency to pursue new
achievements and socialization. It is no wonder that they are so likely to deal with lasting depression at this age. A social worker
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might start a support group for women in this phase of life to help ease the transition to an empty nest and a return to personal freedom.
They would be able to share challenges and triumphs with one another, as well as go on outings for exercise and activity. A group like
this would add to their social convoys and capital, allowing them opportunities and space to redefine themselves and teach others
from their own experiences. My mother is experiencing this phase of her life at this very moment and is lashing out at me and my
siblings due to feelings of emptiness and regret. Empowerment strategies in practice would offer her space to reconnect with herself as
an individual and allow her to reflect on what she has managed to achieve amidst a cohort of her peers (Carr, 2003; Robbins et al.,
2019; Hutchinson, 2019).
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References:
Carr, E., Summerson, A. (2003). Rethinking empowerment theory using a feminist lens: the importance of
process. Journal of Women & Social Work, 18(1), 8-20.
Agrigoroael, S., & Lachman, M. (2011). Cognitive functioning in midlife and old age: Combined
effects of psychosocial and behavioral factors. The Journals of Gerontology, Series B:
Psychological Sciences and Social Sciences, 88B (Suppl. 1), i130-1140
Robbins, Susan, P., Chatterjee, P., & Canda, E. R., Leibowitz. (2019). Contemporary human
behavior theory: A critical perspective for social work practice (4th Ed). Boston, MA: Allyn
and Bacon.
Hutchison, E. D. (2019). Dimensions of human behavior: The changing life course (6th Ed).
Thousand Oaks, Ca: SAGE Publications, Inc.