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CHAPTER 29 Pamela G. Reed 577

of developmental resources were measured 3 times (Reed, 1991b). In this study, self-transcendence
(6 weeks apart) with the 36-item Developmental was defined as “the expansion of one’s conceptual
Resources of Later Adulthood (DRLA) scale, previ- boundaries inwardly through introspective activi-
ously developed and tested by Reed. Healthy adults ties, outwardly through concerns about other’s
perceived higher levels of resources across time welfare, and temporally by integrating perceptions
than did depressed adults. Scores on the Center for of one’s past and future to enhance the present”
Epidemiological Studies Depression (CES-D) scale (Reed, 1991b, p. 5). Self-transcendence was mea-
(Radloff, 1977) were significantly higher in depressed sured by the newly developed Self-Transcendence
individuals across time than were those of the men- Scale (STS), derived from the previously identified
tally healthy. Strong relationships between DRLA transcendence factor in the original DRLA scale.
scores and subsequent CES-D scores indicated that The STS score was correlated inversely with both
developmental resources influenced mental health CES-D and Langner Scale of Mental Health Symp-
outcomes in the healthy group; the reverse relation- tomatology (MHS) scores. The MHS is an index of
ship found in the depressed group indicated that general mental health on which higher scores indi-
depression negatively influenced developmental re- cate impairment in mental health in nonpsychiatric
sources in terms of the ability to explore new out- populations (Langner, 1962). In addition, the four
looks on life, to share wisdom and experience with patterns of self-transcendence identified by partici-
others, and to find spiritual meaning. pants (generativity, introjectivity, temporal integra-
In the second study, Reed (1989) explored the tion, and body-transcendence) were congruent with
degree to which key developmental resources of later Reed’s definition of the concept.
adulthood were related to mental health in 30 hospi- In summary, Reed’s three studies provided evi-
talized clinically depressed older adults (mean age, dence for her theoretical idea that self-transcendence
67 years). Participants completed the DRLA and views and behaviors were, in fact, present in older
CES-D measures and rated the importance in their adults. Data indicated that such views and behaviors
current lives of each developmental resource re- were strongly related to mental health. Thus, the find-
flected in the DRLA items. An inverse correlation ings supported a conceptualization of mental health
was found between the level of resources and depres- in later adulthood that went beyond preoccupation
sion. Participants also reported that the resources with physical and cognitive declines and pointed out
represented by the DRLA items were highly impor- the importance of resources that expanded self-con-
tant in their lives. In addition, key reasons given by cept boundaries in aging.
participants for their psychiatric hospitalization were
congruent with self-transcendence issues significant
in later adulthood (e.g., physical health concerns, Major Assumptions
relationships with adult children, questions about life Early in her theoretical work, Reed (1986a, 1987)
and death). proposed a process model for constructing concep-
During the initial DRLA instrument development tual frameworks that would guide nurses and nursing
and testing, a factor labeled transcendence accounted education in clinical specialties. In this model, health
for 45.2% of the variance in DRLA scores. In the sec- was proposed as the central concept, or axis, around
ond study (Reed, 1989), the 15-item transcendence which nursing activity, person, and environment
factor was also more highly correlated with the CES- evolved. An assumption of the model was that the
D than was the entire DRLA. Therefore, a recommen- focus of the nursing discipline was on building and
dation for future research was to examine further the engaging knowledge to promote health processes.
psychometric properties of the instrument, with a
goal to shorten the DRLA to facilitate ease of admin- Nursing
istration in clinical settings. The role of nursing activity was to assist persons
A third study explored patterns of self-transcen- (through interpersonal processes and therapeutic
dence and mental health in 55 independent-living management of their environments) with the skills
older adults (ranging from 80 to 97 years of age) required for promoting health and well-being.