Aging & Mental Health Vol. 14, No.

5, July 2010, 516523

Help me! Im old! How negative aging stereotypes create dependency among older adults
` ve Coudin and Theodore Alexopoulos* Genevie
Laboratoire de Psychologie des menaces sociales et environnementales, Universite Paris Descartes, 71, av. Edouard Vaillant, 92100 Boulogne-Billancourt, France (Received 2 September 2009; final version received 25 January 2010) Objectives: This study examined the effects of negative aging stereotypes on self-reported loneliness, risk-taking, subjective health, and help-seeking behavior in a French sample of older adults. The aim of this study was to show the detrimental effects of negative aging stereotypes on older adults self-evaluations and behaviors, therefore contributing to the explanations of the iatrogenic effect of social environments that increase dependency (e.g., health care institutions). Method: In the first experiment conducted on 57 older adults, we explored the effects of positive, neutral, or negative stereotype activation on the feeling of loneliness and risk taking decision. The second experiment (n 60) examined the impact of stereotype activation on subjective health, self-reported extraversion as well as on a genuine help-seeking behavior, by allowing participants to ask for the experimenters help while completing a task. Results: As predicted, negative stereotype activation resulted in lower levels of risk taking, subjective health and extraversion, and in higher feelings of loneliness and a more frequent help-seeking behavior. Conclusion: These findings suggest that the mere activation of negative stereotypes can have broad and deleterious effects on older individuals self-evaluation and functioning, which in turn may contribute to the often observed dependency among older people. Keywords: aging stereotype; dependency; help-seeking behavior; risk-taking; subjective health

Introduction The aging of society has not significantly changed our perceptions of the elderly. Ageism is widespread in Western societies (Kite & Johnson, 1988; Nelson, 2002; Palmore, 2005; Ray, Sharp, & Abrams, 2006; Whitbourne & Sneed, 2002). Older adults are viewed, among others, as irritable, boring, grumpy, weak, mournful, debilitated, and most importantly cognitively impaired (Braithwaite, 1986; Coudin, Beaufils, & Henrard, 1998; Nuessel, 1982; Scholl & Sabat, 2008). These negative stereotypes can be endorsed by the elderly themselves negative self-stereotyping (Kruse & Schmitt, 2006) and are also found among professional caregivers (e.g., Cowan, Fitzpatrick, Roberts, & While, 2004). The image according to which older people are more incompetent than younger adults is particularly dominant (Cuddy, Norton, & Fiske, 2005). However, in various domains, older adults tend to have comparable performances and sometimes even outperform younger people (McCann & Giles, 2002). Nevertheless, these stereotypes have been found to possess an influential power and to shape older peoples general functioning. There is now an important body of research suggesting that priming stereotypes of aging can have reliable influences on various aspects of older adults functioning including cognition, behavior, and physiology (for a review, see Levy, 2003). In an original study, Levy (1996) implicitly primed older participants either with negative-aging-stereotype words

(e.g., senile, dependent, and incompetent) or positiveaging-stereotype words (e.g., wise, sage, and alert) and asked them to perform various memory tasks before and after this experimental treatment. Results indicated that negative primes had deleterious consequences on participants performance whereas positive primes improved participants performance on most of the tasks (see also Abrams et al., 2008; Abrams, Eller, & Bryant, 2006; Desrichard & Kopetz, 2005; Hess, Auman, Colcombe, & Rahhal, 2003). In another research, Levy (2000) has shown that priming aging stereotypes influences the quality of handwriting, which is considered as an indicator of personality and physical condition. Older adults exposed to negative stereotypes adopted a more impaired or deteriorated handwriting style than those primed with positive aging stereotypes. In a similar vein, Levy, Hausdorff, Hencke, and Wei (2000) found that priming negative or positive aging stereotypes tended to heighten or reduce, respectively, the cardiovascular response to various arithmetic or verbal challenges. Taken together, these findings suggest that the mere activation of aging stereotypes can affect basic cognitive and physical processes of older adults. Such a mechanism, we think, could also contribute to the emergence of a dependent state. Dependency Dependency has become an important social topic due to demographic changes and an increasing risk of

*Corresponding author. Email: theodore.alexopoulos@parisdescartes.fr

ISSN 13607863 print/ISSN 13646915 online 2010 Taylor & Francis DOI: 10.1080/13607861003713182 http://www.informaworld.com

Aging & Mental Health physical and psychological dependency with age. It is usually defined as an outcome of a temporary or chronic functional disability where an individual is unable to perform a behavior that he/she could previously perform alone. However, besides stemming from functional losses, dependency can be regarded as the result of the actual interactions between older people and their social partners, frequently influenced by ageist stereotypes. In fact, it has been shown that dependency may stem more heavily from the social interactions with others than from biological deficits per se (e.g., Baltes, 1996; Baltes & Wahl, 1996; Grant, 1996; Langer & Rodin, 1976). In line with this idea, the present research further explores the interpersonal situational factors that induce dependent states among older adults by highlighting the dominant role of stereotypes. Dependent elders often show a loss of motivation, a feeling of loneliness and helplessness, and action inhibition which can then turn to psychopathological symptoms of severe depression and other health problems (Solomon, 1990), as well as to an increase of cognitive deficits (Rabbit, 1988). Previous research has shown this to be true for older people residing in long-term institutional settings, but also private and community dwellings (Baltes & Wahl, 1992).

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it is either negated or responded to in a delayed or ambiguous way, he/she will eventually give up communicating any further needs and resign him/herself to a passive acceptance of any social partners action, including those that are not required. The inappropriate, staggered, and sometimes non-existent responses directed toward an older person are again originating from a negative image of the elderly as senile, disabled, helpless, and incompetent (Solomon, 1990). These attitudes lead the caregivers to believe that they know better what the elders needs are and simply discredit or ignore the requests. Since the older person cannot control the outcome anymore, he/she enters into a state of resignation where he/she integrates these interacting rules and tends to accept the partners responses even if they are not directly referring to his/her needs.

Models of dependency Having spent many years observing the behavioral sequences involving older people and staff members in health care institutions, Baltes and Wahl (1992) described consistent patterns of contingencies in the social environment, which they called the dependencesupport, independence-ignore script of behavior (Baltes & Wahl, 1996; Wahl, 1991). This script describes systematic pattern of interactions between older people and others (e.g., staff members) where dependent behaviors on activities of daily living such as being dressed or fed are generally attended to and treated as adequate (or expected) behaviors by staff members whereas independent behaviors such as using the toilet or eating are ignored or even discouraged. Therefore, even if an institutions goal or a familys wish is to maintain autonomy, the actual environmental contingencies tend to enhance dependent behaviors. Such a consistent mapping of social supportive actions upon dependent behaviors is driven by staff members beliefs that older people are weak and in need of help. Another process that has been put forward in the literature to account for elders dependent behavior is learned helplessness (Seligman, 1975; Solomon, 1990). Dependency and helplessness have in common a heightened perception of an external locus of control, and are associated with an experience of loss of control and subsequently a loss of autonomy and enhanced passivity. This model focuses on caregivers behaviors when responding to older peoples needs: If an older person communicates a need (e.g., being hungry), and

Aging stereotypes and dependent behaviors The aforementioned explanations of dependency consider as a central feature the fact that the helping behaviors from the staff exceed the elders actual needs when, for example, they are being fed despite the fact that they could eventually eat by themselves. Indeed, Avorn and Langer (1982) observed that often caregivers perform helping tasks that are beyond their professional duties or responsibilities, which then may convey an implicit message that the older person is helpless and incapable of taking care of herself. These authors directly compared the consequences of control-enhancing versus control-reducing situations in a nursing-home experiment. Older participants were divided into three groups and asked to complete a jigsaw puzzle during a series of sessions. The first group was given extensive assistance during the completion of the task. A second group was verbally encouraged, while the third group did not receive any support (control group). Results showed that performance of the assisted participants deteriorated while the performance of the encouraged participants improved. In other words, when the staffs actions convey an expectation of disability, older adults tend to confirm this attitude by becoming helpless. It seems then that in caregiving situations, social support can have deleterious effects through the denial of older adults autonomy (Rowe & Kahn, 1987). Importantly, all these explanations focus on environmental affordances as well as on behaviors offered by social partners, who are then accountable for shaping elders behaviors. In such a case, negative attitudes or beliefs operate as self-fulfilling prophecies that are grounded in specific communicational and behavioral patterns (Word, Zanna, & Cooper, 1974). In this article, we propose another, more direct route that deals with the immediate impact of stereotypes on the behavior of the elderly. We present two studies that document reliable consequences of stereotype activation on various features that are typically encountered in a dependent

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G. Coudin and T. Alexopoulos manager of the club. The rest were approached in a shopping center where many people refused to take part due in majority to time constraints. The mean age was comparable across experimental conditions (Mpositive 72, Mnegative 71, and Mcontrol 73). Procedure and material The experiment was presented as two ostensibly different tasks. The first one was said to be on language comprehension. The experimenter asked participants to read a text that was presented as a speech held at a gerontology conference and conveyed stereotypical images of the old person (for a similar procedure, see Guo, Erber, & Szuchman, 1999). There were three versions depending on the image of the elderly (positive vs. negative vs. neutral) portrayed by the speaker. The different texts were balanced as to the number of presented arguments and their length (about 550 words). In the positive condition, elderly were presented as an important group that holds a key position and represents an advantage for the financial development of society (e.g., Older persons represent a huge market and therefore contribute to the economical growth of our society). Also, it was said that older persons are respected and that society could benefit from their experience (e.g., The experience that older adults acquired through their life is precious for others). Finally, the text insisted on the minor consequences of aging on health (e.g., Although the sensitivity of the five senses such as hearing, touch, vision, smell, taste is somehow reduced with age, research has revealed many compensatory mechanisms that contribute to a successful living). In the negative condition, elderly were portrayed as failing to adapt to their environmental context, passive and costly for society (e.g., Aging is characterized by a loss of some important social roles that contribute to the devaluation of older adults). Moreover, the text outlined the various consequences of aging on memory loss or attention, and presented the elderly as disabled persons (e.g., With age, the sensitivity of the five senses such as hearing, touch, vision, smell, taste is considerably reduced). Finally, in the neutral condition, the description was mainly focused on older persons leisure and occupations as well as on their musical taste. After participants read the text, the experimenter asked participants a comprehension question. Next, a questionnaire was introduced as a pretest for the material of another study. In the first part, it contained 20 items translated and adapted from the UCLA Loneliness Scale (Russell, Peplau, & Cutrona, 1980). The various items tapped the facets of emotional loneliness, such as lacking companionship (e.g., I feel no longer close to anybody; I lack a partner), and social loneliness, such as failures in the social network (e.g., I feel isolated; There are people around me but not with me). Importantly, the original four-point response format was replaced by a seven-point scale anchored at 1 (not at all ) and 7 (extremely). A pilot study where 15 participants

and given up state. In Experiment one, we studied loneliness and risk-taking. This is particularly relevant because it has been shown that dependency increases social isolation or withdrawal and leads to action inhibition (Barder, Slimmer, & LeSage, 1994; Rodin, 1989). In Experiment two, we explored another aspect of the phenomenon, namely, the consequences of stereotype activation on subjective health and helpseeking behavior. In this research, we were mainly interested in normal aging because we wanted to show reliable influences of the stereotype on non-pathological cognitive and behavioral functioning. If anything, we expect that this impact could only be larger for persons in caregiving situations.

Experiment one In order to study the effects of aging stereotypes, we relied on a procedural priming methodology that consists of activating the stereotype in a first part and assessing its effects on a second (ostensibly unrelated) task. The goal of the first experiment was to show that the activation of a negative (as compared to a positive or neutral) aging stereotype can have detrimental effects on loneliness and risk-taking decision, both of which are important concomitant features of dependency among older adults. Based on the work of Weiss (1973), loneliness can be described as a subjective feeling following a lack of intimate relationships and/or an absence of involvement in a social network. Therefore, we considered an emotional and a social loneliness, respectively. As far as risk taking is concerned, previous research led to mixed results. Some studies did not reveal any differences between young and older adults in risk decisions in a card game (Chou, Lee, & Ho, 2007; Dror, Katona, & Mungur, 1998), financial choices for retirement (Hershey & Wilson, 1997), and therapeutic decisions (Curley, Eraker, & Yates, 1984). However, Vroom and Pahl (1971) showed that older adults are more risk averse than younger participants when they perform choice dilemma problems.

Method Participants and design Fifty-seven older adults took part voluntarily in the study (range 6578 years; M 72). The proportion of female and male participants was balanced across conditions. We included in our sample older adults aged 65 and over who declared living alone. Participants signed a consent form, which specified that they might get incomplete or inaccurate information due to methodological reasons but that full information will be provided at the end. They were run individually and randomly assigned to our experimental conditions (positive vs. negative vs. control). About 60% of our sample was recruited in an elderly club where the experimenter was introduced by the

Aging & Mental Health (aged 6575 years) from the same population completed the questionnaire and commented on it revealed that this format was more convenient as it offered a broader spectrum of choice. Finally, risk taking was assessed using a case description of an everyday life dilemma. This was a typical item taken from the Choice Dilemmas Questionnaire (Kogan & Wallach, 1967) which has been widely used to assess risk taking and constitutes a well-accepted operationalization of risktaking (Forgas, 1982). Additionally, the narrative and realistic content of this task is well suited for the specific population under study. The task was describing a case of an electrical engineer, Mr A, whose income is fair but modest, and has the possibility to raise it considerably if he accepted a job in a newly founded but financially uncertain company. Below the story, there was a list of several probabilities or odds of the new companys proving financially sound. At the outcome, participants had to choose between a conservative and less rewarding option, and a risky and highly rewarding alternative. Risk taking was assessed by asking participants to imagine that they were to advise Mr A and to check the lowest probability that they would consider acceptable to make it worthwhile for Mr A to take the new job (from one in 10 to nine in 10, included was also the option to advise him not to take the job whatever the probabilities were). Within this paradigm, higher probabilities indicate a more risk-averse or cautious choice. Finally, participants were thoroughly debriefed as to the true purpose of the study. Particular care was taken to discuss with participants in the negative condition and to develop with them all of the arguments presented in the positive condition. Importantly, no participant raised suspicions concerning the impact of the text.

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the job. An outlier identified by a gap in term of his Cook D (McClelland, 2000) was excluded from the analysis. Data were submitted to a 3 (Stereotype: positive vs. negative vs. control) one-way ANOVA. Results revealed the expected main effect of experimental condition, F(2, 53) 7.05, p50.01, and PRE 0.21. Participants primed with the negative stereotype were more risk-averse (M 4.11, SD 1.37) than their counterparts in the control condition (M 2.75, SD 1.25) or the positive condition (M 3.23, SD 0.56), ps50.03. The contrast opposing the positive to the control condition was not significant, F 1.60. The results of this experiment confirmed our expectations by showing that exposure to a negative aging-stereotype increased self-reported loneliness compared to a positive aging-stereotype or a control condition. Additionally, participants were more riskaverse in the negative age-stereotype condition than in the positive age-stereotype or control condition. Our results highlight that the mere activation of negative stereotypes can cause older adults to adopt a condition that is reminiscent of dependent states, where the elderly complain about their loneliness and remain passive, avoiding any behavioral initiative or risk taking. In the next experiment, we assess whether priming aging stereotypes can also trigger a social behavior frequently encountered in a dependent state, namely, help-seeking. Experiment two Our contention is that the mere activation of the stereotype influences the extent to which older people engage in dependent behaviors and, for example, ask for assistance from their social environment. The second experiment aimed at exploring this hypothesis by considering help-seeking behaviors showed by our older participants. Importantly, we depart from previous investigations that explored the impact of elderly stereotypes on simple behaviors (e.g., walking; Bargh, Chen, & Burrows, 1996) because in our paradigm, we study the impact of stereotypes on real social interactions. Noteworthy, even though the study was run with healthy, autonomous older adults, we were able to reproduce the asymmetry of power that exists between caregivers and patients in institutions, by relying on the fairly high status of the experimenter in a research experiment. Furthermore, we also measured other important indicators that may come into play like subjective health, self-esteem, and extraversion. Indeed, it has been argued that dependency can be accompanied by a perceived loss of confidence and self-esteem, as well as negative perceptions about ones health (Davies, Laker, & Ellis, 1997; Langer & Rodin, 1976; Rodin, 1989). Method The procedure was basically the same as in Experiment one. Only major changes are highlighted.

Results and discussion Loneliness We successively computed an index of emotional loneliness ( 0.86), which is described as a lack in intimate relationships (8 items), and an index of social loneliness ( 0.93), which is described as an experienced failure in social networking (12 items). Data were then submitted to a 3 (Stereotype: positive vs. negative vs. control) 2 (Loneliness scale: emotional vs. social) mixed-model ANOVA with repeated measures on the last factor. Results revealed a main effect of scale type, F(1, 48) 5.01, p50.03, and PRE 0.09, and stereotype condition, F(2, 48) 3.68, p50.04, and PRE 0.13.1 The latter result reflects the fact that participants declared overall more loneliness after a negative stereotype activation (M 2.52, SD 1.12) than after a positive (M 1.94, SD 0.51) or neutral activation (M 1.92, SD 0.46), all ps50.05. Risk taking Risk taking was assessed by taking the probability that participants considered as acceptable for Mr A to take

520 Participants and design

G. Coudin and T. Alexopoulos assessed using 10 items taken from the Rosenberg Self-Esteem Scale (Rosenberg, 1965). Again, in a postexperimental questionnaire, none of the participants expressed suspicions about the purpose of the study. During an extensive debriefing, the experimenter took care to develop all of the positive arguments together with participants of the negative condition. Then, participants were offered some additional time to complete the puzzle task. All of them succeeded.

Sixty autonomous elderly persons living in community housing for the aged took part voluntarily in the study (range 7181 years; M 77). In France, such community housing is planned for totally autonomous elders with no particular health problems or cognitive impairment. Participants were recruited at a research site in the community (three participants declined the invitation). After reading and signing the consent form, they were run individually and randomly assigned to our experimental conditions (positive vs. negative vs. control). The choice of aged persons residing in a community housing was motivated by the goal to obtain a relatively homogeneous sample in terms of living conditions, socioeconomic status, and age (Mpositive 77, Mnegative 76, and Mcontrol 77). Due to the reduced tendency of men to seek support services or help (Tudiver & Talbot, 1999), we chose a sample that was exclusively composed of female participants. Procedure and material Again, the experiment was presented as two ostensibly different tasks. This time participants were asked to listen to the text through headphones. This modification was motivated by the fact that ageist stereotypes are also often conveyed through spoken words. For this purpose, the negative and positive versions of the text were tape-recorded using a female voice that maintained the same rhythm and tone voice across conditions. Participants were asked to listen carefully as they would have to answer a comprehension question at the end. Participants in the control condition did not receive any text and were directly prompted to solve the second task. Next, the puzzle task was introduced. It was presented as a pretest of an insight problem to be integrated in a board game for older people. The goal of the puzzle task was to form a 3-D pyramid using 15 wooden pieces and a base with the help of a bi-dimensional model depicting the end-state on a sheet of paper. The time was relatively short and constrained to 10 min. In fact, a pilot study revealed that, across ages, the mean time to solve this problem was around 25 min. Participants could ask for help by honking a horn. The experimenter would then provide them with a clue to solve the task. Thus, helpseeking behavior was measured by the number of times participants made use of the horn. After 10 min, participants were told to stop and all of them left the puzzle task unfinished. Next, they were asked to complete a questionnaire that assessed subjective health (How would you judge your state of health?) on a (9 cm length) continuous scale with very bad and very good as endpoints. They were also asked to describe how extraverted they viewed themselves using continuous (again 9 cm length) bipolar scales with the following endpoints: withdrawn/expansive, warm/cold, spontaneous/reflective, reserved/open, impulsive/moderate, and cautious/instinctive. Then, self-esteem was

Results Help-seeking behavior The number of honks was considered as our indicator of help-seeking. Data were submitted to a 3(Stereotype: positive vs. negative vs. control) oneway ANOVA. The analysis revealed a significant effect of experimental conditions, F (2, 57) 14.96, p50.001, and PRE 0.34. As expected, participants in the negative condition honked more often (M 5.10, SD 2.63) than participants in the control (M 2.55, SD 1.87) or positive (M 1.60, SD 1.63) condition, ps50.001. The positive condition did not differ from the control condition, F52.06.

Subjective health The distance (in centimeters) between the left anchor and participants answer was measured. A one-way ANOVA on the data yielded a significant effect of our experimental conditions, F (2, 57) 4.27, p50.02, and PRE 0.13. Participants in the negative condition declared being in worse health (M 4.30, SD 2.61) than participants in the positive condition (M 6.47, SD 2.13), F (1, 57) 8.31, p50.01, and PRE 0.13, with participants in the control condition falling in between (M 5.07, SD 1.63).

Extraversion For each scale, the distance (in centimeters) between the left anchor and participants answer was measured. An index of extraversion was computed by averaging the scores on the withdrawn/expansive, reserved/open, cautious/instinctive items and the reversed scores on the impulsive/moderate, warm/cold, spontaneous/reflective items ( 0.87). Data were again submitted to a oneway ANOVA. Results indicated a marginally significant effect of experimental condition, F (2, 57) 3.11, p50.051, and PRE 0.10, such that participants in the negative condition described themselves as less extraverted (M 4.33, SD 2.27) than participants in the positive condition (M 6.11, SD 2.46), F (1, 57) 5.97, p50.02, and PRE 0.17, and only marginally to those in the control condition (M 5.54, SD 2.15), F (1, 57) 2.76, p50.10, and PRE 0.09. The two latter conditions did not differ from each other, F51.

Aging & Mental Health Self-esteem The scores on the different self-esteem items were averaged after reversing the negative items ( 0.82) and submitted to a one-way ANOVA. Results indicate that self-esteem ratings were unaffected by our experimental manipulation, F51. Additional analyses of covariance We also performed several ANCOVAs in order to test the potential role of self-esteem, subjective health, and extraversion in the production of the effects of our experimental conditions on help-seeking. However, for all the analyses, the effect of our experimental manipulation remains significant, F(2, 54) 3.10, p50.05, and PRE 0.10, when considering selfesteem as a covariate, F(2, 54) 9.80, p50.001, and PRE 0.27, when considering extraversion as a covariate, and F(2, 54) 10.09, p50.001, and PRE 0.27, when considering subjective health as a covariate.2

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Discussion The second experiment showed that priming aging stereotypes influence health perception and extraversion, with participants in the negative condition declaring being in a more deteriorated health and describing themselves as less extraverted than their counterparts in the positive stereotype condition. However, the crucial finding of this experiment is the fact that stereotype priming impacts older peoples help-seeking behavior. More specifically, a negative age-stereotype priming increased help-seeking (the number of horn uses) compared to a positive agestereotype priming. This is especially important because the literature on stereotype threat usually focuses on performance (Schmader, Johns, & Forbes, 2008) and studies that tackled the behavioral facet of aging stereotype priming were focused on simple and automatic behaviors such as walking (Bargh et al., 1996) or handwriting (Levy, 2000). Our data suggest that priming aging stereotypes influences the extent to which older individuals engage in more elaborated social behaviors such as initiating an interaction by asking others to help them.

General discussion This research highlights the pervasive impact of stereotypic beliefs and attitudes in shaping older peoples perceptions and behaviors. In Experiment 1, older participants primed with negative aging stereotypes were more risk-averse as assessed by the Choice Dilemma Questionnaire. Moreover, loneliness was also affected by the priming manipulation. Higher amounts of loneliness were reported after activation of a negative aging stereotype than after a positive or neutral aging stereotype. In Experiment two, our

stereotype priming manipulation influenced subjective health and help-seeking behavior. Older participants exposed to a negative aging stereotype assessed their health as being worse than their counterparts exposed to a positive aging stereotype. Also, the former sought assistance of the experimenter more often than the latter when solving a puzzle task. Taken together, these findings show that exposing older individuals to negative aging stereotypes can have various consequences on their functioning reminiscent of a helpless or dependent state. In doing so, we bridged the gap between research on priming of aging stereotypes and a body of work that focuses on health care practices and patterns of communication in clinical as well as in everyday settings. The implications of our findings are straightforward: The mere activation of a negative stereotype leads older individuals to feel lonely, to depreciate their health status, to avoid taking any risks and to systematically seek for help in their social environment. These effects are similar to those symptoms that are frequently encountered in an institutionalized context of enhanced dependency. Until now, we have considered help-seeking behavior and dependence as negative or undesirable behaviors that inescapably lead to a loss of autonomy. However, as has been pointed out elsewhere, dependency and help-seeking may prove to be a highly adaptive strategic device that could constitute the key for a successful aging (Baltes & Baltes, 1990). Rather than an indication of loss of control or helplessness, dependent behaviors and specifically help-seeking could be the manifestation of a secondary control strategy (Lachman, 1986; Rothbaum, Weiss, & Snyder, 1982). Adopting behaviors that are congruent with the expectations of the caregiver could be a useful strategy to maximize their gains and not to lose any of the opportunities that are present in the environment (Marsiske, Lang, Baltes, & Baltes, 1995). The goal of this research was to highlight the dominant role of stereotypes in the elicitation of thoughts and behaviors reminiscent of dependent states among older adults. Our findings show that interpersonal interactions are socially constructed in such a way as to confirm the current beliefs and attitudes that we possess of ourselves and of others. If the caregivers view older people as helpless or incompetent, they will inevitably end up obtaining nothing but dependent and help-seeking behaviors on the part of the elderly. An important implication of our research is that intervention strategies should focus heavily on the content of the stereotypes that are conveyed by the caregivers in institutions or in the community. Consequently, a strategy could focus on the positive aspects of aging as well as enhancing the motivation for a more accurate perception of the elderly. However, this does not mean a denial of the negative consequences of aging: Aging can be viewed as a spiritual journey (Mowat, 2005) and caregivers could assist older adults in this process by helping them to seek meaning by grounding the self

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optimization with compensation. In P.B. Baltes & M.M. Baltes (Eds.), Successful aging: Perspectives from the behavioral sciences (pp. 134). New York: Cambridge University Press. Baltes, M.M., & Wahl, H.-W. (1992). The dependencysupport script in institutions: Generalization to community settings. Psychology and Aging, 7, 409418. Baltes, M.M., & Wahl, H.-W. (1996). Patterns of communication in old age: The dependence-support and independence-ignore script. Health Communication, 8, 217231. Barder, L., Slimmer, L., & LeSage, J. (1994). Depression and issues of control among elderly people in health care settings. Journal of Advanced Nursing, 20, 597604. Bargh, J.A., Chen, M., & Burrows, L. (1996). Automaticity of social behavior: Direct effects of trait construct and stereotype activation on action. Journal of Personality and Social Psychology, 71, 230244. Braithwaite, V.A. (1986). Old age stereotypes: Reconciling contradictions. Journal of Gerontology, 41, 353360. Chou, K.L., Lee, T.M.C., & Ho, A.H.Y. (2007). Does mood state change risk taking tendency in older adults? Psychology and Aging, 22, 310318. ` Coudin, G., Beaufils, B., & Henrard, J.-C. (1998). Au-dela re otypes. Le Journal des Psychologues, 156. Dossier des ste ficits. Vieillissement: Ressources et de Cowan, D.T., Fitzpatrick, J.M., Roberts, J.D., & While, A.E. (2004). Measuring the knowledge and attitudes of health care professionals towards older people: The sensitivity of measurement instruments. Educational Gerontology, 30, 237254. Cuddy, A.J.C., Norton, M.I., & Fiske, S.T. (2005). This old stereotype: The stubbornness and pervasiveness of the elderly stereotype. Journal of Social Issues, 61, 265283. Curley, S.P., Eraker, S.A., & Yates, F.J. (1984). An investigation of patients reactions to therapeutic uncertainty. Medical Decision Making, 4, 501511. Davies, S., Laker, S., & Ellis, L. (1997). Promoting autonomy and independence for older people within nursing practice: A literature review. Journal of Advanced Nursing, 26, 408417. Desrichard, O., & Kopetz, C. (2005). A threat in the elder: The impact of task-instructions, self efficacy and performance expectations on memory performance in the elderly. European Journal of Social Psychology, 35, 537552. Dror, I.E., Katona, M., & Mungur, K. (1998). Age differences in decision making: To take a risk or not? Gerontology, 44, 6771. Forgas, J.P. (1982). Episode cognition: Internal representations of interaction routines. In L. Berkowitz (Ed.), Advances in experimental social psychology (pp. 59100). San Diego, CA: Academic Press. Grant, L. (1996). Effects of ageism on individual and health care providers responses to healthy aging. Health and Social Work, 21, 915. Guo, X., Erber, J.T., & Szuchman, L.T. (1999). Age and forgetfulness: Can stereotypes be modified? Educational Gerontology, 25, 457466. Hershey, D.A., & Wilson, J.A. (1997). Age differences in confidence ratings on a complex financial decision making task. Experimental Aging Research, 23, 257273. Hess, T.M., Auman, C., Colcombe, S.J., & Rahhal, T.A. (2003). The impact of stereotype threat on age differences in memory performance. Journal of Gerontology: Psychological Sciences, 58B, 311.

in both past experiences and the acceptance of the future.

Limitations There are several limitations to this study. The first one concerns the characteristics of our sample. Participants were recruited in a club for the elderly or in a shopping center (Experiment one), and in a housing community (Experiment two). Therefore, we did not gather a representative sample of older persons. Also, we did not screen participants for mental health or any cognitive impairment. Consequently, results on measures like subjective health or help-seeking behavior should be treated cautiously as we cannot definitely exclude a sampling bias. Specifically, results on the puzzle task might be affected by the context from which we selected our participants. Additional studies should assess help-seeking behavior in populations with a higher risk of developing physical or psychological dependency as previous work has shown that the effects are more pronounced with people who perceive the stereotype to be more self-relevant. A second limitation lies in the fact that our experimental setup cannot capture the dynamics and the reciprocity of nursepatient interactions which involve non-verbal communication, implicit affective cues, gestures, or specific language use (e.g., humor). Nevertheless, our findings suggest that staff members should be particularly careful about the messages they convey while providing care to older persons.

Notes
1. The degrees of freedom are affected by five participants who did not complete all the loneliness scale items and thus had missing values. 2. For each ANCOVA, we tested the homogeneity of regression by computing two orthogonal contrasts of our experimental conditions: C1 [2, 1, 1] and C2 [0, 1, 1] and entering them, along with the covariate and their interaction in the equation.

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