A core construct in socioemotional selectivity theory is future time perspective (FTP), conceptualized as a unidimensional and bipolar construct ranging from expansive to limited. Change in FTP across adulthood has been treated as linear, with older adults showing more limited FTP. Studies 1 and 2 showed that a 2-factor model fit better, with focus on opportunities and focus on limitations as distinct dimensions. These dimensions changed differentially with age. In cross-sectional Study 3, focus on opportunities was higher in young adulthood than in early middle age but did not drop further in late middle age. Focus on limitations was the same in young adulthood and early middle age but was higher in late middle age. In longitudinal Study 4, focus on limitations increased from early to late middle age, and focus on opportunities was again maintained, rather than showing the decrease one would assume from a 1-factor model of FTP.

This study implemented an innovative new model of delivering a Mindfulness-Based Stress Reduction (MBSR) program that replaces six of the eight traditional in-person sessions with group telephonic sessions (tMBSR) and measured the program's impact on the health and well-being of nurses employed within a large health care organization. As part of a nonrandomized pre–post intervention study, 36 nurses completed measures of health, stress, burnout, self-compassion, serenity, and empathy at three points in time. Between baseline (Time 1) and the end of the 8-week tMBSR intervention (Time 2), participants showed improvement in general health, t(37) = 2.8, p < .01, decreased stress, t(37) = 6.8, p < .001, decreased work burnout, t(37) = 4.0, p < .001, and improvement in several other areas. Improvements were sustained 4 months later (Time 3), and individuals who continued their MBSR practice after the program demonstrated better outcomes than those that did not. Findings suggest that the tMBSR program can be a low cost, feasible, and scalable intervention that shows positive impact on health and well-being, and could allow MBSR to be delivered to employees who are otherwise unable to access traditional, on-site programs.

Periods of life have underpinnings in the universals of biology and social life, but they are conceptualized differently in different cultures and historical periods (Menon, 2001 ; Shweder, 1998). Middle age is not recognized at all in some societies, but in ours estimates often stretch from age 35 or 40 to age 60 or 65-a span of 20 to 30 years. The question of whether or not personality should be expected to change or develop within this period has received little attention. This chapter begins with a brief and selective review of two background topics: (a) relations between age, roles, status, and personality, and (b) personality change in adulthood. Then after a brief consideration of middle age as a whole, the issue of making differentiations within this long expanse is discussed. Three phases of middle age are proposed, then longitudinal evidence supporting the conception along with divergent findings are presented. Finally, there are suggestions for further research. BRIEF REVIEW OF RESEARCH AREAS Relations between Age, Roles, Status, and Personality

The United States health-care system is in the process of rapid change that poses both opportunities and challenges for the discipline of professional psychology. Quality-improvement processes and outcomes measurement are becoming key features of the evolving system. The current status of quality in health care and behavioral health care is reviewed, as is the growing use of patient-reported outcome measures in clinical practice. We articulate a vision in which quality processes and outcomes measurement are integrated into clinical practice within the discipline of professional psychology. Opportunities and challenges associated with that integration are reviewed, and recommendations are made for the American Psychological Association to assume leadership in ensuring that these concepts become central to training and practice in psychology.

Peer support services (PSS) are an expanding part of the continuum of care provided for behavioral health conditions. These services have been deemed an evidence-based reimbursable model of care by the Centers for Medicare and Medicaid Services. States, counties, employers, and health plans are increasingly covering PSS in benefit plans. Controlled and experimental studies are building the evidence base for these services. Medicaid and the states have not developed level-of-care or medical necessity criteria for PSS, even though these criteria are standards for determining coverage and reimbursement. This review of emerging level-of-care criteria for PSS provides a framework for the further development of these resources.