40 years before Antonovsky and 60 years before the announcement of the so-called of positive psychology, Arlie V. Bock presented a project of intended research as an alternative to current medicine in which... "doctors have traditionally dealt with their patients at the moment when they presented themselves with various problems. The Department of Hygiene proposes a different procedure and will try to analyze the forces that result in normal healthy men... it is necessary to make a systematic study of how people do well and do well..." (Press statement in September 1938, according to Vaillant, 1995, p. 41). The research on healthy development, which lasted an incredible 70 years, was founded by doctors Arlie V. Bock and C. Heath. For the first 10 years, it was financed by the benefactor W.T. Grant. The study is therefore called the Grant study. It is also known as the Study of Adult Development or the Harvard study. Currently, or in the recent past, following this tradition of healthy development research, there has been a shift towards the topic of optimal human development, in which the approaches of developmental psychology meet the approaches of personality psychology, clinical psychology, health psychology and social psychology. In addition to the term "optimal development", we also encounter other terms such as "successful development" (Baltes, 1997; Brandstädter, 2002), "optimal aging" (Aldvin, Gilmer, 2004), "active aging" (WHO, 2002) or "healthy aging" (Swedish NIPH, 2006).

248 men, second-year students at Harvard, participated in the research. Their selection was conducted in such a way that promising, healthy ("sound") individuals were selected, and it is assumed that they will live up to their potential. These were not always boys from rich or privileged families (half of the group received a scholarship or earned extra money for their studies), but all of them were white and none of them were from (newly) immigrant families. A third of the boys belonged to the highest social class according to their father's occupation. A third of mothers had university education. The group was then followed for decades, during which the participants finished their studies, applied themselves professionally, went through the Second World War, got married, divorced, raised children, ended their professional careers and retired, struggled with illnesses...

Psychological questionnaires and tests were administered to the cohort every two years, participants underwent a medical examination every five years, including detailed anthropometric measurements, and interviews were repeated every 15 years. The psychological and psychiatric examination was very detailed. The psychologist who started the project was Henry A. Murray. The first psychiatrist was Adolf Meyer. In the 1960s, psychiatrist George E. Vaillant took over research.

At the beginning of the research, a social worker visited the parents of all research participants in their homes and conducted a thorough interview with them regarding the participant's early and further development, family history, including family burden of diseases, etc. The task of the social worker was also to classify the family into one of the five social classes according to the social status of the father (I – doctors, lawyers... V – unskilled workers). In the later years of the research, the wives and later even the children of the participants were also approached with a request for information.

As a control group, the so-called Inner City Men, a group created by husband and wife Eleanor and Sheldon Glueck during their research. Their research concerned juvenile delinquency (Unraveling Juvenile Delinquency) and a group of 500 delinquent boys was created (matched in pairs in terms of age, race/ethnicity, level of intelligence and region) who had no problems with the law (they were disadvantaged and at the same time resistant boys). Boys from lower social classes predominated in this group - the fathers of a third of them were unskilled workers. None of the families belonged to the highest social class. None of the mothers had a university education. The research was started in 1939, when the participants were around 14 years old. The Gluecks worked with groups until 1962 (Phelps, Furstenberg, Colby, 2002). Later, in 1975, the control set was again approached by G. E. Vaillant and continued to follow him for many more years. According to Vaillant's reasoning, the groups were very different from each other, but they were internally very homogeneous. From the files arranged in this way, he concluded that similarities between groups and differences within groups are generalizable.

Grant Cohort Results

The research results were published by the original authors within their scientific disciplines. A number of methods were also used by the army during the Second World War. G. E. Vaillant led the research for the next 30 years. His main topic was adaptation to life situations, especially from the point of view of defense mechanisms (he was a dynamically oriented active psychoanalyst). In recent years, he has focused his research on the issue of healthy aging.

Defense Mechanisms

When it comes to defense mechanisms, Vaillant puts their importance on par with the importance of basic biological processes (eg immune system reactions). They classify them into four categories according to the adaptation to the given situational conditions:

  • unhealthy (also psychotic) adaptations – paranoid processing, hallucinations,
  • immature – passive aggression, projections, hypochondriac manifestations, fantasies,
  • neurotic – irrationalization, dissociation, suppression (in the sense of repression = unconscious act),
  • mature – altruism, humor, anticipation, suppression (a conscious decision not to pay attention to the situation temporarily) and sublimation.

In his view of the use of defense mechanisms, Vaillant deviated from the orthodox analytical approach: he considers the development of defense mechanisms to be lifelong and dependent on experience<.i>. Based on the results of Grant's study, he was able to show that with advancing age, defense mechanisms from the "mature" category increase.

Time-dependent influence of some factors

  • Some factors are important in a certain age period and then lose their importance: e.g. cholesterol affects health up to 50 years of age. The importance of sociability (social ease) for psychosocial adaptation is lost in early adulthood. The predictive value of temperament in childhood is lost in adulthood. A child's temperament no longer affects well-being and happiness at the age of 70. From this, Vaillant drew the general conclusion that when human life is monitored for a sufficiently long period of time, the factors supporting adaptation and health change.
  • Physical activity is important from an early age: regular exercise in early adulthood is a predictor of mental health in later life.
  • A very serious factor that damages physical health is depression: 70% of participants who suffered from depression at the age of 50 died or fell ill with a serious chronic disease at the age of 63.
  • A number of men from the study were direct participants in the war. Those of them who were more exposed to the hardships of war in combat were sicker in later life and died earlier compared to participants in the war who were not deployed in combat.
  • According to Vaillant, the importance of social relationships cannot be overestimated: relationships with family, parents, siblings and friends at the age of 47 predicted adaptation in late life. In addition to the well-known importance of an emotional bond with parents, the study pointed to the importance of sibling relationships - 93% of men who thrived at the age of 65 had a close relationship with a brother or sister in childhood.

Glueck cohort results

  • Industriousness in childhood was a predictor of mental health in adulthood: boys who had some work in childhood (participated in housework, went to clubs and sports clubs) performed better as adults than those who did not have such activities. Industriousness thus proved to be a more robust predictor than e.g. family cohesion or an emotional relationship with the mother.
  • Although the Glueck group was 50% more prone to alcohol addiction, they were twice as likely to get rid of their alcoholism (it seems that men from modest backgrounds more easily recognized the signs that their addiction had gone too far).
  • The mortality of men in the Glueck group aged 68-70 corresponded to the mortality in Grant's group aged 78-80. Differences were found in education, obesity, alcohol consumption and smoking.
  • For men from Glueck's group who graduated, the mortality results were identical to the results of Grant's group; however, only 6% of the Glueck group graduated.

Factors that, according to Vaillant's conclusions, lead to healthy development in adulthood and to healthy aging 1) mature adaptation, 2) education, 3) stable marriage, 4) non-smoking (or early cessation of smoking), 5) low alcohol consumption, 6) physical activity (exercise) 7) healthy weight.

  • Of the 106 men in the group who showed five to six of these factors around the age of fifty, almost two-thirds passed the age of eighty with a feeling of well-being and happiness ("happy-well" in Vaillant's terminology).
  • Those who had three or fewer of the above-mentioned factors at the age of 50 did not enter their eighties happy and well. Even if they were in good health at age 50, they were four times less likely to live into their 80s compared to those who had 4 or more factors.

Methodological knowledge of longitudinal studies

Based on his lifelong work, Vaillant (2002) summarized some advantages and disadvantages of prospective studies:

  • Causality can be correctly established.
  • They are less dependent on the memory of the interviewees – data is obtained "now and here".
  • They are less subject to distortions caused by defense mechanisms.
  • Long-term follow-up allows the respondents to re-evaluate their previous statements (eg after years they admit their sexual orientation).

The disadvantage is the demandingness of prospective studies, especially on financial resources, perseverance of the researcher, loyalty of the participants and also on luck (sponsors, suitable time for opening a certain topic, etc.). The fact that they are not representative should also be considered a significant disadvantage of these studies. The influence of the halo effect is also at work here - the first contact, as well as intimate knowledge of the participants, influences the researcher's judgment. Gradually, researchers have to wean themselves from working directly with data, and it is necessary to recruit new "blind" collaborators.

Conclusion

Grant's study brought a number of factual and methodological findings. She showed that due to the dynamic and variable nature of resilience, the logitudinal design of the study is extremely appropriate.

Authors: Iva Šolcová, Vladimír Kebza Literature

Aldvin, C.M., Gilmer, D.F., (2004): Health, illness, and optimal aging. Biological and psychosocial perspectives. Sage Publications Baltes, P. B., (1997): On the incomplete architecture of human ontogeny: Selection, optimization, and compensation as a foundation of developmental theory. American Psychologist 52, 366-380 Brandstädter, J., (2002): Searching for paths to successful development and aging: Integrating developmental and action-theoretical perspectives. In: Pulkkinen, L., Caspi, A. (Eds.), Paths to successful development: Personality in the life course. Cambridge University Press, 380-408 Vaillant, G.E., (1995): Adaptation to life. Boston, Harvard University Press Vaillant, G. E., (2002): Aging Well: Surprising Guideposts to a Happier Life from the Landmark Harvard Study of Adult Development. Boston, Little, Brown and Company Phelps, E., Furstenberg, F.F., Colby, A., (2002): Looking at lives: American longitudinal studies of the twentieth century. New York, Russell Sage Foundation. Swedish National Institute of Public Health, (2006): Healthy ageing. A challenge for Europe. Stockholm, Swedish National Institute of Public Health World Health Organization, (2002): Active ageing: a policy framework. Report No. WHO/NMH/NPH/02.8. Geneva, World Health Organization.

The paper was presented at the 5th annual conference entitled ,,Psychology of health 2010", which took place on May 19, 2010 in Bratislava. The conference was organized by the health psychology section of the SPS at SAV in cooperation with the health section of the Ministry of Health of the Slovak Republic. The following participated in the preparation of the event: National Institute of Heart and Vascular Diseases in Bratislava, VŠZaSP St. Elizabeth in Bratislava, WHO Office in Slovakia, KISH Košice, Department of Psychology FF KU in Ružomberok and Department of Psychology FF TU in Trnava.

Proceedings from the 5th conference of health psychology, Bratislava, 2010 was published only in electronic form Availability: http://www.prohuman.sk/psychologia/zbornik-prispevkov-z-konferencie-psychologia-zdravia-2010