Editor's Introduction

Three of the six articles in this issue are about the elderly, one discusses widowhood, and one focuses on grief. The final article is on pathological narcissism.

The meaning of the term “old” has changed dramatically during the past century. Fifty used to be considered old once, but no longer. The reasons for this are many, but prominent among them is remarkable medical progress that has influenced increased longevity. The change in life expectancy has provided many with increased opportunities but others with increased stress and distress and the health and mental health communities with complex challenges. The mass media (source of our cultural iconography) may emphasize the disparity between chronological and psychological age, but stereotyped attitudes and beliefs about the “elderly” persist. The articles in this issue of the journal present a refreshingly modern—albeit sometimes sobering—perspective about older-age patients. They attest to the need for a developmental, bio-psycho-social model in order to carry out adequate assessment and treatment planning.

The research study by Guenther Klug and colleagues suggests that both early life and present experience shape the context within which depression occurs. Thus, attachment style, a function of early life experience, may buffer patients, especially men, against late life depression. Loneliness may provoke depression, however, particularly in women. This research illustrates how important it is for mental health providers to be aware of the quality of relationships of a depressed person, not simply how many people are in their social network. Clinicians must understand how meaningful particular relationships are and the patient's emotional responses to them. While recognizing the beneficial effects of combined psychopharmacological and psychotherapeutic treatment, it should be noted that loneliness cannot be treated with a pill.

Contrary to popular belief, older age is not necessarily a time of life when the prev