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Durak M, Karakose S, Yow WQ. Editorial: Late-life psychopathology. Front Psychol 2023; 14:1204202. [PMID: 37303896 PMCID: PMC10249054 DOI: 10.3389/fpsyg.2023.1204202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 05/05/2023] [Indexed: 06/13/2023] Open
Affiliation(s)
- Mithat Durak
- Department of Psychology, Bolu Abant Izzet Baysal University, Bolu, Türkiye
| | - Selin Karakose
- College of Medicine, Florida State University, Tallahassee, FL, United States
| | - W. Quin Yow
- Humanities, Arts and Social Sciences, Singapore University of Technology and Design, Singapore, Singapore
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Alfaro AJ, Carlson C, Segal DL, Gould CE. Distinctions between depression and anxiety with fear of being a burden in late life. Aging Ment Health 2022; 26:2366-2371. [PMID: 34713761 DOI: 10.1080/13607863.2021.1993131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Objectives: The perception of being a burden is a well-known risk factor for dying by suicide. Research on factors that precede the state of perceived burdensomeness, such as fearing being a burden, is necessary. We investigated the extent to which health status, elevated depressive symptoms, and elevated anxiety symptoms are associated with fear of being a burden in late life.Method: Older adult participants (N = 155) completed the Geriatric Anxiety Scale (GAS), Patient Health Questionnaire (PHQ-8), and demographic and health questions. Fear of being a burden, assessed with a supplemental item on the GAS, was categorically grouped as 'no fear' or 'some fear'. Using logistic regression, we examined predictors of fear of being a burden.Results: In the first step, elevated depression was associated with fear of being a burden (OR = 2.30, 95% CI: 1.09, 4.89, p = .03), but health status was not significant. In the second step, elevated anxiety was significant (OR = 2.63, 95% CI: 1.15, 5.99, p = .02); depression was no longer significant.Conclusion: Contrary to expectations, anxiety more strongly predicted fear of being a burden than depression. Future research should further investigate the role of anxiety in fear of being a burden and ways of intervening.
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Affiliation(s)
- Ana Jessica Alfaro
- GRECC, VA Palo Alto Health Care System, Palo Alto, CA, USA.,Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | | | - Daniel L Segal
- Department of Psychology, University of Colorado, Colorado Springs, CO, USA
| | - Christine E Gould
- GRECC, VA Palo Alto Health Care System, Palo Alto, CA, USA.,Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
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Picconi L, Fairfield B, Sergi MR, Cataldi F, Padulo C, Brugnera A, Parisi G, Compare A, Gottschling J, Segal DL. Development and Validation of a Short Form of the Geriatric Anxiety Scale (GAS-12) among Italian Older Adults. Clin Gerontol 2022:1-17. [PMID: 36065753 DOI: 10.1080/07317115.2022.2120445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES We developed a new Italian short version of the Geriatric Anxiety Scale (GAS-12) and evaluated its psychometric properties. The GAS-12 specifically screens for anxiety symptoms in the Italian older adult population by identifying items that best discriminate anxiety in this population. METHODS In Study 1, we administered the full-length Italian translation of the GAS to 517 older adults and used item response theory to identify the most discriminating items and to develop the short form used in Study 2. In Study 2, we evaluated the functioning of the new short form of the questionnaire in a new sample of 427 older adults using Confirmatory factor analysis. RESULTS Analyses indicated 12 items that discriminated well between anxious and non-anxious participants and distributed along the latent continuum of each trait. The GAS-12 fits a three-factor structure. There was also evidence for convergent and divergent validity. CONCLUSIONS The Italian GAS-12 appears to be a useful instrument for the quantitative screening of anxiety in Italian older adults. CLINICAL IMPLICATIONS Anxiety imposes significant impairment thus making imperative the screening and assessment of anxiety symptoms. The GAS-12 is particularly indicated with limited time and many scales in a clinical assessment or research protocols.
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Affiliation(s)
- Laura Picconi
- Department of Medicine and Aging Sciences, University of Chieti, Chieti, Italy
| | - Beth Fairfield
- Department of Humanities Studies, University Federico II of Naples, Naples, Italy
| | - Maria Rita Sergi
- Department of Medicine and Aging Sciences, University of Chieti, Chieti, Italy
| | - Fedele Cataldi
- Department of Psychological, Health & Territorial Sciences, University of Chieti, Chieti, Italy
| | - Caterina Padulo
- Department of Psychological, Health & Territorial Sciences, University of Chieti, Chieti, Italy
| | - Agostino Brugnera
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
| | - Giulia Parisi
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
| | - Angelo Compare
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
| | - Juliana Gottschling
- Department of Behavioural and Cognitive Sciences, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Daniel L Segal
- Department of Psychology, University of Colorado at Colorado Springs, Colorado Springs, Colorado, USA
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Kashimura M, Ishizu K, Fukumori T, Ishiwata A, Tateno A, Nomura T, Pachana NA. Psychometric properties of the Japanese version of the Geriatric Anxiety Inventory for community-dwelling older adults. Psychogeriatrics 2021; 21:378-386. [PMID: 33774888 DOI: 10.1111/psyg.12683] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 02/02/2021] [Accepted: 03/02/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND This study developed a Japanese version of the Geriatric Anxiety Inventory (GAI-J) and its short form (GAI-J-SF) to evaluate anxiety in older adults in Japan and assess these measures' psychometric properties with a cross-sectional design. METHODS Participants (N = 400; mean age: 75 years) were community-dwelling older adults who answered a set of self-report questionnaires. They were recruited from a community centre for older persons in the Kanto region of Japan. Of the respondents, 100 participated in a follow-up survey to evaluate test-retest reliability. Item response theory was adopted to evaluate item parameters. RESULTS Confirmatory factor analysis with categorical data suggested that, as with the original Geriatric Anxiety Inventory, the GAI-J/GAI-J-SF had a unifactor structure. Test-retest correlation and internal consistency analyses indicated that these scales had high reliability. Item response theory results showed that both measures' item parameters were acceptable. Correlations with the Penn State Worry Questionnaire, State Trait Anxiety Inventory-State Only, Generalized Anxiety Disorder-7 and Patient Health Questionnaire-9 were mostly consistent with our hypotheses. This supports the high convergent validity of the GAI-J/GAI-J-SF. CONCLUSIONS The findings indicate that the GAI-J and the GAI-J-SF have robust psychometric properties for assessing late-life anxiety in older Japanese adults. Future GAI-J studies in clinical groups are needed.
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Affiliation(s)
- Masami Kashimura
- Department of Medical Psychology, Nippon Medical School, Tokyo, Japan
| | - Kenichiro Ishizu
- Graduate School of Teacher Training Development, University of Toyama, Toyama, Japan
| | - Takaki Fukumori
- Graduate School of Integrated Arts and Sciences, Tokushima University, Tokushima, Japan
| | - Akiko Ishiwata
- Department of Neurology, Nippon Medical School, Tokyo, Japan
| | - Amane Tateno
- Department of Psychiatry, Nippon Medical School, Tokyo, Japan
| | - Toshiaki Nomura
- Department of Medical Psychology, Nippon Medical School, Tokyo, Japan
| | - Nancy A Pachana
- School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
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Abstract
BACKGROUND Emotional cognition and effective interpretation of affective information is an important factor in social interactions and everyday functioning, and difficulties in these areas may contribute to aetiology and maintenance of mental health conditions. In younger people with depression and anxiety, research suggests significant alterations in behavioural and brain activation aspects of emotion processing, with a tendency to appraise neutral stimuli as negative and attend preferentially to negative stimuli. However, in ageing, research suggests that emotion processing becomes subject to a 'positivity effect', whereby older people attend more to positive than negative stimuli. AIMS This review examines data from studies of emotion processing in Late-Life Depression and Late-Life Anxiety to attempt to understand the significance of emotion processing variations in these conditions, and their interaction with changes in emotion processing that occur with ageing. METHOD We conducted a systematic review following PRISMA guidelines. Articles that used an emotion-based processing task, examined older persons with depression or an anxiety disorder and included a healthy control group were included. RESULTS In Late-Life Depression, there is little consistent behavioural evidence of impaired emotion processing, but there is evidence of altered brain circuitry during these processes. In Late-Life Anxiety and Post-Traumatic Stress disorder, there is evidence of interference with processing of negative or threat-related words. CONCLUSIONS How these findings fit with the positivity bias of ageing is not clear. Future research is required in larger groups, further examining the interaction between illness and age and the significance of age at disease onset.
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Affiliation(s)
- Vanessa Gray
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Katie M Douglas
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Richard J Porter
- Department of Psychological Medicine, University of Otago; and Canterbury District Health Board, Christchurch, New Zealand
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Picconi L, Balsamo M, Palumbo R, Fairfield B. Testing Factor Structure and Measurement Invariance Across Gender With Italian Geriatric Anxiety Scale. Front Psychol 2018; 9:1164. [PMID: 30026718 PMCID: PMC6042251 DOI: 10.3389/fpsyg.2018.01164] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 06/18/2018] [Indexed: 11/13/2022] Open
Abstract
Late-life anxiety is an increasingly relevant psychiatric condition that often goes unnoticed and/or untreated compared to anxiety in younger populations. Consequently, assessing the presence and severity of clinical anxiety in older adults an important challenge for researchers and clinicians alike. The Geriatric Anxiety Scale is a 30-item geriatric-specific measure of anxiety severity, grouped in three subscales (Somatic, Affective, and Cognitive), with solid evidence for the reliability and validity of its scores in clinical and community samples. Translated into several languages, it has been proven to have strong psychometric properties. In Italy only one recent preliminarily investigative study has appeared on its psychometric properties. However, sample data was largely collected from one specific Italian region (Lombardy) alone. Here, our aim in testing the items of the GAS in a sample of 346 healthy subjects (50% females; 52% from Southern Italy), with mean age of 71.74 years, was 2-fold. First, we aimed to determine factor structure in a wider sample of Italian participants. Confirmatory factor analysis showed that the GAS fits an originally postulated three-factor structure reasonably well. Second, results support gender invariance, entirely supported at the factorial structure, and at the intercept level. Latent means can be meaningfully compared across gender groups. Whereas the means of F1 (Somatic) and F3 (Affective) for males were significantly different from those for females, the means for F2 (Cognitive) were not. More specifically, in light of the negative signs associated with these statistically significant values, the finding showed that F1 and F3 for males appeared to be less positive on average than females. Overall, the GAS displayed acceptable convergent validity with matching subscales highly correlated, and satisfactory internal discriminant validity with lower correlations between non-matching subscales. Implications for clinical practice and research are discussed.
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Affiliation(s)
- Laura Picconi
- Department of Psychological, Health & Territorial Sciences, University of Chieti, Chieti, Italy
| | - Michela Balsamo
- Department of Psychological, Health & Territorial Sciences, University of Chieti, Chieti, Italy
| | - Rocco Palumbo
- Department of Neurology, Boston University, Boston, MA, United States
| | - Beth Fairfield
- Department of Psychological, Health & Territorial Sciences, University of Chieti, Chieti, Italy.,Centro Scienze dell'Invecchiamento e Medicina Traslazionale, University of Chieti, Chieti, Italy
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Brenes GA, Danhauer SC, Lyles MF, Anderson A, Miller ME. Effects of Telephone-Delivered Cognitive-Behavioral Therapy and Nondirective Supportive Therapy on Sleep, Health-Related Quality of Life, and Disability. Am J Geriatr Psychiatry 2016; 24:846-54. [PMID: 27421617 PMCID: PMC5026974 DOI: 10.1016/j.jagp.2016.04.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Revised: 04/08/2016] [Accepted: 04/13/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVES The purpose of this study was to compare the effects of cognitive-behavioral therapy delivered by telephone (CBT-T) and telephone-delivered nondirective supportive therapy (NST-T) on sleep, health-related quality of life, and physical disability in rural older adults with generalized anxiety disorder. METHODS This was a secondary analysis of a randomized clinical trial on 141 rural-dwelling adults 60 years and older diagnosed with generalized anxiety disorder. Sleep was assessed with the Insomnia Severity Index. Health-related quality of life was assessed with the 36-item Short-Form Health Survey (SF-36). Physical disability was assessed with the Pepper Center Tool for Disability. Assessments occurred at baseline, 4 months, 9 months, and 15 months. RESULTS Insomnia declined in both groups from baseline to 4 months, with a significantly greater improvement among participants who received CBT-T. Similarly, Mental and Physical Component Summaries of the SF-36 declined in both groups, with a differential effect favoring CBT-T. Participants in both interventions reported declines in physical disability, although there were no significant differences between the two interventions. Improvements in insomnia were maintained at the 15-month assessment, whereas between-group differences shrank on the Mental and Physical Component Summaries of the SF-36 by the 15-month assessment. CONCLUSION CBT-T was superior to NST-T in reducing insomnia and improving health-related quality of life. The effects of CBT-T on sleep were maintained 1 year after completing the treatment.
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Affiliation(s)
- Gretchen A. Brenes
- Department of Psychiatry and Behavioral Medicine, Wake Forest School of Medicine
| | - Suzanne C. Danhauer
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine
| | - Mary F. Lyles
- Department of Internal Medicine-Geriatrics, Wake Forest School of Medicine
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Bergua V, Meillon C, Potvin O, Ritchie K, Tzourio C, Bouisson J, Dartigues JF, Amieva H. Short STAI-Y anxiety scales: validation and normative data for elderly subjects. Aging Ment Health 2016; 20:987-95. [PMID: 26055726 DOI: 10.1080/13607863.2015.1051511] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES The aim of this study was to develop short forms of the STAI-Y trait and state scales and associated norms suitable for the screening of anxiety in elderly populations. METHOD This study was based on population-based cohorts of older persons from two epidemiological French studies that each included one subscale of the STAI-Y, i.e. state and trait anxiety scales. For both scales, the most discriminative items were retained and their factorial structure was examined using principal components analysis. Internal consistency (Cronbach's alpha) was estimated and cut-offs and norms were computed. RESULTS A 10-item STAI-Y version produced scores similar to those obtained with the full form of the STAI-Y. The factorial structure of the shortened form is comparable to that of the full scales. Results showed good internal consistency (alpha coefficients were 0.92 and 0.85 for short STAI-Y state and trait scales, respectively). Moreover, both short STAI-Y state and trait scales correctly classified 88% of the participants using a cut-off point of 23. Norms for both short trait and state anxiety scales are provided according to age, gender, educational level and depressive symptoms. CONCLUSION Both shortened scales have similar factorial structure and internal consistency to the longer scales and classify anxious/non-anxious elderly with acceptable accuracy. The shorter form is likely to be more acceptable to elderly persons through reduction of fatigue effects.
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Affiliation(s)
- Valérie Bergua
- a EA 4139, Psychologie, Santé et Qualité de Vie , University of Bordeaux , Bordeaux , France
| | - Céline Meillon
- b INSERM, ISPED , University of Bordeaux , Bordeaux , France
| | - Olivier Potvin
- c Centre de recherche de l'Institut Universitaire en santé mentale de Québec , University of Sherbrooke , Sherbrooke , Canada
| | - Karen Ritchie
- d INSERM , University of Montpellier 1, Montpellier , France ; Imperial College, Division of Neuroscience and Mental Health , London , UK
| | | | - Jean Bouisson
- a EA 4139, Psychologie, Santé et Qualité de Vie , University of Bordeaux , Bordeaux , France
| | | | - Hélène Amieva
- b INSERM, ISPED , University of Bordeaux , Bordeaux , France
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Webb SA, Diefenbach G, Wagener P, Novy DM, Kunik M, Rhoades HM, Stanley MA. Comparison of self-report measures for identifying late-life generalized anxiety in primary care. J Geriatr Psychiatry Neurol 2008; 21:223-31. [PMID: 19017779 PMCID: PMC2597543 DOI: 10.1177/0891988708324936] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study evaluated the Penn State Worry Questionnaire, Penn State Worry Questionnaire-Abbreviated, and the Generalized Anxiety Disorder Questionnaire-IV for identifying generalized anxiety disorder in older medical patients. Participants were 191 of 281 patients screened for a clinical trial evaluating cognitive-behavior treatment, n = 110 with generalized anxiety disorder, 81 without. Participants completed the Penn State Worry Questionnaire and Generalized Anxiety Disorder Questionnaire-IV at pretreatment. Kappa coefficients estimated agreement with the Structured Clinical Interview for Diagnosis. Receiver operating characteristic curves compared sensitivity and specificity of self-report measures. The Penn State Worry Questionnaire (cutoff = 50) provided the strongest prediction of generalized anxiety disorder (sensitivity, 76%; specificity, 73%; 75% correctly classified; kappa = .49. Item 2 of the Generalized Anxiety Disorder Questionnaire-IV demonstrated comparable accuracy. The Penn State Worry Questionnaire, Generalized Anxiety Disorder Questionnaire-IV, and briefer versions of these measures may be useful in identifying late-life generalized anxiety disorder in medical settings.
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Affiliation(s)
- Sarah A. Webb
- Menninger Department of Psychiatry and Behavioral Sciences
| | | | - Paula Wagener
- Houston Center for Quality of Care & Utilization Studies, Michael E. DeBakey Veterans Affairs Medical Center, Menninger Department of Psychiatry and Behavioral Sciences
| | - Diane M. Novy
- Department of Anesthesiology, The University of Texas M.D. Anderson Cancer Center
| | - Mark Kunik
- Veterans Affairs South Central Mental Illness Research, Education & Clinical Center, Houston Center for Quality of Care & Utilization Studies, Michael E. DeBakey Veterans Affairs Medical Center, Department of Medicine Baylor College of Medicine, Houston, Texas
| | - Howard M. Rhoades
- Department of Psychiatry, The University of Texas Health Science Center Houston, Texas
| | - Melinda A. Stanley
- Veterans Affairs South Central Mental Illness Research, Education & Clinical Center, Houston Center for Quality of Care & Utilization Studies, Michael E. DeBakey Veterans Affairs Medical Center, Menninger Department of Psychiatry and Behavioral Sciences
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