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Title: Investigation of the psychometric properties of mood disorder self-report measures used with older adults with a medical illness
Author: Clifford, Carol Ann
Awarding Body: University of Edinburgh
Current Institution: University of Edinburgh
Date of Award: 2002
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Objective: The growing proportion of older adults in the population and the recognition that this age group is often underserved by health services (Unutzer et al, 1999) has recently led to an increased interest in the study of mental health of older adults. Initial investigations suggest that anxiety is one of the most prevalent psychiatric conditions affecting older adults (Blazer, 1997). Assessing anxiety in older adults is difficult as it may present differently than it does in younger adults (Himmelfarb & Murrel, 1983) and often presents co-morbidly with medical illness and/or other psychiatric conditions (Stanley & Beck, 2000). Many of the existing standardised measures of anxiety have been developed with younger populations and their applicability to older adults is questionable (Blazer, 1997). The primary aim of this study is to investigate the psychometric utility of anxiety self-report measures in older adults who have a co-existing medical illness. Method: Older adults who had recently undergone cardiac artery bypass graft surgery were invited to participate. The Mini-Mental State Examination was administered to participants to ensure that they were able to give informed consent and demographic information was collected. A semi-structured interview (SCID-IV) was conducted, leading to a clinician-rated diagnosis of anxiety. The participant was also asked to complete five self-report anxiety and depression measures (Beck Anxiety Inventory; Penn State Worry Questionnaire; Short Anxiety Screening Test; Hospital Anxiety and Depression Scale; Geriatric Depression Scale). The self-report questionnaires were subsequently re-administered after a two-week interval. Results: Seventeen older adults (mean age 69.5 years) agreed to participate. The results must be interpreted with caution due to the small number of participants. The majority of the anxiety self-report measures failed to demonstrated sensitivity for this population of medically compromised older adults (with the exception of the SAST). Most were found to demonstrate specificity between anxiety and depression (with the exception of the HADS anxiety scale). None of the scales demonstrated test-retest reliability. Conclusion The SAST shows promise as a self-report questionnaire that can be utilised to accurately assess anxiety disorders in medically compromised older adults. The BAI, PSWQ and HADS would not be recommended for use with this population on the basis of results found in this study. Further research is needed to assess the utility of self-report anxiety measures for older adults with medical difficulties. Accurate assessment and evaluation of anxiety in older adults will provide a sold foundation upon which to base future research and intervention (Stanley & Beck, 2000).
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (D.Clin.Psy.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available