Hostname: page-component-cd9895bd7-dzt6s Total loading time: 0 Render date: 2024-12-25T04:16:47.017Z Has data issue: false hasContentIssue false
  • English
  • Français

Measuring anxiety in the elderly: psychometric properties of the state trait inventory of cognitive and somatic anxiety (STICSA) in an elderly Italian sample

Published online by Cambridge University Press:  16 January 2015

Michela Balsamo ,
Marco Innamorati ,
Nicholas T. Van Dam ,
Leonardo Carlucci  and
Aristide Saggino
Michela Balsamo*
Affiliation:
Department of Psychological Sciences, Humanities and Territory, “G. d’Annunzio” University, Via dei Vestini 30, 66100 Chieti, Italy
Marco Innamorati
Affiliation:
Department of Psychological Sciences, Humanities and Territory, “G. d’Annunzio” University, Via dei Vestini 30, 66100 Chieti, Italy
Nicholas T. Van Dam
Affiliation:
Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY 10962, USA
Leonardo Carlucci
Affiliation:
Department of Psychological Sciences, Humanities and Territory, “G. d’Annunzio” University, Via dei Vestini 30, 66100 Chieti, Italy
Aristide Saggino
Affiliation:
Department of Psychological Sciences, Humanities and Territory, “G. d’Annunzio” University, Via dei Vestini 30, 66100 Chieti, Italy
*
Correspondence should be addressed to: Michela Balsamo, Psychometric Laboratory, Department of Psychological Sciences, Humanities and Territory, “G. d’Annunzio” University, Via dei Vestini 30, 66100 Chieti, Italy. Phone/Fax: +39-0871 3555309. Email: [email protected].
Get access

Abstract

Background:

Despite its increasing personal and societal impact, assessment of late-life anxiety has received relatively little attention in psychiatric research. Differential symptom presentation and physical comorbidities among the elderly, relative to younger cohorts creates a need for anxiety measures that are psychometrically validated in the elderly.

Methods:

The present study examined the factor structure and discriminant validity of the state-trait inventory for cognitive and somatic anxiety (STICSA) in a sample of Italian middle-aged and older adults. Participants were 396 community-dwelling middle-aged (50–64 years) and older (≥65 years) adults. In addition to the STICSA, participants completed two depression measures and a general well-being survey with physical and mental health subscales.

Results:

Factor analysis supported the validity of both state–trait and cognitive–somatic distinctions underlying the STICSA, all dimensions exhibited excellent internal consistency (Cronbach's α coefficients ≥ 0.86), and correlations with depression measures provided limited evidence for differentiation of anxious and depressive symptoms. The STICSA also showed evidence of discriminating anxious symptoms from physical health symptoms, a particularly relevant feature of a valid anxiety measure in elderly samples.

Conclusions:

The STICSA appears to be a valid measure of cognitive and somatic anxiety in the elderly.

Keywords

anxietyfactor analysisgeriatricsphysical healthdepression
Type
Research Article
Information
International Psychogeriatrics , Volume 27 , Issue 6 , June 2015 , pp. 999 - 1008
Copyright
Copyright © International Psychogeriatric Association 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Alwahhabi, F. (2003). Anxiety symptoms and generalized anxiety disorder in the elderly: a review. Harvard Review of Psychiatry, 11, 180–193.Google Scholar
American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders, 4th edn, text revision ed. Washington, DC: American Psychiatric Association.Google Scholar
American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders, 5th edn, Arlington, VA: American Psychiatric Association.Google Scholar
Andrew, D. H. and Dulin, P. L. (2007). The relationship between self-reported health and mental health problems among older adults in New Zealand: experiential avoidance as a moderator. Aging & Mental Health, 11, 596–603.CrossRefGoogle ScholarPubMed
Andrich, D. (1995). Models for measurement, precision, and the nondichotomization of graded responses. Psychometrika, 60, 7–26.Google Scholar
Ayers, C. R., Sorrell, J. T., Thorp, S. R. and Wetherell, J. L. (2007). Evidence-based psychological treatments for late-life anxiety. Psychology and Aging, 22, 8–17.CrossRefGoogle ScholarPubMed
Balsamo, M., Giampaglia, G. and Saggino, A. (2014). Building a new Rasch-based self-report inventory of depression. Neuropsychiatric Disease and Treatment, 13, 153–165.Google Scholar
Balsamo, M., Romanelli, R., Innamorati, M., Ciccarese, G., carlucci, L. and Saggino, A. (2013). The state-trait anxiety inventory: shadows and lights on its construct validity. Journal of Psychopathology and Behavioral Assessment, 35, 475–486.CrossRefGoogle Scholar
Balsamo, M. and Saggino, A. (2007). Test per l’assessment della depressione nel contesto italiano: un’analisi critica [Tests for depression assessment in Italian context: a critical review]. Psicoterapia Cognitiva e Comportamentale, 13, 167–199.Google Scholar
Balsamo, M. and Saggino, A. (2013). Il Teate Depression Inventory- Manuale di standardizzazione [Teate Depression Inventory, Manual]ed. Firenze: Hoegrefe.Google Scholar
Balsamo, M. and Saggino, A. (2014). Determining a diagnostic cut-off on the teate depression inventory. Neuropsychiatric Disease and Treatment, 10, 987–995.CrossRefGoogle ScholarPubMed
Beekman, A. T., de Beurs, E., van Balkom, A. J., Deeg, D. J., van Dyck, R. and van Tilburg, W. (2000). Anxiety and depression in later life: co-occurrence and communality of risk factors. The American Journal of Psychiatry, 157, 89–95.Google Scholar
Bergua, V. et al. (2012). The STAI-Y trait scale: psychometric properties and normative data from a large population-based study of elderly people. International Psychogeriatrics, 24, 1163–1171.Google Scholar
Brown, T. A. (2006). Confirmatory Factor Analysis for Applied Researched. New York: Guilford Press.Google Scholar
Browne, M. W. and Cudek, R. (1993). Alternative ways of assessing model fit. In Long, J. S. (ed.), Testing Structural Equation Models (pp. 136–162) Newbury Park, CA: Sage.Google Scholar
Byrne, G. J. and Pachana, N. A. (2011). Development and validation of a short form of the geriatric anxiety inventory–the GAI-SF. International Psychogeriatrics, 23, 125–131.Google Scholar
Byrne, G. J., Pachana, N. A., Arnold, L., Chalk, J. B. and Appadurai, K. (2008). P2-239: performance characteristics of the geriatric anxiety inventory in memory clinic attendees. Alzheimer's and Dementia, 4, T441–T442.Google Scholar
Copeland, J., Kelleher, M., Duckworth, G. and Smith, A. (1976). Reliability of psychiatric assessment in older patients. International Journal of Aging & Human Development, 7, 313–322.CrossRefGoogle ScholarPubMed
Crawford, J. R. and Henry, J. D. (2003). The depression anxiety stress scales (DASS): normative data and latent structure in a large non-clinical sample. The British Journal of Clinical Psychology, 42, 111–131.Google Scholar
Crittendon, J. and Hopko, D. R. (2006). Assessing worry in older and younger adults: Psychometric properties of an abbreviated penn state worry questionnaire (PSWQ-A). Journal of Anxiety Disorders, 20, 1036–1054.Google Scholar
Cully, J. A. et al. (2006). Quality of life in patients with chronic obstructive pulmonary disease and comorbid anxiety or depression. Psychosomatics, 47, 312–319.CrossRefGoogle ScholarPubMed
Dawson, P., Kline, K., Wiancko, D. C. and Wells, D. (1986). Preventing excess disability in patients with Alzheimer's disease. Geriatric Nursing, 7, 298–301.Google Scholar
Dennis, R. E., Boddington, S. J. and Funnell, N. J. (2007). Self-report measures of anxiety: are they suitable for older adults? Aging & Mental Health, 11, 668–677.Google Scholar
Diefenbach, G. J., Tolin, D. F., Meunier, S. A. and Gilliam, C. M. (2009). Assessment of anxiety in older home care recipients. The Gerontologist, 49, 141–153.Google Scholar
Edelstein, B. A. et al. (2008). Older adult psychological assessment: current instrument status and related considerations. Clinical Gerontologist, 31, 1–35.Google Scholar
Federal Interagency Forum on Aging-Related Statistics (2012). Older Americans 2012: Key Indicators of Well-Beinged. Washington, DC: U.S. Government Printing Office.Google Scholar
Foley, D., Ancoli-Israel, S., Britz, P. and Walsh, J. (2004). Sleep disturbances and chronic disease in older adults: results of the 2003 national sleep foundation sleep in America survey. Journal of Psychosomatic Research, 56, 497–502.CrossRefGoogle ScholarPubMed
Gould, C. E., Segal, D. L., Yochim, B. P., Pachana, N. A., Byrne, G. J. and Beaudreau, S. A. (2014). Measuring anxiety in late life: a psychometric examination of the geriatric anxiety inventory and geriatric anxiety scale. Journal of Anxiety Disorders, 28, 804–811.Google Scholar
Gros, D. F., Antony, M. M., Simms, L. J. and McCabe, R. E. (2007). Psychometric properties of the state-trait inventory for cognitive and somatic anxiety (STICSA): comparison to the state-trait anxiety inventory (STAI). Psychological Assessment, 19, 369–381.Google Scholar
Gros, D. F., Simms, L. J. and Antony, M. M. (2010). Psychometric properties of the state-trait inventory for cognitive and somatic anxiety (STICSA) in friendship dyads. Behavior Therapy, 41, 277–284.Google Scholar
Hopko, D. R. et al. (2003). Assessing worry in older adults: confirmatory factor analysis of the penn state worry questionnaire and psychometric properties of an abbreviated model. Psychological Assessment, 15, 173–183.Google Scholar
Hu, L. and Bentler, P. M. (1998). Fit indices in covariance structure modeling: sensitivity to underparameterized model misspecification. Psychological Methods, 3, 424–453.Google Scholar
Hu, L. and Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives. Structural Equation Modeling: a Multidisciplinary Journal, 6, 1–55.Google Scholar
Innamorati, M. et al. (2013). Psychometric properties of the Attitudes toward Self-Revised in Italian young adults. Depression Research and Treatment. Available at: http://dx.doi.org/10.1155/2013/209216; last accessed 5 January 2015.Google Scholar
Johnco, C., Knight, A., Tadic, D. and Wuthrich, V. M. (2014). Psychometric properties of the Geriatric Anxiety Inventory (GAI) and its short-form (GAI-SF) in a clinical and non-clinical sample of older adults. International Psychogeriatrics, CJO2014. doi:10.1017/S1041610214001586.Google Scholar
Jöreskog, K. G. and Sörbom, D. (2006). LISREL for Windows [Computer software]. Lincolnwood, IL: Scientific Software International, Inc.Google Scholar
Kahn, J. H. (2006). Factor analysis in counseling psychology research, training, and practice: principles, advances, and applications. The Counseling Psychologist, 34, 684–718.Google Scholar
Kennedy, B. L., Schwab, J. J., Morris, R. L. and Beldia, G. (2001). Assessment of state and trait anxiety in subjects with anxiety and depressive disorders. The Psychiatric Quarterly, 72, 263–276.CrossRefGoogle ScholarPubMed
Kline, R. B. (2011). Principles and Practice of Structural Equation Modeling, 3rd ed. New York: Guilford Press.Google Scholar
Kogan, J. N., Edelstein, B. A. and McKee, D. R. (2000). Assessment of anxiety in older adults: current status. Journal of Anxiety Disorders, 14, 109–132.Google Scholar
Lovibond, P. F. and Lovibond, S. H. (1995). The structure of negative emotional states: comparison of the depression anxiety stress scales (DASS) with the beck depression and anxiety inventories. Behaviour Research and Therapy, 33, 335–343.Google Scholar
Magni, G. and DeLeo, D. (1984). Anxiety and depression in geriatric and adult medical patients. Psychological Reports, 55, 607–612.Google Scholar
Meng, X. L., Rosenthal, R. and Rubin, D. B. (1992). Comparing correlated correlation coefficients. Psychological Bulletin, 111, 172–175.Google Scholar
Mineka, S., Watson, D. and Clark, L. A. (1998). Comorbidity of anxiety and unipolar mood disorders. Annual Review of Psychology, 49, 377–412.Google Scholar
Mueller, A. E. (2014). Psychometric Properties of the Geriatric Anxiety Scale in Community-Dwelling, Clinical, and Medical Samples of Older Adults. Department of Psychology Colorado Springs: University of Colorado.Google Scholar
Naughton, C., Feely, J. and Bennett, K. (2007). A clustered randomized trial of the effects of feedback using academic detailing compared to postal bulletin on prescribing of preventative cardiovascular therapy. Family Practice, 24, 475–480.Google Scholar
Nuevo, R., Mackintosh, M. A., Gatz, M., Montorio, I. and Wetherell, J. L. (2007). A test of the measurement invariance of a brief version of the penn state worry questionnaire between American and Spanish older adults. International Psychogeriatrics, 19, 89–101.Google Scholar
Pachana, N. A., Byrne, G. J., Siddle, H., Koloski, N., Harley, E. and Arnold, E. (2007). Development and validation of the geriatric anxiety inventory. International Psychogeriatrics, 19, 103–114.CrossRefGoogle ScholarPubMed
Rasch, G. (1980). Probabilistic Models for some Intelligence and Attainment Tests, Expanded ed. Chicago: University of Chicago Press.Google Scholar
Ree, M. J., French, D. J., Macleod, C. and Locke, V. M. (2008). Distinguishing cognitive and somatic dimensions of state and trait anxiety: Development and validation of the state-trait inventory for cognitive and somatic anxiety (STICSA). Behavioural and Cognitive Psychoterapy, 36, 313–332.Google Scholar
Reynolds, C. R., Richmond, B. O. and Lowe, P. A. (2003). The Adult Manifest Anxiety Scale-Elderly Version (AMAS-E) ed. Los Angeles: Western Psychological Services.Google Scholar
Satorra, A. and Bentler, E. M. (1994). Corrections to test statistics and standard enors in covariance structure analysis. In von Eye, A. and Clogg, C. C. (eds.), Latent Variables Analysis: Applications for Developmental Research (pp. 399–419) Thousand Oaks, CA: Sage.Google Scholar
Schermelleh-Engel, K., Moosbrugger, H. and Müller, H. (2003). Evaluating the fit of structural equation models: test of significance and descriptive goodness-of-fit measures. Methods of Psychological Research Online, 8, 23–74.Google Scholar
Segal, D. L., June, A., Payne, M., Coolidge, F. L. and Yochim, B. (2010). Development and initial validation of a self-report assessment tool for anxiety among older adults: The geriatric anxiety scale. journal of anxiety disorders, 24, 709–714.Google Scholar
Seignourel, P. J., Kunik, M. E., Snow, L., Wilson, N. and Stanley, M. (2008). Anxiety in dementia: a critical review. Clinical Psychology Review, 28, 1071–1082.Google Scholar
Smarr, K. L. and Keefer, A. L. (2011). Measures of depression and depressive symptoms: beck depression inventory-II (BDI-II), center for epidemiologic studies depression scale (CES-D), geriatric depression scale (GDS), hospital anxiety and depression scale (HADS), and patient health questionnaire-9 (PHQ-9). Arthritis Care & Research, 63 (Suppl. 11), S454–S466.Google Scholar
Spielberger, C. D., Gorsuch, R. L., Lushene, R. E., Vagg, P. R. and Jacobs, G. A. (1983). Manual for the State-Trait Anxiety Inventory STAI (Form Y) ed. Palo Alto, CA: Consulting Psychologists Press.Google Scholar
Stewart, A. and Ware, J. (eds.) (1992). Measuring Functioning and Well-being: the Medical Outcomes Study Approach. Durham, NC: Duke University Press.Google Scholar
Therrien, Z. and Hunsley, J. (2012). Assessment of anxiety in older adults: a systematic review of commonly used measures. Aging & mental Health, 16, 1–16.Google Scholar
Van Dam, N. T., Gros, D. F., Earleywine, M. and Antony, M. M. (2013). Establishing a trait anxiety threshold that signals likelihood of anxiety disorders. Anxiety, Stress, and Coping, 26, 70–86.Google Scholar
van de Vijver, F. J. R. and Tanzer, N. K. (1997). Bias and equivalence in cross-cultural assessment: an overview. European Review of Applied Psychology, 47, 263–280.Google Scholar
Ware, J. E. Jr., Kosinski, M. and Keller, S. D. (1996). A 12-item short-form health survey: construction of scales and preliminary tests of reliability and validity. Medical Care, 34, 220–233.Google Scholar
Ware, J. E. Jr. and Sherbourne, C. D. (1992). The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Medical Care, 30, 473–483.Google Scholar
Wolitzky-Taylor, K. B., Castriotta, N., Lenze, E. J., Stanley, M. A. and Craske, M. G. (2010). Anxiety disorders in older adults: a comprehensive review. Depression and Anxiety, 27, 190–211.Google Scholar
World Health Organisation (2014). Definition of An Older or Elderly Person. Geneva: WHO.Google Scholar
Wuthrich, V. M., Johnco, C. and Knight, A. (2014). Comparison of the penn state worry questionnaire (PSWQ) and abbreviated version (PSWQ-A) in a clinical and non-clinical population of older adults. Journal of Anxiety Disorders, 28, 657–663.Google Scholar
Yesavage, J. A. et al. (1982). Development and validation of a geriatric depression screening scale: a preliminary report. Journal of Psychiatric Research, 17, 37–49.Google Scholar
Yochim, B. P., Mueller, A. E., June, A. and Segal, D. L. (2011). Psychometric properties of the geriatric anxiety scale: comparison to the beck anxiety inventory and geriatric anxiety inventory. Clinical Gerontologist, 34, 21–33.Google Scholar