Psychometric properties of the Portuguese Version of the Geriatric Anxiety Inventory in a sample of eldery people in residential care

Authors

DOI:

https://doi.org/10.7342/ismt.rpics.2015.1.2.22

Keywords:

Anxiety, Self-report, Elderly Population, Psychometrics

Abstract

Background: The progressive increase in the prevalence of anxiety disorders in advanced ages advises the extensive use of screening inventories in this population that, everywhere in the world, has become increasingly numerically significant. Goals: The aim of this study is to present the results of validation and reliability studies of the Portuguese version of the Geriatric Anxiety Inventory (GAI). Method: After, translation and back-translation of GAI, the Portuguese version was administered to 805 institutionalized elderly. The reliability of the scale was assessed by Cronbach's alpha coefficient and factorial validity using the extraction method of Principal Components Analysis. The convergent validity study was conducted with the Geriatric Depression Scale and the Negative Affects Schedule while discriminant validity was performed with the Positive Affects Schedule and the Satisfaction With Life Scale. We used confirmatory factor analysis, by means of structural equation modeling, to test the fit of the model with 20 items. We used the area under the ROC curve (AUC) to predict the group of elderly patients with generalized anxiety disorder and the group of healthy elderly. Results: The scale has good internal consistency (α = 0.94), indicators of good convergent and discriminant validity, were all significant. The model showed a good quality of fit to the data (χ2/df = 2.805; TLI = 0.959; CFI = 0.964; RMSEA = 0.047). The ROC analysis revealed a sensitivity of 100% and specificity of 84.7% in the detection of generalized anxiety disorder with a cutoff score of 13 (AUC = 0.92). Finally, women showed higher scores than men. Conclusions: The GAI has good psychometric and factorial qualities to measure anxiety symptoms in epidemiological surveys and in geriatric institutionalized settings.

Downloads

Download data is not yet available.

References

American Psychiatric Association. (2014). DSM-5. Manual de diagnóstico e estatística das perturbações mentais. (Médicos do Centro Hospitalar Psiquiátrico de Lisboa, J. C. Fernandes) (5th ed.). Lisboa: Climepsi Editores. [Google Scholar]

Amorim, P. (2000). Mini International Neuropsychiatric Interview (MINI): Validation of a short structured diagnostic psychiatric interview. Revista Brasileira de Psiquiatria, 22(3), 106-115. [Google Scholar] [CrossRef]

Ayers, C. R., Sorrell, J. T., Thorp, S. R., & Wetherell, J. L. (2007). Evidence-based psychological treatments for late-life anxiety. Psychology and Aging, 22(1), 8-17. [Google Scholar] [CrossRef]

Barreto, J., Leuschner, A., Santos, F., & Sobral, M. (2003). Escala de depressão geriátrica, Tradução portuguesa da Geriatric Depression Inventory. Escalas e testes na demência [Scales and tests in dementia] (2nd ed., pp. 65-67). Lisboa: Grupo de Estudos de Envelhecimento Cerebral e Demência. [Google Scholar]

Bartlett, M. S. (1954). A note on the multiplying factors for various χ2 approximations. Journal of the Royal Statistical Society. Series B (Methodological), 16(2), 296-298. [Google Scholar] [Jstor]

Beaudreau, S. A., & O’Hara, R. (2008). Late-life anxiety and cognitive impairment: a review. The American Journal of Geriatric Psychiatry, 16(10), 790-803. [Google Scholar] [CrossRef]

Beekman, A. T., Bremmer, M. A., Deeg, D. J., van Balkom, A. J., Smit, J. H., de Beurs, E., van Dyck, R., van Tilburg, W. (1998). Anxiety disorders in later life: a report from the Longitudinal Aging Study Amsterdam. International Journal of Geriatric Psychiatry, 13(10), 717-726. [Google Scholar] [CrossRef]

Boddice, G., Pachana, N. A., & Byrne, G. J. (2008). The clinical utility of the geriatric anxiety inventory in older adults with cognitive impairment. Nursing Older People, 20(8), 36-39. [Google Scholar] [CrossRef]

Bound, F. (2005). Keywords in the history of medicine. Anxiety. The Lancet, 363(9418), 1407. [Google Scholar] [CrossRef]

Brenes, G. A., Guralnik, J. M., Williamson, J. D., Fried, L. P., Simpson, C., Simonsick, E. M., & Penninx, B. W. J. H. (2005). The influence of anxiety on the progression of disability. Journal of the American Geriatrics Society, 53(1), 34-39. [Google Scholar] [CrossRef]

Brown, P. J., & Roose, S. P. (2011). Age and anxiety and depressive symptoms: The effect on domains of quality of life. International Journal of Geriatric Psychiatry, 26(12), 1260-1266. [Google Scholar] [CrossRef]

Bryant, C. (2010). Anxiety and depression in old age: Challenges in recognition and diagnosis. International Psychogeriatrics, 22(04), 511-513. [Google Scholar] [CrossRef]

Bryant, C., Jackson, H., & Ames, D. (2008). The prevalence of anxiety in older adults: Methodological issues and a review of the literature. Journal of Affective Disorders, 109(3), 233-250. [Google Scholar] [CrossRef]

Butler, R. N. (1975). Psychiatry and the elderly: An overview. American Journal of Psychiatry, 132(9), 893-900. [Google Scholar] [CrossRef]

Byrne, G. J., Pachana, N. A., Arnold, E., Chalk, J. B., & Appadurai, K. (2008). Performance characteristics of the Geriatric Anxiety Inventory in memory clinic attendees. Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association, 4(4), T441-T442. [Google Scholar] [CrossRef]

Byrne, G. J., & Pachana, N. A. (2010). Development and validation of a short form of the Geriatric Anxiety Inventory - the GAI-SF. International Psychogeriatrics, 23(01), 125-131. [Google Scholar] [CrossRef]

Byrne, G. J., Pachana, N. A., Gonçalves, D. C., Arnold, E., King, R., & Keat Khoo, S. (2010). Psychometric properties and health correlates of the Geriatric Anxiety Inventory in Australian community-residing older women. Aging & Mental Health, 14(3), 247-254. [Google Scholar] [CrossRef]

Cattell, R. B. (1966). The scree test for the number of factors. Multivariate Behavioral Research, 1(2), 245-276. [Google Scholar] [CrossRef]

Comer, R. J. (2013). Abnormal psychology (8th ed.). New York: Worth Publishers. [Google Scholar]

Cook, J. M., Orvaschel, H., Simco, E., Hersen, M., & Joiner, T. (2004). A test of the tripartite model of depression and anxiety in older adult psychiatric outpatients. Psychology and Aging, 19(3), 444-451. [Google Scholar] [CrossRef]

Cohen, J. W. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Hilsdale, NJ: Lawrence Erlbaum Associates. [Google Scholar]

Cravello, L., Palmer, K., de Girolamo, G., Caltagirone, C., & Spalletta, G. (2010). Neuropsychiatric symptoms and syndromes in institutionalized elderly people without dementia. International Psychogeriatrics, 23(03), 425-434. [Google Scholar] [CrossRef]

de Visser, L., van der Knaap, L. J., van de Loo, A. J. A. E., van der Weerd, C. M. M., Ohl, F., & van den Bos, R. (2010). Trait anxiety affects decision-making differently in healthy men and women: Towards gender-specific endophenotypes of anxiety. Neuropsychologia, 48(6), 1598-1606. [Google Scholar] [CrossRef]

Diener, E., Emmons, R. A., Larsen, R. J., & Griffin, S. (2010). The Satisfaction With Life Scale. Journal of Personality Assessment, 49(1), 71-75. [Google Scholar] [CrossRef]

Diefenbach, G. J., Robison, J. T., Tolina, D. F., & Blank, K. (2004). Late-life anxiety disorders among Puerto Rican primary care patients: Impact on well-being, functioning, and service utilization. Journal of Anxiety Disorders, 18(6), 841-858. [Google Scholar] [CrossRef]

Dong, X., Chen, R., & Simon, M. A. (2014). Anxiety among community-dwelling U.S. Chinese older adults. The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, 69(Suppl. 2), S61-S67. [Google Scholar] [CrossRef]

Espírito Santo, H., & Daniel, F. (2010). Inventário Geriátrico de Ansiedade [Geriatric Anxiety Inventory] (Assessment instrument). Coimbra: Instituto Superior Miguel Torga. [Handle]

Espírito Santo, H. (2011). Questionário de Avaliação de Sinais de Doença [Assessment Questionnaire of Disease Signs] (Unpublished assessment instrument). Coimbra: Instituto Superior Miguel Torga.

Espírito-Santo, H., Lemos, L., Pena, I. T., Guadalupe, S., Daniel, F., & Vicente, H. T. (2014). Development of a Geriatric Functionality Scale to screen for functional ability. Revista de Saúde Pública, 48(n. esp.), 124. [Google Scholar]

Faculdade de Ciências Médicas., & Universidade Nova de Lisboa. [FCM-UNL]. (2013). Estudo epidemiológico nacional de saúde mental. 1.º relatório [Epidemiology National study of mental health. 1st report]. Lisboa: Faculdade de Ciências Médicas, Universidade Nova de Lisboa. [Google Scholar]

Fingerhood, M. (2000). Substance abuse in older people. Journal of the American Geriatrics Society, 48(8), 985-995. [Google Scholar] [CrossRef]

Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975). Mini-Mental State: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12(3), 189-198. [Google Scholar] [CrossRef]

Fundação Francisco Manuel dos Santos. (2015). População residente segundo os Censos: total e por grandes grupos etários - Municípios. Onde há mais e menos jovens, idosos ou pessoas em idade activa? [Resident population according to Census: total and by age groups - Municipalities. Where there is more and less young, elderly, or people of working age?]. [Google Scholar] [URL]

Gale, C. R., Sayer, A. A., Cooper, C., Dennison, E. M., Starr, J. M., Whalley, L. J., Gallacher, J. E., Ben-Shlomo, Y., Kuh, D., Hardy, R., Craig, L., Deary, I. J., HALCyon Study Team. (2011). Factors associated with symptoms of anxiety and depression in five cohorts of community-based older people: The HALCyon (Healthy Ageing across the Life Course) Programme. Psychological Medicine, 41(10), 2057-2073. [Google Scholar] [CrossRef]

Gabbard, G. O. (1998). Psiquiatria psicodinâmica: Baseado no DSM-IV [Psychodynamic psychiatry: Based on DSM-IV] (2nd ed.). Porto Alegre: ArtMed. [Google Scholar]

Gatz, M., & Pearson, C. G. (1988). Ageism revised and the provision of psychological services. American Psychologist, 43(3), 184-188. [Google Scholar] [CrossRef]

GEP. (2007-2014). Carta social. Gabinete de Estratégia e Planeamento. [URL]

Guerreiro, M., Silva, A. P., Botelho, M., Leitão, O., Castro-Caldas, A., & Garcia, C. (1994). Adaptação à população portuguesa da tradução do Mini Mental State Examination (MMSE) [Adaptation to the Portuguese population of the translation of the Mini Mental State Examination]. Revista Portuguesa de Neurologia, 1, 9-10. [Google Scholar]

Headey, B., Kelley, J., & Wearing, A. (1993). Dimensions of mental health: Life satisfaction, positive affect, anxiety and depression. Social Indicators Research, 29(1), 63-82. [Google Scholar] [CrossRef]

Henderson, A. S., Jorm, A. F., Korten, A. E., Jacomb, P., Christensen, H., & Rodgers, B. (1998). Symptoms of depression and anxiety during adult life: Evidence for a decline in prevalence with age. Psychological Medicine, 28(6), 1321-1328. [Google Scholar] [CrossRef]

Hu, L., & Bentler, P. (1999). Cutoff criteria for fit indices in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling, 6(1), 1-55. [Google Scholar] [CrossRef]

INE (Instituto Nacional de Estatística), & INSA (Instituto Nacional de Saúde Doutor Ricardo Jorge). (2009). Inquérito Nacional de Saúde 2005-2006 [National Health Survey 2005-2006]. Lisboa: INE e INSA. [Google Scholar] [PDF]

Jorm, A. F. (2000). Does old age reduce the risk of anxiety and depression? A review of epidemiological studies across the adult life span. Psychological Medicine, 30(1), 11-22. [Google Scholar] [CrossRef]

Kaiser, H. F. (1970). A second generation little jiffy. Psychometrika, 35(4), 401-415. [Google Scholar] [CrossRef]

Kessler, R. C., & Frank, R. G. (1997). The impact of psychiatric disorders on work loss days. Psychological Medicine, 27(4), 861-873. [Google Scholar] [CrossRef]

Kline, R. B. (2011). Principles and practice of structural equation modeling (3rd ed.). New York: Guilford Press. [Google Scholar]

Koffel, E., & Watson, D. (2009). The two-factor structure of sleep complaints and its relation to depression and anxiety. Journal of Abnormal Psychology, 118(1), 183-194. [Google Scholar] [CrossRef]

Kring, A. M., Johnson, S. L., Davison, G. C., & Neale, J. M. (2010). Abnormal psychology (11nd ed.). Hoboken, NJ: John Wiley & Sons, Inc. [Google Scholar]

Kuerbis, A., Sacco, P., Blazer, D. G., & Moore, A. A. (2014). Substance abuse among older adults. Clinics in Geriatric Medicine, 30(3), 629-654. [Google Scholar] [CrossRef]

Ladin, K. (2008). Risk of late-life depression across 10 European Union countries: Deconstructing the education effect. Journal of Aging and Health, 20(6), 653-670. [Google Scholar] [CrossRef]

Lenze, E. J., Mulsant, B. H., Shear, M. K., Schulberg, H. C., Dew, M. A., Begley, A. E., … Reynolds III, C. F. (2000). Comorbid anxiety disorders in depressed elderly patients. American Journal of Psychiatry, 157(5), 722-728. [Google Scholar] [CrossRef]

Martiny, C., de Oliveira e Silva, A. C., Nardi, A. E., & Pachana, N. A. (2011). Tradução e adaptação transcultural da versão brasileira do Inventário de Ansiedade Geriátrica (GAI) [Translation and cultural adaptation of the Brazilian version of the Geriatric Anxiety Inventory]. Revista de Psiquiatria Clínica, 38(1), 8-12. [Google Scholar] [CrossRef]

Matheson, S. F., Byrne, G. J., Dissanayaka, N. N. W., Pachana, N. A., Mellick, G. D., O'Sullivan, J. D., ... Marsh, R. (2012). Validity and reliability of the Geriatric Anxiety Inventory in Parkinson's disease. Australasian Journal on Ageing, 31(1), 13-16. [Google Scholar] [CrossRef]

Mendlowicz, M. V., & Stein, M. B. (2000). Quality of life in individuals with anxiety disorders. American Journal of Psychiatry, 157(5), 669-682. [Google Scholar] [CrossRef]

Mohlman, J., Bryant, C., Lenze, E. J., Stanley, M. A., Gum, A., Flint, A., … Craske, M. G. (2012). Improving recognition of late life anxiety disorders in Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition: Observations and recommendations of the Advisory Committee to the Lifespan Disorders Work Group. International Journal of Geriatric Psychiatry, 27(6), 549-56. [Google Scholar] [CrossRef]

Norton, J., Ancelin, M.-L., Stewart, R., Berr, C., Ritchie, K., & Carrière, I. (2012). Anxiety symptoms and disorder predict activity limitations in the elderly. Journal of Affective Disorders, 141(2-3), 276-285. [Google Scholar] [CrossRef]

Orbach, A. (1994). Psychotherapy in the third age. British Journal of Psychotherapy, 11, 221-231. [Google Scholar] [CrossRef]

Organização Mundial de Saúde. (2005). Envelhecimento ativo: Uma política de saúde [Active aging: A health policy] (S. Gontijo, Trad.). Brasília: Organização Pan-Americana da Saúde. [Google Scholar]

Pachana, N. A., Byrne, G. J., Siddle, H., Koloski, N., Harley, E., & Arnold, E. (2007). Development and validation of the Geriatric Anxiety Inventory. International Psychogeriatrics, 19(1), 103-114. [Google Scholar] [CrossRef]

Pachana, N. A., & Byrne, G. J. (2011). The Geriatric Anxiety Inventory: International use and future directions. Australian Psychologist, 47(1), 33-38. [Google Scholar] [CrossRef]

Pachana, N. A., McLaughlin, D., Leung, J., Byrne, G. J., & Dobson, A. (2011). Anxiety and depression in adults in their eighties: Do gender differences remain? International Psychogeriatrics, 24(01), 145-150. [Google Scholar] [CrossRef]

Pardal, A., Espirito-Santo, H., Lemos, L., Matreno, J., Amaro, H., Guadalupe, S., … Gonçalves, R. (2013). Social suport, mental health, and satisfaction with life in institutionalized elderly. European Psychiatry, 28(Supl. 1). [Google Scholar] [CrossRef]

Paúl, C., & Fonseca, A. M. (2001). Psicossociologia da saúde [Health psychosociology]. Lisboa: Climepsi. [Google Scholar]

Potvin, O., Bergua, V., Swendsen, J., Meillon, C., Tzourio, C., Ritchie, K., ... Amieva, H. (2013). Anxiety and 10-year risk of incident and recurrent depressive symptomatology in older adults. Depression and Anxiety, 30(6), 554-563. [Google Scholar] [CrossRef]

Rabasquinho, C., & Pereira, H. (2007). Género e saúde mental: uma abordagem epidemiológica [Gender and mental health: An epidemiological approach]. Análise Psicológica, 3(XXV), 439-454. [Google Scholar] [Scielo]

Rapaport, M. H., Clary, C., Fayyad, R., & Endicott, J. (2005). Quality-of-life impairment in depressive and anxiety disorders. American Journal of Psychiatry, 162(6), 1171-1178. [Google Scholar] [CrossRef]

Ribeiro, O., Paul, C., Simões, M. R., & Firmino, H. (2011). Portuguese version of the Geriatric Anxiety Inventory: Transcultural adaptation and psychometric validation. Aging & Mental Health, 15(6), 742-748. [Google Scholar] [CrossRef]

Riedel-Heller, S. G., Busse, A., & Angermeyer, M. C. (2006). The state of mental health in old-age across the “old” European Union — A systematic review. Acta Psychiatrica Scandinavica, 113(5), 388-401. [Google Scholar] [CrossRef]

Robb, C., Chen, H., & Haley, W. E. (2002). Ageism in mental health and health care: A critical review. Journal of Clinical Geropsychology, 8(1), 1-12. [Google Scholar] [CrossRef]

Rozzini, L., Chilovi, B. V., & Peli, M. (2009). Anxiety symptoms in mild cognitive impairment. International Journal of Geriatric Psychiatry, 24(3), 300-305. [Google Scholar] [CrossRef]

Simoni-Wastila, L., & Yang, H. K. (2006). Psychoactive drug abuse in older adults. The American Journal of Geriatric Pharmacotherapy, 4(4), 380-394. [Google Scholar] [CrossRef]

Scott, T., Mackenzie, C. S., Chipperfield, J. G., & Sareen, J. (2010). Mental health service use among Canadian older adults with anxiety disorders and clinically significant anxiety symptoms. Aging & Mental Health, 14(7), 790-800. [Google Scholar] [CrossRef]

Schaub, R. T., & Linden, M. (2000). Anxiety and anxiety disorders in the old and very old: results from the Berlin Aging Study (BASE). Comprehensive Psychiatry, 41(2-Suppl. S1), 48-54. [Google Scholar] [CrossRef]

Segal, D. L., June, A., Payne, M., Coolidge, F. L., & Yochim, B. P. (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(7), 709-714. [Google Scholar] [CrossRef]

Shapiro, A. M., Roberts, J. E., & Beck, J. G. (1999). Differentiating symptoms of anxiety and depression in older adults: Distinct cognitive and affective profiles? Cognitive Therapy and Research, 23(1), 53-74. [Google Scholar] [CrossRef]

Sheikh, J. I. (2003) Anxiety in older adults: Assessment and management of three common presentations. Geriatrics, 58(5), 44-45. [Google Scholar]

Simões, A. (1992). Ulterior validação de uma escala de satisfação com a vida (SWLS) [Further validation of a scale of satisfaction with life]. Revista Portuguesa de Pedagogia, 26(3), 503-515. [Google Scholar]

Simões, A. (1993). São os homens mais agressivos que as mulheres? [Are men more aggressive than women?]. Revista Portuguesa de Pedagogia, 27(3), 387-404. [Google Scholar]

Therrien, Z., & Hunsley, J. (2012). Assessment of anxiety in older adults: A systematic review of commonly used measures. Aging & Mental Health, 16(1), 1-16. [Google Scholar] [CrossRef]

Thurstone, L. L. (1947). Multiple factor analysis. Chicago: University of Chicago Press. [Google Scholar]

Trocóniz, M. I., & Montorio, I. (1999). Comportamiento y salud en la vejez [Behavior and health in old age]. In M. I. F. Trocóniz & I. Montorio (Eds.), Gerontologia conductual: Intervención y ámbitos de aplicación [Behavioral gerontology: Intervention and areas of application] (pp. 115-137). Madrid: Editorial Síntesis. [Google Scholar]

United Nations, Department of Economic and Social Affairs, Population Division [UN-DESA]. (2013). World population ageing 2013. ST/ESA/SER.A/348. [Google Scholar] [PDF]

Verhoeven, J. E., Revesz, D., van Oppen, P., Epel, E. S., Wolkowitz, O. M., & Penninx, B. W. J. H. (2015). Anxiety disorders and accelerated cellular ageing. The British Journal of Psychiatry, 206(5), 371-378. [Google Scholar] [CrossRef]

Watkins, M. W. (2000, February 4). Monte Carlo PCA for parallel analysis [Computer software]. State College, PA: Ed e Psych Associates. [Google Scholar] [URL]

Wang, Z., Shu, D., Dong, B., Luo, L., & Hao, Q. (2013). Anxiety disorders and its risk factors among the Sichuan empty-nest older adults: A cross-sectional study. Archives of Gerontology and Geriatrics, 56(2), 298-302. [Google Scholar] [CrossRef]

Watson, D., Clark, L. A., & Tellegen, A. (1988). Development and validation of brief measures of positive and negative affect: The PANAS scales. Journal of Personality and Social Psychology, 54(6), 1063-1070. [Google Scholar] [CrossRef]

Wolitzky-Taylor, K. B., Castriotta, N., Lenze, E. J., Stanley, M. A., & Craske, M. G. (2010). Anxiety disorders in older adults: a comprehensive review. Depression and Anxiety, 27(2), 190-211. [Google Scholar] [CrossRef]

Yesavage, J. A., Brink, T. L., Rose, T. L., Lum, O., Huang, V., Adey, M., & Leirer, V. O. (1983). Development and validation of a geriatric depression screening scale: A preliminary report. Journal of Psychiatric Research, 17(1), 37-49. [Google Scholar] [CrossRef]

Published

2015-09-30

How to Cite

Daniel, F., Vicente, H., Guadalupe, S., Silva, A., & Espirito Santo, H. M. A. (2015). Psychometric properties of the Portuguese Version of the Geriatric Anxiety Inventory in a sample of eldery people in residential care. Portuguese Journal of Behavioral and Social Research, 1(2), 15–30. https://doi.org/10.7342/ismt.rpics.2015.1.2.22

Issue

Section

Thematic Section

Most read articles by the same author(s)

1 2 > >>