Screening for GAD among Frail Elderly

体弱老年人的广泛性焦虑症筛查

• 批准号: 6976879
• 负责人: GRETCHEN J DIEFENBACH
• 金额: $ 7.36万
• 依托单位: HARTFORD HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-07-15 至 2007-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6976879
• 关键词: anxiety disorders; avoidance behavior; behavioral /social science research tag; belief; clinical research; cognitive behavior therapy; frail elderly; human subject; interview; mental disorder diagnosis; psychological aspect of aging; anxiety disorders; avoidance behavior; behavioral /social science research tag; belief; clinical research; cognitive behavior therapy; frail elderly; human subject; interview; mental disorder diagnosis; psychological aspect of aging

DESCRIPTION (provided by applicant): Changing population demographics are creating a need for additional geriatric mental health care services. Late-life anxiety is a prevalent and distressing mental health problem associated with decreased functioning, life satisfaction, and increased service utilization. Among late-life anxiety disorders, generalized anxiety disorder (GAD) is one of the most common. While there have been increased research efforts recently to study late-life GAD, most research to date has been conducted in academic trials and primary care settings, and there is a clear need for extension of late-life GAD research to community settings, who serve more diverse and severely impaired older adults. One (1) step toward improving mental health services for this population is to validate effective GAD screening measures. The primary aim of this study is to determine the sensitivity and specificity of several GAD screening measures administered to a sample of frail elderly involved in a community care management organization. In accomplishing this goal this study will also establish the feasibility of recruiting and assessing participants for a subsequent research program to develop and pilot-test a cognitive-behavioral intervention for late-life GAD. The development of an effective treatment for late-life GAD will follow from an understanding of the nature and function of worry within this population. Although it is beyond the scope of this proposal to test theoretical models of late-life GAD, a secondary aim is to assess associated features and functional mechanisms of worry among frail elderly. A battery of diagnostic interviews, self-report measures, and clinician-rated scales will be administered to 70 participants who will be prescreened based upon a priori inclusion/exclusion criteria. Half of the participants will be "screen positive" and the other half "screen negative" for worry/anxiety. Administered measures will assess diagnostic criteria for GAD; cognitive, affective, somatic, and behavioral features of late-life anxiety; and experiential avoidance and beliefs about worry (proposed mechanisms of action of worry). These assessments will serve as a first step toward clarifying conceptualizations of late-life GAD worry to ultimately inform treatment development. Granting of this R03 proposal will support a new investigator's development of an independent late-life GAD research program. The R03 will provide pilot data to support a subsequent R34 to develop and pilot test a cognitive behavioral treatment for use within the community-based program.

描述（由申请人提供）：不断变化的人口统计数据正在创造对其他老年精神卫生保健服务的需求。晚年焦虑是一个普遍且令人痛苦的心理健康问题，与功能下降，生活满意度和服务利用率的增加相关。在晚期焦虑症中，广义焦虑症（GAD）是最常见的一种。尽管最近进行了研究后期GAD的研究工作，但迄今为止，大多数研究都是在学术试验和初级保健环境中进行的，并且显然需要将晚期GAD研究扩展到社区环境，他们为更多样化和严重受损的老年人提供服务。朝着改善该人群的心理健康服务的一（1）一步是验证有效的GAD筛查措施。这项研究的主要目的是确定针对社区护理管理组织涉及的脆弱老年人的几种GAD筛查措施的敏感性和特异性。在实现这一目标时，本研究还将确定招募和评估参与者的可行性，以开发和试生晚期GAD的认知行为干预措施。对后期GAD的有效治疗的发展将取决于对该人群中担忧的性质和功能的理解。尽管测试晚期GAD的理论模型超出了该提议的范围，但第二个目的是评估脆弱的老年人中相关的特征和功能机制。将对70名参与者进行一系列诊断访谈，自我报告措施和临床医生评价的量表，这些参与者将根据先验的包含/排除标准进行预筛选。一半的参与者将是“屏幕正面”，而另一半“屏幕为负”，以忧虑/焦虑。管理措施将评估GAD的诊断标准；后期焦虑的认知，情感，体细胞和行为特征；以及经验性的回避和对忧虑的信念（提出的忧虑作用机制）。这些评估将是澄清晚年GAD担心的概念化的第一步，以最终为治疗开发提供信息。授予该R03提案将支持新的研究者开发独立的后期GAD研究计划。 R03将提供试点数据，以支持随后的R34，以开发和试点测试认知行为治疗以在社区计划中使用。