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

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产生了对额外老年心理保健服务的需求。晚年焦虑是一种普遍且令人痛苦的心理健康问题，与功能下降、生活满意度下降和服务利用增加有关。在晚年焦虑症中，广泛性焦虑症（GAD）是最常见的一种。虽然最近加大了研究晚年广泛性焦虑症的力度，但迄今为止大多数研究都是在学术试验和初级保健机构中进行的，并且显然需要将晚年广泛性焦虑症研究扩展到社区环境，这些社区服务于更加多样化和严重受损的老年人。改善该人群心理健康服务的一（1）步是验证有效的广泛性焦虑症筛查措施。本研究的主要目的是确定对社区护理管理组织中的体弱老年人样本实施的几种 GAD 筛查措施的敏感性和特异性。为了实现这一目标，本研究还将确定为后续研究项目招募和评估参与者的可行性，以开发和试点测试针对晚年广泛性焦虑症的认知行为干预措施。对晚年广泛性焦虑症的有效治疗方法的开发将基于对这一人群中忧虑的性质和功能的了解。尽管测试晚年广泛性焦虑症的理论模型超出了本提案的范围，但次要目标是评估体弱老年人的相关特征和担忧的功能机制。将对 70 名参与者进行一系列诊断访谈、自我报告测量和临床医生评分量表，这些参与者将根据先验的纳入/排除标准进行预筛选。一半的参与者将因担心/焦虑而“筛查呈阳性”，另一半则“筛查呈阴性”。采取的措施将评估广泛性焦虑症的诊断标准；晚年焦虑的认知、情感、躯体和行为特征；以及关于担忧的经验性回避和信念（提出的担忧作用机制）。这些评估将作为澄清晚年广泛性焦虑症担忧概念的第一步，最终为治疗开发提供信息。 R03 提案的批准将支持新研究者开发独立的晚年 GAD 研究项目。 R03 将提供试点数据，以支持后续的 R34 开发和试点测试认知行为治疗，以便在基于社区的计划中使用。