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Cited by 87Mindfulness and Compassion InterventionsAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesPsychosomatic Disorders and Their Treatments

Anxiety Sensitivity, Experiential Avoidance, and Mindfulness Among Younger and Older Adults: Age Differences in Risk Factors for Anxiety Symptoms

Open access
Mahoney, Colin T., Segal, Daniel L., Coolidge, Frederick L.·2015·The International Journal of Aging and Human Development
DOI 10.1177/0091415015621309
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Abstract

In this cross-sectional study, we examined age-related differences in anxiety sensitivity (AS), experiential avoidance (EA), and mindfulness among younger adult students (N = 426; M age = 20.1 years) and community-dwelling older adults (N = 85; M age = 71.8 years). Participants anonymously completed the Anxiety Sensitivity Index-3, Acceptance and Action Questionnaire-II, Mindful Attention Awareness Scale, Kentucky Inventory of Mindfulness Skills, Beck Anxiety Inventory, Geriatric Anxiety Scale, and State-Trait Anxiety Inventory. Independent t tests indicated that younger adults reported significantly higher levels of AS and EA, whereas older adults reported significantly higher levels of trait mindfulness. Correlational analyses demonstrated that AS and EA were significantly associated with each other and with anxiety-related symptoms. However, trait mindfulness was significantly inversely related to AS, EA, and to trait and state anxiety. To date, these three factors have yet to be examined simultaneously within the context of age differences, and the present study illuminates these differences as well as their relationships. AS, EA, and low mindfulness appear to be significant correlates for anxiety-related symptoms in younger and older adults.

AI snapshot

Written from the paper’s full text.

TL;DR

This cross-sectional study compared anxiety sensitivity (AS), experiential avoidance (EA), and trait mindfulness in younger undergraduate and community-dwelling older adults. Younger adults reported higher AS, EA, and anxiety symptoms, while older adults reported higher trait mindfulness; AS and EA were positively linked to anxiety and negatively linked to mindfulness in both groups.

Key findings

  • Younger adults (N = 426, M age = 20.1) scored higher than older adults (N = 85, M age = 71.8) on ASI-3 AS (M = 18.70 vs. 11.57, d = 0.62), AAQ-II EA (M = 22.56 vs. 16.80, d = 0.61), BAI trait anxiety (M = 16.42 vs. 8.87, d = 0.78), GAS state anxiety (M = 20.37 vs. 12.97, d = 0.61), and STAI state anxiety (M = 39.23 vs. 33.34, d = 0.49).
  • Older adults scored higher on trait mindfulness on the MAAS (M = 4.47 vs. 3.81, d = 0.80) and KIMS (M = 134.34 vs. 119.38, d = 0.90).
  • AS and EA correlated positively with anxiety measures in both groups; for example, AS–BAI was r = .57 in younger adults and r = .24 in older adults, while EA–GAS was r = .70 in both groups. Mindfulness was inversely related to AS, EA, and anxiety across measures.
  • The AS–EA correlation was stronger in younger adults (r = .62) than older adults (r = .40; Z = 2.19, p < .05), and the KIMS–BAI correlation was stronger in older adults (Z = 2.36, p < .05).

Methods

  • Cross-sectional anonymous online survey of 511 participants (381 women, 130 men; 70.6% Caucasian): younger undergraduates recruited from psychology courses for extra credit and community-dwelling older adults aged 60–86 recruited from a university gerontology registry and paid $5.
  • Measures included the ASI-3, AAQ-II, MAAS, KIMS, BAI, GAS, and STAI-Y1.
  • Analyses used chi-square tests and independent t tests for age-group differences, bivariate Pearson correlations within each age group, and comparisons of correlation strengths.

Limitations

  • The authors state that the age groups differed on ethnicity, marital status, and education; the younger sample was entirely undergraduate, both groups had many more women than men, and findings may not generalize to clinical populations because symptoms ranged from minimal to severe.
  • The authors also note that all measures were self-report, the design was cross-sectional and nonexperimental so causality cannot be determined, cohort effects cannot be ruled out, and the MAAS may be less suitable for older adults.
  • Evident in the text: the older adult ASI-3 cognitive concerns subscale had low internal consistency (α = .64), and the age groups were very unequal in size (426 younger vs. 85 older adults).

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1177/0091415015621309

Cites

51 of 51 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

4 of 16 cited sources checked · 3 supported · 0 flagged · accuracy not yet measured

  • Premisecitation

    Kashdan et al. (2014) found that EA significantly predicted higher social anxiety in social situations with greater chance of being vulnerable and negatively evaluated compared with situations where self-disclosure was minimized.

    “Kashdan et al. (2014) also found context to be important, as EA significantly predicted higher social anxiety in social situations where there was a greater chance of being vulnerable and negatively evaluated by others compared with social situations where personal self-disclosure was minimized.”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Kashdan et al. (2014) source
  • Premisecitation

    MBSR has been demonstrated to significantly reduce anxiety symptoms in younger and middle age adults.

    “MBSR has also been demonstrated to significantly reduce anxiety symptoms in younger and middle age adults (Hoge et al., 2013).”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Hoge et al., 2013 source

      Table 1 (II. Method; page not provided) reports mean ages of 41 in the MBSR group and 37 in the control group. The Results report significantly greater anxiety reductions with MBSR on several measures, but not on the primary HAM-A measure. The study enrolled adults diagnosed with generalized anxiety disorder, so it does not establish the claim for younger and middle-aged adults generally. (LLM, conf=0.85)

      Experimental — accuracy not yet measured
  • Findingown data

    In older adults, AS was positively correlated with STAI.

    “STAI, r ¼ .38).”
    Quote in the paperNot a substantial claim
  • Findingown data

    In younger adults, EA was positively correlated with GAS.

    “the GAS, r ¼ .70”
    Quote in the paperNot a substantial claim
  • Findingown data

    In younger adults, BAI and GAS were positively correlated.

    “the results indicated a strong and positive relationships (r ¼ .80) between the major anxiety measures in this younger adult sample, namely the BAI and the GAS.”
    Quote in the paperNot a substantial claim
  • Classified as probably not a substantial claim. 11
  • May combine two claims. 17
  • The quote only partly states this claim. 1

  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    Lenze et al. (2014) found that the MAAS does not account for increases in mindfulness due to the effects of MBSR, attributing this shortcoming to possible difficulty some older adults may have in understanding items on this measure.

    “Lenze et al. (2014) found that the MAAS does not account for increases in mindfulness due to the effects of MBSR, attributing this shortcoming to the possible difficulty some older adults may have in understanding items on this measure.”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites Lenze et al. (2014) source

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Previous research has shown that the mindfulness facets nonreactivity and describing are significantly negatively related to anxious distress and physiological anxious arousal, respectively.

    “Previous research has shown that the specific facets of mindfulness known as nonreactivity, allowing emotions and cognitions to pass without reacting to them, and describing, nonjudgmentally labeling experiences, are significantly negatively related to anxious distress and physiological anxious arousal, respectively (Desrosiers, Klemanski, & Nolen-Hoeksema, 2013).”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Desrosiers, Klemanski, & Nolen-Hoeksema, 2013 source

  • May combine two claims.

    Findingown data

    The age groups significantly differed on ethnicity, current marital status, and level of education.

    “First, the agegroups significantly differed on ethnicity, current marital status, and level of education.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The present results provide evidence of excellent internal scale reliability for STAI scale scores among younger and older adults and otherwise solid psychometric properties for community-dwelling older adults.

    “the present results provide evidence of excellent internal scale reliability for STAI scale scores among younger and older adults and otherwise solid psychometric properties for community-dwelling older adults.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    The KIMS-BAI relationship was significantly greater only for that combination and not for any other combination of primary measures (KIMS or GAS; MAAS or BAI; MAAS or GAS).

    “However, this relationship was only significantly greater while examining trait mindfulness as assessed by the KIMS and trait anxiety as measured by the BAI but was not found for any other combination of primary measures of these constructs (i.e., KIMS or GAS; MAAS or BAI, MAAS or GAS).”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    AS is associated with various anxiety disorder symptoms among younger adults.

    “Researchers have highlighted the connection between AS and various anxiety disorder symptoms among younger adults.”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites Wheaton, Mahaffey, et al. (2012) source
    • cites Rector, Szacun-Shimizu, and Leybman (2007) source
    • cites Deacon and Valentiner (2001) source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Older adults tend to report lower levels of uncontrollable worry than younger adults.

    “Gould and Edelstein (2010) established that older adults tend to report lower levels of uncontrollable worry than younger adults.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Gould and Edelstein (2010) source

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Age and trait mindfulness are positively associated across the life span, and mindfulness partially mediates the relationship between age and negative affect.

    “Another study found that age and trait mindfulness are positively associated across the life span, and that mindfulness partially mediates the relationship between age and negative affect (Raes, Bruyneel, Loeys, Moerkerke, & De Raedt, 2013).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Raes, Bruyneel, Loeys, Moerkerke, & De Raedt, 2013 source

  • May combine two claims.

    Study design and conductown data

    The younger adult sample had a significantly higher proportion of mixed ethnicity and were more likely to be single than older adults.

    “However, the younger adult sample had a significantly higher proportion of mixed ethnicity, 2 (7, N ¼ 511) ¼ 27.69, p < .001,and they were more likely to be single, 2 (5, N ¼ 511) ¼ 270.95, p < .001.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    EA is significantly positively correlated with pathological features of anxiety such as trait anxiety, social anxiety, body sensation fears, suffocation fears, and AS.

    “Kashdan et al. (2006) used the original Acceptance and Action Questionnaire (AAQ) and found that EA was significantly positively correlated with pathological features of anxiety such as trait anxiety, social anxiety, body sensation fears, suffocation fears, and AS”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Kashdan et al. (2006) source

  • May combine two claims.

    Premisecitation

    Compared with older adults, younger adults tend to report higher levels of AS along with greater levels of health anxiety.

    “Furthermore, compared with older adults, younger adults tend to report higher levels of AS along with greater levels of health anxiety (Gerolimatos & Edelstein, 2012).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Gerolimatos & Edelstein, 2012 source

  • May combine two claims.

    Interpretationreasoning

    Attempts to suppress or resist one's thoughts, feelings, and internal experiences may lead to higher amounts of anxiety, and higher levels of anxiety may lead to more engagement in EA, highlighting a bidirectional relationship.

    “It appears that attempts to suppress or resist one's thoughts, feelings, and internal experiences may lead to higher amounts of anxiety, and alternatively, higher levels of anxiety may lead to more engagement in EA, highlighting a bidirectional relationship.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationreasoning

    Individuals may engage in EA or maintain mindfulness in some situations but not others, depending on the content or context of the distressing experience.

    “However, it is possible that individuals engage in EA or maintain mindfulness in some situations but not others, depending on the content or context of the distressing experience.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

    Interpretationreasoning

    The perceived subjective threat to one's sense of self-worth or self-esteem may be the deciding factor in evaluating the necessity to avoid or accept one's experience.

    “Thus, the perceived subjective threat to one's sense of self-worth or self-esteem may be the deciding factor in evaluating the necessity to avoid or accept one's experience.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationown data

    Someone who regularly experiences anxiety symptoms is likely to be sensitive to signs of anxious arousal, and this relationship is generally similar for younger and older adults.

    “Our results support the idea that someone who regularly experiences anxiety symptoms is likely to be sensitive to signs of anxious arousal, and that this relationship is generally similar for younger adults and older adults, with strong positive correlations.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationreasoning

    Efforts to remain reluctant to experience and emotionally process negatively evaluated events seem to be counterproductive to healthy functioning as they can exacerbate the symptoms one is trying to avoid and create constant internal pressure to resist natural responses to life stressors.

    “Thus, these efforts to remain reluctant to experience and emotionally process negatively evaluated events seem to be counterproductive to healthy functioning as they can exacerbate the symptoms that one is trying to avoid, and create constant internal pressure to resist natural responses to life stressors.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationreasoning

    There is a problem of lack of representativeness of college students as a comparison group to the older adult group, as well as the relatively high percentage of women in both age-groups.

    “Relatedly, there is a problem of lack of representativeness of college students as a comparison group to the older adult group, as well as the relatively high percentage of women in both age-groups.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based). May combine two claims.

    Interpretationreasoning

    Lack of control and predictability appear to be paramount to maintaining anxiety symptoms, which makes increasing one's sense of mindfulness more difficult for people high on trait anxiety.

    “Lack of control and predictability appear to be paramount to maintaining anxiety symptoms, which makes increasing one's sense of mindfulness more difficult for people high on trait anxiety as its basic foundation involves learning to relinquish control, bias, and judgments about potentially distressing experiences.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationown data

    Anxiety-related symptoms are highly associated with AS, such that as anxiety increases, AS follows suit, and vice versa.

    “Thus, results from the present study further bolster the extant literature establishing that anxiety-related symptoms are highly associated with AS, indicating that as anxiety increases, AS follows suit, and vice versa”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Study design and conductreasoning

    As the present study design was cross-sectional and nonexperimental, causality among the variables cannot be determined.

    “as the present study design was cross-sectional and nonexperimental, causality among the variables cannot be determined.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationown data

    Open-minded attention and awareness coupled with acceptance without judgment of subjective experiences allows an individual to fully immerse in daily life, creating less anxious distress and subsequent impairment.

    “Thus, it appears that open-minded attention and awareness coupled with acceptance without judgment of subjective experiences allows an individual to fully immerse in his or her daily life, creating less anxious distress and subsequent impairment.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationown data

    The GAS had reliable scale scores and evidence for validity for use as a measure of anxiety for younger adults, and the BAI for older adults.

    “This finding indicates that the GAS had reliable scale scores and evidence for validity for use as a measure of anxiety for younger adults, and vice versa for the BAI with older adults.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The measures included in the study were all self-report in nature.

    “Second, the measures included in the study were all self-report in nature.”
    Quote in the paperNot a substantial claim

  • The quote only partly states this claim.

    Interpretationreasoning

    The present study highlights the dynamics of three important interrelated factors (AS, EA, lowered trait mindfulness) that likely cause significant distress and impairment in younger and older adults.

    “the present study highlights the dynamics of three important interrelated factors that likely cause significant distress and impairment in younger and older adults.”
    Quote in the paperNot a substantial claim
24 of 24

  • The paper relies on this without support.

    The ASI-3 is valid for assessing anxiety sensitivity in older adults despite no prior examination of its psychometric properties in this population.

    “However, to date, no study has examined the psychometric properties of the ASI-3 with older adults.”

  • The paper relies on this without support.

    Cross-sectional age differences in AS, EA, and mindfulness reflect age-related developmental differences rather than cohort effects.

    “As there are no longitudinal studies examining these risk factors across the lifespan, cross-sectional analyses may uncover novel insights about the dynamics of these variables in different age-groups.”

  • The paper relies on this without support.

    The younger and older adult samples are comparable enough for age-group comparisons despite significant differences in education, ethnicity, and marital status.

    “However, the younger adult sample had a significantly higher proportion of mixed ethnicity, 2 (7, N ¼ 511) ¼ 27.69, p < .001,and they were more likely to be single, 2 (5, N ¼ 511) ¼ 270.95, p < .001.”

  • The paper relies on this without support.

    The GAS is valid for assessing state anxiety in younger adults.

    “The GAS is an increasingly popular and promising research instrument for older adults (Segal, June, Payne, Coolidge, & Yochim, 2010).”

  • The paper relies on this without support.

    The STAI-Y1 is valid for assessing state anxiety in older adults despite weak evidence for validity among older adult outpatients.

    “The STAI-Y1 has demonstrated good to excellent psychometric properties among diverse adult populations, although the evidence for validity was weak among older adult outpatients (Kabacoff et al., 1997).”

  • The paper relies on this without support.

    Experiential avoidance can be considered a type of coping strategy.

    “To the extent EA can be considered a type of coping strategy”

  • The paper relies on this without support.

    Older adults are afraid of becoming demented.

    “older adults are known to be afraid of becoming demented, likely due to the sharp increase in developing cognitive impairment with advancing age.”
7 of 7

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • The STAI score ceiling is too low

    Minor

    Twenty items scored up to 4 points each yield a maximum of 80, not 60. The reported observed scores of 71 and 73 also exceed the stated ceiling.

    Reported 60 · recomputed 80

  • Older adults' GAS subscale means do not match the total mean

    Minor

    The three older-adult subscale means sum to 12.43, whereas the reported GAS total mean is 12.97. The gap exceeds what rounding the three displayed means could explain.

    Reported 12.97 · recomputed 12.43

  • Older-adult AS-BAI correlation is called significant but is unmarked in the table

    Minor

    The results describe the older-adult AS-BAI relationship as significant, but Table 3 lists its correlation as .24 without the asterisk used for the other reported significant correlations.

3 of 3

Cites

Flagged first, then by citations

Research works printed but not linked: 1

  1. Glick D. M., 2011, Journal of Cognitive and Behavioral Psychotherapies, 11, 1

Cited by

Sorted by citations

Related

Authors
Mahoney, C. T., Segal, D. L., & Coolidge, F. L.
Affiliations
University of Colorado Colorado Springs (US)
Corresponding author
Segal, Daniel L.
ORCID
Venue
The International Journal of Aging and Human Development
Publisher
SAGE Publications
Published
2015-10
Volume
81
Issue
4
Pages
217-240
ISSN
  • 0091-4150 (ISSN-L)
  • 1541-3535
DOI
10.1177/0091415015621309
OpenAlex
W2200075150
Cited by
87
References
51
Citations by year
2026: 5 · 2025: 8 · 2024: 7 · 2023: 11 · 2022: 9 · 2021: 9 · 2020: 14 · 2019: 8 · 2018: 5 · 2017: 11
FWCI
6.61
Type
journal article
Language
en
Open access
Licence
journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
Locations
  • The International Journal of Aging and Human Development (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
Keywords
anxiety sensitivity, experiential avoidance, mindfulness, age differences, older adults, young adults, anxiety symptoms, trait anxiety, state anxiety, Acceptance and Action Questionnaire, Mindful Attention Awareness Scale, Anxiety Sensitivity Index
MeSH terms
Adaptation, Psychological, Adolescent, Adult, Aged, Aged, 80 and over, Aging, Anxiety, Awareness, Cross-Sectional Studies, Female, Humans, Male, Middle Aged, Surveys and Questionnaires, Risk Factors, Stress, Psychological, Young Adult, Mindfulness

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