Comparison of Self-report Measures for Identifying Late-life Generalized Anxiety in Primary Care
Open accessAbstract
This study evaluated the Penn State Worry Questionnaire, Penn State Worry Questionnaire—Abbreviated, and the Generalized Anxiety Disorder Questionnaire-IV for identifying generalized anxiety disorder in older medical patients. Participants were 191 of 281 patients screened for a clinical trial evaluating cognitive-behavior treatment, n = 110 with generalized anxiety disorder, 81 without. Participants completed the Penn State Worry Questionnaire and Generalized Anxiety Disorder Questionnaire-IV at pretreatment. Kappa coefficients estimated agreement with the Structured Clinical Interview for Diagnosis. Receiver operating characteristic curves compared sensitivity and specificity of self-report measures. The Penn State Worry Questionnaire (cutoff = 50) provided the strongest prediction of generalized anxiety disorder (sensitivity, 76%; specificity, 73%; 75% correctly classified; kappa = .49. Item 2 of the Generalized Anxiety Disorder Questionnaire-IV demonstrated comparable accuracy. The Penn State Worry Questionnaire, Generalized Anxiety Disorder Questionnaire-IV, and briefer versions of these measures may be useful in identifying late-life generalized anxiety disorder in medical settings.
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The PSWQ-A can identify GAD in older primary care patients and can detect treatment-related change.
“The PSWQ-A is useful for identifying GAD in older primary care patients (Webb et al., 2008), is capable of demonstrating change following treatment (Stanley et al., 2009; Shrestha et al., 2012)”
From Cognitive-behavioral therapy for late-life anxiety: Similarities and differences between Veteran and community participants (2015) · cites this paper as Webb et al., 2008
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“A cut off score of 23 on the PSWQ‐Awas selected, based on prior work demonstrating this method to predict GAD in older adults.(27,28) Additional inclusion criteria were an ability to speak English, willingness to provide contact information for a primary care provider, and no changes to psychotropic medication(s) in t…”
MethodSelf-citationStanley, M. A., Wilson, N. L., Amspoker, A. B., Kraus-Schuman, C., Wagener, P. D., Calleo, J. S., Cully, J. A., Teng, E., Rhoades, H. M., Williams, S., et al. (2014) · Depression and Anxiety · doi:10.1002/da.22239 · Cited by 96 · see citing works
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MethodResultInfluentialSelf-citationWuthrich, V., Johnco, C., & Knight, A. (2014) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2014.07.005 · Cited by 66 · see citing works
“One tudy comparing the PSWQ and PSWQ-A in older adults has sugested similar accuracy of the two measures to identify those with AD from those without GAD (e.g., Webb et al., 2008).”
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“An ASI score of 25 (Taylor, Peterson, & Plehn, 1999) is suggested as a cut off of low versus high anxiety, a PSWQ score of 50 or greater generally defines clinically significant anxiety as seen in GAD (Stanley et al., 2003; Webb et al., 2008; Wuthrich, Johnco, & Knight, 2014).”
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“This cutoff score of 4.42 is closer to reports of previous ROC findings with older adult GAD samples (Webb et al., 2008).”
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“The PSWQ-A is useful for identifying GAD in older primary care patients (Webb et al., 2008), is capable of demonstrating change following treatment J Anxiety Disord.”
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“The PSWQ-A is useful for identifying GAD in older primary care patients (Webb et al., 2008), is capable of demonstrating change following treatment (Stanley et al., 2009; Shrestha et al., 2012), and is advantageous for older adults because of its brevity and simplicity (Hopko, et al 2003).”
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“Of note, 90% of participants in the high-worry group scored at or above a PSWQ score of 50, an empirically derived cut-off score that has been shown to maximize sensitivity and specificity in determining the presence of late-life GAD in a geriatric sample (30, 31).”
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“Discriminant validity of the PSWQ-A has also been established in distinguishing GAD among clinical and nonclinical samples of older adults (Kertz, Lee, & Bj€orgvinsson, 2014; Webb et al., 2008; Wuthrich, Johnco, & Knight, 2014).”
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“…has been shown to have good internal consistency with samples consisting of older adults with GAD (Beck, Stanley, & Zebb, 1995; Hopko, et al., 2003; Webb et al., 2008), children (Pestle, Chorpita, & Schiffmann, 2008), community subjects (Brown, Antony, & Barlow, 1992; Olatunji , Schottenbauer,…”
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“The 16-item PSWQ has adequate psychometric properties in older patients (Stanley et al., 2001; Webb et al., 2008).”
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“sensitivity and specificity for detecting GAD in healthy older adults [37].”
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“Methodological limitations of high risk-of-bias studies included lack of blinding [34, 35, 38, 39, 42–47], lack of appropriate interval between tests [27–29, 32, 34, 35, 42, 44, 46, 47], inadequate sampling [30, 34, 35], and not analyzing data from the full sample [27–30, 32, 34, 35, 43–47].”
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MethodEmotional stroop performance in older adults
Price, R. B. (2011) · Rutgers University Community Repository (Rutgers University) · doi:10.7282/t35b01jp
“Of note, 90% of participants in the HW group scored at or above a PSWQ score of 50, an empirically derived cut-off score that has been shown to maximize sensitivity and specificity in determining the presence of latelife GAD in a geriatric sample (Stanley et al., 2003; Webb et al., 2008).”
Stanley, M. A., WILSON, N. L., Amspoker, A. B., Shrestha, S., Kraus-Schuman, C. A., Freshour, J. S., Barrera, T. L., Bavineau, J., Turner, M., Wagener, P. D., et al. (2019) · doi:10.25302/10.2019.ad.131006824
Self-citationCurrent awareness in geriatric psychiatry
(2009) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.2116
- Authors
- Webb, S. A., Diefenbach, G., Wagener, P., Novy, D. M., Kunik, M., Rhoades, H. M., & Stanley, M. A.
- Affiliations
- Baylor College of Medicine (US)
- Institute of Living Hartford, Connecticut
- Michael E. DeBakey VA Medical Center (US)
- The University of Texas MD Anderson Cancer Center (US)
- The University of Texas Health Science Center at Houston (US)
- Venue
- Journal of Geriatric Psychiatry and Neurology
- Publisher
- SAGE Publications
- Published
- 2008-12
- Volume
- 21
- Issue
- 4
- Pages
- 223-231
- ISSN
- 0891-9887 (ISSN-L)
- 1552-5708
- PMC
- PMC2597543
- OpenAlex
- W2104035044
- Cited by
- 32
- References
- 49
- Citations by year
- 2025: 2 · 2022: 1 · 2021: 2 · 2020: 1 · 2019: 3 · 2018: 2 · 2016: 2 · 2015: 1 · 2014: 3 · 2013: 2 · 2012: 2
- FWCI
- 4.99
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Geriatric Psychiatry and Neurology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health
- National Institute of Mental Health (MH 53932, R01MH053932)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Keywords
- generalized anxiety disorder, late-life anxiety, older adults, Penn State Worry Questionnaire, diagnostic accuracy, primary care, medical patients, cognitive behavioral therapy
- MeSH terms
- Aged, Anxiety Disorders, Data Interpretation, Statistical, Female, Humans, Male, Neuropsychological Tests, Predictive Value of Tests, Primary Health Care, Psychiatric Status Rating Scales, Surveys and Questionnaires
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