Advertisement

Assessment of Anxiety in Older Adults: Translation and Psychometric Evaluation of the German Version of the Geriatric Anxiety Scale (GAS)

  • Juliana Gottschling
  • Daniel L. Segal
  • Claudia Häusele
  • Frank M. Spinath
  • Gundula Stoll
Article

Abstract

Anxiety occurs frequently among older adults, and can have deleterious impacts on the quality of daily life. Due to the dearth of well-validated elder-specific anxiety screening instruments available in the German language, this study aimed to translate the Geriatric Anxiety Scale (GAS), a reliable and valid 30-item self-report screening instrument for assessing anxiety based on DSM-IV-TR diagnostic criteria (Segal et al. Journal of Anxiety Disorders, 24(7), 709–714, 2010a), into German, and to validate the new measure. The German version of the GAS was developed through a translation and back translation process, with careful attention paid to culturally-sensitive expressions of anxiety in the German older adult population. The final version of the German GAS was tested in a sample of 242 community-dwelling older adults (Mage = 72.0 years, SD = 6.9 years; 59 % women) who completed either an online (26 %) or a paper-pencil (74 %) version of the questionnaire. The findings confirmed the successful translation of the GAS into German and provided psychometric support for the new measure. The validation of the factor structure based on confirmatory factor analyses was in support of a unidimensional structure of the GAS-G. Correlational analyses with inventories measuring anxiety related and non-anxiety related personality traits additionally confirmed the convergent and discriminant validity of the GAS for use as an assessment measure for anxiety among German older adults.

Keywords

Anxiety Aging Assessment Screening GAS Geriatric anxiety scale 

Notes

Acknowledgments

We gratefully thank Cynthia Mech and Christine Waegner from Saarland University for their help in collecting and preparing the data. We also thank Octavia Harrison from Saarland University for her support in the back translation process, as well as Prof. Dr. Oliver K. Schilling from Heidelberg University and Dr. Sonja Römer from Saarland University for their evaluation of the appropriateness of the German GAS items.

The GAS is available for free for research purposes and may be obtained from either Dr. Gottschling (j.gottschling@mx.uni-saarland.de) or Dr. Segal (dsegal@uccs.edu).

Conflict of Interest

Juliana Gottschling, Daniel Segal, Claudia Häusele, Gundula Stoll, and Frank Spinath declare that they do not have any interests that might have influenced this research. The same work (or closely related research) has not been published or accepted for publication elsewhere. It will not be submitted elsewhere prior to Journal of Psychopathology and Behavioral Assessment making an editorial decision. No other papers using the same data set have been published. The article has been approved by all of the authors and by the institutions at which the work was carried out. Informed consent was obtained from all individual participants included in the study. I have assumed responsibility for keeping my coauthors informed of our progress through the editorial review process, the content of the reviews, and any revisions made.

Experiment Participants

The procedures, protocol, and informed consent in the present study were approved by the Institutional Review Board of Saarland University.

References

  1. Allgulander, C., & Lavori, P. W. (1993). Causes of death among 936 elderly patients with “pure” anxiety neurosis in Stockholm County, Sweden, and in patients with depressive neurosis or both diagnoses. Comprehensive Psychiatry, 34(5), 299–302.PubMedCrossRefGoogle Scholar
  2. Alwahhabi, F. (2003). Anxiety symptoms and generalized anxiety disorder in the elderly: a review. Harvard Review of Psychiatry, 11(4), 180–193.PubMedCrossRefGoogle Scholar
  3. American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed.). Arlington: American Psychiatric Publishing.Google Scholar
  4. Andrew, D. H., & Dulin, P. L. (2007). The relationship between self-reported health and mental health problems among older adults in New Zealand: experiential avoidance as a moderator. Aging & Mental Health, 11(5), 596–603.CrossRefGoogle Scholar
  5. Babcock, R. L., MaloneBeach, E. E., Hou, B., & Smith, M. (2012). The experience of worry among young and older adults in the United States and Germany: a cross-national comparison. Aging & Mental Health, 16(4), 413–422.CrossRefGoogle Scholar
  6. Baxter, A. J., Scott, K. M., Vos, T., & Whiteford, H. A. (2013). Global prevalence of anxiety disorders: a systematic review and meta-regression. Psychological Medicine, 43(05), 897–910.PubMedCrossRefGoogle Scholar
  7. Beck, A. T., Steer, R. A., & Carbin, M. G. (1988). Psychometric properties of the Beck Depression Inventory: twenty-five years of evaluation. Clinical Psychology Review, 8(1), 77–100.CrossRefGoogle Scholar
  8. Bolghan-Abadi, M., Segal, D. L., Coolidge, F. L., & Gottschling, J. (2013). Persian version of the Geriatric Anxiety Scale: translation and preliminary psychometric properties among Iranian older adults. Aging & Mental Health, 17(7), 896–900.CrossRefGoogle Scholar
  9. 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.PubMedPubMedCentralCrossRefGoogle Scholar
  10. Brown, T. A. (2006). Confirmatory factor analysis for applied research. New York: Guilford Press.Google Scholar
  11. 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.PubMedCrossRefGoogle Scholar
  12. Byrne, G. J., Pachana, N. A., Goncalves, D. C., Arnold, E., King, R., & Khoo, S. K. (2010). Psychometric properties and health correlates of the Geriatric Anxiety Inventory in Australian community-residing older women. Aging & Mental Health, 14(3), 247–254.CrossRefGoogle Scholar
  13. Cairney, J., Corna, L. M., Veldhuizen, S., Herrmann, N., & Streiner, D. L. (2008). Comorbid depression and anxiety in later life: patterns of association, subjective well-being, and impairment. The American Journal of Geriatric Psychiatry, 16(3), 201–208.PubMedCrossRefGoogle Scholar
  14. Cohan, S. L., Jang, K. L., & Stein, M. B. (2006). Confirmatory factor analysis of a short form of the Coping Inventory for Stressful Situations. Journal of Clinical Psychology, 62(3), 273–283.PubMedCrossRefGoogle Scholar
  15. Coolidge, F. L., Segal, D. L., Hook, J. N., & Stewart, S. (2000). Personality disorders and coping among anxious older adults. Journal of Anxiety Disorders, 14(2), 157–172.PubMedCrossRefGoogle Scholar
  16. Dennis, R. E., Boddington, S. J. A., & Funnell, N. J. (2007). Self-report measures of anxiety: are they suitable for older adults? Aging & Mental Health, 11(6), 668–677.CrossRefGoogle Scholar
  17. Derogatis, L. R. (1993). The Brief Symptom Inventory (BSI): Administration, scoring and procedures manual (3rd ed.). Minneapolis: National Computer Systems, Inc. Retrieved from https://www.statisticssolutions.com/brief-symptom-inventory-bsi/
  18. Derogatis, L. R. (2000). BSI-18: Brief Symptom Inventory 18 – Administration, scoring, and procedures manual. Minneapolis: Pearson.Google Scholar
  19. Diefenbach, G. J., Tolin, D. F., Meunier, S. A., & Gilliam, C. M. (2009). Assessment of anxiety in older home care recipients. The Gerontologist, 49(2), 141–153.PubMedPubMedCentralCrossRefGoogle Scholar
  20. Dilling, H., Mombour, W., Schmidt, M. H., & Schulte-Markwort, E. (2004). Internationale Klassifikation psychischer Störungen: ICD-10 Kapitel V [International Classification of mental disorders: ICD-10 Chapter V] (5th ed.). Bern: Huber.Google Scholar
  21. Edelstein, B. A., Woodhead, E. L., Segal, D. L., Heisel, M. J., Bower, E. H., Lowery, A. J., & Stoner, S. A. (2008). Older adult psychological assessment: current instrument status and related considerations. Clinical Gerontologist, 31(3), 1–35.CrossRefGoogle Scholar
  22. Endler, N. S., & Parker, J. D. A. (1999). Coping Inventory for Stressful Situations (CISS): Manual. Multi-Health Systems.Google Scholar
  23. First, M., Spitzer, R., Gibbon, M., & Williams, J. (2002). Structured clinical interview for DSM-IV-TR Axis I Disorders, research version. New York: New York State Psychiatric Institute.Google Scholar
  24. Franke, G. H. (2000). BSI. Brief Symptom Inventory – Deutsche Version. Manual.. Beltz: Göttingen.Google Scholar
  25. Gould, C. E., Segal, D. L., Yochim, B. P., Pachana, N. A., Byrne, G. J., & Beaudreau, S. A. (2014). Measuring anxiety in late life: a psychometric examination of the Geriatric Anxiety Inventory and Geriatric Anxiety Scale. Journal of Anxiety Disorders, 28(8), 804–811.PubMedCrossRefGoogle Scholar
  26. Gum, A. M., King-Kallimanis, B., & Kohn, R. (2009). Prevalence of mood, anxiety, and substance-abuse disorders for older Americans in the national comorbidity survey-replication. The American Journal of Geriatric Psychiatry: Official Journal of the American Association for Geriatric Psychiatry, 17(9), 769–781.CrossRefGoogle Scholar
  27. Hu, L., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives. Structural Equation Modeling, 6(1), 1–55.CrossRefGoogle Scholar
  28. John, O. P., Donahue, E. M., & Kentle, R. L. (1991). The big five inventory: Versions 4a and 54. Berkeley: University of California, Institute of Personality and Social Research.Google Scholar
  29. Kabacoff, R. I., Segal, D. L., Hersen, M., & Van Hasselt, V. B. (1997). Psychometric properties and diagnostic utility of the Beck Anxiety Inventory and the State-Trait Anxiety Inventory with older adult psychiatric outpatients. Journal of Anxiety Disorders, 11(1), 33–47.PubMedCrossRefGoogle Scholar
  30. Kessler, R. C., Amminger, G. P., Aguilar-Gaxiola, S., Alonso, J., Lee, S., & Ustun, T. B. (2007). Age of onset of mental disorders: a review of recent literature. Current Opinion in Psychiatry, 20(4), 359–364.PubMedPubMedCentralCrossRefGoogle Scholar
  31. Kline, R. B. (2011). Principles and practice of structural equation modeling. New York: Guilford Press.Google Scholar
  32. Kogan, J. N., Edelstein, B. A., & McKee, D. R. (2000). Assessment of anxiety in older adults: current status. Journal of Anxiety Disorders, 14(2), 109–132.PubMedCrossRefGoogle Scholar
  33. Krohne, H. W., Egloff, B., Kohlmann, C.-W., & Tausch, A. (1996). Untersuchungen mit einer deutschen Version der “Positive and Negative Affect Schedule”(PANAS) [Studies with a German version of the “Positive and Negative Affect Schedule”(PANAS)]. Diagnostica, 42, 139–156.Google Scholar
  34. Laidlaw, K., & Pachana, N. A. (2009). Aging, mental health, and demographic change: challenges for psychotherapists. Professional Psychology: Research and Practice, 40(6), 601–608.CrossRefGoogle Scholar
  35. Lang, F. R., Lüdtke, O., & Asendorpf, J. B. (2001). Testgüte und psychometrische Äquivalenz der deutschen Version des Big Five Inventory (BFI) bei jungen, mittelalten und alten Erwachsenen [Test quality and equivalence of the German version of the Big Five Inventory (BFI) with young, middle-old and old adults]. Diagnostica, 47(3), 111–121.CrossRefGoogle Scholar
  36. Little, R. J. A., & Rubin, D. B. (2002). Statistical analysis with missing data. Hoboken: Wiley.CrossRefGoogle Scholar
  37. Luszczynska, A., Scholz, U., & Schwarzer, R. (2005). The general self-efficacy scale: multicultural validation studies. Journal of Psychology: Interdisciplinary and Applied, 139(5), 439–457.CrossRefGoogle Scholar
  38. Margraf, J., & Ehlers, A. (2007). Beck-Angst-Inventar (BAI) Manual. [The Beck Anxiety Inventory (BAI), Manual]. Frankfurt am Main: Hardcourt Test Services GmbH.Google Scholar
  39. Meeks, S., Woodruff-Borden, J., & Depp, C. A. (2003). Structural differentiation of self-reported depression and anxiety in late life. Journal of Anxiety Disorders, 17(6), 627–646.PubMedCrossRefGoogle Scholar
  40. Mehta, K. M., Simonsick, E. M., Penninx, B. W. J. H., Schulz, R., Rubin, S. M., Satterfield, S., & Yaffe, K. (2003). Prevalence and correlates of anxiety symptoms in well-functioning older adults: findings from the health aging and body composition study. Journal of the American Geriatrics Society, 51(4), 499–504.PubMedCrossRefGoogle Scholar
  41. Mueller, A. E., Segal, D. L., Gavett, B., Marty, M. A., Yochim, B., June, A., & Coolidge, F. L. (2015). Geriatric Anxiety Scale: item response theory analysis, differential item functioning, and creation of a ten-item short form (GAS-10). International Psychogeriatrics, 27, 1099–1111.PubMedCrossRefGoogle Scholar
  42. Muthén, L. K., & Muthén, B. O. (1998). Mplus: Statistical analysis with latent variables (Version 6). Los Angeles: Authors.Google Scholar
  43. Noorbala, A. A., Bagheri Yazdi, S. A., Yasamy, M. T., & Mohammad, K. (2004). Mental health survey of the adult population in Iran. The British Journal of Psychiatry, 184, 70–73.PubMedCrossRefGoogle Scholar
  44. 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.PubMedCrossRefGoogle Scholar
  45. Pettit, F. A. (2002). A comparison of World-Wide Web and paper-and-pencil personality questionnaires. Behavior Research Methods, Instruments, & Computers: A Journal of the Psychonomic Society, Inc, 34(1), 50–54.CrossRefGoogle Scholar
  46. Rammstedt, B., & John, O. P. (2005). Kurzversion des Big Five Inventory (BFI-K) [Short version of the Big Five Inventory, BFI-K]. Diagnostica, 51(4), 195–206.CrossRefGoogle Scholar
  47. Sass, H., Wittchen, H. U., Zaudig, M., & Houben, I. (2003). Diagnostisches und Statistisches Manual Psychischer Störungen DSM-IV-TR: Textrevision [Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR: Revised text]. Göttingen: Hogrefe Verlag.Google Scholar
  48. 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), 48–54.PubMedCrossRefGoogle Scholar
  49. Schermelleh-Engel, K., Moosbrugger, H., & Müller, H. (2003). Evaluating the fit of structural equation models: tests of significance and descriptive goodness-of-fit measures. MPR-Online, 8(2), 23–74.Google Scholar
  50. Schwarzer, R., & Jerusalem, M. (1995). Generalized self-efficacy scale. In J. Weinman & S. Wright (Eds.), Measures in health psychology: A user’s portfolio. Causal and control beliefs (pp. 35–37). Windsor: NFER-NELSON.Google Scholar
  51. Seeman, T. E., Berkman, L. F., Charpentier, P. A., Blazer, D. G., Albert, M. S., & Tinetti, M. E. (1995). Behavioral and psychosocial predictors of physical performance: MacArthur studies of successful aging. The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, 50(4), 177–183.CrossRefGoogle Scholar
  52. Segal, D. L., June, A., Payne, M., Coolidge, F. L., & Yochim, B. (2010a). 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.PubMedCrossRefGoogle Scholar
  53. Segal, D. L., Qualls, S. H., & Smyer, M. A. (2010b). Aging and mental health (2nd ed.). Chichester: Wiley-Blackwell.Google Scholar
  54. Seignourel, P. J., Kunik, M. E., Snow, L., Wilson, N., & Stanley, M. (2008). Anxiety in dementia. Clinical Psychology Review, 28(7), 1071–1082.PubMedPubMedCentralCrossRefGoogle Scholar
  55. Spinath, F. M., & Wolf, H. (2006). CoSMoS and TwinPaW: initial report on two new German twin studies. Twin Research and Human Genetics, 9(6), 787–790.PubMedCrossRefGoogle Scholar
  56. Spitzer, C., Hammer, S., Löwe, B., Grabe, H., Barnow, S., Rose, M., et al. (2011). Die Kurzform des Brief Symptom Inventory (BSI-18): Erste Befunde zu den psychometrischen Kennwerten der deutschen Version [The short version of the Brief Symptom Inventory (BSI-18): Initial results of the psychometric properties of the German version]. Fortschritte der Neurologie Psychiatrie, 79(09), 517–523.PubMedCrossRefGoogle Scholar
  57. Statistisches Bundesamt. (2013). Statistisches Jahrbuch 2013.“Deutschland und Internationales” [Statistical Yearbook 2013]. Wiesbaden: Statistisches Bundesamt.Google Scholar
  58. Strine, T. W., Chapman, D. P., Kobau, R., & Balluz, L. (2005). Associations of self-reported anxiety symptoms with health-related quality of life and health behaviors. Social Psychiatry and Psychiatric Epidemiology, 40(6), 432–438.PubMedCrossRefGoogle Scholar
  59. Teachman, B. A., Siedlecki, K. L., & Magee, J. C. (2007). Aging and symptoms of anxiety and depression: structural invariance of the tripartite model. Psychology and Aging, 22(1), 160–170.PubMedCrossRefGoogle Scholar
  60. 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.CrossRefGoogle Scholar
  61. Van Zelst, W. H., de Beurs, E., Beekman, A. T. F., Deeg, D. J. H., & van Dyck, R. (2003). Prevalence and risk factors of posttraumatic stress disorder in older adults. Psychotherapy and Psychosomatics, 72(6), 333–342.PubMedCrossRefGoogle Scholar
  62. Vink, D., Aartsen, M. J., Comijs, H. C., Heymans, M. W., Penninx, B. W. J. H., Stek, M. L., et al. (2009). Onset of anxiety and depression in the aging population: comparison of risk factors in a 9-year prospective study. The American Journal of Geriatric Psychiatry, 17(8), 642–652.PubMedCrossRefGoogle Scholar
  63. 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
  64. West, S. G., Finch, J. F., & Curran, P. J. (1995). Structural equation models with nonnormal variables: Problems and remedies. In R. Hoyle (Ed.), Structural equation modeling: Concepts, issues, and applications (pp. 56–75). Thousand Oaks: SAGE Publications, Inc.Google Scholar
  65. Wetherell, J. L., & Areán, P. A. (1997). Psychometric evaluation of the Beck Anxiety Inventory with older medical patients. Psychological Assessment, 9(2), 136–144.CrossRefGoogle Scholar
  66. Wetherell, J. L., & Gatz, M. (2005). The Beck Anxiety Inventory in older adults with generalized anxiety disorder. Journal of Psychopathology and Behavioral Assessment, 27(1), 17–24.CrossRefGoogle Scholar
  67. Wetherell, J. L., Thorp, S. R., Patterson, T. L., Golshan, S., Jeste, D. V., & Gatz, M. (2004). Quality of life in geriatric generalized anxiety disorder: a preliminary investigation. Journal of Psychiatric Research, 38(3), 305–312.PubMedCrossRefGoogle Scholar
  68. 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.PubMedCrossRefGoogle Scholar
  69. Yochim, B. P., Mueller, A. E., June, A., & Segal, D. L. (2011). Psychometric properties of the Geriatric Anxiety Scale: comparison to the Beck Anxiety Inventory and Geriatric Anxiety Inventory. Clinical Gerontologist, 34(1), 21–33.CrossRefGoogle Scholar
  70. Yochim, B. P., Mueller, A. E., & Segal, D. L. (2013). Late life anxiety is associated with decreased memory and executive functioning in community dwelling older adults. Journal of Anxiety Disorders, 27(6), 567–575.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  1. 1.Department of PsychologySaarland UniversitySaarbrueckenGermany
  2. 2.Department of PsychologyUniversity of Colorado at Colorado SpringsColorado SpringsUSA
  3. 3.Hector Research Institute of Education Sciences and PsychologyUniversity of TuebingenTuebingenGermany

Personalised recommendations