Hostname: page-component-cd9895bd7-hc48f Total loading time: 0 Render date: 2024-12-22T18:25:11.842Z Has data issue: false hasContentIssue false

Illness burden and symptoms of anxiety in older adults: optimism and pessimism as moderators

Published online by Cambridge University Press:  17 May 2012

Jameson K. Hirsch*
Affiliation:
Department of Psychology, East Tennessee State University, Johnson City, Tennessee, USA
Kristin L. Walker
Affiliation:
Department of Psychology, East Tennessee State University, Johnson City, Tennessee, USA
Edward C. Chang
Affiliation:
Department of Psychology, University of Michigan, Ann Arbor, Michigan, USA
Jeffrey M. Lyness
Affiliation:
Department of Psychiatry, University of Rochester Medical Center, Rochester, New York, USA
*
Correspondence should be addressed to: Jameson K. Hirsch, PhD, Department of Psychology, East Tennessee State University, Johnson City, TN 37614, USA. Phone: +1(423) 439-4463; Fax: +1(423) 439-5695. Email: [email protected].
Get access

Abstract

Background: We assessed the association between medical illness burden and anxiety symptoms, hypothesizing that greater illness burden would be associated with symptoms of anxiety, and that optimism would buffer, while pessimism would exacerbate, this relationship.

Methods: We recruited 109 older adults, aged 65 years and older, from primary care and geriatric clinics to participate in this cross-sectional, interview-based study. Participants completed the Snaith Clinical Anxiety Scale and the Life Orientation Test – Revised, a measure of optimism/pessimism. A physician-rated measure of illness burden, the Cumulative Illness Rating Scale, was also administered.

Results: Supporting our hypotheses, greater levels of overall optimism weakened, and pessimism strengthened, the association between illness burden and anxiety symptoms, after accounting for the effects of demographic, cognitive, functional, and psychological covariates.

Conclusions: Bolstering positive and reducing negative future expectancies may aid in the prevention of psychological distress in medically ill older adults. Therapeutic strategies to enhance optimism and reduce pessimism, which may be well-suited to primary care and other medical settings, and to which older adults may be particularly amenable, may contribute to reduced health-related anxiety.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Albrecht, G. L. and Devlieger, P. J. (1999). The disability paradox: high quality of life against all odds. Social Science & Medicine, 48, 977988.CrossRefGoogle ScholarPubMed
Baron, R. M. and Kenny, D. A. (1986). The moderator mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51, 11731182.Google Scholar
Benyamini, Y., Idler, E. L., Leventhal, H. and Leventhal, E. A. (2000). Positive affect and function as influences on self-assessments of health: expanding our view beyond illness and disability. Journals of Gerontology B: Psychological Sciences and Social Sciences, 55, 107116.CrossRefGoogle ScholarPubMed
Bjelland, I., Dahl, A. A., Haug, T. T. and Neckelmann, D. (2002). The validity of the Hospital Anxiety and Depression Scale: an updated literature review. Journal of Psychosomatic Research, 52, 6977.CrossRefGoogle ScholarPubMed
Brissette, I., Scheier, M. F. and Carver, C. S. (2002). The role of optimism in social network development, coping, and psychological adjustment during a life transition. Journal of Personality and Social Psychology, 82, 102111.CrossRefGoogle ScholarPubMed
Carstensen, L. L., Fung, H. H. and Charles, S. T. (2003). Socioemotional selectivity theory and the regulation of emotion in the second half of life. Motivation and Emotion, 27, 103123.Google Scholar
Chang, E. C. and Farrehi, A. S. (2001). Optimism/pessimism and information-processing styles: can their influences be distinguished in predicting psychological adjustment? Personality and Individual Differences, 31, 555562.Google Scholar
Chang, E. C. and Sanna, L. J. (2001). Optimism, pessimism, and positive and negative affectivity in middle-aged adults: a test of a cognitive-affective model of psychological adjustment. Psychology and Aging, 16, 524531.Google Scholar
Cigolle, C. T., Langa, K. M., Kabeto, M. U., Tian, Z. and Blaum, C. S. (2007). Geriatric conditions and disability: the health and retirement study. Annals of Internal Medicine, 147, 156164.CrossRefGoogle ScholarPubMed
Cully, J. A. et al. (2006). Quality of life in patients with chronic obstructive pulmonary disease and comorbid anxiety or depression. Psychosomatics, 47, 312319.Google Scholar
de Ridder, D., Fournier, M. and Bensing, J. (2004). Does optimism affect symptom report in chronic disease? What are its consequences for self-care behaviour and physical functioning? Journal of Psychosomatic Research, 56, 341350.Google Scholar
DiMatteo, M. R., Lepper, H. S. and Croghan, T. W. (2000). Depression is a risk factor for noncompliance with medical treatment: meta-analysis of the effects of anxiety and depression on patient adherence. Archives of Internal Medicine, 160, 21012107.Google Scholar
Duke, J., Leventhal, H., Brownlee, S. and Leventhal, E. A. (2002). Giving up and replacing activities in response to illness. Journals of Gerontology B: Psychological Sciences and Social Sciences, 57, 367376.Google Scholar
Folstein, M. F., Folstein, S. E. and McHugh, P. R. (1975). “Mini-mental state”: a practical method of grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189198.CrossRefGoogle Scholar
Hamilton, M. (1960). A rating scale for depression. Journal of Neurology, Neurosurgery and Psychiatry, 23, 5661.Google Scholar
Hawkins, M. T. and Miller, R. J. (2003). Cognitive vulnerability and resilience to depressed mood. Australian Journal of Psychology, 55, 176183.Google Scholar
Hirsch, J. K., Duberstein, P. R., Chapman, B. and Lyness, J. M. (2007). Positive and negative affect and suicide ideation in older adult primary care patients. Psychology & Aging, 22, 8085.CrossRefGoogle ScholarPubMed
Hocking, L. B. and Koenig, H. G. (1995). Anxiety in medically ill older patients: a review and update. International Journal of Psychiatry in Medicine, 25, 221238.CrossRefGoogle Scholar
Hudon, C., Fortin, M. and Vanasse, A. (2005). Cumulative Illness Rating Scale was a reliable and valid index in a family practice context. Journal of Clinical Epidemiology, 58, 603608.Google Scholar
Karnofsky, D. A. and Barchenal, J. H. (1949). The clinical evaluation of chemotherapeutic agents in cancer. In Macleod, C. M. (ed.), Evaluation of Chemotherapeutic Agents (pp. 191205). New York: Columbia University Press.Google Scholar
Katon, W. J., Richardson, L., Lozano, P. and McCauley, E. (2004). The relationship of asthma and anxiety disorders. Psychosomatic Medicine, 66, 349355.Google ScholarPubMed
Koder, D. A. (1998). Treatment of anxiety in the cognitively impaired elderly: can cognitive-behavior therapy help? International Psychogeriatrics, 10, 173182.Google Scholar
Kraus, C. A. et al. (2008). Cognitive-behavioral treatment for anxiety in patients with dementia: two case studies. Journal of Psychiatric Practice, 14, 186192.CrossRefGoogle ScholarPubMed
Lenze, E. J. et al. (2001). The association of late-life depression and anxiety with physical disability: a review of the literature and prospectus for future research. American Journal of Geriatric Psychiatry, 9, 113135.CrossRefGoogle ScholarPubMed
Linn, B. S., Linn, M. W. and Gurel, L. (1968). Cumulative illness rating scale. Journal of the American Geriatrics Society, 16, 622626.CrossRefGoogle ScholarPubMed
Marshall, G. N., Wortman, C. B., Kusulas, J. W., Hervig, L. K. and Vickers, R. R. (1992). Distinguishing optimism from pessimism: relations to fundamental dimensions of mood and personality. Journal of Personality & Social Psychology, 62, 10671074.Google Scholar
Mroczek, D. K., Spiro, A., Aldwin, C. M., Ozer, D. J. and Bosse, R. (1993). Construct validation of optimism and pessimism in older men: findings from the normative aging study. Health Psychology, 12, 406409.Google Scholar
Myers, L. B. and Steed, L. (1999). The relationship between dispositional optimism, dispositional pessimism, repressive coping and trait anxiety. Personality and Individual Differences, 27, 12611272.CrossRefGoogle Scholar
Pachana, N. A., Byrne, G. J., Siddle, H., Koloski, N., Harley, E. and Arnold, E. (2007). Development and validation of the Geriatric Anxiety Inventory. International Psychogeriatrics, 19, 103114.Google Scholar
Parmelee, P. A., Thuras, P. D., Katz, I. R. and Lawton, M. P. (1995). Validation of the Cumulative Illness Rating Scale in a geriatric residential population. Journal of the American Geriatrics Society, 43, 130137.CrossRefGoogle Scholar
Robinson-Whelen, S., Kim, C., MacCallum, R. C. and Kiecolt-Glaser, J. (1997). Distinguishing optimism from pessimism in older adults: is it more important to be optimistic or not to be pessimistic? Journal of Personality & Social Psychology, 73, 13451353.CrossRefGoogle ScholarPubMed
Scheier, M. F. and Carver, C. S. (1985). Optimism, coping, and health: assessment and implications of generalized outcome expectancies. Health Psychology, 4, 219247.Google Scholar
Scheier, M. F. and Carver, C. S. (1992). Effects of optimism on psychological and physical well-being: theoretical overview and empirical update. Cognitive Therapy and Research, 16, 201228.Google Scholar
Scheier, M. F., Carver, C. S. and Bridges, M. W. (1994). Distinguishing optimism from neuroticism (and trait anxiety, self-mastery, and self-esteem): a reevaluation of the Life Orientation Test. Journal of Personality and Social Psychology, 67, 10631078.Google Scholar
Segal, D. L., June, A., Payne, M., Coolidge, F. L. and Yochim, B. (2010). Development and initial validation of a self-report assessment tool for anxiety among older adults: the Geriatric Anxiety Scale. Journal of Anxiety Disorders, 24, 709714.Google Scholar
Snaith, R. P., Constantopoulos, A. A., Jardine, M. Y. and McGuffin, P. (1978). A clinical scale for the self-assessment of irritability. British Journal of Psychiatry, 132, 164171.CrossRefGoogle ScholarPubMed
Soo, H., Burney, S. and Basten, C. (2009). The role of rumination in affective distress in people with a chronic physical illness. Journal of Health Psychology, 14, 956966.Google Scholar
Stanley, M., Roberts, R., Bourland, S. and Novy, D. (2001). Anxiety disorders among older primary care patients. Journal of Clinical Geropsychology, 7, 105116.CrossRefGoogle Scholar
Wetherell, J. L., Sorrell, J. T., Thorp, S. R. and Patterson, T. L. (2005). Psychological interventions for late-life anxiety: a review and early lessons from the CALM study. Journal of Geriatric Psychiatry and Neurology, 18, 7282.Google Scholar