In this essay, the prevalence, negative health implications, and clinical management of geriatric anxiety are reviewed. Despite disproportionately high rates of anxiety amongst the elderly, little research effort has been directed at this problem. An interactive model of geriatric anxiety is proposed, whereby physical disease and anxiety processes enter into reciprocal stimulation as a function of 1) diminished capacity to withstand stress, and 2) hypervigilance of stress symptomatology. To date, pharmacotherapy has been virtually the sole approach to managing geriatric anxiety, although special hazards accrue to the elderly when anxiolytics are used. Potentially useful psychological treatments including relaxation, cognitive restructuring, activity structuring, and prevention are outlined. It is concluded that the potential human and financial rewards of increased understanding and control of geriatric anxiety are substantial.
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References
1.
GurinG.VeroffJ.FeldS., Americans View Their Mental Health, Basic Books, New York, 1963.
2.
ParryH. J.BalterM. B.MellingerG. D.CisinI. H.ManheimerD. I., National Patterns of Psychotherapeutic Drug Use, Archives of General Psychiatry, 28, pp. 769–783, 1973.
3.
SpeilbergerC. D., Anxiety: State-Trait-Process, in SpeilbergerC. D.SarasonI. G. (eds.), Stress and Anxiety, 1, Hemisphere, Washington, 1975.
4.
BorkovecT. D., Physiological and Cognitive Processes in the Regulation of Anxiety, in SchwartzG. E.ShapiroD. (eds.), Consciousness and Self-Regulation: Advances in Research, 1, Plenum, New York, 1976.
5.
DavidsonR. J.SchwartzG. E., The Psychobiology of Relaxation and Related States: A Multi-Process Theory, in MostofskyD. I. (ed.), Behavior Confrol and Modificaton of Physiological Activity, Prentice-Hall, Englewood Cliffs, New Jersey, 1976.
6.
GaitzC. M.ScottJ., Age and the Measurement of Mental Health, Journal of Health and Social Behavior, 13, pp. 55–67, 1972.
7.
LeightonD. C.HardingJ. S.MacklinD. B.MacMillanA. M.LeightonA. H., The Character of Danger: Psychiatric Symptoms in Selected Communities, III, Basic Books, New York, 1963.
8.
WalshD. A., Age Differences in Learning and Memory, in WoodruffD. S.BirrenJ. E. (eds), Aging: Scientific Perspectives and Social Issues, D. Van Nostrand, New York, 1975.
9.
NeugartenB. L., Awareness of Middle Age, in NeugartenB. L. (ed.), Middle Age and Aging, University of Chicago Press, Chicago, 1968.
10.
SandbergB.BlidingA., Duodenal Ulcer in Army Trainees During Basic Military Training, Journal of Psychosomatic Research, 20, pp. 61–74, 1976.
11.
AlexanderA. B., Systematic Relaxation and Flow Rates in Asthmatic Children: Relationship to Emotional Precipitants and Anxiety, Journal of Psychosomatic Research, 16, pp. 405–410, 1972.
12.
WhiteheadW. E.BlackwellB.DeSilvaH.RobinsonA., Anxiety and Anger in Hypertension, Journal of Psychosomatic Research, 21, pp. 383–389, 1977.
13.
SchwabJ. J.TravenN. D., Factors Related to the Incidence of Psychosomatic Illness, Psychosomatics, 20, pp. 307–315, 1979.
14.
JenkinsC. D., Psychological and Social Precursors of Coronary Disease, New England Journal of Medicine, 284, pp. 244–255, 1971.
15.
NowlinJ. B.WilliamsR.WilkieF., Prospective Study of Physical and Psychological Factors in Elderly Men Who Subsequently Suffer Acute Myocardial Infarction (AMI), Clinical Research, 21, p. 465, 1973.
16.
LebovitzB. Z.ShekelleR. B.OstfeldA. M.OglesbyP., Prospective and Retrospective Psychological Studies of Coronary Heart Disease, Psychosomatic Medicine, 29, pp. 265–272, 1967.
17.
SuinnR. M., Behavior Therapy for Cardiac Patients, Behavior Therapy, 5, pp. 569–571, 1974.
18.
GundersonE. K. E.RaheR. H., (eds.), Life Stress and Illness, Thomas, Springfield, Illinois, 1974.
19.
DekkerD. J.WebbJ. T., Relationships of the Social Readjustment Rating Scale to Psychiatric Patient Status, Anxiety, and Social Desirability, Journal of Psychosomatic Research, 18, pp. 125–130, 1974.
20.
MuellerD. P.EdwardsD. W.YarvisR. M., Stressful Life Events and Psychiatric Symptomatology: Change or Desirability?, Journal of Health and Social Behavior, 18, pp. 307–317, 1977.
21.
DohrenwendB. S., Life Events as Stressors: A Methodological Inquiry, Journal of Health and Social Behavior, 28, pp. 225–235, 1973.
22.
MyersJ. K.LindenthalJ. J.PepperM. P.OstranderM. P., Life Events and Mental Status: A Longitudinal Study, Journal of Health and Social Behavior, 13, pp. 398–406, 1972.
23.
MasudaM.HolmesT. H., Life Events: Perceptions and FrequenciesPsychosomatic Medicine, 40, pp. 236–261, 1978.
24.
LazarusR. S., Psychological Stress and the Coping Process, McGraw-Hill, New York, 1966.
25.
BalterM. B.LevineJ.ManheimerD. I., Cross-National Study of the Extent of Anti-Anxiety/Sedative Drug Use, New England Journal of Medicine, 290, pp. 769–774, 1974.
26.
SolomonK. H., Benzodiazepines and Neurotic Anxiety: Critique, New York State Journal of Medicine, pp. 2156–2164, 1976.
27.
ZianceR. J., Side Effects of Drugs in the Elderly, in PetersonP. M.WhittingtonF. J.PayneB. P. (eds.), Drugs and the Elderly: Social and Pharmacological Issues, Thomas, Springfield, Illinois, 1979.
28.
ChapronD.LawsonI., Drug Prescribing and Care of the Elderly, in ReichelW. (ed.), Clinical Aspects of Aging, Williams and Wilkins, Baltimore, 1978.
29.
GreenblattD. J.ShaderR. I., Benzodiazepines in Clinical Practice, Raven, New York, 1974.
30.
LaderM., Antianxiety Drugs: Clinical Pharmacology and Therapeutic Use, Drugs, 12, pp. 362–373, 1976.
31.
KrupkaL. R.VenerA. M., Hazards of Drug Use Among the Elderly, The Gerontologist, 19, pp. 90–95, 1979.
32.
BernsteinD. A.BorkovecT. D., Progressive Relaxation: A Manual for the Helping Professions, Research Press, Champaign, Illinois, 1973.
33.
BensonH., The Relaxation Response, Morrow, New York, 1975.
34.
MeichenbaumD., Self-Instructional Strategy Training: A Cognitive Prosthesis for the Aged, Human Development, 17, pp. 273–280, 1974.
35.
MahoneyM. J., Cognition and Behavior Modification, Ballinger, Cambridge, Massachusetts, 1974.
36.
PalmoreE. B., Social Factors in Mental Illness of the Aged, in BusseE. W.PfeifferE. (eds.), Mental Illness in Later Life, American Psychiatric Association, Washington, 1973.
37.
FordyceW. E., Behavioral Methods for Chronic Pain and Illness, Mosby, St. Louis, 1976.
38.
LewinsohnP. M., The Behavioral Study and Treatment of Depression, in HersenM.EislerR. M.MillerP. M. (eds.), Progress in Behavior Modification, 1, Academic Press, New York, 1975.
39.
DeVriesH. A., Physiology of Exercise and Aging, in WoodruffD. S.BirrenJ. E. (eds.), Aging: Scientific Perspectives and Social Issues, D. Van Nostrand, New York, 1975.
40.
LawtonM. P., The Impact of the Environment on Aging and Behavior, in BirrenJ. E.SchaieK. W. (eds.), Handbook of the Psychology of Aging, Van Nostrand Reinhold, New York, 1977.
41.
AlbeeG. W.JoffeJ. M., (eds.), Primary Prevention of Psychopathology: The Issues, 1University Press of New England, Hanover, New Hampshire, 1977.
