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Comparison of Self-report Measures for Identifying Late-life Generalized Anxiety in Primary Care

Menninger Department of Psychiatry and Behavioral Sciences

Gretchen Diefenbach, PhD

Institute of Living Hartford, Connecticut

Paula Wagener, BA

Houston Center for Quality of Care & Utilization Studies, Michael E. DeBakey Veterans Affairs Medical Center, Menninger Department of Psychiatry and Behavioral Sciences

Diane M. Novy, PhD

Department of Anesthesiology, The University of Texas M.D. Anderson Cancer Center

Mark Kunik, MD, MPH

Veterans Affairs South Central Mental Illness Research, Education & Clinical Center, Houston Center for Quality of Care & Utilization Studies, Michael E. DeBakey Veterans Affairs Medical Center, Department of Medicine Baylor College of Medicine, Houston, Texas

Howard M. Rhoades, PhD

Department of Psychiatry, The University of Texas Health Science Center Houston, Texas

Melinda A. Stanley, PhD

Veterans Affairs South Central Mental Illness Research, Education & Clinical Center, Houston Center for Quality of Care & Utilization Studies, Michael E. DeBakey Veterans Affairs Medical Center, Menninger Department of Psychiatry and Behavioral Sciences, mstanley{at}bcm.tmc.edu

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.

Key Words: late-life anxiety • PSWQ • GAD-Q-IV • PRIME-MD • primary care psychology • sensitivity • specificity

Journal of Geriatric Psychiatry and Neurology, Vol. 21, No. 4, 223-231 (2008)
DOI: 10.1177/0891988708324936


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