Biomedical subjects

Diane M Novy

Publications and source records attributed to Diane M Novy.

8 recordsLinked to original sources

PubMed2003

'Minor GAD': characteristics of subsyndromal GAD in older adults.

Subsyndromal emotional symptoms are common in older adults and are associated with increased disability, health care utilization, and risk for developing psychiatric disorders. The purpose of this study was to examine subsyndromal generalized anxiety disorder (GAD) in older adults. Participants included 30 older adults with diagnosable GAD, 19 with subsyndromal anxiety symptoms [minor GAD; (MGAD)], and 21 normal control volunteers (NC). Participants were assessed using the Anxiety Disorders Interview Schedule for DSM-IV and completed self-report measures of anxiety, worry, depression, and life satisfaction. Excessive worry on more days than not, difficulty controlling worry, and clinically significant distress or impairment were the diagnostic criteria endorsed by MGAD participants least often. Therefore, these criteria may be useful in distinguishing between GAD and subsyndromal GAD. Self-reported anxiety and worry also systematically differed across groups in the expected directions, with a discriminant analysis yielding good classification of the GAD and NC groups based on these measures. Categorization of MGAD participants generally was poor, with most misclassified as GAD patients. Clinical implications of these findings are discussed.

Aged↗

PubMed2003

Cognitive-behavioral treatment of late-life generalized anxiety disorder.

This study addressed the efficacy of cognitive-behavioral therapy (CBT), relative to minimal contact control (MCC), in a sample of 85 older adults (age 60 years and over) with generalized anxiety disorder (GAD). All participants completed measures of primary outcome (worry and anxiety), coexistent symptoms (depressive symptoms and specific fears), and quality of life. Results of both completer and intent-to-treat analyses revealed significant improvement in worry, anxiety, depression, and quality of life following CBT relative to MCC. Forty-five percent of patients in CBT were classified as responders, relative to 8% in MCC. Most gains for patients in CBT were maintained or enhanced over 1-year follow-up. However, posttreatment scores for patients in CBT failed to indicate return to normative functioning.

Age Factors↗

PubMed2003

Assessing worry in older adults: confirmatory factor analysis of the Penn State Worry Questionnaire and psychometric properties of an abbreviated model.

The assessment of worry among older adults typically has involved measures designed with younger cohorts. Because of special concerns in assessing older adults, modifications to existing instruments may be necessary. Addressing equivocal factor analytic data on the Penn State Worry Questionnaire (PSWQ) among younger adults, the authors conducted confirmatory factor analyses to evaluate the generalizability of previous models to older adults with generalized anxiety disorder. Data fit poorly with established single- and two-factor models. The single-factor model was modified, resulting in the elimination of 8 items, strong fit indices, high internal consistency, adequate test-retest reliability, and good convergent and divergent validity. Further psychometric work is required to assess whether the revised model is a more parsimonious method to assess late-life anxiety.

Aged↗

PubMed2003

Differentiating anxiety and depression in older adults with generalized anxiety disorder.

To examine affect and cognition in differentiating anxiety and depression, 83 older participants with generalized anxiety disorder completed the Cognitive Checklist (CCL) and the Positive and Negative Affect Schedule (PANAS). A 3-factor solution was found for the PANAS: positive affect (PA), anxiety and anger (Negative Affect 1 [NA-1]), and guilt and shame (Negative Affect 2 [NA-2]). A 2-factor structure was noted for the CCL. Correlations with anxiety and depression measures suggested that the CCL Depression (CCL-D) subscale showed stronger correlations with depression, whereas the CCL Anxiety subscale did not uniquely correlate with anxiety. The NA-1 subscale correlated positively with measures of depression and anxiety, whereas the PA subscale showed negative correlations. Hierarchical regression suggested that the CCL-D subscale was a significant predictor of self-reported depression.

Affect↗

PubMed2002

Physical performance tasks: what are the underlying constructs?

OBJECTIVES: To investigate the structural validity of a battery of physical performance tasks and to investigate the construct validity of the resulting factors. DESIGN: A measurement study. SETTING: A large, private orthopedic clinic and a physical therapy clinic in an urban area. PARTICIPANTS: One hundred three consecutive adult patients with low back pain who were referred for physical therapy assessment. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: The physical performance battery was composed of the 50-foot speed walk, 5-minute walk, repeated trunk flexion, sit to stand, loaded reach, rollover tasks, and Sorensen upper-body lift. Participants also completed 5 self-report measures. RESULTS: Two correlated (.74) factors, speed and coordination and endurance and strength, were derived from the physical performance tasks. The Sorenson upper-body lift task was the only indicator that was not useful in defining the factors. Both factors had statistically significant correlations with measures of physical disability, lack of self-efficacy, and negative affect. Both factors had a trivial correlation with a numeric rating of pain intensity. CONCLUSIONS: There is support for 2 meaningful empiric groupings (ie, the derived factors) of the performance tasks. Pain intensity had a trivial overlap with speed-coordination and endurance-strength factors.

Adult↗

PubMed2002

Measures of self-efficacy and optimism in older adults with generalized anxiety.

This study provides initial psychometric data for the Self-Efficacy Scale (SES) and the Life Orientation Test (LOT) in a sample of older adults with generalized anxiety disorder (GAD). Participants included 76 adults, ages 60 to 80, who met Diagnostic and Statistical Manual of Mental Disorders (4th ed.) criteria for GAD. Self-efficacy and outcome expectancies were lower in older adults with GAD relative to published data from younger and older community samples. Both the SES and LOT demonstrated adequate internal consistency. Confirmatory factor analysis provided evidence for optimism and pessimism factors within the LOT and exploratory factor analysis of the SES suggested threefactors that overlap with previous findings. Overall, the data support the potential utility of these instruments in late-life GAD and set the stage forfuture investigations of generalized self-efficacy expectancies and outcome expectancies (or optimism) as they relate to the prediction of affect and behavior in this group.

Aged↗

PubMed1996

Correlates of depression in chronic pain patients: a comprehensive examination.

This study examined the relations between depression and demographic, pain-related, and work-related variables in 254 chronic pain patients. Regression analyses were conducted, initially by category (i.e., demographic, pain-related, and work-related), and finally a comprehensive regression analysis was performed, containing the significant independent variables from each category. Among the demographic variables, education level and marital status were related to depression, and an interaction between age and gender was associated with depression, with younger women and older men reporting more depression. Among the pain-related variables, longer duration of pain was associated with increased depression. Among the work-related variables, unemployment was associated with depression, and there was an interaction between work status and litigation status, with working and litigating being associated with depression and not working and not litigating being associated with depression. In the comprehensive analysis, work status, education level, and marital status accounted for a significant amount of the variance in depression scores. These findings, together with future research directions, are discussed.

Adult↗

PubMed1995

What does the Beck Depression Inventory measure in chronic pain?: a reappraisal.

The Beck Depression Inventory (BDI) is widely used to document the prevalence of depression in suffers of chronic pain and in research designs about this population. Williams and Richardson (1993) initially posed the question, "What does the BDI measure in chronic pain?". Results from their study found 3 independent constructs, which differed somewhat from those obtained in analyses with other non-pain subsamples. In our reappraisal of the question, we used confirmatory factor analytic procedures to assess the dimensionality of the BDI. Specifically, we questioned whether a hierarchical model in which a second-level depression construct underlies 3 constituent first-level constructs is reasonable for the data. Our results, based on a sample of 247 chronic pain patients, corroborated the adequacy of this model. The first-level constituent constructs were labeled Negative Attitudes/Suicide, Performance Difficulty, and Physiological Manifestations and were conceptually similar to first-level constructs obtained with other subsamples. Furthermore, external psychological measures and selected questionnaire items were used to assess convergent and discriminant validity of scales operationalizing the factor-analytically derived constructs. With these analyses, we clarify the constituents of depression as measured by the BDI. The findings from this study have implications for more refined epidemiologic and clinical research with chronic pain patients.

Adult↗