Psychological treatment of late-life anxiety: An empirical review.

Abstract

This study provides a meta-analytic review of nonpharmacological interventions for late-life anxiety, focusing on treatment efficacy. Included in the analysis are studies in which a comparison was made either to a control condition or to another treatment. A total of 15 outcome studies, published or reported between January 1975 and January 2002, were identified involving 495 participants (mean age exceeding 55.0 years and a grand mean of 69.5 years) and providing 20 separate treatment interventions. The analysis indicated that psychological interventions were reliably more effective than no treatment on self-rated and clinician-rated measures of anxiety, yielding an effect size of .55. Maintenance of treatment gains (a minimum of 6 months follow-up) was insufficiently reported across studies to allow for a reliable demonstration of an overall estimate of long-term efficacy. It is concluded that psychological interventions produce significant improvements, but the analyses must be qualified by data limitations in the research synthesis.

Ageism in Mental Health Assessment and Treatment of Older Adults

“…We will then relate to the possible impact of physicians' ageist attitudes on their tendency for overuse of psychiatric medications in older adults. Cognitive behavioral therapy (Beck 1995) is effective for older adults suffering from depression (Arean and Cook 2002) and anxiety (Nordhus and Pallesen 2003). However, an ageist approach which perceives older patients as generally frail and incompetent may cause the psychotherapist to assign fewer tasks for patients to complete between therapy sessions, though these "homework assignments" are considered fundamental to treatment success in this modality.…”

Psychological Therapy for Depression and Anxiety in Older Adults

“…Using the classification adopted for the behavioural sciences (Cohen, 1977) 0.2 is considered a small effect size, 0.5 is considered a moderate effect size and 0.8 is considered a large effect size. It was noted that effect sizes are reduced when considering psychosocial treatments with active control conditions, thus suggesting that active control conditions are probably variants on active treatment conditions (Nordhus & Pallesen, 2003). It may also reflect the type of studies included in this meta-analysis.…”

“…Despite an increasing awareness of the importance of anxiety disorders in older people there still remains a limited number of systematic studies examining psychotherapy for anxiety in later life (Gatz et al, 1998;Nordhus & Pallesen, 2003;Stanley & Beck, 2000;Woods & Roth, 1996). This paucity of systematic studies is all the more surprising given the evidence supporting cognitive therapy as a treatment of choice for panic disorder and phobic disorders .…”

“…To date the only meta-analytic review of the nonpharmacological treatment of anxiety disorders has been carried out by Nordhus & Pallesen (2003). For this meta-analysis, the authors identified 15 psychosocial studies looking at the treatment of anxiety disorders in older people.…”

“…Some of the studies were pilot studies and some were published as proceedings of a conference. Overall, Nordhus & Pallesen (2003) calculated a mean effect size for psychosocial treatments of 0.55. Using the classification adopted for the behavioural sciences (Cohen, 1977) 0.2 is considered a small effect size, 0.5 is considered a moderate effect size and 0.8 is considered a large effect size.…”