Hostname: page-component-848d4c4894-p2v8j Total loading time: 0.001 Render date: 2024-06-01T23:06:30.243Z Has data issue: false hasContentIssue false
  • English
  • Français

Comorbid Depressive and Anxiety Symptomatology in Older Adults: The Role of Aging Self-Stereotypes, Loneliness, and Feelings of Guilt Associated with Self-Perception as a Burden

Published online by Cambridge University Press:  29 September 2023

María del Sequeros Pedroso-Chaparro Open the ORCID record for María del Sequeros Pedroso-Chaparro [Opens in a new window] ,
Isabel Cabrera Open the ORCID record for Isabel Cabrera [Opens in a new window] ,
María Márquez-González Open the ORCID record for María Márquez-González [Opens in a new window] ,
Óscar Ribeiro Open the ORCID record for Óscar Ribeiro [Opens in a new window]  and
Andrés Losada-Baltar Open the ORCID record for Andrés Losada-Baltar [Opens in a new window]
María del Sequeros Pedroso-Chaparro*
Affiliation:
Universidad Autónoma de Madrid (Spain)
Isabel Cabrera
Affiliation:
Universidad Autónoma de Madrid (Spain)
María Márquez-González
Affiliation:
Universidad Autónoma de Madrid (Spain)
Óscar Ribeiro
Affiliation:
Universidade de Aveiro (Portugal)
Andrés Losada-Baltar
Affiliation:
Universidad Rey Juan Carlos (Spain)
*
Corresponding author: Correspondence concerning this article should be addressed to María del Sequeros Pedroso-Chaparro. Universidad Autónoma de Madrid. Facultad de Psicología. Departamento de Psicología Biológica y de la Salud. Calle Iván Pavlov, 6, Campus de Cantoblanco. 28049 Madrid (Spain). E-mail: maria.pedroso@uam.es
Get access Rights & Permissions [Opens in a new window]

Abstract

The main objective of this study was to analyze the differences between older adults’ symptom profiles (subclinical, anxiety, depressive, and comorbid) in negative aging self-stereotypes, loneliness, and feelings of guilt associated with self-perception as a burden. Participants were 310 community-dwelling people aged 60 years and over. The sample was grouped into four symptom profiles of older adults: anxiety, depressive, comorbid anxiety-depression, and subclinical symptoms. We carried out multinomial logistic regression analyses to analyze the role of assessed variables in the explanation of the four symptom profiles. Older adults who reported a comorbid symptomatology presented higher negative aging self-stereotypes and feelings of loneliness than the other three profiles. Compared with the subclinical profile, older adults who reported clinical symptomatology (anxiety, depressive, and comorbid profile) presented higher feelings of guilt associated with self-perception as a burden. The findings of this study suggest potential associations that may contribute to understanding and treating comorbid anxiety and depressive symptoms in older adults.

Keywords

comorbid anxiety-depressive symptomsguilt associated with self-perception as a burdenlonelinessnegative self-perceptions of aging
Type
Research Article
Information
The Spanish Journal of Psychology , Volume 26 , 2023 , e26
Copyright
© The Author(s), 2023. Published by Cambridge University Press on behalf of Universidad Complutense de Madrid and Colegio Oficial de la Psicología de Madrid

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

Almeida, O. P., Draper, B., Pirkis, J., Snowdon, J., Lautenschlager, N. T., Byrne, G., Sim, M., Stocks, N., Kerse, N., Flicker, L., & Pfaff, J. J. (2012). Anxiety, depression, and comorbid anxiety and depression: Risk factors and outcome over two years. International Psychogeriatrics, 24(10), 1622–1632. https://doi.org/10.1017/S104161021200107XCrossRefGoogle ScholarPubMed
Beekman, A. T., de Beurs, E., van Balkom, A. J., Deeg, D. J., van Dyck, R., & van Tilburg, W. (2000). Anxiety and depression in later life: Co-occurrence and communality of risk factors. American Journal of Psychiatry, 157(1), 89–95. http://doi.org/10.1176/ajp.157.1.89CrossRefGoogle ScholarPubMed
Bigger, S. E., & Vo, T. (2022). Self-perceived burden: A critical evolutionary concept analysis. Journal of Hospice and Palliative Nursing, 24(1), 40–49. https://doi.org/10.1097/NJH.0000000000000805CrossRefGoogle Scholar
Bryant, C., Bei, B., Gilson, K., Komiti, A., Jackson, H., & Judd, F. (2012). The relationship between attitudes to aging and physical and mental health in older adults. International Psychogeriatrics, 24(10), 1674–1683. https://doi.org/10.1017/S1041610212000774CrossRefGoogle ScholarPubMed
Cacioppo, J. T., Hawkley, L. C., & Thisted, R. A. (2010). Perceived social isolation makes me sad: 5-year cross-lagged analyses of loneliness and depressive symptomatology in the Chicago Health, Aging, and Social Relations Study. Psychology and Aging, 25(2), 453–463. https://doi.org/10.1037/a0017216CrossRefGoogle ScholarPubMed
Cairney, J., Corna, L. M., Veldhuizen, S., Herrmann, N., & Streiner, D. L. (2008). Comorbid depression and anxiety in later life: Patterns of association, subjective well-being, and impairment. The American Journal of Geriatric Psychiatry, 16(3), 201–208. https://doi.org/10.1097/JGP.0b013e3181602a4aCrossRefGoogle ScholarPubMed
Ciuffreda, G., Cabanillas-Barea, S., Carrasco-Uribarren, A., Albarova-Corral, M. I., Argüello-Espinosa, M. I., & Marcén-Román, Y. (2021). Factors associated with depression and anxiety in adults ≥ 60 years old during the COVID–19 pandemic: A systematic review. International Journal of Environmental Research and Public Health, 18(22), Article 11859. https://doi.org/10.3390/ijerph182211859CrossRefGoogle ScholarPubMed
de Gracia Blanco, M., Garre Olmo, J., Marcó Arbonès, M., & Monreal Bosch, P. (2004). Analysis of self-concept in older adults in different contexts. European Journal of Psychological Assessment, 20(4), 262–274. https://doi.org/10.1027/1015-5759.20.4.262CrossRefGoogle Scholar
DeLuca, A. K., Lenze, E. J., Mulsant, B. H., Butters, M. A., Karp, J. F., Dew, M. A., Pollock, B. G., Shear, M. K., Houck, P. R., & Reynolds, C. F. III. (2005). Comorbid anxiety disorder in late life depression: Association with memory decline over four years. International Journal of Geriatric Psychiatry, 20(9), 848–854. https://doi.org/10.1002/gps.1366CrossRefGoogle ScholarPubMed
Domènech-Abella, J., Mundó, J., Haro, J. M., & Rubio-Valera, M. (2019). Anxiety, depression, loneliness and social network in the elderly: Longitudinal associations from The Irish Longitudinal Study on Ageing (TILDA). Journal of Affective Disorders, 246, 82–88. https://doi.org/10.1016/j.jad.2018.12.043CrossRefGoogle ScholarPubMed
Dong, L., Freedman, V. A., & Mendes de Leon, C. F. (2020). The association of comorbid depression and anxiety symptoms with disability onset in older adults. Psychosomatic Medicine, 82(2), 158–164. https://doi.org/10.1097/PSY.0000000000000763CrossRefGoogle ScholarPubMed
Freeman, A. T., Santini, Z. I., Tyrovolas, S., Rummel-Kluge, C., Haro, J. M., & Koyanagi, A. (2016). Negative perceptions of ageing predict the onset and persistence of depression and anxiety: Findings from a prospective analysis of the Irish Longitudinal Study on Ageing (TILDA). Journal of Affective Disorders, 199, 132–138. https://doi.org/10.1016/j.jad.2016.03.042CrossRefGoogle ScholarPubMed
Gendron, T., Inker, J. K., Andricosky, R., & Zanjani, F. (2020). Development of the Relational Ageism Scale: Confirmatory test on survey data. The International Journal of Aging and Human Development, 90(3), 281–296. https://doi.org/10.1177/0091415019836956CrossRefGoogle ScholarPubMed
Hek, K., Tiemeier, H., Newson, R. S., Luijendijk, H. J., Hofman, A., & Mulder, C. L. (2011). Anxiety disorders and comorbid depression in community dwelling older adults. International Journal of Methods in Psychiatric Research, 20(3), 157–168. https://doi.org/10.1002/mpr.344CrossRefGoogle ScholarPubMed
Hughes, M. E., Waite, L. J., Hawkley, L. C., & Cacioppo, J. T. (2004). A short scale for measuring loneliness in large surveys. Research on Aging, 26(6), 655–672. https://doi.org/10.1177/0164027504268574CrossRefGoogle Scholar
Igbokwe, C. C., Ejeh, V. J., Agbaje, O. S., Umoke, P. I. C., Iweama, C. N., & Ozoemena, E. L. (2020). Prevalence of loneliness and association with depressive and anxiety symptoms among retirees in Northcentral Nigeria: A cross-sectional study. BMC Geriatrics, 20(1), Article 153. https://doi.org/10.1186/s12877-020-01561-4CrossRefGoogle ScholarPubMed
Jeste, N. D., Hays, J. C., & Steffens, D. C. (2006). Clinical correlates of anxious depression among elderly patients with depression. Journal of Affective Disorders, 90(1), 37–41. https://doi.org/10.1016/j.jad.2005.10.007CrossRefGoogle ScholarPubMed
Joyner, J. D. (1998). A phenomenological exploration of suffering within chronic depressive illness. The Catholic University of America.Google Scholar
King-Kallimanis, B., Gum, A. M., & Kohn, R. (2009). Comorbidity of depressive and anxiety disorders for older Americans in the national comorbidity survey replication. The American Journal of Geriatric Psychiatry, 17(9), 782–792. https://doi.org/10.1097/JGP.0b013e3181ad4d17CrossRefGoogle ScholarPubMed
Kvaal, K., McDougall, F. A., Brayne, C., Matthews, F. E., Dewey, M. E., & MRC, CFAS. (2008). Co-occurrence of anxiety and depressive disorders in a community sample of older people: Results from the MRC CFAS (Medical Research Council Cognitive Function and Ageing Study). International Journal of Geriatric Psychiatry, 23(3), 229–237. https://doi.org/10.1002/gps.1867CrossRefGoogle Scholar
Lee, Y., & Bierman, A. (2019). Loneliness as a mediator of perceived discrimination and depression: Examining education contingencies. The International Journal of Aging and Human Development, 89(2), 206–227. https://doi.org/10.1177/0091415018763402CrossRefGoogle ScholarPubMed
Lenze, E. J., Mulsant, B. H., Shear, M. K., Schulberg, H. C., Dew, M. A., Begley, A. E., Pollock, B. G., & Reynolds, C. F. (2000). Comorbid anxiety disorders in depressed elderly patients. The American Journal of Psychiatry, 157(5), 722–728. http://doi.org/10.1176/appi.ajp.157.5.722CrossRefGoogle ScholarPubMed
Levy, B. (2009). Stereotype embodiment: A psychosocial approach to aging. Current Directions in Psychological Science, 18(6), 332–336. http://doi.org/10.1111/j.1467-8721.2009.01662.xCrossRefGoogle ScholarPubMed
Levy, B. R., Chung, P. H., Slade, M. D., van Ness, P. H., & Pietrzak, R. H. (2019). Active coping shields against negative aging self-stereotypes contributing to psychiatric conditions. Social Science & Medicine, 228, 25–29. https://doi.org/10.1016/j.socscimed.2019.02.035CrossRefGoogle ScholarPubMed
Levy, B. R., Pilver, C. E., & Pietrzak, R. H. (2014). Lower prevalence of psychiatric conditions when negative age stereotypes are resisted. Social Science & Medicine, 119, 170–174. https://doi.org/10.1016/j.socscimed.2014.06.046CrossRefGoogle ScholarPubMed
Levy, B. R., Slade, M. D., Murphy, T. E., & Gill, T. M. (2012). Association between positive age stereotypes and recovery from disability in older persons. JAMA, 308(19), 1972–1973. https://doi.org/10.1001/jama.2012.14541CrossRefGoogle ScholarPubMed
Losada, A., Márquez-González, M., García-Ortiz, L., Gómez-Marcos, M. A., Fernández-Fernández, V., & Rodríguez-Sánchez, E. (2012). Loneliness and mental health in a representative sample of community-dwelling Spanish older adults. The Journal of Psychology, 146(3), 277–292. https://doi.org/10.1080/00223980.2011.582523CrossRefGoogle Scholar
Losada-Baltar, A., Márquez-González, M., Jiménez-Gonzalo, L., Pedroso-Chaparro, M. d. S., Gallego-Alberto, L., & Fernandes-Pires, J. (2021). Diferencias en función de la edad y la autopercepción del envejecimiento en ansiedad, tristeza, soledad y sintomatología comórbida ansioso-depresiva durante el confinamiento por la COVID–19 [Differences in anxiety, sadness, loneliness and comorbid anxiety and sadness as a function of age and self-perceptions of aging during the lock-out period due to COVID–19]. Revista Española de Geriatría y Gerontología, 55(5), 272–278. https://doi.org/10.1016/j.regg.2020.05.005CrossRefGoogle Scholar
Lykes, V. A., & Kemmelmeier, M. (2014). What predicts loneliness? Cultural difference between individualistic and collectivistic societies in Europe. Journal of Cross-Cultural Psychology, 45(3), 468–490. https://doi.org/10.1177/0022022113509881CrossRefGoogle Scholar
Márquez-González, M., Losada, A., Fernández-Fernández, V., & Pachana, N. A. (2012). Psychometric properties of the Spanish version of the Geriatric Anxiety Inventory. International Psychogeriatrics, 24, 137–144. https://doi.org/10.1017/S1041610211001505CrossRefGoogle ScholarPubMed
Miller, P. A., Sinding, C., Griffith, L. E., Shannon, H. S., & Raina, P. (2016). Seniors’ narratives of asking (and not asking) for help after a fall: Implications for identity. Ageing & Society, 36(2), 240–258. https://doi.org/10.1017/S0144686X14001123CrossRefGoogle Scholar
O’Shea, D. M., Dotson, V. M., & Fieo, R. A. (2017). Aging perceptions and self-efficacy mediate the association between personality traits and depressive symptoms in older adults. International Journal of Geriatric Psychiatry, 32(12), 1217–1225. https://doi.org/10.1002/gps.4584CrossRefGoogle ScholarPubMed
Pachana, N. A., Byrne, G. J., Siddle, H., Koloski, N., Harley, E., & Arnold, E. (2007). Development and validation of the Geriatric Anxiety Inventory. International Psychogeriatrics, 19, 103–114. https://doi.org/10.1017/S1041610206003504CrossRefGoogle ScholarPubMed
Palgi, Y., Shrira, A., Ring, L., Bodner, E., Avidor, S., Bergman, Y., Cohen-Fridel, S., Keisari, S., & Hoffman, Y. (2020). The loneliness pandemic: Loneliness and other concomitants of depression, anxiety and their comorbidity during the COVID–19 outbreak. Journal of Affective Disorders, 275, 109–111. https://doi.org/10.1016/j.jad.2020.06.036CrossRefGoogle ScholarPubMed
Pedroso-Chaparro, M. S., Cabrera, I., Márquez-González, M., Olmos, R., Romero-Moreno, R., Vara-García, C., Gallego-Alberto, L., Barrera-Caballero, S., & Losada-Baltar, A. (2021). Validation of the Guilt associated with Self-Perception as a Burden Scale (G-SPBS). Behavioural and Cognitive Psychotherapy, 49(2), 185–196. https://doi.org/10.1017/S1352465820000557CrossRefGoogle ScholarPubMed
Pedroso-Chaparro, M. d. S., Márquez-González, M., Fernandes-Pires, J.-A., Gallego-Alberto, L., Jiménez-Gonzalo, L., Nuevo, R., & Losada, A. (2022). Validación de la versión española de la Escala de Soledad de Tres Ítems [Validation of the Spanish version of the Three-Item Loneliness Scale]. Studies in Psychology, 43(2), 311–331. https://doi.org/10.1080/02109395.2021.1989889CrossRefGoogle Scholar
Peek, S. T. M, Luijkx, K. G., Rijnaard, M. D., Nieboer, M. E., van der Voort, C. S., Aarts, S., van Hoof, J., Vrijhoef, H. J. M., & Wouters, E. J. M. (2016). Older adults’ reasons for using technology while aging in place. Gerontology, 62(2), 226–237. https://doi.org/10.1159/000430949CrossRefGoogle ScholarPubMed
Porensky, E. K., Dew, M. A., Karp, J. F., Skidmore, E., Rollman, B. L., Shear, M. K., & Lenze, E. J. (2009). The burden of late-life generalized anxiety disorder: Effects on disability, health-related quality of life, and healthcare utilization. The American Journal of Geriatric Psychiatry, 17(6), 473–482. http://doi.org/10.1097/JGP.0b013e31819b87b2CrossRefGoogle ScholarPubMed
Prina, A. M., Ferri, C. P., Guerra, M., Brayne, C., & Prince, M. (2011). Co-occurrence of anxiety and depression amongst older adults in low- and middle-income countries: Findings from the 10/66 study. Psychological Medicine, 41(10), 2047–2056. https://doi.org/10.1017/S0033291711000444CrossRefGoogle ScholarPubMed
Radloff, L. S. (1977). The CES-D Scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385–401. https://doi.org/10.1177/014662167700100306CrossRefGoogle Scholar
Russell, D., Peplau, L. A., & Cutrona, C. E. (1980). The revised UCLA Loneliness Scale: Concurrent and discriminant validity evidence. Journal of Personality and Social Psychology, 39(3), 472–480. https://doi.org/10.1037/0022-3514.39.3.472CrossRefGoogle ScholarPubMed
Saade, Y. M., Nicol, G., Lenze, E. J., Miller, J. P., Yingling, M., Wetherell, J. L., Reynolds, C. F. III & Mulsant, B. H. (2019 ). Comorbid anxiety in late-life depression: Relationship with remission and suicidal ideation on venlafaxine treatment. Depression & Anxiety, 36(12), 1125–1134. https://doi.org/10.1002/da.22964CrossRefGoogle ScholarPubMed
Santini, Z. I., Fiori, K. L., Feeney, J., Tyrovolas, S., Haro, J. M., & Koyanagi, A. (2016). Social relationships, loneliness, and mental health among older men and women in Ireland: A prospective community-based study. Journal of affective disorders, 204, 59–69. https://doi.org/10.1016/j.jad.2016.06.032CrossRefGoogle Scholar
Sindi, S., Juster, R.-P., Wan, N., Nair, N. P. V., Ying Kin, N., & Lupien, S. J. (2012). Depressive symptoms, cortisol, and cognition during human aging: The role of negative aging perceptions. Stress, 15(2), 130–137. https://doi.org/10.3109/10253890.2011.599047CrossRefGoogle ScholarPubMed
Tan, J., Ma, C., Zhu, C., Wang, Y., Zou, X., Li, H., Li, J., He, Y., & Wu, C. (2023). Prediction models for depression risk among older adults: Systematic review and critical appraisal. Ageing Research Reviews, 83, Article 101803. https://doi.org/10.1016/j.arr.2022.101803CrossRefGoogle ScholarPubMed
Wolitzky-Taylor, K. B., Castriotta, N., Lenze, E. J., Stanley, M. A., & Craske, M. G. (2010). Anxiety disorders in older adults: A comprehensive review. Depression & Anxiety, 27(2), 190–211. https://doi.org/10.1002/da.20653CrossRefGoogle ScholarPubMed
World Health Organization. (2017, December 12). Mental health of older adults. https://www.who.int/news-room/fact-sheets/detail/mental-health-of-older-adultsGoogle Scholar
Wuthrich, V. M., Meuldijk, D., Jagiello, T., González Robles, A., Jones, M. P., & Cuijpers, P. (2021). Efficacy and effectiveness of psychological interventions on co-occurring mood and anxiety disorders in older adults: A systematic review and meta-analysis. International Journal of Geriatric Psychiatry, 36(6), 858–872. https://doi.org/10.1002/gps.5486CrossRefGoogle ScholarPubMed
Zenebe, Y., Akele, B., W/Selassie, M., & Necho, M. (2021). Prevalence and determinants of depression among old age: A systematic review and meta-analysis. Annals of General Psychiatry, 20(1), Article 55. https://doi.org/10.1186/s12991-021-00375-xCrossRefGoogle ScholarPubMed
Zhao, W., Zhang, Y., Liu, X., Yue, J., Hou, L., Xia, X., Zuo, Z., Liu, Y., Jia, S., Dong, B., & Ge, N. (2020). Comorbid depressive and anxiety symptoms and frailty among older adults: Findings from the West China health and aging trend study. Journal of Affective Disorders, 277, 970–976. https://doi.org/10.1016/j.jad.2020.08.070CrossRefGoogle ScholarPubMed