Worry, emotion control, and anxiety control in older and young adults
Introduction
Generalized anxiety disorder (GAD) is one of the most prevalent anxiety disorders among older adults, affecting about 7.3% of adults aged 55 and older during a 6-month period (Beekman et al., 1998). Further, GAD is associated with a host of problems among older adults including: increased disability (Porensky et al., 2009), sleep problems (Wetherell, Le Roux, & Gatz, 2003), diminished well-being (Wetherell et al., 2004), and poorer social functioning (Wetherell et al., 2004). As worry is one of the central diagnostic features of GAD, improving our understanding of older adults’ experience of worry and control over worry is important.
Worry has been examined in community-dwelling older adults (e.g., Hunt, Wisocki, & Yanko, 2003), in older primary care patients (e.g., Brenes, 2006, Stanley et al., 2001), and most frequently in older adults with GAD (e.g., Wetherell et al., 2003). In general, older adults have lower levels of uncontrollable or excessive worry, and less frequent worry than young adults (e.g., Hunt et al., 2003). Interestingly, Hunt and colleagues found that while young adults worried more frequently than older adults, young adults utilized more strategies to cope with their worries (Hunt et al., 2003). Additionally, young and older adults worry about different topics (e.g., Diefenbach et al., 2001, Hunt et al., 2003), such that young adults worry frequently about work- or school-related and social issues, while older adults’ concerns are mostly health-related concerns (Diefenbach et al., 2001, Person and Borkovec, 1995, Wisocki, 1994).
While there are age differences in worry across adulthood, there is considerable variability in the frequency of worry among older adults. For example, older adults participating in the workforce report more frequent worry than retired older adults (Skaborn & Nicki, 2000). Furthermore, Neikrug (2003) found that the prevalence of worry is higher among the oldest-old (85 years or older) compared to the young-old (65–74). This variability is not surprising when one considers that older adults are a heterogeneous age group, spanning approximately 20 or more years difference in age between the young-old and the oldest-old.
One lifespan motivation theory that may provide a theoretical account for age differences in the frequency of worry is Socioemotional Selectivity Theory (SST; Carstensen, 1991, Carstensen, 1995). According to SST and its supporting research (as reviewed by Carstensen, Isaacowitz, & Charles, 1999), older adults have a shortened time perspective and are motivated to maximize their positive experiences and minimize negative experiences. As one ages and becomes more aware of time limitations, this emotion regulation is achieved through the selection of social situations and individuals with whom one interacts in a fashion that maximizes the frequency, duration, and intensity with which one experiences positive emotions (Carstensen, Fung, & Charles, 2003). In light of Carstensen's well-supported theory, older adults may be motivated to maintain lower levels of worry compared to young adults.
The findings of Gross et al. (1997) on emotion regulation are consistent with Carstensen's theory. That is, there appear to be age-related differences in emotion regulation, with older adults demonstrating better control over their emotions than young adults. In particular, older women report greater control over the inner experience of anger (Gross et al., Study 2, 3). Furthermore older adults endorse greater control over the inner experience of happiness, sadness, fear, and disgust (Gross et al., Study 3). In a sample of women, older age was associated with: (1) greater inner control over happiness, sadness, fear, and anger; (2) greater external control over the signs of happiness and sadness; (3) less control over the external signs of disgust (Gross et al., Study 4).
Another possible explanation of age-related differences in emotion regulation may be found in research addressing the use of specific emotion regulation strategies. For example, older adults are more likely to use passive emotion regulation strategies to avoid situations that may be anger-provoking compared to middle-aged and young adults (Blanchard-Fields, Stein, & Watson, 2004). In another study, older women reported more frequent positive reappraisal of thoughts about a conflict situation and less frequent suppressing of emotions compared to young women (John & Gross, 2004). Either being more skilled in reappraisal or using this technique more frequently may help older adults to dismiss or avoid troublesome worries. This notion is partially supported by Mennin, Heimberg, Turk, and Fresco's (2005) Emotion Dysregulation Theory of GAD. Mennin et al. found that greater worry (more excessive and uncontrollable) is associated with lower levels of emotion regulation in a sample of young adults. In summary, older adults worry less frequently and may be better at regulating their emotions compared to young adults. Additionally, worrying is associated with lower levels of emotion regulation among young adult samples. However, to date, no studies have examined the relation between emotion regulation and worry in older adults.
The present study first aimed to reproduce the findings of earlier work demonstrating age differences in the frequency and content of worry (e.g., Hunt et al., 2003, Stanley et al., 1996). The second aim was to examine the extent that there are age differences in emotion control1 as demonstrated in previous studies (Blanchard-Fields et al., 2004, Gross et al., 1997, John and Gross, 2004). The hypothesis that older adults have greater control over their emotions compared to young adults was tested. In addition to examining age differences in emotion control, age differences in control over one particular state, anxiety, was addressed in this study as well. While no studies have investigated age differences in anxiety control, age differences have been found for inner control over fear and inner and external control over other emotions, with older adults reporting more emotion control than young adults (Gross et al., 1997). It was also hypothesized that older adults would report greater perceived anxiety control compared to young adults in the present study.
The third aim of this study was to examine possible explanations for the age differences in worry. In light of previous findings that worrying generates negative affect (e.g., McLaughlin, Borkovec, & Sibrava, 2007) and that worrying is related to greater emotion dysregulation (e.g., Mennin et al., 2005), it was hypothesized that emotion control would be negatively related to worry. Additionally, it was hypothesized that greater perceived anxiety control would be associated with lower levels of worry, as had been found in a previous examination of young adults (Brown, Antony, & Barlow, 1992).
In light of the age differences in worry and in emotion regulation strategies (e.g., Stanley et al., 1996, Gross et al., 1997), and the relation of emotion control to anxiety (e.g., Brown et al., 1992), perceived anxiety control was proposed a mediator of the relation between age and worry. Older adults may structure their lives to not engage in anxiety-inducing situations, and thus older adults may report having more control over their anxiety. This antecedent-control strategy is focused on the selection of situations to participate in (Gross, 2007). After using overt avoidance strategies, older adults may be less likely to use worry as a cognitive avoidance strategy (c.f., Cognitive Avoidance Theory of Worry, Borkovec, Alcaine, & Behar, 2004). This proposed mediation model could account for the lower prevalence of pathological worry in older adults due to the increased perceived anxiety control.
A second mediation model was examined with emotion control as a mediator of the relation between age and worry. That is, emotion control would account (or partially account) for the difference in worry that is predicted by age. Older adults might be more skilled at managing their emotional experience and emotion expression (Gross et al., 1997, John and Gross, 2004), which could explain the lower frequency of worry in this age group. Variables such as gender, will also be explored worry and emotion control may differ among males and females.
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Participants
One hundred and ten young and older adults were recruited from undergraduate and graduate classes, and from the community (via flyers, a television ad, and researcher visits to senior centers and independent living facilities). Seven older adults were not included in the following analyses for various reasons (n = 1 withdrew consent, n = 6 questionnaires not returned or returned with large amounts of missing data). All participants were entered into a raffle for four $75 cash prizes.
Fifty-one young
Results
Descriptive statistics (means and standard deviations) for each age group were calculated and are presented in Table 2.
Age and sex differences in worry
Young adults reported higher levels of uncontrollable worry than older adults, which support the findings of previous studies (e.g., Beekman et al., 1998, Hunt et al., 2003). Consistent with previous research (e.g., Robichaud, Dugas, & Conway, 2003), young women worried more than young men. This gender difference also has been found in non-anxious and unselected samples, but not in clinical samples (as reviewed in Startup & Erickson, 2006). The gender difference in non-clinical samples for
Conclusions
Older adults worry less than young adults. Specifically, young women worry more than young men and older adults. Young women also have less perceived control over their anxiety and over their emotions. Interestingly, older men and women did not differ in their perceived control over emotions, worry, or anxiety control. Regardless of age, worriers have less perceived control over their anxiety, less control over the inner experience of emotions, and less control over the external signs of
Acknowledgements
This research was conducted as a partial fulfillment of the first author's requirements for a master of science degree at West Virginia University. The authors would like to thank Kevin Larkin and Hawley Montgomery-Downs for their contributions as committee members. This research was supported in part by a grant from the West Virginia University Alumni Fund. Portions of these data were presented at the annual American Psychological Association Convention (2009).
References (54)
- et al.
The differential effects of inductions of worry, somatic anxiety, and depression on emotional experience
Journal of Behavior Therapy and Experimental Research
(1988) - et al.
The effect of worry on cardiovascular response to phobic imagery
Behaviour Research and Therapy
(1990) - et al.
Psychometric properties of the Penn State Worry Questionnaire in a clinical anxiety disorders sample
Behaviour Research and Therapy
(1992) - et al.
Facets of emotional expressivity: three self-report factors and their correlates
Personality and Individual Differences
(1995) - et al.
Worry and use of coping strategies among older and younger adults
Journal of Anxiety Disorders
(2003) - et al.
Psychophysiological responses of older adults: a critical review with implications for assessment of anxiety disorders
Clinical Psychology Review
(2001) - et al.
The effects of worry and rumination on affect states and cognitive activity
Behavior Therapy
(2007) - et al.
Preliminary evidence for an emotion dysregulation model of generalized anxiety disorder
Behaviour Research and Therapy
(2005) - et al.
Development and validation of the Penn State Worry Questionnaire
Behaviour Research and Therapy
(1990) - et al.
The burden of late-life generalized anxiety disorder: effects on disability, health-related quality of life and healthcare utilization
American Journal of Geriatric Psychiatry
(2009)
Measurement of perceived control over anxiety-related events
Behavior Therapy
Gender differences in worry and associated cognitive-behavioral variables
Anxiety Disorders
Psychometric properties of four anxiety measures in older adults
Behaviour Research and Therapy
Assessing older adults with generalized anxiety: a replication and extension
Behaviour Research and Therapy
Superstitiousness and perceived anxiety control as predictors of psychological distress
Journal of Anxiety Disorders
The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations
Journal of Personality and Social Psychology
Age-related differences in worry and related processes
International Journal of Aging and Human Development
Psychometric properties of the Penn State Worry Questionnaire in older adults
Journal of Clinical Geropsychology
Anxiety disorders in later life: a report from the Longitudinal Aging Study Amsterdam
International Journal of Geriatric Psychiatry
Age differences in problem solving style: the role of emotional salience
Psychology and Aging
Age differences in emotion-regulation strategies in handling everyday problems
Journals of Gerontology, Series B: Psychological Sciences and Social Sciences
Avoidance theory of worry and generalized anxiety disorder
A proposal for a dimensional classification system based on the shared features of the DSM-IV anxiety and mood disorders: implications for assessment and treatment
Psychological Assessment
Age differences in the presentation of anxiety
Aging and Mental Health
Anxiety Disorders Interview Schedule for DSM-IV
Selectivity theory: social activity in life-span context
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