Anxiety disorders in older adults are increasingly recognized as an important mental health and wellbeing concern. The literature on late life anxiety is growing, as is the literature on assessment and treatment approaches (see review by Ramos & Stanley, 2018). Anxiety disorders across all age groups are the most prevalent mental disorders, with up to 33.7% of the population affected during their lifetime, with significant health care and burden of disease costs (Bandelow & Michaelis, 2015), including in older persons (Porensky et al. 2009). Subthreshold anxiety is a particular issue in later life (Witlox et al., 2021), and contributes to underdiagnosis and treatment for older persons. Anxiety disorders are an important consideration across psychiatric, physical and cognitive comorbidities, clinical settings and cultural contexts, and research on these areas including novel work on animal models and innovative treatment strategies is burgeoning (Byrne & Pachana, 2021).

A recent systematic review and meta-analysis of 46 articles on anxiety in later life anxiety yielded the following pooled prevalences (Witlox et al., 2021):

Agoraphobia                             1.62% [0.93-2.81]

GAD                                           2.32% [1.72-3.12]

OCD                                           0.89% [0.58-1.16]

Panic Disorder                         0.76% [0.50-1.16]

PTSD                                          1.57% [1.13-2.18]

Social Anxiety                          1.23% [0.90-1.67]

Specific Phobia                        5.40% [3.55-8.14]

Another systematic review reported the current global prevalence of anxiety disorders at 7.3%, and higher (10.4%) among developed (i.e. Anglo/European) compared to developing (i.e. African) nations (5.3%), again highlighting the importance of culture and national contexts (Baxter, Scott, Vos, & Whiteford, 2013). Co-morbidity is also high between anxiety and depression in later life; in one study 47.5% of those with major depressive disorder also met criteria for anxiety disorders, and 26.1% of those with anxiety disorders also met criteria for major depressive disorder (Beekman, van Balkom, Deeg, van Dyck, & van Tilburg, 2000).

The relationship between age, physical health concerns and anxiety and depression is complex. In a recent study, a majority of older persons with chronic physical or pain conditions did not have co-morbid mental disorders; by contrast, the majority of those with mental disorders reported physical/pain co-morbidity, particularly among the older age groups (Scott et al., 2008). Anxiety symptoms in later life are associated with diminished well-being, reduced quality of life, increased mortality, impaired ability to carry out basic activities of daily living (such as preparing meals), poorer health, and reduced life satisfaction (Bryant, Jackson, & Ames, 2009; Porensky, et al., 2009).

There are several identified protective factors and risk factors for anxiety in later life. Protective factors include high perceived social support, regular exercise and higher levels of education (Vink, Aartsen & Schoevers, 2008). Risk factors include female gender, lower levels of education, poor self-rated general health, current anxiolytic use (which is a risk factor as well as a common form of treatment of anxiety), physical or sexual abuse in childhood, current smoking and excessive alcohol use, stressful life events and neuroticism (Vink et al., 2009). Anxiety and depression have been shown to act as bidirectional risk factors for one another (Jacobson & Newman, 2017). Not enough research has been conducted to date to comment on culture and ethnicity with respect either to risk or protective factors or symptom presentation differences (e.g. Wolitzky-Taylor et al., 2010), although some recent work with older persons suggests that culture of origin may play a role in determining expression of anxiety symptoms and perhaps modify acculturation Zisberg, 2017).

Diagnosis of anxiety in later life is important both due to changes in anxiety disorders in DSM5 as well as the need for a careful clinical interview (Bryant et al., 2012). There has now been excellent evidence for the validity and reliability of a number of self-report assessment instruments for anxiety in later life (Balsamo et al., 2018). Current evidence suggests that cognitive behavioral and pharmacological interventions are effective in treating late life anxiety (Ramos & Stanley, 2018). However, a recent systematic review suggests that further research is warranted before endorsing Mindfulness-Based Cognitive Therapy for anxiety in later life (Thomas, Chur-Hansen, & Turner, 2020). Other forms of therapy have also been subject to increasing research, for example problem-solving therapy (Beaudreau et al., 2019) and interpersonal psychotherapy (Bernecker et al., 2017), but more research is required. A recent systematic review suggests that more methodological rigor is required in later-life psychotherapy trials (Wuthrich et al., 2020).

 Written by Nancy Pachana, PhD, University of Queensland, Australia

GENERAL

American Psychiatric Association. (2013). DSM 5. American Psychiatric Association.

American Psychiatric Association. (2013). DSM 5. American Psychiatric Association.

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Bandelow, B., & Michaelis, S. (2015). Epidemiology of anxiety disorders in the 21st century. Dialogues in clinical neuroscience, 17(3), 327.

Bandelow, B., & Michaelis, S. (2015). Epidemiology of anxiety disorders in the 21st century. Dialogues in clinical neuroscience, 17(3), 327.

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Baxter, A. J., Scott, K. M., Vos, T., & Whiteford, H. A. (2013). Global prevalence of anxiety disorders: a systematic review and meta-regression. Psychological medicine, 43(5), 897.

Baxter, A. J., Scott, K. M., Vos, T., & Whiteford, H. A. (2013). Global prevalence of anxiety disorders: a systematic review and meta-regression. Psychological medicine, 43(5), 897.

Posted in Uncategorized | Tagged , | Comments Off on Baxter, A. J., Scott, K. M., Vos, T., & Whiteford, H. A. (2013). Global prevalence of anxiety disorders: a systematic review and meta-regression. Psychological medicine, 43(5), 897.

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.

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.

Posted in Uncategorized | Tagged , , | Comments Off on 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.

Bryant, C., Jackson, H., & Ames, D. (2009). Depression and anxiety in medically unwell older adults: Prevalence and short-term course. International Psychogeriatrics, 21(4), 754-763. doi:10.1017/S1041610209009399

Bryant, C., Jackson, H., & Ames, D. (2009). Depression and anxiety in medically unwell older adults: Prevalence and short-term course. International Psychogeriatrics, 21(4), 754-763. doi:10.1017/S1041610209009399

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Bryant, C., Mohlman, J., Gum, A., Stanley, M., Beekman, A. T., Wetherell, J. L., Thorp, S. R., Flint, A. J., & Lenze, E. J. (2013). Anxiety disorders in older adults: looking to DSM5 and beyond… The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry, 21(9), 872–876. https://doi.org/10.1016/j.jagp.2013.01.011

Bryant, C., Mohlman, J., Gum, A., Stanley, M., Beekman, A. T., Wetherell, J. L., Thorp, S. R., Flint, A. J., & Lenze, E. J. (2013). Anxiety disorders in older adults: looking to DSM5 and beyond… The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry, 21(9), 872–876. https://doi.org/10.1016/j.jagp.2013.01.011

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Byrne, G., & Pachana, N. (Eds.). (2021). Anxiety in Older People: Clinical and Research Perspectives. Cambridge University Press.

Byrne, G., & Pachana, N. (Eds.). (2021). Anxiety in Older People: Clinical and Research Perspectives. Cambridge University Press.

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Gum, A. M., King-Kallimanis, B., & Kohn, R. (2009). Prevalence of mood, anxiety, and substance-abuse disorders for older Americans in the National Comorbidity Survey?Replication. American Journal of Geriatric Psychiatry, 17, 769-781.

Gum, A. M., King-Kallimanis, B., & Kohn, R. (2009). Prevalence of mood, anxiety, and substance-abuse disorders for older Americans in the National Comorbidity Survey: Replication. American Journal of Geriatric Psychiatry, 17, 769-781.

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Jacobson, N. C., & Newman, M. G. (2017). Anxiety and depression as bidirectional risk factors for one another: A meta-analysis of longitudinal studies. Psychological bulletin, 143(11), 1155.

Jacobson, N. C., & Newman, M. G. (2017). Anxiety and depression as bidirectional risk factors for one another: A meta-analysis of longitudinal studies. Psychological bulletin, 143(11), 1155.

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Laidlaw, K., & Knight, B. (2008). Handbook of emotional disorders in later life: Assessment and treatment . New York, NY US: Oxford University Press.

Laidlaw, K., & Knight, B. (2008). Handbook of emotional disorders in later life: Assessment and treatment . New York, NY US: Oxford University Press.

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Pachana, N. A., Laidlaw, K., & Knight, B. G. (Eds.). (2010). Casebook of clinical geropsychology: International perspectives on practice . New York: Oxford University Press.

Pachana, N. A., Laidlaw, K., & Knight, B. G. (Eds.). (2010). Casebook of clinical geropsychology: International perspectives on practice . New York: Oxford University Press.

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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.

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.

Posted in Uncategorized | Tagged , | Comments Off on 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.

Ramos, K., & Stanley, M. A. (2018). Anxiety disorders in late life. Psychiatric Clinics, 41(1), 55-64.

Ramos, K., & Stanley, M. A. (2018). Anxiety disorders in late life. Psychiatric Clinics, 41(1), 55-64.

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Scott, K. M., Von Korff, M., Alonso, J., Angermeyer, M., Bromet, E. J., Bruffaerts, R., … & Williams, D. (2008). Age patterns in the prevalence of DSM-IV depressive/anxiety disorders with and without physical co-morbidity. Psychological Medicine, 38(11), 1659.

Scott, K. M., Von Korff, M., Alonso, J., Angermeyer, M., Bromet, E. J., Bruffaerts, R., … & Williams, D. (2008). Age patterns in the prevalence of DSM-IV depressive/anxiety disorders with and without physical co-morbidity. Psychological Medicine, 38(11), 1659.

Posted in Uncategorized | Tagged , , | Comments Off on Scott, K. M., Von Korff, M., Alonso, J., Angermeyer, M., Bromet, E. J., Bruffaerts, R., … & Williams, D. (2008). Age patterns in the prevalence of DSM-IV depressive/anxiety disorders with and without physical co-morbidity. Psychological Medicine, 38(11), 1659.

Segal, D. L., Qualls, S. H., & Smyer, M. A. (2018). Aging and mental health (3rd edition). Wiley/Blackwell.

Segal, D. L., Qualls, S. H., & Smyer, M. A. (2018). Aging and mental health (3rd edition). Wiley/Blackwell.

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Vink, D., Aartsen, M. J., & Schoevers, R. A. (2008). Risk factors for anxiety and depression in the elderly: a review. Journal of affective disorders, 106(1-2), 29-44.

Vink, D., Aartsen, M. J., & Schoevers, R. A. (2008). Risk factors for anxiety and depression in the elderly: a review. Journal of affective disorders, 106(1-2), 29-44.

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Witlox, M., Garnefski, N., Kraaij, V., Simou, M., Dusseldorp, E., Bohlmeijer, E., & Spinhoven, P. (2020). Prevalence of anxiety disorders and subthreshold anxiety throughout later life: Systematic review and meta-analysis. Psychology and Aging.

Witlox, M., Garnefski, N., Kraaij, V., Simou, M., Dusseldorp, E., Bohlmeijer, E., & Spinhoven, P. (2020). Prevalence of anxiety disorders and subthreshold anxiety throughout later life: Systematic review and meta-analysis. Psychology and Aging.

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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 and Anxiety, 27 (2):190-211. PMID: 20099273

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 and Anxiety, 27 (2):190-211. PMID: 20099273

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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 and Anxiety, 27 (2):190-211. PMID: 20099273

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 and Anxiety, 27 (2):190-211. PMID: 20099273

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Zisberg, A. (2017). Anxiety and depression in older patients: the role of culture and acculturation. International journal for equity in health, 16(1), 1-10.

Zisberg, A. (2017). Anxiety and depression in older patients: the role of culture and acculturation. International journal for equity in health, 16(1), 1-10.

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ASSESSMENT OF ANXIETY IN LATER LIFE

Balsamo, M., Cataldi, F., Carlucci, L., & Fairfield, B. (2018). Assessment of anxiety in older adults: a review of self-report measures. Clinical interventions in aging, 13, 573.

Balsamo, M., Cataldi, F., Carlucci, L., & Fairfield, B. (2018). Assessment of anxiety in older adults: a review of self-report measures. Clinical interventions in aging, 13, 573.

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Bryant, C., Mohlman, J., Gum, A., Stanley, M., Beekman, A.T.F., Wetherell, J.L., Thorp, S.R., Flint, A.J, and Lenze, E.J. (2012). Anxiety disorders in older adults looking to DSM-5 and beyond. American Journal of Geriatric Psychiatry. Published online – doi: 10.1097/JGP.0b013e3182546167

Bryant, C., Mohlman, J., Gum, A., Stanley, M., Beekman, A.T.F., Wetherell, J.L., Thorp, S.R., Flint, A.J, and Lenze, E.J. (2012). Anxiety disorders in older adults looking to DSM-5 and beyond. American Journal of Geriatric Psychiatry. Published online – doi: 10.1097/JGP.0b013e3182546167

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Lichtenberg, P.A. (Ed.) (2010). Handbook of assessment in clinical gerontology (2nd edition). Burlington, MA: Academic Press.

Lichtenberg, P.A. (Ed.) (2010). Handbook of assessment in clinical gerontology (2nd edition). Burlington, MA: Academic Press.

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Thorp, S. R., Sones, H. M., & Cook, J. M. (2011). Prolonged exposure therapy for older combat veterans in the VA Healthcare System. In K. H. Sorocco & S. Lauderdale (Eds.), Cognitive behavior therapy with older adults: Innovations across care settings (pp. 421-442). New York, NY: Springer Publishing Company.

Thorp, S. R., Sones, H. M., & Cook, J. M. (2011). Prolonged exposure therapy for older combat veterans in the VA Healthcare System. In K. H. Sorocco & S. Lauderdale (Eds.), Cognitive behavior therapy with older adults: Innovations across care settings (pp. 421-442). New York, NY: Springer Publishing Company.

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Zarit, S.H., & Zarit, J.M. (2007). Mental disorders in older adults: Fundamentals of Assessment and Treatment (2 nd ed.). New York: The Guilford Press.

Zarit, S.H., & Zarit, J.M. (2007). Mental disorders in older adults: Fundamentals of Assessment and Treatment (2 nd ed.). New York: The Guilford Press.

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MEASURES OF ANXIETY

Look at the extensive assessment database of geriatric measures from the University of Alabama’s Alabama Research Institute on Aging! Register for access to the database HERE.

In the meantime, the most commonly used, validated measures of anxiety include:

PSYCHOTHERAPY FOR ANXIETY IN LATER LIFE

Cognitive Behavioral Therapy

Brenes, G.A., Miller, M.E., Williamson, J.D., McCall, W.V., Knudson, M., & Stanley, M.A., (2012). A randomized controlled trial of telephone-delivered cognitive-behavioral therapy for late-life anxiety disorders. American Journal of Geriatric Psychiatry, 20(8) 707-16. PMID: 22828172 PMCID: PMC3407971

Brenes, G.A., Miller, M.E., Williamson, J.D., McCall, W.V., Knudson, M., & Stanley, M.A., (2012). A randomized controlled trial of telephone-delivered cognitive-behavioral therapy for late-life anxiety disorders. American Journal of Geriatric Psychiatry, 20(8) 707-16. PMID: 22828172 PMCID: PMC3407971

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Cully, J.A., Paukert, A., Falco, J., & Stanley, M.A. (2009). Cognitive-behavioral therapy: Innovations for cardiopulmonary patients with depression and anxiety. Cognitive and Behavioral Practice, 16 , 394-407.

Cully, J.A., Paukert, A., Falco, J., & Stanley, M.A. (2009). Cognitive-behavioral therapy: Innovations for cardiopulmonary patients with depression and anxiety. Cognitive and Behavioral Practice, 16 , 394-407.

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Gallagher-Thompson, D. G. Steffen, A. M., & Thompson, L. W. (2008). Handbook of behavioral and cognitive therapies with older adults . New York: Springer.

Gallagher-Thompson, D. G. Steffen, A. M., & Thompson, L. W. (2008). Handbook of behavioral and cognitive therapies with older adults . New York: Springer.

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Laidlaw, K., Thompson, L. W., Dick-Siskin, L., & Gallagher-Thompson, D. (2003). Cognitive Behaviour Therapy with Older People . Chichester, West Sussex, England: John Wiley & Sons. (2 nd ed. expected in 2012)

Laidlaw, K., Thompson, L. W., Dick-Siskin, L., & Gallagher-Thompson, D. (2003). Cognitive Behaviour Therapy with Older People . Chichester, West Sussex, England: John Wiley & Sons. (2 nd ed. expected in 2012)

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Leichsenring, F., Salzer, S., Jaeger, U., Kachele, H., Kreische, R., Leweke, F. Ruger, U., Winkelbach, C., & Leibing, E. (2009) Short-Term Psychodynamic Psychotherapy and Cognitive-Behavioral Therapy in Generalized Anxiety Disorder: A Randomized, Controlled Trial. American Journal of Psychiatry, 166, 875-881. doi: 10.1176/appi.ajp.2009.09030441

Leichsenring, F., Salzer, S., J aeger, U., Kachele, H., Kreische, R., Leweke, F. Ruger, U., Winkelbach, C., & Leibing, E. (2009) Short-Term Psychodynamic Psychotherapy and Cognitive-Behavioral Therapy in Generalized Anxiety Disorder: A Randomized, Controlled Trial. American Journal of Psychiatry, 166, 875-881. doi: 10.1176/appi.ajp.2009.09030441

Posted in reference | Tagged , , , , | Comments Off on Leichsenring, F., Salzer, S., Jaeger, U., Kachele, H., Kreische, R., Leweke, F. Ruger, U., Winkelbach, C., & Leibing, E. (2009) Short-Term Psychodynamic Psychotherapy and Cognitive-Behavioral Therapy in Generalized Anxiety Disorder: A Randomized, Controlled Trial. American Journal of Psychiatry, 166, 875-881. doi: 10.1176/appi.ajp.2009.09030441

Paukert, A.L., Phillips, L., Cully, J.A., Loboprabhu, S.M., Lomax, J.W., & Stanley, M.A. (2009). Integration of religion into cognitive behavioral therapy for geriatric anxiety and depression. Journal of Psychiatric Practice, 15(2):103-112. PMID: 19339844

Paukert, A.L., Phillips, L., Cully, J.A., Loboprabhu, S.M., Lomax, J.W., & Stanley, M.A. (2009). Integration of religion into cognitive behavioral therapy for geriatric anxiety and depression. Journal of Psychiatric Practice, 15(2):103-112. PMID: 19339844

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Sorocco, KH & Lauderdale, S. (2001). Cognitive Behavior Therapy with Older Adults: Innovations Across Care Settings . New York, NY: Springer.

Sorocco, KH & Lauderdale, S. (2001). Cognitive Behavior Therapy with Older Adults: Innovations Across Care Settings . New York, NY: Springer.

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Stanley, M. A., Diefenbach, G. J., Hopko, D.R. (2004). Cognitive behavioral treatment for older adults with generalized anxiety disorder: A therapist manual for primary care settings. Behavior Modification, 28, 73-117.

Stanley, M. A., Diefenbach, G. J., Hopko, D.R. (2004). Cognitive behavioral treatment for older adults with generalized anxiety disorder: A therapist manual for primary care settings. Behavior Modification, 28, 73-117.

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Stanley, M. A., Beck, J., G., Novy, D. M., Averill, P. M., Swann, A. C., Diefenbach, G. J., & Hopko, D. R. (2003). Cognitive-behavioral treatment of late-life generalized anxiety disorder. Journal of Consulting and Clinical Psychology, 71, 309-319. doi: 10.1037/0022-006X.71.2.309

Stanley, M. A., Beck, J., G., Novy, D. M., Averill, P. M., Swann, A. C., Diefenbach, G. J., & Hopko, D. R. (2003). Cognitive-behavioral treatment of late-life generalized anxiety disorder. Journal of Consulting and Clinical Psychology, 71, 309-319. doi: 10.1037/0022-006X.71.2.309

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Thorp, S. R., Sones, H. M., & Cook, J. M. (2011). Posttraumatic stress disorder among older adults. In K. H. Sorocco & S. Lauderdale (Eds.), Cognitive behavior therapy with older adults: Innovations across care settings (pp. 189-217). New York, NY: Springer Publishing Company.

Thorp, S. R., Sones, H. M., & Cook, J. M. (2011). Posttraumatic stress disorder among older adults. In K. H. Sorocco & S. Lauderdale (Eds.), Cognitive behavior therapy with older adults: Innovations across care settings (pp. 189-217). New York, NY: Springer Publishing Company.

Posted in reference | Tagged , , , , | Comments Off on Thorp, S. R., Sones, H. M., & Cook, J. M. (2011). Posttraumatic stress disorder among older adults. In K. H. Sorocco & S. Lauderdale (Eds.), Cognitive behavior therapy with older adults: Innovations across care settings (pp. 189-217). New York, NY: Springer Publishing Company.

Thorp, S. R., Stein, M. B., Jeste, D. V., Patterson, T. L., & Wetherell, J. L. (accepted for publication). Prolonged exposure therapy for older veterans with posttraumatic stress disorder: Pilot study. American Journal of Geriatric Psychiatry.

Thorp, S. R., Stein, M. B., Jeste, D. V., Patterson, T. L., & Wetherell, J. L. (accepted for publication). Prolonged exposure therapy for older veterans with posttraumatic stress disorder: Pilot study. American Journal of Geriatric Psychiatry.

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Cognitive Behavioral Therapy for Anxiety Manuals

Quijano, L.M., Calleo, J., Wetherell, J.L., & Stanley, M.A. (2007). Peaceful Living: Intervention manual: Cognitive behavioral treatment for older medical patients with generalized anxiety disorder, with or without depression. Unpublished manuscript, Department of Psychiatry and Behavioral Sciences, University of Texas-Houston Medical School. ACCESS MANUAL HERE.

Quijano, L.M., Calleo, J., Wetherell, J.L., & Stanley, M.A. (2007). Peaceful Living: Intervention manual: Cognitive behavioral treatment for older medical patients with generalized anxiety disorder, with or without depression.  Unpublished manuscript, Department of Psychiatry and Behavioral Sciences, University of Texas-Houston Medical School. ACCESS MANUAL HERE.

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Quijano, L.M., Calleo, J., Wetherell, J.L., & Stanley, M.A. (2007). Peaceful Living: Patient manual, edited for brief CBT. Unpublished manuscript, Department of Psychiatry and Behavioral Sciences, University of Texas-Houston Medical School. ACCESS MANUAL HERE.

Quijano, L.M., Calleo, J., Wetherell, J.L., & Stanley, M.A. (2007). Peaceful Living: Patient manual, edited for brief CBT.  Unpublished manuscript, Department of Psychiatry and Behavioral Sciences, University of Texas-Houston Medical School.  ACCESS MANUAL HERE.

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Stanley, M. A., Diefenbach, G. J., Hopko, D.R. (2004). Cognitive behavioral treatment for older adults with generalized anxiety disorder: A therapist manual for primary care settings. Behavior Modification, 28, 73-117.

Stanley, M. A., Diefenbach, G. J., Hopko, D.R. (2004). Cognitive behavioral treatment for older adults with generalized anxiety disorder: A therapist manual for primary care settings. Behavior Modification, 28, 73-117.

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Stanley, M.A., Diefenbach, G.J., & Hopko, DR. (2004). Cognitive Behavioral Treatment for Older Adults with Generalized Anxiety Disorder in Primary Care (CBT-GAD/PC). Unpublished manuscript, Department of Psychiatry and Behavioral Sciences, University of Texas-Houston Medical School. Access Manual Here.

Stanley, M.A., Diefenbach, G.J., & Hopko, DR. (2004). Cognitive Behavioral Treatment for Older Adults with Generalized Anxiety Disorder in Primary Care (CBT-GAD/PC).  Unpublished manuscript, Department of Psychiatry and Behavioral Sciences, University of Texas-Houston Medical School.  ACCESS MANUAL HERE.

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Stanley, M.A., Kraus, C., Paukert, A., Balasubramanyam, A., Wilson, N.L., Snow, A.L., McNeese, T.D., & Robinson, C.M. (2007). Peaceful Mind Workbook: Collateral Version. Unpublished manuscript, Department of Psychiatry and Behavioral Sciences, University of Texas-Houston Medical School. ACCESS MANUAL HERE.

Stanley, M.A., Kraus, C., Paukert, A., Balasubramanyam, A., Wilson, N.L., Snow, A.L., McNeese, T.D., & Robinson, C.M. (2007). Peaceful Mind Workbook: Collateral Version. Unpublished manuscript, Department of Psychiatry and Behavioral Sciences, University of Texas-Houston Medical School.  ACCESS MANUAL HERE.

Posted in reference | Tagged , , | Comments Off on Stanley, M.A., Kraus, C., Paukert, A., Balasubramanyam, A., Wilson, N.L., Snow, A.L., McNeese, T.D., & Robinson, C.M. (2007). Peaceful Mind Workbook: Collateral Version. Unpublished manuscript, Department of Psychiatry and Behavioral Sciences, University of Texas-Houston Medical School. ACCESS MANUAL HERE.

Stanley, M.A., Kraus, C., Paukert, A., Balasubramanyam, A., Wilson, N.L., Snow, A.L., McNeese, T.D., & Robinson, C.M. (2007). Peaceful Mind Workbook: Patient Manual. Unpublished manuscript, Department of Psychiatry and Behavioral Sciences, University of Texas-Houston Medical School. ACCESS MANUAL HERE.

Stanley, M.A., Kraus, C., Paukert, A., Balasubramanyam, A., Wilson, N.L., Snow, A.L., McNeese, T.D., & Robinson, C.M. (2007). Peaceful Mind Workbook: Patient Manual. Unpublished manuscript, Department of Psychiatry and Behavioral Sciences, University of Texas-Houston Medical School.  ACCESS MANUAL HERE.

Posted in reference | Tagged , , | Comments Off on Stanley, M.A., Kraus, C., Paukert, A., Balasubramanyam, A., Wilson, N.L., Snow, A.L., McNeese, T.D., & Robinson, C.M. (2007). Peaceful Mind Workbook: Patient Manual. Unpublished manuscript, Department of Psychiatry and Behavioral Sciences, University of Texas-Houston Medical School. ACCESS MANUAL HERE.

Stanley, M.A., Kraus, C., Paukert, A., Balasubramanyam, A., Wilson, N.L., Snow, A.L., McNeese, T.D., & Robinson, C.M. (2007). The Peaceful Mind Program: CBT-AD Therapist Manual. Unpublished manuscript, Department of Psychiatry and Behavioral Sciences, University of Texas-Houston Medical School. ACCESS MANUAL HERE.

Stanley, M.A., Kraus, C., Paukert, A., Balasubramanyam, A., Wilson, N.L., Snow, A.L., McNeese, T.D., & Robinson, C.M. (2007). The Peaceful Mind Program: CBT-AD Therapist Manual. Unpublished manuscript, Department of Psychiatry and Behavioral Sciences, University of Texas-Houston Medical School.  ACCESS MANUAL HERE.

Posted in reference | Tagged , , | Comments Off on Stanley, M.A., Kraus, C., Paukert, A., Balasubramanyam, A., Wilson, N.L., Snow, A.L., McNeese, T.D., & Robinson, C.M. (2007). The Peaceful Mind Program: CBT-AD Therapist Manual. Unpublished manuscript, Department of Psychiatry and Behavioral Sciences, University of Texas-Houston Medical School. ACCESS MANUAL HERE.

Wetherell, J.L., Sorrell, J.T., Stoddard, J.A., McChesney, K.A., Lenze, E.J., Kornblith, S., & White, K.S. (2007). The Extended Relief Study: Escitalopram Plus Psychotherapy in the Management of Late-life Anxiety Psychotherapy Therapist Manual. University of California, San Diego and VA San Diego Healthcare System. ACCESS MANUAL HERE.

Wetherell, J.L., Sorrell, J.T., Stoddard, J.A., McChesney, K.A., Lenze, E.J., Kornblith, S., & White, K.S. (2007). The Extended Relief Study: Escitalopram Plus Psychotherapy in the Management of Late-life Anxiety Psychotherapy Therapist Manual.  University of California, San Diego and VA San Diego Healthcare System. ACCESS MANUAL HERE.

Posted in reference | Tagged , , | Comments Off on Wetherell, J.L., Sorrell, J.T., Stoddard, J.A., McChesney, K.A., Lenze, E.J., Kornblith, S., & White, K.S. (2007). The Extended Relief Study: Escitalopram Plus Psychotherapy in the Management of Late-life Anxiety Psychotherapy Therapist Manual. University of California, San Diego and VA San Diego Healthcare System. ACCESS MANUAL HERE.

Wetherell, J.L., Sorrell, J.T., Stoddard, J.A., McChesney, K.A., Lenze, E.J., Kornblith, S., & White, K.S. (2007). The Extended Relief Study: Escitalopram Plus Psychotherapy in the Management of Late-life Anxiety Psychotherapy Workbook. University of California, San Diego and VA San Diego Healthcare System. ACCESS MANUAL HERE.

Wetherell, J.L., Sorrell, J.T., Stoddard, J.A., McChesney, K.A., Lenze, E.J., Kornblith, S., & White, K.S. (2007). The Extended Relief Study: Escitalopram Plus Psychotherapy in the Management of Late-life Anxiety Psychotherapy Workbook.  Unpublished manuscript, University of California, San Diego and VA San Diego Healthcare System. ACCESS MANUAL HERE.

Posted in reference | Tagged , , | Comments Off on Wetherell, J.L., Sorrell, J.T., Stoddard, J.A., McChesney, K.A., Lenze, E.J., Kornblith, S., & White, K.S. (2007). The Extended Relief Study: Escitalopram Plus Psychotherapy in the Management of Late-life Anxiety Psychotherapy Workbook. University of California, San Diego and VA San Diego Healthcare System. ACCESS MANUAL HERE.
Psychodynamic Therapy

Evans, S. (2004). Talking over the years: A handbook of psychodynamic psychotherapy with older people . New York, NY: Brunner-Routledge.

Evans, S. (2004). Talking over the years: A handbook of psychodynamic psychotherapy with older people . New York, NY: Brunner-Routledge.

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Leichsenring, F., Salzer, S., Jaeger, U., Kachele, H., Kreische, R., Leweke, F. Ruger, U., Winkelbach, C., & Leibing, E. (2009) Short-Term Psychodynamic Psychotherapy and Cognitive-Behavioral Therapy in Generalized Anxiety Disorder: A Randomized, Controlled Trial. American Journal of Psychiatry, 166, 875-881. doi: 10.1176/appi.ajp.2009.09030441

Leichsenring, F., Salzer, S., J aeger, U., Kachele, H., Kreische, R., Leweke, F. Ruger, U., Winkelbach, C., & Leibing, E. (2009) Short-Term Psychodynamic Psychotherapy and Cognitive-Behavioral Therapy in Generalized Anxiety Disorder: A Randomized, Controlled Trial. American Journal of Psychiatry, 166, 875-881. doi: 10.1176/appi.ajp.2009.09030441

Posted in reference | Tagged , , , , | Comments Off on Leichsenring, F., Salzer, S., Jaeger, U., Kachele, H., Kreische, R., Leweke, F. Ruger, U., Winkelbach, C., & Leibing, E. (2009) Short-Term Psychodynamic Psychotherapy and Cognitive-Behavioral Therapy in Generalized Anxiety Disorder: A Randomized, Controlled Trial. American Journal of Psychiatry, 166, 875-881. doi: 10.1176/appi.ajp.2009.09030441