American Psychological Association
Table of Contents
Executive Summary
Authors
Why Practitioners Need Information
Demographic Realities
Myths About Older Adults
Realities of Aging
Psychological Problems
of Aging
Assessment of Older Adults
Psychological Intervention
Professional Concerns
Conclusion
Professional Resources
Bibliography |
- Since geriatric and subclinical variants of some of the major psychological
disorders exist, comparing the individual's particular scores on a continuum
with the relative performance of the older age group (e.g., dimensional
analysis) is preferable to the use of strict cutoffs (e.g., categorical
analysis).
- No widely used self-report measures of anxiety have been specifically
developed for older adults. The Beck Anxiety Scale is brief and easily
administered, but results should be viewed with caution in the assessment
of frail and less educated older adults.
- A variety of good screening measures exists for depression (e.g., Hamilton
Depression Rating Scale, Beck Depression Inventory). The Geriatric Depression
Scale (GDS) was specifically developed for older adults. The GDS is useful
because it (1) has age-related norms; (2) can be administered in oral and
written form, thus allowing for more accurate assessment of persons with
mild cognitive impairment; and (3) omits somatic items that can elevate
depression scores for clients who may be manifesting somatic symptoms associated
with medical problems and not depression.
- The CAGE and Michigan Alcoholism Screening Test-Geriatric Version are
instruments that have demonstrated potential as alcohol screening tools
with older adults.
- Broad-based measures of psychopathology that have been normed on older
people are available. The MMPI-2 is a widely used self-report instrument
that was normed on persons up to 84 years of age. However, in view of its
length and required reading level, it may not be practical for very old,
less educated, or visually or cognitively impaired adults. The Brief Psychiatric
Rating Scale is a clinician-rated scale encompassing primary domains of
psychopathology and has been found to be useful with older adults.
- Assessment of personality features can be important in planning treatment
strategies. Unfortunately, there are no measures of personality disorder
(PD) specifically developed for use with older adults. Current structured
PD scales are lengthy, and their routine use with older adults is impractical.
- The Rorschach Inkblot Test should only be used with caution in assessing
the personality or disordered thinking of older adults. Age-related norms
have not been established for the widely used Exner system, and psychopathology
can easily be overdiagnosed by inexperienced examiners testing older adults
who are not comfortable with unstructured tasks.
- The Thematic Apperception Test has been used extensively with older
adults in research studies and clinical settings. It yields geriatric themes
with the same frequency as the Senior Apperception Test and Gerontological
Apperception Test. Information from these measures is sometimes useful
in identifying life issues that need to be addressed in psychotherapeutic
interventions.
 
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