Background This study investigated symptom patterns that might distinguish between individuals with and without a diagnosis of Social Phobia (SP) across the adult lifespan. Methods A sample of 5411 self-reported social worriers was derived from Wave 1 (2001 and 2002) of the U.S. National Epidemiological Survey of Alcohol and Related Conditions (NESARC). Participants were stratified into four age groups (18-29 years, 30-44 years, 45-64 years, 65-96 years), and further divided into two diagnostic groups (self-reported social worriers with and without a SP diagnosis). Results Binary logistic regression analyses revealed that a core set of symptoms was associated with SP across the adult lifespan. There were also successive reductions in the number of symptoms associated with SP in each age group, such that older adults endorsed numerically fewer SP symptoms. Limitations Though our sample size is smaller than ideal for the nature of our analyses, the NESARC represents one of the largest existing clinical datasets we know of. Conclusions Despite age-related reductions in symptom frequency, a core set of SP symptoms consistently distinguished between diagnostic groups, irrespective of age.
Objective Symptoms and disorders of anxiety are highly prevalent among older adults; however, late-life anxiety disorders remain underdiagnosed. The objective of this study was to (1) estimate the prevalence of late-life threshold and subthreshold generalized anxiety disorder (GAD), (2) examine sociodemographic and health correlates associated with membership in these groups, (3) assess 3-year conversion rates of these groups, and (4) explore characteristics associated with 3-year conversion to GAD. Methods Using Waves 1 and 2 of the National Epidemiological Survey of Alcohol and Related Conditions, 13,420 participants aged 55-98 years were included in this study. Results Subthreshold GAD was more highly prevalent than threshold GAD and was interposed between asymptomatic and GAD groups in terms of severity of health characteristics. Although most participants with subthreshold and threshold GAD were asymptomatic by Wave 2, differences in disability persisted. Subthreshold GAD at baseline was not a predictor of threshold GAD at follow-up. Conclusion These findings suggest that late-life GAD should be conceptualized as a dimensional rather than categorical construct. The temporal stability of anxiety-associated disability further suggests that subthreshold GAD bears clinical significance. However, the suitability and efficacy of interventions for minimizing negative sequelae in this group remain to be determined.