Date of Conferral

2023

Degree

Ph.D.

School

Psychology

Advisor

Benita L. Stiles-Smith

Abstract

Little is known as to the age-related presentation of somatic complaints of those diagnosed with generalized anxiety disorder in primary care settings. A retrospective medical records review sought to identify the affective symptoms of generalized anxiety disorder (GAD) by age as recorded by primary care providers and to test the association of these symptoms by age. Guided by Engle’s (1977) biopsychosocial (BPS) model, a large administrative claim database system was used to derive a sample of 1,336, including 500 patients diagnosed with generalized anxiety disorder between 2018 to 2021. Binary logistics regression, one-way ANOVA, chi-square, correlation, and logistical regression with SPSS software were used to describe the results. Logistic regression analyses determined there were significant associations between the diagnosis of GAD and indicative physical symptoms noted in primary care. These included sleep disorders, gastro-esophageal reflux, muscle conditions, abnormalities of heartbeat, abnormalities of breathing, pain in throat and chest, abdominal and pelvic pain, nausea and vomiting, and malaise and fatigue by age stratification. The need to develop an age specific case-finding algorithm to enable primary care practitioners to more readily identify and appropriately refer patients with generalized anxiety disorder was highlighted. This study may contribute to positive social change improvements for these patients, providers, healthcare systems, analytical processes, and psychometrics. These findings can contribute to the development of age-specific screening tools which could improve recognition and diagnosis of GAD in primary care patients.

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