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Salud mental

versão impressa ISSN 0185-3325

Salud Ment vol.30 no.4 México Jul./Ago. 2007

 

Artículos originales

Escala de ansiedad ante el envejecimiento de Lasher y Faulkender: propiedades psicométricas en adultos mayores mexicanos

Armando Rivera-Ledesma* 

María Montero-López Lena* 

Ana Luisa González-Celis Rangel** 

Juan José Sánchez-Sosa1 

1 Universidad Nacional Autónoma de México, Facultad de Psicología, División de Estudios de Posgrado. Ciudad Universitaria, México, D.F. E.mail: armandoriveral@aol.com , monterol@servidor.unam.mx , johannes@servidor.unam.mx

** Facultad de Estudios Superiores Iztacala, algcr@servidor.unam.mx


Resumen:

Lasher y Faulkender desarrollaron la Escala de Ansiedad ante el Envejecimiento, y Watkins, Coates y Ferroni señalaron la necesidad de adaptarla para su aplicación en adultos mayores. El presente trabajo tuvo como objetivo evaluar las propiedades psicométricas de la escala original de Lasher y Faulkender, así como de una versión adaptada a adultos mayores mexicanos. Se utilizaron dos muestras independientes (n=234 y n=151) de adultos mayores elegidos por disponibilidad en una clínica de salud gubernamental; la media de edad era de 63 años. Se utilizaron dos cuestionarios que incluyeron la escala original (EAE-O), en uno, y la escala adaptada (EAE-A), en el otro, además de la subescala de actitud ante el propio envejecimiento de la Philadelphia Geriatric Center Morale Scale de Lawton, APE, y la Escala de Ideación Suicida (EIS), diseñada por Roberts. Adicionalmente se les preguntó a los respondedores: «Si tuviera que fijar una edad, olvidándose un poco de lo que dicen los médicos y la gente, ¿a qué edad cree usted que empieza uno a ser "viejo(a)" realmente?, y ¿a qué edad cree usted que empieza uno a ser "muy viejo(a)" ».

Un análisis factorial con rotación Varimax y valores eigen mayores a uno arrojó resultados satisfactorios tanto para la EAE-O como para la EAE-A. En cuanto a la validez concurrente, tanto la EAE-O como la EAE-A obtuvieron correlaciones moderadas y significativas con respecto a la APE.

Se analizó la relación entre vejez percibida (¿Cuándo se es viejo?, y ¿Cuándo se es muy viejo?) y ansiedad ante el envejecimiento; con una significancia marginal. Se halló así que los sujetos con niveles bajos de ansiedad tienden a referir una edad más remota (X- =68.2 años, DE= 9.8), que aquéllos con altos niveles de ansiedad (X- =64.47, DE=11.7; t=1.74, gl=57.9, p=.08), a la pregunta sobre la edad en que se es "viejo". Con respecto a la segunda pregunta (¿Cuándo se es muy viejo?), se observó la misma tendencia, pero esta vez de manera significativa (baja ansiedad: X- =80.9 años; DE=9.1; alta ansiedad: X- =76.4 años; DE=9.1; t=2.51, gl=128, p=.01). En relación con la ideación suicida se halló que aquellos sujetos que obtuvieron bajos niveles de ansiedad ante el envejecimiento según la EAE-A, tuvieron también menores niveles de ideación suicida (X- = 1.25, DE=1.47) que aquéllos con altos niveles de ansiedad (X- =2.35, DE=2.51; t=2.84, gl=64.45, p=.006).

Los resultados aportados por el análisis psicométrico de ambas versiones de la EAE han permitido confirmar su utilidad en muestras mexicanas. En conjunto, la EAE-O parece investigar la ansiedad ante la vejez como una etapa de la vida; como un estado del ser, y podría quizá ser especialmente útil para personas que no sean necesariamente adultas mayores (cuidadores de viejos, adultos entre los 50 y 60 años en franca transición hacia la adultez mayor socialmente concebida, etc.). Sin embargo, puede resultar provechoso centrarse en la situación singular de un sujeto con respecto a su propio proceso de envejecimiento (físico o psicosocial) cuando éste sea precisamente el objetivo por investigar. Para este efecto puede resultar útil la EAE-A.

El criterio cronológico aportado por los adultos mayores a la pregunta sobre cuándo se es "viejo" o "muy viejo" parece obedecer, al menos en parte, al grado de ansiedad ante el envejecimiento: cuanto mayor sea la ansiedad, será menor la edad que consideran como inicio de la vejez, o la ancianidad. Al parecer, la ansiedad ante el envejecimiento es una variable importantemente vinculada al desajuste psicológico en el adulto mayor.

Palabras clave: Ansiedad; envejecimiento; escala; ideación suicida; adultos mayores

Summary:

Lifshitz has documented that conceptualization of old age is influenced by stereotypes. Milligan, Powell, Harley and Furchtgott, made evident that elderly people with poor health have a tendency to see themselves as the stereotype of an "old person", whereas those with better health tend to see themselves as younger people. Lasher and Faulkender have stressed the importance of anxiety in the process of getting old as an important factor adjusting to themselves. Lack of adjustment may manifest in four main dimensions: physical, psychological and social, and transpersonal or spiritual. These four dimensions are synthesized in three specific fears: 1. Fear of the process of aging, 2. fear of the state of being old, and 3. fear or anxiety facing old people. Based on this theoretical frame, the authors developed the Anxiety about Aging Scale, and Watkins, Coates and Ferroni pointed out the need to adapt it in order to apply it on elderly people. The objective of this paper is to evaluate the psychometric properties of the original Lasher and Faulkender scale, as well as presenting an adapted version for Mexican elderly people.

Method.

Two independent samples of elder adults were used (n=234 and n=151) selected by availability within a government health clinic; on average, they were 63 years old. The original Lasher and Faulkender scale was translated into Spanish following a double blind procedure, using Likert type answer options with four alternatives. Two questionnaires were used, which included the original scale (EAE-O), in one, and the adapted scale (EAE-A) in the other, as well as the sub-scale of attitude facing one's own aging of the Philadelphia Geriatric Center Morale Scale, APE (2), and the Suicidal Ideational Scale (EIS), designed by Roberts (3). Additionally, interviewees were asked: «If you should have to set an age, forgetting a little about what doctors and people say, at what age would you consider that you really start to be "Old"? » and at what age do you think one would get "very old"? The scales were applied to subjects who agreed voluntarily to participate in an anonymous and informed way. Resulting data were analyzed with the system SPSS, v. 11.0.

Factorial structure. A factorial analysis with varimax rotation and eigen values greater than 1 produced the following results: EAE-O: The structure obtained was compounded by three factors that explained 53.1% of the variance with Cronbach's alpha of .74 (Fear facing one's own aging, Positive attitude towards old people and Optimism facing one's own aging). EAE-A: The analysis shed a factorial structure compounded by four factors that explained 60.8% of the variance with a general internal alpha consistency of .76 (Positive attitude towards old people, Fear of physical changes, Age and satisfaction with the self and life, and Age and dissatisfaction with the self and life).

Concurrent validity. EAE-O. The correlation among the total punctuations of the EAE-O and APE was moderate and significant (r=.481, p<.000). The factors Fear facing one's own aging and Optimism facing one's own aging of the EAE-O, calculated here, obtained a moderate association with the total punctuation of the APE (r=.423, p<.000; r=.333, p<.000, respectively), and the factor of Positive attitude facing old people reported a very low association and no significant (r=.075, p=.252). As expected, the two factors of the APE that seem to evaluate positive and negative attitudes facing aging obtained moderate associations and significant with the two scales of the EAE-O that seem to evaluate the same attitudes (Optimism facing one's own aging, r=.415, p<.000; and Fear facing one's own aging, r=.424, p<.000, respectively). Consequently, a very low association was obtained when relating it with the opposite factor (v.gr. negative vs. positive).

EAE-A. Associations between the factors Age and dissatisfaction and Age and satisfaction (similar to the factors of Fear facing one's own aging and Optimism facing one's own aging) and the total score of the APE were moderately high (r =.499, p<.000, and r =.383, p<.000, respectively), as long as the other two factors of the EAE-A presented associations moderately low. As it was to be expected, again were associated in an important way the EAE-A scales with a positive nuance (aging and satisfaction, Positive attitude before old people) with the scale of the APE's Positive attitude, and vice versa. The factors of aging and dissatisfaction and Fear to physical changes were significantly associated with the negative attitude of the APE.

The relationship between perceived aging (when is one old?, and when is one too old?) and anxiety before aging; with a marginal meaning, it was found that those people with low levels of anxiety tend to refer an age but remote (X- =68.2 years, DE= 9.8), than those with high levels of anxiety (X- =64.47, DE=11.7; t=1.74, gl=57.9, p=.08), to the question of the age that one is "old". Concerning the question when is one too old?, the same tendency it was observed, but this time in a meaningful way (Low Anxiety: X- =80.9 years; DE=9.1; High Anxiety: X- =76.4 years; DE=9.1; t=2.51, gl=128, p=.01). Regarding suicidal ideation, it was found that subjects who score low levels of anxiety before aging according to EAE-A also had lower levels of anxiety of suicidal ideation (X- = 1.25, DE=1.47), than those with high levels of anxiety (X- =2.35, DE=2.51; t=2.84, gl=64.45, p=.006).

Results contributed by the psicometric analysis of both versions of the EAE have allowed to confirm their utility in Mexican samples. Together, the EAE-O seems to investigate the anxiety before aging as a stage of life; as a state of being, and perhaps could be specially useful on people who are not necessarily elders (old people caretakers, adults between 50 and 60 years old in a frank transition towards the socially conceived old Adulthood, etc.). However, it could be worthwhile to focus on the singular situation of a subject regarding his own aging process (physical or psychosocial), when this is precisely the objective to be investigated; the EAE-A could be useful to this effect.

Elderly adults seem to conceptualize "being old" as an event that occurs approximately at 70, and "very old" around 80; this chronological approach seems to obey, at least in part, to the level of anxiety before the aging process; the higher the anxiety, the earlier the beginning of old age. Results allowed to highlight the anxiety facing aging like a variable importantly linked to the psychological imbalance in the old adult, as it was possible to evidence in broadly significant terms with the EAE-A as with the APE, starting from their relationship with the suicidal ideational, and more, when this relationship is found in fellows without current marital commitment and of low educational level. This should be considered in programs of attention to this age sector where these factors of risk are evaluated with a view toward preventing the incidence of suicides. Different studies have highlighted the importance of developing a positive attitude before one's own aging and that of the other ones, in order to achieve a successful aging. This suggests the need to identify methods to promote positive attitudes in young adults toward the elders and the aging process.

Key words: Anxiety; aging; scale; suicidal ideation; elderly

Texto completo disponible sólo en PDF.

Agradecimientos

Al apoyo financiero otorgado por el Consejo Nacional de Ciencia y Tecnología por medio de la beca No. 95177 para la realización de estudios doctorales otorgada al primer autor de este trabajo.

REFERENCIAS

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Recibido: 06 de Junio de 2006; Aprobado: 02 de Abril de 2007

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