Feeling Guilty and Anxiety in the Elderly: The Role of Existential Concerns

Document Type : Original Article

Authors

1 Department of Psychology, Faculty of Psychology and Educational Sciences, Islamic Azad University, South Tehran Branch, Tehran, Iran

2 Department of Rehabilitation Counseling, Faculty of Psychology and Educational Sciences, Islamic Azad University South Tehran Branch, Tehran, Iran

10.22126/jap.2021.5827.1480

Abstract

Feeling guilty and anxiety are part of the most important human experiences, especially in the elderly, which can affect their mental health. Hence, identifying the factors that affect them is of particular importance. Therefore, this study aimed to predict feeling guilty and anxiety based on existential concerns in the elderly. The present study was a descriptive study, of correlational type. The statistical population included non-resident elderly in the nursing homes of districts one, three, and five of Tehran, Iran in 2019, among which a sample of 150 people were selected using convenience sampling method. The research tools included existential anxiety questionnaire (Massoudi Sani et al.,) guilt inventory (Kugler & Jones) and Anxiety Inventory (Cattle). The collected data were analyzed using Pearson correlation coefficient and multiple regression analysis. The results showed that sense of responsibility and death anxiety had positive and significant relationship with feeling guilty, existential concerns (meaninglessness, sense of responsibility, loneliness and death anxiety) were positively and significantly related to anxiety. The results of multiple regression analyses also revealed that 11% of the variance of feeling guilty and 22% of the variance of anxiety was explained by existential concerns. Therefore, according to the findings, it can be said that using strategies to reduce the existential concerns of the elderly seems to be an effective measure to reduce their feeling guilty and anxiety.
 
 

 

References
Andreescu, C., & Varon, D. (2015). New Research on Anxiety Disorders in the Elderly and an Update on Evidence-Based Treatments. Current Psychiatry Reports, 17(7), 53.
Carlos, T. O., David, A. C., &Julia, W. F. (2010). Definition and measurement of guilt: Implications for clinical research and practice. Clinical Psychology Review, 30(5), 536–546.
Cicirelli, V. G. (2002). Fear of death in older adults: Predictions from terror management theory. Death Studies, 57(4), 358–366.
Corey, G. (2013). Theory and Practice of Counseling and Psychotherapy (9th Ed). Publisher, Cengage Learning. [Persian]
Davtalab, M. (2007). Existential psychoanalysis from Sartre's point of view (Master’s thesis). Allameh Tabataba'i University, Tehran. [Persian]
Domènech-Abella, J., Mundó, J., Haro, J. M., & Rubio-Valera, M., (2019). Anxiety, depression, loneliness and social network in the elderly: longitudinal associations from The Irish Longitudinal Study on Ageing (TILDA). Journal of Affective Disorders, 246, 82-88.
Eisenberg, N. (2000). Emotion reulation and moral development. Annual Review of Psychology, 51,665-697.
Fry, P. S. (2000). Religious in volvement, spirituality and personal meaning for life: Existential predictors of psychological well-being in community-Residing and institutional care elders. Aging and Mental Health, 4(4), 375-387.
Fountoulakis, K. N., Siamouli, M., Magiria, S., & Kaprinis, G. (2008). Late-life depression, religiosity, cerebrovascular disease, cognitive impairment and attitudes towards death in the elderly: Interpreting the data. Medical Hypotheses, 70(3), 493-496.
Ghorbanalipoor M, Borjali A, Sohrabi F, & Falsafinejad M R. (2010). The effect of death anxiety and age on health promoting behaviors. The Journal of Urmia University of Medical Science, 21 (2), 286-292. [Persian]
Hamidizadeh, S., Ahmadi, F. & Asghari, M. (2006). Study effect of relaxation technique on anxiety and stress in elders with hypertension. Journal of Shahrekord University of Medical Science, 8(2), 45- 51.[Persian]
Henrie, J., & Patrick, J. H. (2014). Religiousness, religious doubt, and death anxiety. The International Journal of Aging and Human Development, 78(3), 203-227.
Hohls, J. K., König, H., Quirke E., & Hajek, A. (2019). Association between anxiety, depression and quality of life: study protocol for a systematic review of evidence from longitudinal studies. BMJ Open Journal, 9, 1-5.
Khademi, M. J., Rashedi, V., Sajadi, S., & Moradi Gheshlaghi, Sh. (2015). Anxiety and Loneliness in the Iranian Older Adults. International Journal of Psychology and Behavioral Sciences, 5(2), 49-52.
Kalantarkoosheh, S. M. (2011). Efficiacy of Existential Freedom training in marital satisfaction of Iranian woman. Australian journal of Basic and Applied science,5(12), 872-876.
Kang, K. A., Im, J. I., Kim, S. J., Song, M. K., & Sim, S. (2009). The effect of logo therapy on the suffering, finding meaning and spiritual well-being of terminal cancer. Journal of Korean Academy of Child health nursing, 15(2), 136-144.
Kugler, K., & Jones, W. H. (1992). On conceptualizing and assessing guilt. Journal of Personality and Social  Psychology, 62(2), 318-327.
Längle, A., & Probst, C. (2000). Existential Questions of the Elderly. International Medical Journal, 7(3), 193-196
 Maltby, J., & Day, L. (2000). The reliability and validity of the Death obsession scaleamong English university and adult samples. Personality and individualDifferences, 28, 695-700.
 Mansour, M., & Dadsetan, P. (2002). Mental Illnesses. Tehran: Roshd Press. [Persian]
Masoudi Sani, R., Bahmani, B., Asgari, A., Khanjani, M., & Pakniya, N. (2020). Construction, validity and reliability of existential anxiety questionnaire (QFEA). Clinical Psychology and Personality, 13(2), 151-162. [Persian]
Miceli, M. (1992). How to make someone feel guilty: Strategies of guilt inducement and their goals. Journal for the Theory of Social Behavior, 22, 81–104.
 Mijuskovic, B. (1996). The Phenomenology and dynamic of loneliness. Psychology: A journal of human behavior, 32 (2), 41-51.
 Naziri, Q. (1995). The role of guilt in the information processing process of obsessive-compulsive patients and its roots in perfectionist parenting methods (Master’s thesis). Institute of Psychiatry, Tehran. [Persian]
Pashang, S., Hoseinzadeh Taghvaee, M., & Vanaki Farahani, Z. (2016). Group therapy with the approach of logo therapy on general health of elderlies. Journal of Applied Psychology, 10(2), 39-53. [Persian]
Pourfaraj, O. (2009). The Study of the Relationship of Thought-Action Fusion, the Feelings of Responsibility and Guilt with Different Dimensions of Obsessive-Compulsive Disorder Symptoms in Shiraz University Students. Clinical Psychology and Personality7(2), 69-82. [Persian]
 Rachman, S. (1997). A cognitive theory of obsessions. Behaviour Research and Therapy, 35(9), 793–802.
 Rebecca, P., & Jigging, O. (2011). Association between caregiving, meaning in life and life satisfaction beyond 50 in an Asian sample. Social indicators researchers, 108(3), 525-535.
Ribeiro, O., Teixeira, L., Araújo, L., Rodríguez-Blázquez, C., Calderón-Larrañaga, A., & Forjaz, M. J. (2020). Anxiety, Depression and Quality of Life in Older Adults: Trajectories of Influence across Age. International Journal of Environmental Research and Public Health17(23), 1-10.
 Riedel Heller, S. G., Busse, A., Angermeyer, M. C. (2006) .The state of mental health in old age across the ‘old’ European union–a systematic review. Acta Psychiatrica Scandinavica, 113(5), 388-401.
 Robinaugh, D. J., & McNally, R. J. (2010). Autobiographical memory for shame or guilt events: Association with psychological symptoms. Behaviour Research and Therapy48(7), 646–652.
Sadri Demichi, E., & Ramezani, S. (2016). Effectiveness of Existential Therapy on Loneliness and Death Anxiety in the Elderly. Aging Psychology, 2(1), 1-12. [Persian]
Salarifar, M. H., Pouretemad, H. R. (2012). The relationship between metacognitive beliefs and anxiety and depression disorder. Journal of Lorestan University of Medical Sciences, 13 (4), 29-38. [Persian]
Sand, L. (2008). Existential challenge and coping in palliative care, experiences of patients and family members. (Unpublished Doctoral Dissertation, Karolinska institute, Stockholm, Sweden)  http://hdl.handle.net/10616/38011   
Sigelman, C. K., & Rider, Ae. (2010). Life Span Human Development. USA: Wadsworth.
Sommers-Flanagan, J. & Sommers-Flanagan, R. (2014). Counseling and Psychotherapy Theories in Context and Practice: Skills, Strategies, and Techniques. Publisher: John Wiley & Sons. [Persian]
Sousa, R. D., Rodrigues, A. M., Gregório, M. J., Branco, J. C., Gouveia, M. J., Canhão, H., & Dias, S. S. (2017). Anxiety and Depression in the Portuguese Older Adults: Prevalence and Associated Factors. Frontiers in Medicine, 4, 1-12.
Stancliffe, R. J., Wiese, M. Y., Read, S., Jeltes, G., & Clayton, J. M. (2016). Knowing, planning for and fearing death: Do adults with intellectual disability and disability staff differ? Journal of Research in Developmental Disabilities, 49(12), 47–59.
Statistical Center of Iran. (2016). General Census, Population and Housing. Tehran: Statistics Center of Iran. [Persian]
Steger, M. F., Oishi, S., & Kesebir, S. (2011). Is a life without meaning satisfying? The moderating role of the search for meaning in satisfaction with life judgments. The Journal of Positive Psychology, 6(3), 173-180
 Sura, L., Madhavan, A., Carnaby, G., & Crary, M. A. (2012). Dysphagia in the elderly:management and nutritional considerations. Clinical Interventions in Aging, 7(287), 98-102.
 Suri, R. (2010). Working with the elderly: An Existential-Humanistic Approach. Journal of Humanistic Psychology, 50(2), 175-186.
Tak, S. H. (2006). An insider perspective of daily stress and coping in elders with arthritis. Orthopaedic Nursing, 25(2), 127-132.
Tangney, J. P., & Dearing, R. L. (2002). Shame and guilt. Guilford Press.
 Vontress, C. E. (2008). Existential therapy. In J. Frew & M. D. Spiegler (Eds.),Contemporary psychotherapies for a diverse world (pp.141-176). Boston: Lahaska press.
 Yalom, I. D. (2008). Existential psychotherapy. New York: Basic Books. [Persian]
Yek, M. H., Olendzki, N., Kekecs, Z., Patterson, V., & Elkins, G. (2017). Presence of Meaning in Life and Search for Meaning in Life and Relationship to Health Anxiety. Psychological Reports, 120(3), 383–390
Zhou, G., Wang, Y., & Yu, X. (2016). Direct and Indirect Effects of Family Functioning on Loneliness of Elderly Chinese Individuals. Current Psychology, 37 (1), 1-7.

Keywords


References
Andreescu, C., & Varon, D. (2015). New Research on Anxiety Disorders in the Elderly and an Update on Evidence-Based Treatments. Current Psychiatry Reports, 17(7), 53.
Carlos, T. O., David, A. C., &Julia, W. F. (2010). Definition and measurement of guilt: Implications for clinical research and practice. Clinical Psychology Review, 30(5), 536–546.
Cicirelli, V. G. (2002). Fear of death in older adults: Predictions from terror management theory. Death Studies, 57(4), 358–366.
Corey, G. (2013). Theory and Practice of Counseling and Psychotherapy (9th Ed). Publisher, Cengage Learning. [Persian]
Davtalab, M. (2007). Existential psychoanalysis from Sartre's point of view (Master’s thesis). Allameh Tabataba'i University, Tehran. [Persian]
Domènech-Abella, J., Mundó, J., Haro, J. M., & Rubio-Valera, M., (2019). Anxiety, depression, loneliness and social network in the elderly: longitudinal associations from The Irish Longitudinal Study on Ageing (TILDA). Journal of Affective Disorders, 246, 82-88.
Eisenberg, N. (2000). Emotion reulation and moral development. Annual Review of Psychology, 51,665-697.
Fry, P. S. (2000). Religious in volvement, spirituality and personal meaning for life: Existential predictors of psychological well-being in community-Residing and institutional care elders. Aging and Mental Health, 4(4), 375-387.
Fountoulakis, K. N., Siamouli, M., Magiria, S., & Kaprinis, G. (2008). Late-life depression, religiosity, cerebrovascular disease, cognitive impairment and attitudes towards death in the elderly: Interpreting the data. Medical Hypotheses, 70(3), 493-496.
Ghorbanalipoor M, Borjali A, Sohrabi F, & Falsafinejad M R. (2010). The effect of death anxiety and age on health promoting behaviors. The Journal of Urmia University of Medical Science, 21 (2), 286-292. [Persian]
Hamidizadeh, S., Ahmadi, F. & Asghari, M. (2006). Study effect of relaxation technique on anxiety and stress in elders with hypertension. Journal of Shahrekord University of Medical Science, 8(2), 45- 51.[Persian]
Henrie, J., & Patrick, J. H. (2014). Religiousness, religious doubt, and death anxiety. The International Journal of Aging and Human Development, 78(3), 203-227.
Hohls, J. K., König, H., Quirke E., & Hajek, A. (2019). Association between anxiety, depression and quality of life: study protocol for a systematic review of evidence from longitudinal studies. BMJ Open Journal, 9, 1-5.
Khademi, M. J., Rashedi, V., Sajadi, S., & Moradi Gheshlaghi, Sh. (2015). Anxiety and Loneliness in the Iranian Older Adults. International Journal of Psychology and Behavioral Sciences, 5(2), 49-52.
Kalantarkoosheh, S. M. (2011). Efficiacy of Existential Freedom training in marital satisfaction of Iranian woman. Australian journal of Basic and Applied science,5(12), 872-876.
Kang, K. A., Im, J. I., Kim, S. J., Song, M. K., & Sim, S. (2009). The effect of logo therapy on the suffering, finding meaning and spiritual well-being of terminal cancer. Journal of Korean Academy of Child health nursing, 15(2), 136-144.
Kugler, K., & Jones, W. H. (1992). On conceptualizing and assessing guilt. Journal of Personality and Social  Psychology, 62(2), 318-327.
Längle, A., & Probst, C. (2000). Existential Questions of the Elderly. International Medical Journal, 7(3), 193-196
 Maltby, J., & Day, L. (2000). The reliability and validity of the Death obsession scaleamong English university and adult samples. Personality and individualDifferences, 28, 695-700.
 Mansour, M., & Dadsetan, P. (2002). Mental Illnesses. Tehran: Roshd Press. [Persian]
Masoudi Sani, R., Bahmani, B., Asgari, A., Khanjani, M., & Pakniya, N. (2020). Construction, validity and reliability of existential anxiety questionnaire (QFEA). Clinical Psychology and Personality, 13(2), 151-162. [Persian]
Miceli, M. (1992). How to make someone feel guilty: Strategies of guilt inducement and their goals. Journal for the Theory of Social Behavior, 22, 81–104.
 Mijuskovic, B. (1996). The Phenomenology and dynamic of loneliness. Psychology: A journal of human behavior, 32 (2), 41-51.
 Naziri, Q. (1995). The role of guilt in the information processing process of obsessive-compulsive patients and its roots in perfectionist parenting methods (Master’s thesis). Institute of Psychiatry, Tehran. [Persian]
Pashang, S., Hoseinzadeh Taghvaee, M., & Vanaki Farahani, Z. (2016). Group therapy with the approach of logo therapy on general health of elderlies. Journal of Applied Psychology, 10(2), 39-53. [Persian]
Pourfaraj, O. (2009). The Study of the Relationship of Thought-Action Fusion, the Feelings of Responsibility and Guilt with Different Dimensions of Obsessive-Compulsive Disorder Symptoms in Shiraz University Students. Clinical Psychology and Personality7(2), 69-82. [Persian]
 Rachman, S. (1997). A cognitive theory of obsessions. Behaviour Research and Therapy, 35(9), 793–802.
 Rebecca, P., & Jigging, O. (2011). Association between caregiving, meaning in life and life satisfaction beyond 50 in an Asian sample. Social indicators researchers, 108(3), 525-535.
Ribeiro, O., Teixeira, L., Araújo, L., Rodríguez-Blázquez, C., Calderón-Larrañaga, A., & Forjaz, M. J. (2020). Anxiety, Depression and Quality of Life in Older Adults: Trajectories of Influence across Age. International Journal of Environmental Research and Public Health17(23), 1-10.
 Riedel Heller, S. G., Busse, A., Angermeyer, M. C. (2006) .The state of mental health in old age across the ‘old’ European union–a systematic review. Acta Psychiatrica Scandinavica, 113(5), 388-401.
 Robinaugh, D. J., & McNally, R. J. (2010). Autobiographical memory for shame or guilt events: Association with psychological symptoms. Behaviour Research and Therapy48(7), 646–652.
Sadri Demichi, E., & Ramezani, S. (2016). Effectiveness of Existential Therapy on Loneliness and Death Anxiety in the Elderly. Aging Psychology, 2(1), 1-12. [Persian]
Salarifar, M. H., Pouretemad, H. R. (2012). The relationship between metacognitive beliefs and anxiety and depression disorder. Journal of Lorestan University of Medical Sciences, 13 (4), 29-38. [Persian]
Sand, L. (2008). Existential challenge and coping in palliative care, experiences of patients and family members. (Unpublished Doctoral Dissertation, Karolinska institute, Stockholm, Sweden)  http://hdl.handle.net/10616/38011   
Sigelman, C. K., & Rider, Ae. (2010). Life Span Human Development. USA: Wadsworth.
Sommers-Flanagan, J. & Sommers-Flanagan, R. (2014). Counseling and Psychotherapy Theories in Context and Practice: Skills, Strategies, and Techniques. Publisher: John Wiley & Sons. [Persian]
Sousa, R. D., Rodrigues, A. M., Gregório, M. J., Branco, J. C., Gouveia, M. J., Canhão, H., & Dias, S. S. (2017). Anxiety and Depression in the Portuguese Older Adults: Prevalence and Associated Factors. Frontiers in Medicine, 4, 1-12.
Stancliffe, R. J., Wiese, M. Y., Read, S., Jeltes, G., & Clayton, J. M. (2016). Knowing, planning for and fearing death: Do adults with intellectual disability and disability staff differ? Journal of Research in Developmental Disabilities, 49(12), 47–59.
Statistical Center of Iran. (2016). General Census, Population and Housing. Tehran: Statistics Center of Iran. [Persian]
Steger, M. F., Oishi, S., & Kesebir, S. (2011). Is a life without meaning satisfying? The moderating role of the search for meaning in satisfaction with life judgments. The Journal of Positive Psychology, 6(3), 173-180
 Sura, L., Madhavan, A., Carnaby, G., & Crary, M. A. (2012). Dysphagia in the elderly:management and nutritional considerations. Clinical Interventions in Aging, 7(287), 98-102.
 Suri, R. (2010). Working with the elderly: An Existential-Humanistic Approach. Journal of Humanistic Psychology, 50(2), 175-186.
Tak, S. H. (2006). An insider perspective of daily stress and coping in elders with arthritis. Orthopaedic Nursing, 25(2), 127-132.
Tangney, J. P., & Dearing, R. L. (2002). Shame and guilt. Guilford Press.
 Vontress, C. E. (2008). Existential therapy. In J. Frew & M. D. Spiegler (Eds.),Contemporary psychotherapies for a diverse world (pp.141-176). Boston: Lahaska press.
 Yalom, I. D. (2008). Existential psychotherapy. New York: Basic Books. [Persian]
Yek, M. H., Olendzki, N., Kekecs, Z., Patterson, V., & Elkins, G. (2017). Presence of Meaning in Life and Search for Meaning in Life and Relationship to Health Anxiety. Psychological Reports, 120(3), 383–390
Zhou, G., Wang, Y., & Yu, X. (2016). Direct and Indirect Effects of Family Functioning on Loneliness of Elderly Chinese Individuals. Current Psychology, 37 (1), 1-7.