Volume 13, Issue 1 (4-2018)                   Salmand: Iranian Journal of Ageing 2018, 13(1): 38-49 | Back to browse issues page


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Sadri Damirchi E, Behbuei S, Mojarrad A. Role of Performance in the Stroop Test in Anticipation of Anxiety and Aggression in the Elderly in Ardabil. Salmand: Iranian Journal of Ageing 2018; 13 (1) :38-49
URL: http://salmandj.uswr.ac.ir/article-1-1419-en.html
1- Department of Educational Sciences, Faculty of Education and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran. , araz_sadri@yahoo.com
2- Department of Psychology, Faculty of Education and Psychology, University of Tabriz, Tabriz, Iran.
3- Department of Educational Sciences, Faculty of Education and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran.
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Extended Abstract
1. Objectives

Currently, due to an increase in life expectancy, the old age phenomenon has been under intensive focus more than before due to the associated issues and dilemmas. Aging is an inevitable biological process involving all living beings, and in some cases, unpleasant experiences [1]. According to international estimates, since 1419, the elderly population of Iran has grown rapidly as compared to other locations as well as the average growth rate of the elderly worldwide. Until 1424 , Iran overtook the average rate of population growth of the elderly and surpassed that of Asia within the subsequent5 years [2]. Over the last 50 years, the proportion and number of elderly individuals have increased in a majority of the Third World countries [3]. Given the rising population of the elderly and the associated problems, the present study investigated the role of Stroop performance with respect to anxiety and self-efficacy in falling of the elderly >60 years of age.
2. Methods and Materials
The research design was descriptive correlational. The statistical population included all elderly men >60-year-old, who were residents of the nursing home of Ardebil city in 2017. Among these, a sample of 200 individuals was selected by the available sampling method. The present study was approved by the Welfare Organization of Ardebil Committee and conducted after coordination with the Welfare Organization of the city of Ardebil and Rayehe Omid Nursing Home; appropriate research and ethical permissions were obtained prior to the study. Data were analyzed using Pearson’s correlation test and regression analysis. P<0.05 was considered as statistically significant. The following questionnaires were used to collect the information:
Stroop Test
Stroop Test was invented in 1935 by Stroop to evaluate the proprietary attention and cognitive flexibility. Since then, several variations of this test have been available. The reliability of this test for the first and second cards was 0.81, and that for the third and fourth cards was 0.80 [4].
Beck Anxiety Inventory
Beck Anxiety Inventory was introduced by Iron Beck et al. (1990).  This questionnaire specifically measured the severity of the symptoms of clinical anxiety in individuals. This questionnaire contains 21 options. The coefficient of internal consistency (alpha coefficient) was 0.92, and its validity by retest method at an interval of 1week was 0.75 [5]. Kaviani and Mousavi (1999) also reported the coefficient of the validity of this questionnaire as 0.72 and there-validation factor with a1-month interval as 0.83; the Cronbach’s alpha coefficient was 0.92 [40].
Falls Self-efficacy Scale (FES-I)
Falls Self-efficacy Scale (FES-I) comprises of 16 items invented by Yardley et al. The items in this questionnaire had four options: “I am not at all worried” to “I am quite worried” and the score of each subject, will be the total points from 16 questions. The scores range was16–64. A high score indicated fear of falling or low self-efficacy [6]. Furthermore, Borhani Nezhad et al. (2015) reported the Cronbach’s alpha coefficient as 0.909 [43].
3. Results
Herein, 200 married elderly men >60-year-old [Mean (SD)=47.66(6.576)] participated in the study. The descriptive statistics of the variables studied are reported in Table 1.
As observed in Table 1, the highest average score belonged to self-efficacy variable of falling (58.550) and to the amount of reaction to the fourth card (49.472); the fourth card reaction score was 37.2766. Also, the highest standard deviation score corresponding to the score of the fourth card reaction was 78.548, and the fourth card's score was 54.708. The Pearson’s correlation test was used to examine the relationship between self-efficacy in falling and anxiety by Stroop test performance. The Kolmogorov–Smirnov test was employed before the Pearson’s test in order to assess the normality of the variable. The results did not show any significance . Therefore, the distribution of the variables was normal, and Pearson’s test could be used (Table 2).
As seen in Table 2, a significant correlation was established between Stroop’s performance (third and fourth card) in all the four sub-scales including errors, integrity, reaction, and interference and anxiety as well as self-efficacy in falling in the elderly. In addition, regression analysis assessed the level of anxiety prediction and self-efficacy in falling based on Stroop test performance. The regression test results are reported in Table 3.
As observed in Table 3, both anxiety and self-efficacy variables of falling can be predicted by Stroop test performance. The results indicated that the performance of the test predicts the anxiety and self-efficacy in falling negatively .
4. Conclusion
The Stroop test performance was significantly correlated to anxiety, which was in agreement with the studies by Reiner et al. [7] and Kertz et al. [8]. The results also showed that Stroop performance was significantly correlated to the self-efficacy in falling, which was in agreement with the study by Holford et al. [9] and Walson et al. [10]. The result of the regression test also indicated that Stroop test performance predicted the anxiety and self-efficacy in the falling of the elderly. Therefore, Stroop test performance can be improved in the elderly by conducting training classes and performing different group treatments in order to indirectly reduce the amount of anxiety and increase the self-efficacy in the elderly. 
Acknowledgments
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Conflict of Interest
The authors declared no conflicts of interest.


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Type of Study: Research | Subject: Psychology
Received: 2017/09/05 | Accepted: 2018/01/03 | Published: 2018/04/01

References
1. Saydshohadai M, Heshmat S, Seidfatemi N, Haghani H, Mehrdad N. [The spiritual health of seniors living in sanitarium and home residents (Persian)]. Iran Journal of Nursing. 2013; 26(81):11-20
2. Lashkarboloki F, Aryaei M, Djazayery A, Eftekhar-Ardebily H, Minaei M. [Association ofdemographic, socio-economic features and some health problems with nutritional status in elderly (Persian)]. Journal of Nutrition Sciences & Food Technology. 2015; 9(4):27-34.
3. Hajiaziz A H, Bahmani B, Mahdi N, Manzari Tavakoli V, Barshan A. [Effectivness of group logotherapy on death anxiety and expectancy of elderly liv-ing in boarding houses in Kerman (Persian)]. Iranian Journal Ageing. 2017; 12(2):220-31.
4. Azadchehr M, Rahgozar M, Karimloo M, Adib Haj Bageri M. [To identify some factors effective on survival of the elderly living in nursing home using Copula Competing Risk Model: Bayesian approach (Persian)]. Journal of Health Promotion Management. 2014; 3(4):46-55
5. World Health Organization. Definition of an older or elderly person, health statistics & health information. Geneva: World Health Organization; 2014.
6. Ahrari S, Moshki M, Bahrami M. [The relationship between social support and adherence of dietary and fluids restrictions among hemodialysis patients in Iran]. Journal of Caring Sciences. 2014; 3(1):11-9. doi: 10.5681/jcs.2014.002
7. Gilasi H R, Sori H, Yazdani Sh, Taheri Tnjati P. [Methodological considerations in the elderly study: Case study (Persian)]. Iranian Journal of Special Ep-idemiology. Iranian Journal of Epidemiology 2015; 11(2):1-12.
8. Feizabadi M, Nakhoda M, Delbari A. [Rresearch databases and geriatrics and gerontology journals: the comparison of databases and their covered journals (Persian)]. Salmand. 2016; 11(2):358-69. [DOI:10.21859/sija-1102358]
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10. Wijlhuizen GJ, de Jong R, Hopman-Rock M. Older persons afraid of falling reduce physical activity to prevent outdoor falls. Preventive Medicine. 2007; 44(3):260–4. doi: 10.1016/j.ypmed.2006.11.003 [DOI:10.1016/j.ypmed.2006.11.003]
11. Khajavi D. [Validation and reliability of Persian version of fall efficacy scale-international (FES-I) in community-dwelling older adults (Persian)]. Salmand. 2013; 8(29):39-47.
12. Evitt C, Quigley P. Fear of falling in older adults: A guide to its prevalence, risk factors, and consequences. Rehabilitation Nursing. 2004; 29(6):207-10. PMID: 15597999 [PMID]
13. Sharaf A, Ibrahim H. Physical and psychosocial correlates of fear of falling among older adults in assisted living facilities. Journal of Gerontological Nurs-ing. 2008; 34(12):27-35. doi: 10.3928/00989134-20081201-07 [DOI:10.3928/00989134-20081201-07]
14. Arfken CL, Lach HW, Birge SJ, Miller JP. The prevalence and correlates of fear of falling in elderly persons living in the community. American Journal of Public Health. 1994; 84(4):565–70. doi: 10.2105/ajph.84.4.565 [DOI:10.2105/AJPH.84.4.565]
15. Zijlstra GAR, Van Haastregt JCM, Van Eijk JTM, Van Rossum E, Stalenhoef PA, Kempen GIJM. Prevalence and correlates of fear of falling, and associated avoidance of activity in the general population of community-living older people. Age and Ageing. 2007; 36(3):304–9. doi: 10.1093/ageing/afm021 [DOI:10.1093/ageing/afm021]
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17. Iranmanesh H, Arab Ameri A, Sheikh M, Iranmanesh H. [The effect of 2 types of dual-task training on the balance of older adults: Allocated attention abil-ity (Persian)]. Salmand. 2016; 11(1):30-43 [DOI:10.21859/sija-110130]
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20. Choi K, Jeon G-S, Cho S. Prospective study on the impact of fear of falling on functional decline among community dwelling elderly women. International Journal of Environmental Research and Public Health. 2017; 14(5):469. doi: 10.3390/ijerph14050469 [DOI:10.3390/ijerph14050469]
21. Peach T, Pollock K, van der Wardt V, das Nair R, Logan P, Harwood RH. Attitudes of older people with mild dementia and mild cognitive impairment and their relatives about falls risk and prevention: A qualitative study. Plos One. 2017; 12(5):e0177530. doi: 10.1371/journal.pone.0177530 [DOI:10.1371/journal.pone.0177530]
22. Barban F, Annicchiarico R, Melideo M, Federici A, Lombardi M, Giuli S, et al. Reducing fall risk with combined motor and cognitive training in elderly fallers. Brain Sciences. 2017; 7(2):19. doi: 10.3390/brainsci7020019 [DOI:10.3390/brainsci7020019]
23. Bar-Haim Y, Lamy D, Pergamin L, Bakermans-Kranenburg MJ, van IJzendoorn MH. Threat-related attentional bias in anxious and nonanxious individuals: A meta-analytic study. Psychological Bulletin. 2007; 133(1):1–24. doi: 10.1037/0033-2909.133.1.1 [DOI:10.1037/0033-2909.133.1.1]
24. Williams JMG, Mathews A, MacLeod C. The emotional Stroop task and psychopathology. Psychological Bulletin. 1996; 120(1):3–24. doi: 10.1037/0033-2909.120.1.3 [DOI:10.1037/0033-2909.120.1.3]
25. Clark DA. Cognitive-behavioral therapy for OCD. New York: Guilford; 2007.
26. Koshan M, Vaghe'i S. [Psychiatric nursing (Persian)]. Tehran: Andishe-ye Rafi'; 2011
27. Sadock B, Sadock V, Ruiz P. Kaplan Sadock's synopsis of psychiatry: Behavioral sciences. [M. Ganji, Persian Trans]. Tehran: Savalan; 2015.
28. Katzelnick DJ, Kobak KA, DeLeire T, Henk HJ, Greist JH, Davidson JRT, et al. Impact of generalized social anxiety disorder in managed care. American Journal of Psychiatry. 2001; 158(12):1999–2007. doi: 10.1176/appi.ajp.158.12.1999 [DOI:10.1176/appi.ajp.158.12.1999]
29. Yiend J. The effects of emotion on attention: A review of attentional processing of emotional information. Cognition & Emotion. 2010; 24(1):3–47. doi: 10.1080/02699930903205698 [DOI:10.1080/02699930903205698]
30. Fox E, Russo R, Bowles R, Dutton K. Do threatening stimuli draw or hold visual attention in subclinical anxiety? Journal of Experimental Psychology: General. 2001; 130(4):681–700. doi: 10.1037/0096-3445.130.4.681 [DOI:10.1037/0096-3445.130.4.681]
31. Berggren N, Derakshan N. Attentional control deficits in trait anxiety: Why you see them and why you don't. Biological Psychology. 2013; 92(3):440–6. doi: 10.1016/j.biopsycho.2012.03.007 [DOI:10.1016/j.biopsycho.2012.03.007]
32. Sussman TJ, Jin J, Mohanty A. Top-down and bottom-up factors in threat-related perception and attention in anxiety. Biological Psychology. 2016; 121:160–72. doi: 10.1016/j.biopsycho.2016.08.006 [DOI:10.1016/j.biopsycho.2016.08.006]
33. Renner KA, Valentiner DP, Holzman JB. Focus-of-attention behavioral experiment: an examination of a therapeutic procedure to reduce social anxiety. Cognitive Behaviour Therapy. 2016; 46(1):60–74. doi: 10.1080/16506073.2016.1225814 [DOI:10.1080/16506073.2016.1225814]
34. Kertz SJ, Stevens KT, Klein KP. The association between attention control, anxiety, and depression: the indirect effects of repetitive negative thinking and mood recovery. Journal of Anxiety, Stress & Coping. 2017; 30(4):456-468. doi: 10.1080/10615806.2016.1260120 [DOI:10.1080/10615806.2016.1260120]
35. Shahamat DehSorkh F, Salehi Fadrdari J. [attentional bias in state and trait anxiety: A dot-probe study (Persian)]. Journal of Advanced Psychological Re-search. 2013; 8(29):183-194.
36. Curtin A. Prevention of falls in older adults. Medicine and Health. 2005; 88(1):22-5. PMID: 15779552
37. Mann R, Birks Y, Hall J, Torgerson D, Watt I. Exploring the relationship between fear of falling and neuroticism: a cross-sectional study in community-dwelling women over 70. Age and Ageing. 2005; 35(2):143–7. doi: 10.1093/ageing/afj013 [DOI:10.1093/ageing/afj013]
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