Vanessa K. Ma’s research while affiliated with VA Palo Alto Health Care System and other places

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Publications (4)


Clinical Assessment of Late-Life Anxiety
  • Chapter

March 2021

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9 Reads

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2 Citations

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Vanessa K. Ma

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Historically, clinicians and researchers have focused on depression and dementia in older people, paying little attention to anxiety except as a complication of these disorders. However, increased research into late-life anxiety has seen a growth in scientific literature and clinical interest. This important book brings together international experts to provide a comprehensive overview of current knowledge in relation to anxiety in older people, highlighting gaps in both theory and practice, and pointing towards the future. Early chapters cover the broader aspects of anxiety disorders, including epidemiology, risk factors, diagnostic issues, association with insomnia, impaired daily functioning, suicidality, and increased use of healthcare services. The book then explores cross-cultural issues, clinical assessment, and pharmacological and psychological interventions across a variety of settings. An invaluable resource for mental health professionals caring for older people including researchers, psychiatrists, psychologists, specialist geriatric nurses and social workers.


Video-Delivered Relaxation Intervention Reduces Late-Life Anxiety: A Pilot Randomized Controlled Trial

December 2018

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79 Reads

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18 Citations

American Journal of Geriatric Psychiatry

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Vanessa K. Ma

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[...]

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Objective: The study's aim was to demonstrate the feasibility and preliminary efficacy of a 4-week video-delivered relaxation program called Breathing, Relaxation, and Education for Anxiety Treatment in the Home Environment (BREATHE) for reducing anxiety and increasing activity engagement in older adults with anxiety disorders. Methods: This was an 8-week pilot randomized controlled trial performed as outpatient and self-directed learning at home among 40 community-dwelling adults aged 60years or older who met criteria for an anxiety disorder (generalized anxiety disorder, social anxiety disorder, panic disorder, agoraphobia, or anxiety disorder unspecified). The study looked at the BREATHE intervention compared with a wait list control condition. The primary outcome measure was anxiety symptoms (Geriatric Anxiety Scale). Secondary outcomes included activity engagement (modified Activity Card Sort), depressive symptoms (Patient Health Questionnaire), and somatic symptoms (Somatic Symptom Scale). Results: In linear mixed-effects models, findings indicated a significant reduction in anxiety symptoms. There was no significant effect of group on activity engagement. Results also showed significant reductions in depressive and somatic symptoms associated with the BREATHE intervention compared with wait list. Conclusion: Our findings demonstrate feasibility and preliminary efficacy for this brief video-delivered relaxation intervention and suggest that older adults can benefit from technology-delivered interventions with minimal provider contact. Although activity engagement did not improve, lessons learned suggest that targeted coaching around activity goals may help target this outcome.


Table 2 (continued)
Veterans Affairs and the Department of Defense Mental Health Apps: A Systematic Literature Review
  • Literature Review
  • Full-text available

November 2018

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574 Reads

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57 Citations

Psychological Services

In the present systematic review, we summarize the feasibility, usability, efficacy, and effectiveness of mental health-related apps created by the Veterans Affairs (VA) or the Department of Defense (DoD). Twenty-two articles were identified, reporting on 8 of the 20 VA/DoD mental health self-management and treatment companion apps. Review inclusion criteria were studies that reported original data on the usability, acceptability, feasibility, efficacy, and effectiveness, or attitudes toward the app. We collected data from each article regarding type of study, sample size, participant population, follow-up period, measures/assessments, and summary of findings. The apps have been tested with patients seeking treatment, patients with elevated mental health symptoms, and clinicians. The strongest area of support for the apps is regarding evidence of their feasibility and acceptability. Research support for efficacy and effectiveness of the apps is scarce with exceptions for two apps (PTSD Coach, Virtual Hope Box). Until more evidence accumulates, clinicians should use their judgment and be careful not to overstate the potential benefits of the apps.

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Validation of the Older Adult Social Evaluative Scale (OASES) as a measure of social anxiety

March 2018

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58 Reads

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3 Citations

International Psychogeriatrics

Background Social anxiety disorder (SAD) (formerly called social phobia ) is among the most common mental health diagnoses among older adults; however, the research on late-life social anxiety is scarce. A limited number of studies have examined the assessment and diagnosis of social anxiety disorder in this population, and there are few social anxiety measures that are validated for use with older adults. One such measure, the Older Adult Social Evaluative Scale (OASES), was designed for use with this population, but until now has lacked validation against a gold-standard diagnostic interview. Methods Using a sample of 47 community-dwelling older adults (aged 60 years and over) with anxiety, the present study compared OASES performance to that of the Structured Clinical Interview for DSM-5 Disorders (SCID-5), as well as other measures of anxiety and depression. Results The OASES demonstrated convergent validity with other measures of anxiety, and demonstrated discriminant validity on other measures (e.g. depression, somatic symptoms). Receiver operating characteristic (ROC) analysis revealed that a cut-point of ≥76 optimized sensitivity and specificity compared to SCID-5 derived diagnoses of social anxiety disorder. Conclusions This study is the first study to provide psychometric validation for the OASES and one of the first to administer the SCID-5 to an older adult sample. In addition to establishing a clinically significant cut-off, this study also describes the clinical utility of the OASES, which can be used to identify distressing situations, track anxiety severity, and monitor behavioral avoidance across a variety of social situations.

Citations (4)


... Older adults, however, have a number of unique features that make assessing anxiety more difficult and complicated (Gould et al., 2021). It is also said that older people do not suffer from overwhelming and unmanageable anxiety but rather have cognitive worries about their lives (Gould et al., 2021). ...

Reference:

Testing the Psychometric Properties of the Geriatric Anxiety Inventory in a Sample of Older Adults in Turkey
Clinical Assessment of Late-Life Anxiety
  • Citing Chapter
  • March 2021

... In this study, the importance of expressing their emotions and assertion was emphasized through video-based psychoeducation, and it is assumed that participants in the intervention group experienced decreased depression and anxiety by actively adopting emotional expression as a form of self-management. Furthermore, it has been shown that cognitive reframing (Serrat et al. 2022) and relaxation (Felix et al. 2018;Gould et al. 2019) could alleviate depression and anxiety through video-based stress management for patients. We found that participants commented on ⟨Expressing emotions/communication⟩, ⟨Balanced thinking⟩, and ⟨Relaxation⟩. ...

Video-Delivered Relaxation Intervention Reduces Late-Life Anxiety: A Pilot Randomized Controlled Trial
  • Citing Article
  • December 2018

American Journal of Geriatric Psychiatry

... These apps are free to the public, evidence-informed, and do not collect or share identifiable data (Owen et al., 2018). While evidence for the efficacy of specific apps for mental health is limited, VA's MH apps have a growing research base supporting their acceptability, feasibility, and effectiveness (see Bröcker et al., 2023;Gould et al., 2019;Kuhn et al., 2017). ...

Veterans Affairs and the Department of Defense Mental Health Apps: A Systematic Literature Review

Psychological Services

... A description of all tools identified and the reported ease of use is provided in Supplementary Fifteen studies looked at one index tool, while 12 and 5 studies, respectively, looked at two tools and three or more tools. Index tools were not used for detection in two studies, but rather as a way to identify GAD response/remission [26] and the severity and triggers of SAD [27]. The GAI-20 item (GAI-20) [7, 25, 28-34] (9/32) and GAI-Short Form (GAI-SF) [25,31,33,35] (4/32), HADS-Anxiety Subscale (HADS-A) [22,24,36,37] (4/32) and PSWQ [26,32,38,39] (4/32) and PSWQ-Abbreviated (PSWQ-A) [26,32,38] (3/32) were the index tools investigated across the most studies, while the Generalized Anxiety Disorder Scale-7 item (GAD-7) and GAD-2 were studied in large participant samples (Table 2). ...

Validation of the Older Adult Social Evaluative Scale (OASES) as a measure of social anxiety
  • Citing Article
  • March 2018

International Psychogeriatrics