Differences in Self-Reported Somatic Anxiety Symptoms in Rural and Urban Older Adults

The purpose of the study was to examine differences in self-reported anxiety symptoms between older adults living in rural and urban areas. Past research has suggested that stigma of mental illness and the higher prevalence of medical conditions in older adults may affect the presentation of their anxiety symptoms. Further, research suggests that urban populations should display more cognitive symptoms of anxiety, while rural populations should express more somatic symptoms. The reasoning is that due to stigma involving mental health and lower education in rural areas, individuals will be more prone to somaticize their symptoms. One hundred forty-seven older individuals were recruited from senior centers located in urban and rural areas, as classified objectively by Rural-Urban Codes. The subjects were asked to fill out two questionnaires that examine cognitive and somatic symptoms of anxiety, the Trimodal Anxiety Questionnaire (TAQ) and State-Trait Inventory for Cognitive and Somatic Anxiety (STICSA). The primary hypothesis that rural older individuals would endorse more somatic symptoms on self-report measures of anxiety than urban older individuals was partially supported. Participants from rural areas scored significantly higher on the TAQ somatic subscale than did urban individuals, but no differences in STICSA somatic subscale scores emerged between the two groups. The secondary hypothesis which examined a difference in expression of cognitive symptoms as measured by TAQ and STICSA cognitive subscales was not supported. However, the results raise the possibility that anxiety may be expressed differently between older adults in rural and urban areas, and therefore health service providers may consider unexplained somatic symptoms as potential indicators of anxiety in rural older adults.