Older adults' beliefs about anxiety: a multicultural qualitative study informed by Leventhal's Common-Sense Model of...

Anxiety disorders in older adults are commonly underdiagnosed and undertreated, especially among minority ethnic groups. This UK-based multicultural qualitative study explored beliefs about anxiety among White British, South Asian, African and Caribbean older adults who self-reported anxiety, and examined the applicability of Leventhal's Common-Sense Model.

Individual interviews were conducted with 52 older adults self-reporting current or past anxiety. Data were managed and analysed using the Framework Method. Professional interpreters facilitated interviews with non-English speakers.

The study included 27 participants with distressing anxiety and 25 with non-distressing anxiety. Participants' accounts revealed a fragmented understanding of anxiety. Beliefs varied within and across cultural groups, shaped by the interaction between culture, participants' salient identities, degree of distress and prior contact with mental health services. Despite this variability, participants' beliefs broadly mapped onto Leventhal's Model, supporting its applicability. Inductive analysis identified two new dimensions: aggravating factors and protective factors.

Older adults' understanding of anxiety is often fragmented. Broad cultural classifications risk obscuring within-group diversity. Cross-cultural research should adopt nuanced approaches to provide meaningful, person-centred insights into people's perceptions of illness. While applying Leventhal's Model provided new insights, further theoretical refinement may be needed to capture dimensions extending beyond the model.