Konovalchik T.K., Strizhitskaya O.Yu. Psychological Determinants of Avoidance Behavior Associated with Fear of Falling in older Adults with Anxiety and Depressive Symptoms
Tatyana K. Konovalchik , PhD Student, Department of Medical Psychology, St. Petersburg State University, St. Petersburg, Russia; 6 Makarova Emb., St. Petersburg 199034, Russia; Lecturer, Department of Clinical Psychology, St. Petersburg State Institute of Psychology and Social Work, St. Petersburg, Russia; 13, 12th Line of Vasilievsky Island, St. Petersburg 199178, Russia; konovalchikpsy@yandex.ru
Olga Yu. Strizhitskaya , D.Sc. (Psychology), Professor, St. Petersburg State University, St. Petersburg, Russia; bld. 6. Makarova Emb., St. Petersburg, Russia, 199034; o.strizhitskaya@spbu.ru
Statement of the Problem. Fear of falling in older adults is a psychological risk factor for falls alongside anxiety and depression. It is associated with avoidance of daily activities and loss of autonomy. However, the psychological factors and mechanisms underlying fear of falling, particularly in the context of anxiety and depressive symptoms, remain insufficiently studied.
Objective. To identify the psychological determinants of avoidance behavior associated with fear of falling in older adults with different levels of anxiety and depression.
Methods. The study included 229 respondents aged 60 to 97 years (M = 76.56; SD = 10.45). The assessment battery included the Visual Analogue Scale of Fear of Falling, the Modified Fear of Falling Avoidance Behavior Questionnaire, the Cornell Scale for Depression, the Integrative Anxiety Test, the General Self-Efficacy Scale, the Pain Catastrophizing Scale, the Differential Loneliness Experience Questionnaire, and the Fear of Loss of Autonomy subscale. Statistical analyses included descriptive statistics, nonparametric tests, regression analysis, and structural equation modeling (SEM).
Results. Participants with depressive symptoms demonstrated higher levels of fear of falling and avoidance behavior. No differences were found in general trait anxiety; however, the severity of fear of falling and avoidance behavior varied depending on the phobic component of anxiety. Regression analysis and structural equation modeling confirmed the multifactorial nature of avoidance behavior associated with fear of falling and demonstrated that the psychological mechanisms underlying its development differ depending on the levels of anxiety and depression.
Conclusions. Avoidance behavior associated with fear of falling is determined by a combination of emotional, cognitive, behavioral, and somatic factors. These findings support the need for a differentiated approach to the psychological assessment of older adults with fear of falling and to the selection of appropriate psychological interventions.
Key words: fear of falling, avoidance behavior, older adults, anxiety, depressive symptoms, phobic component of anxiety
For citation: Konovalchik, T.K., Strizhitskaya, O.Yu. (2026). Psychological determinants of avoidance behavior associated with fear of falling in older adults with anxiety and depressive symptoms. New Psychological Research, No. 3, 70–94. DOI: 10.51217/npsyresearch_2026_06_03_04
Keywords: fear of falling avoidance behavior older adults anxiety depressive symptoms phobic component of anxiety
Received: 26th septemper 2026
Published: 26th septemper 2026