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PTSD (Post-Traumatic Stress Disorder) in Later Life

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Book cover Handbook of Behavioral and Cognitive Therapies with Older Adults

Posttraumatic stress disorder (PTSD) is a stress reaction characterized by symptoms of reexperiencing, avoidance/numbing, and hyperarousal following 1 month or more an exposure to extreme trauma. In recent years, there has been a spate of studies and meta-analyses on the assessment and treatment of this disorder. However, the variable of age in the context of treatment has not been adequately addressed. In addition, little data exist regarding the role of aging as a mediating or moderating influence in the expression of trauma. We do not yet know the importance of a life lived, one’s life history, and how this might affect any current trauma. Importantly too, clinical data of client-treatment factors with elders are lacking. That said, we have apt models of treatment for other age groups and can reasonably export empirically supported principles for older adults.

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References

  • Averill, A., & Beck, J. (2000). Posttraumatic stress disorder in older adults: A conceptual review. Journal of Anxiety Disorders, 14, 133–156.

    Article  PubMed  Google Scholar 

  • Beck, J. (1995). Cognitive therapy: Basics and beyond. New York: Guilford.

    Google Scholar 

  • Beck, A., & Steer, R. A. (1988). Beck anxiety inventory. San Antonio, TX: The Psychological Corporation.

    Google Scholar 

  • Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Beck depression inventory manual (2nd ed.). San Antonio, TX: Psychological Corporation.

    Google Scholar 

  • Beckham, J. C., Crawford, A. L., & Feldman, M. E. (1998). Trail making test performance in Vietnam combat veterans with and without posttraumatic stress disorder. Journal of Traumatic Stress, 11, 811–819.

    Article  PubMed  Google Scholar 

  • Benbow, S. M., & Haddad, P. M. (1993). Sexual abuse of the elderly mentally ill. Blake, D. D., Weathers, F. W., Nagy, L. M., Kaloupek, D. G., Gusman, F. D., Charney, D. S., et al. (1995). The development of a clinician-administered PTSD scale. Journal of Traumatic Stress, 8, 75–90.

    Google Scholar 

  • Blanchard, E. B., & Hickling, E. J. (1997). After the crash: Assessment and treatment of motor vehicle accident survivors. Washington, DC: American Psychological Association.

    Book  Google Scholar 

  • Bremner, J. D. (2002). Neuroimaging studies in post-traumatic stress disorder. Current Psychiatry Reports, 4, 254–263.

    Article  PubMed  Google Scholar 

  • Bremner, J. D., Southwick, S. M., Johnson, D. R., Yehuda, R., & Charney, D. S. (1993). Childhood physical abuse and combat-related posttraumatic stress disorder in Vietnam veterans. American Journal of Psychiatry, 150, 235–239.

    PubMed  Google Scholar 

  • Brewin, C. R., Andrews, B., & Valentine, J. D. (2000). Meta-analysis of risk factors for posttraumatic stress disorder in trauma-exposed adults. Journal of Consulting and Clinical Psychology, 68, 748–766.

    Article  PubMed  Google Scholar 

  • Boehnlein, J., & Sparr, L. (1993).Group therapy with World War II ex-POWs: Longterm adjustment in a geriatric population. American Journal of Psychotherapy, 47, 273–282.

    PubMed  Google Scholar 

  • Bolin, R., & Klenow, D. (1983). Response of the elderly to disaster: An age-stratified analysis. International Journal of Aging and Human Development, 16, 283–296.

    Google Scholar 

  • Borkovec (2005). GAD in the Real World. Symposium given at NJ-ACT, Westfield, NJ.

    Google Scholar 

  • Brown, K., Streubert, G. E., Burgess, A. W. (2004). Effectively detect & manage elder abuse. Nurse Practioner, 8, 22–27.

    Article  Google Scholar 

  • Bryant, R. A., Moulds, M. L., & Nixon, R. V. D. (2003). Cognitive behaviour therapy of acute stress disorder: A four-year follow-up. Behaviour Research and Therapy, 41(4), 489–494.

    Article  PubMed  Google Scholar 

  • Carlson, E. (1999). Trauma assessments: A clinicians guide. Towson, MD: Sidran Foundation and Press.

    Google Scholar 

  • Cappeliez, P., & O’Rourke, N. (2006). Empirical validation of a model of reminiscence and health at later life. Journal of Gerontology, 61B, P237–P244.

    Google Scholar 

  • Charlton, P. F. C., & Thompson, J. A. (1996). Ways of coping with psychological distress after trauma. British Journal of Clinical Psychology, 35, 517–530.

    PubMed  Google Scholar 

  • Cook, J., O’Donnell, C., Moltzen, J., Ruzek, J., & Sheikh, J. (2005). Clinical observations in the treatment of World War II and Korean War veterans with combat-related PTSD. Clinical Geropsychologist, 29(2), 82–94.

    Google Scholar 

  • Cwikel, J., & Rozovski, U. (1998). Coping with the stress of immigration among new immigrants to Israel from Commonwealth of Independent States (CIS) who were exposed to Chernobyl: The effect of age. International Journal of Aging and Human Development, 46, 305–318.

    PubMed  Google Scholar 

  • Davidson, J. R., Hughes, D., Blazer, D. G., & George, L. (1991). PTSD in the community: An epidemiological study. Psychological Medicine, 21, 713–721.

    Article  PubMed  Google Scholar 

  • Dohrenwend, B., & Dohrenwend, B. (1981). Sex differences and psychiatric disorders. American Journal of Sociology, 81, 1447–1454.

    Article  Google Scholar 

  • Elder, G., & Clipp, E. (1989). Combat experience and emotional health: Impairment and resilience in later life. Journal of Personality, 57, 311–341.

    Article  PubMed  Google Scholar 

  • Engels, G. I., & Verney, M. (1997). Efficacy of nonmedical treatments of depression in elders: A quantitative analysis. Journal of Clinical Geropsychology, 3, 17–35.

    Google Scholar 

  • Ensel, W. M. (1991). “Important” life events and depression among older adults: The role of psychological and social resources. Journal of Aging and Health, 3, 546–566.

    Article  Google Scholar 

  • Elzinga, B. M., & Bremner, J. D. (2002). Are the neural substrates of memory the final common pathway in posttraumatic stress disorder (PTSD)? Journal of Affective Disorders, 70, 1–17.

    Article  PubMed  Google Scholar 

  • Falsetti, S. A., Erwin, B. A., Resnick, H. S., Davis, J., & Combs-Lane, A. M. (2003). Multiple channel exposure therapy of PTSD: Impact of treatment on functioning and resources. Journal of Cognitive Psychotherapy, 17, 133–147.

    Article  Google Scholar 

  • Foa, E. B., Dancu, C. N., Hembree, E. A., Jaycox, L. H., Meadows, E. A., & Street, G. P. (1999). A comparison of exposure therapy, stress inoculation training, and their combination for reducing posttraumatic stress disorder in female assault victims. Journal of Consulting and Clinical Psychology, 67, 194–200.

    Article  PubMed  Google Scholar 

  • Foa, E., Keane, T., & Friedman, M. (2000). Effective treatments for PTSD: Practice guidelines from the International Society for Traumatic Stress Studies. New York: Giulford.

    Google Scholar 

  • Frueh, C., Elhai, J., Gold, P., Monnier, J., Magruder, K., Keane, T., et al. (2003). Disability compensation seeking among veterans evaluated for posttraumatic stress disorder. Psychiatric Services, 54, 84–91.

    Article  PubMed  Google Scholar 

  • Garb, R., Bleich, A., & Lerer, B. (1987). Bereavement in combat. The psychiatric clinics of North America, 10(3).

    Google Scholar 

  • Gibbs, M. (1989). Factors in the victim that mediate between disaster and psychopathology: A review. Journal of Traumatic Stress, 24, 489–514.

    Article  Google Scholar 

  • Gleser, G. C., Green, B., & Winglet, C. (1981). Prolonged psychosocial effects of disaster: A study of buffalo creek. New York: Academic Press.

    Google Scholar 

  • Green, B. L. (1996). Trauma History Questionnaire (self-report). In B. H. Stamm (Ed.), Measurement of stress, trauma, and adaptation (pp. 366–368). Lutherville, MD: Sidran.

    Google Scholar 

  • Hamlin, J., Mueser, K., Rosenberg, S., & Rosenberg, H. (2004). Brief cognitive therapy for PTSD. New Hanover, NC: Dartmouth University Medical School Press.

    Google Scholar 

  • Harvey, R., Bryant, A., Dang, S., Sackville, T., & Basten, C. (1998). Treatment of acute stress disorder: A comparison of cognitive-behavioral therapy and supportive counseling. Journal of Consulting and Clinical Psychology, 66(5), 862–866.

    Article  PubMed  Google Scholar 

  • Harvey, A., & Bryant, R. (1998). The relationship between acute stress disorder and posttraumatic stress disorder; A prospective evaluation of motor vehicle accident survivors. Journal of Counseling and Clinical Psychology, 66(3), 507–512.

    Article  Google Scholar 

  • Horowitz, M., Wilner, N., & Alvarez, W. (1979). Impact of event scale: A measure of subjective stress. Psychosomatic Medicine, 41, 209–218.

    PubMed  Google Scholar 

  • Horvath, A. O., & Greenburg, L. S. (1989). Development and validation of the working alliance inventory. Journal of Counseling Psychology, 36, 223–233.

    Article  Google Scholar 

  • Hull, A. M. (2002). Neuroimaging findings in post-traumatic stress disorder. Systematic review. British Journal of Psychiatry, 181, 102–110.

    Article  PubMed  Google Scholar 

  • Hyer, L. (2005). Use of WAI in therapy with older adults. Piscatway, NJ: Grand Rounds at Robert Wood Johnson.

    Google Scholar 

  • Hyer, L., & Brandsma, J. (1997). EMDR minus eye movements equals good psychotherapy. Journal of Traumatic Stress, 10(3), 515–523.

    PubMed  Google Scholar 

  • Hyer, L., & Kushner, B. (in press). EMDR: A review. In P. Lehrer & R. Wolfolk (Eds.), Handbook of Stress (2nd ed.). New York: Guiford.

    Google Scholar 

  • Hyer, L., & Sohnle, S. (2001). Trauma among older people: Issues and treatment. Philadelphia: Brunner-Routledge.

    Google Scholar 

  • Hyer, L., & Stanger, E. (1997). The interaction of Posttraumatic Stress Disorder and depression among older combat veterans. Psychological Reports, 80, 785–786.

    PubMed  Google Scholar 

  • Hyer, L., & Summers, M. (1995). An understanding of combat trauma at later life. Augusta, GA: VA Merit Review.

    Google Scholar 

  • Hyer, L., Swanson, G., Lefkowoitz, R., Hillesland, D., Davis, H., & Woods, M. (1990). The application of the cognitive behavioral model to older stressor groups. Clinical Geropsychologist, 9, 145–190.

    Google Scholar 

  • Kangas, M., Henry, J. L., & Bryant, R. A. (2005). The relationship between acute stress disorder and posttraumatic stress disorder following cancer. Journal of Consulting and Clinical Psychology, 73(2), 360–364.

    Article  PubMed  Google Scholar 

  • Katz, S., Ford, A. B., Moskowitz, R. W., Jackson, B. A., & Jaffee, M. W. (1963). Studies of illness in the aged. The index of ADL: A standardized measure of biological and psychosocial function. Journal of the American Medical Association, 185, 914–919.

    PubMed  Google Scholar 

  • Kessler, R., Sonnega, A., Bromet, E., Hughes, M., & Nelson, C. (1995). Posttrasuamatic stress disorder in the National Comorbidity Survey. Archives of General Psychiatry, 52, 1048–1060.

    PubMed  Google Scholar 

  • Kilijanek, T., & Drabek, T. (1979). Assessing long-term impacts of a natural disaster: Focus on the elderly. Gerontologist, 19, 555–566.

    PubMed  Google Scholar 

  • van der Kolk, B. A. (2002). Posttraumatic therapy in the age of neuroscience. Psychoanalytic Dialogues, 12(3), 381–392.

    Article  Google Scholar 

  • Lawton, M. P., & Brody, E. (1969). Assessment of older people: Self-maintaining and instrumental activities of daily living. The Gerontologist, 9, 179–186.

    PubMed  Google Scholar 

  • Lehman, A., F. (1996). Quality of life interview (QOLI). In L. I. Sederer & B. Dickey (Eds.), Outcomes assessments in clinical practice (pp. 117–119). Baltimore: Williams & Wilkins.

    Google Scholar 

  • Lewis, M., & Butler, R. (1974). Life review therapy: Putting memories to work in individual and group therapy. Geriatrics, 29, 165–173.

    PubMed  Google Scholar 

  • Lipton, M., & Schaffer, W. (1986). Posttraumatic stress disorder in the older veteran. Military Medicine, 151, 522–524.

    PubMed  Google Scholar 

  • Logue, J. N., Melick, M. E., & Struening, E. L. (1981). A study of health and mental health status following a major natural disaster. Research in Community and Mental Health, 2, 217–274.

    Google Scholar 

  • Lyons, J. A. (1991). Research in the trauma recovery program at the Jackson VA Medical Center. PTSD Research Quarterly, 4(3), 8.

    Google Scholar 

  • Martell, C., Addis, M., & Jacobson, N. (2001). Depression in context: Strategies for guided action. New York: W. W. Norton.

    Google Scholar 

  • Mayou, R., Bryant, B., & Duthie, R. (1993). Psychiatric consequences of road traffic accidents. British Medical Journal, 307(11), 647–651.

    Article  PubMed  Google Scholar 

  • McCaertney, J. R., & Severson, K., (1997). Sexual violence, post-traumatic stress disorder, and dementia. Journal of the American Geriatric Society, 45(1), 76–78.

    Google Scholar 

  • McFarlane, A. (1992). Avoidance and intrusion in posttraumatic stress disorder. Journal of Nervous and Mental Disease, 180(7), 439–445.

    Article  PubMed  Google Scholar 

  • Melick, M., & Logue, J. (1985). The effect on the health and well-being of older women. International Journal of Aging and Human Development, 21, 227–238.

    Google Scholar 

  • Meyer, T., Miller, M., Metzger, R., & Borkovec, T. D. (1990). Development and validation of the Penn State Worry Questionnaire. Behaviour Research and Therapy, 28, 487–495.

    Article  PubMed  Google Scholar 

  • Millon, T. (1984). On the renaissance of personality assessment and personality theory. Journal of Personality Assessment, 48(5), 450–466.

    Article  PubMed  Google Scholar 

  • Millon, T. (1994). Millon clinical multiaxial inventory-III. Minneapolis: National Computer Systems.

    Google Scholar 

  • Molinari, V., & Williams, W. (1995). An analysis of aging World War II POWs with PTSD: Implication for practice and research. Journal of Geriatric Psychiatry, 28, 99–114.

    Google Scholar 

  • Morey, L. C. (1991). Personality assessment inventory. Odessa, FL: Psychological Assessment Resources.

    Google Scholar 

  • Mueser, K. T., Bolton, E., Carty, P. C., Bradley, M. J., Ahlgren, K. F., Distaso, D. R., Gilbride, A., Liddell, C. (2007). The trauma recovery group: a cognitive-behavioral program for post-traumatic stress disorder in persons with severe mental illness. Community Mental Health Journal, 43(3), 281–304.

    Article  PubMed  Google Scholar 

  • Newton, K. (2001). Geriatric trauma. Topics in Emergency Medicine, 23(3):1–12.

    Google Scholar 

  • Norris, F. H. (1992). Epidemiology of trauma: Frequency and impact of different potentially traumatic events on difficult demographic groups. Journal of Consulting Clinical Psychology, 60(3), 409–418.

    Article  Google Scholar 

  • O’Hare, T., Sherrer, M. V., Cutler, J., McCall, T. M., Dominique, K. N., & Garlick, K. (2002). Validating the psycho-social wellbeing scale with community clients. Social Work in Mental Health, 1(2), 15–30.

    Article  Google Scholar 

  • Paris, J. (1997). Introduction: Emotion and empiricism: Research on childhood trauma and adult psychopathology. Journal of Personal Disorders, 11, 1–4.

    Google Scholar 

  • Pennebaker, J. W. (1989). Confession, inhibition, and disease. In L. Berkowitz (Ed.), Advances in experimental social psychology (Vol. 22). Orlando, FL: Academic Press.

    Google Scholar 

  • Phifer, J. (1990). Psychological distress and somatic symptoms after natural disaster: Differential vulnerability among older adults. Psychology and Aging, 5, 412–420.

    Article  PubMed  Google Scholar 

  • Phifer, J., & Norris, F. (1989). Psychological symptoms in older adults following natural disaster: Nature, timing, duration, and course. Journal of Gerontology: Social Sciences, 44, S207–S217.

    Google Scholar 

  • Resnick, P. A. (2003). Cognitive therapy for posttraumatic stress disorder. Journal of Cognitive Psychotherapy, 15(4), 321–330.

    Google Scholar 

  • Russo, S. A., Hersen, M., & Van Hasselt, V. B. (2001). Treatment of reactivated post-traumatic stress disorder: Imaginal exposure in an older adult with multiple traumas. Behavior Modification, 25(1), 94–115.

    Article  PubMed  Google Scholar 

  • Rutter, M., & Maughan, B. (1997). Psychosocial adversities in childhood and adulthood. Journal of Personal Disorders, 11, 4–19.

    Google Scholar 

  • Rybarczk, B., & Bellg, A. (1997). Listening to life stories: A new approach to stress intervention in health care. New York: Springer.

    Google Scholar 

  • Salamon, M. (2001). Holocaust survivors and secondary PTSD. Clinical Gerontologist, 24(3–4), 183–185.

    Google Scholar 

  • Schnurr, P., & Spiro, A. (1999). Combat exposure, posttraumatic stress disorder symptoms, and health behaviors as predictors of self-reported physical health in older veterans. Journal of Nervous & Mental Disease, 187(6), 353–359.

    Article  Google Scholar 

  • Spiro, R., Schnurr, P., & Aldwin, C. (1994). Combat related posttraumatic stress disorder symptoms in older men. Psychology and Aging, 9, 17–26.

    Article  PubMed  Google Scholar 

  • Snell, F., & Padin-Rivera, E. (1997). Group treatment for older veterans with post-traumatic stress disorder. Journal of Psychosocial Nursing, 35, 10–16.

    Google Scholar 

  • Sutker, P. B., Uddo-Carne, M., & Allain, A. N. (1991). Clinical and research assessment of posttraumatic stress disorder: A conceptual overview. Psychological Assessment, 3, 520–530.

    Article  Google Scholar 

  • Tedeschi, R. G., & Calhoun, L. G. (1995). Trauma and transformation: Growing in the aftermath of suffering. Thousand Oaks, CA: Sage.

    Google Scholar 

  • Thorp, S., & Stein, M. (2005). PTSD and functioning. PTSD Research Quarterly, 16(3), 1–7.

    Google Scholar 

  • Ullman, S. E., & Siegel, J. M. (1994). Predictors of exposure to traumatic events and posttraumatic stress sequelae. Journal of Community Psychology, 22(4), 328–338.

    Article  Google Scholar 

  • Vasterling, J., & Braily, K. (2005). Neuropsychological findings in adults with PTSD. In J. Vasterling & C. Brewin (Eds.), Neuropsychology of PTSD: Biological, cognitive and clinical perspectives (pp. 178–207). New York: Guilford.

    Google Scholar 

  • Vasterling, J. J., Brailey, K., Constans, J. I., Borges, A., & Sutker, P. B. (1997). Assessment of intellectual resources in Gulf War veterans: Relationship to PTSD. Assessment, 4, 51–59.

    Article  Google Scholar 

  • Vasterling, J. J., Duke, L. M., Brailey, K., Constans, J. I., Allain, A. N., Jr., & Sutker, P. B. (2002). Attention, learning, and memory performances and intellectual resources in Vietnam veterans: PTSD and no disorder comparisons. Neuropsychology, 16, 5–14.

    Article  PubMed  Google Scholar 

  • Ware, J. E., Kosinski, M., & Keller, S. D. (1994). SF-36 physical and mental health summary scales: A user’s manual. Boston: Health Assessment Lab, New England Medical Center.

    Google Scholar 

  • Weathers, F. W., Litz, B. T., Herman, D. S., Huska, J. A., & Keane, T. M. (1993). The PTSD Checklist (PCL): Reliability, validity, and diagnostic utility. Paper presented at the annual meeting of the International Society for Traumatic Stress Studies, Chicago.

    Google Scholar 

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Authors and Affiliations

  1. Georgia Neurosurgical Institute and Department of Psychiatry, Mercer Medical School, Macon, GA, USA

    Lee Hyer

  2. Department of Rehabilitation Medicine, Moun Sinai School of Medicine, New York, NY, USA

    Amanda Sacks

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  1. Lee Hyer
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  2. Amanda Sacks
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Editors and Affiliations

  1. Stanford University, 94305-5717, Stanford, CA, USA

    Dolores Gallagher-Thompson Ph.D. ABPP

  2. University of Missouri-St. Louis, 63121, St. Louis, MO, USA

    Ann M. Steffen Ph.D

  3. Stanford University School of Medicine and Pacifi c Graduate School of Psychology, 94024, Los Atlos, CA, USA

    Larry W. Thompson Ph.D

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Hyer, L., Sacks, A. (2008). PTSD (Post-Traumatic Stress Disorder) in Later Life. In: Gallagher-Thompson, D., Steffen, A.M., Thompson, L.W. (eds) Handbook of Behavioral and Cognitive Therapies with Older Adults. Springer, New York, NY. https://doi.org/10.1007/978-0-387-72007-4_18

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