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,THEME 2
PTSD
, THEME 2
ARTICLE 1
Posttraumatic stress disorder in older adults
1. Averill, P.M. (2000). Posttraumatic stress disorder in older adults: A Conceptual Review. Journal of
Anxiety Disorders, 14(2), 133-156. https://sci-hub.se/10.1016/s0887-6185%2899%2900045-6
KEYWORDS/POINTS OF THE ARTICLE
Delayed Onset information
PTSD in older adults
Posttraumatic stress disorder in older adults: A Conceptual Review
This review indicates that PTSD does occur in older adults with similar symptoms as noted in younger
adults
Interestingly, some salient differences in PTSD have been documented in older adults, such as differences in
the natural course of the disorder, suggesting that the expression of PTSD may be influenced by factors
such as natural changes brought about by aging, the societal zeitgeist at the time of trauma, and the
presence (or absence) of diagnostic comorbidity
DEFINITION: Posttraumatic stress disorder is initiated by exposure to extraordinarily stressful life events,
such as military combat, violent personal assault, being taken hostage, natural or manmade disasters, and
severe car accidents.
WHAT ARE THE UNIQUE SYMPTOMS OF POSTTRAUMATIC STRESS DISORDER IN OLDER ADULTS ?
most older adults who were traumatized earlier in their life report an episodic course, with symptom
exacerbations and remissions over time
Suggesting that time of study is likely to impact the presentation of symptoms.
Additionally, symptoms such as sleep disturbance and memory impairment are seen more commonly in
older adults in general and may not be associated with trauma exposure per se
Studies examining PTSD symptoms in individuals traumatized later in life show that older adults may
experience somewhat different symptoms than those reported by younger adults after trauma exposure.
CAN POSTTRAUMATIC STRESS DISORDER BEGIN MANY YEARS AFTER TRAUMA EXPOSURE IN OLDER
ADULTS?
Delayed-onset PTSD is an infrequently diagnosed variant of the disorder, despite its recognition in each
version of the DSM
Several theories have been suggested to account for delayed-onset PTSD in later life. These include
consideration of the fact that older adults may experience a reduction in physical and mental resilience
, over time, which reduces their capacity to ward off trauma-related memories and feelings (Aarts & Op Den
Velde, 1996). Additionally, the occurrence of normal stressors such as retirement and bereavement may
precipitate delayed-onset PTSD in older adults, because these individuals may not have the psychological
resources to cope with life changes
Apart from the direct effects of life stress, other authors have noted that indirect effects of aging may be
relevant as well. Hertz (1990) commented that older adults have more time to reflect on events that
occurred earlier in life (including traumatic events) after the demands of their jobs and families are
lessened. Indeed, retirement is the most commonly identified event that has been associated with late-
onset PTSD
Another possible factor in the development of delayed-onset PTSD is the nature of developmental tasks that
are specific to later life. Erikson (1965) described late life as the time when one reflects on earlier events to
find the meaning of one's life.
A final consideration is the possibility that cases of delayed-onset PTSD are more accurately reflective of
delayed help-seeking.
WHAT COMORBID FEATURES ARE ASSOCIATED WITH POSTTRAUMATIC STRESS DISORDER IN OLDER
ADULTS?
It is possible that comorbid disorders are more easily overlooked in the older adult with PTSD, implicating that
misdiagnosis may occur. Likewise, older adults may receive symptomatic treatment
SUMMARY
Specific symptom profiles may differ in the older adult, particularly in those individuals with chronic PTSD.
These potential differences could lead to misdiagnosis of PTSD in the elderly, an outcome that would impact
derivation of accurate prevalence rates and documentation of comorbid disorders that accompany PTSD in
elder
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