Posttraumatic Stress Disorder in Older Adults: A Conceptual Review. Issue 4 (8th August 2019)

• Record Type: Journal Article
• Authors: Pless Kaiser, Anica; Cook, Joan M.; Glick, Debra M.; Moye, Jennifer
• Is Part Of: Clinical gerontologist. Volume 42:Issue 4(2019)
• Page Start: 359
• Page End: 376
• Publication Date: 2019-08-08
• Subjects: Older adults -- posttraumatic stress disorder -- psychotherapy -- trauma; Geriatrics -- Periodicals; Geriatric psychiatry -- Periodicals; Older people -- Mental health services -- Periodicals; Older people -- Psychology -- Periodicals; 618.97689
• DOI: 10.1080/07317115.2018.1539801
• Languages: English
• ISSNs: 0731-7115

Abstract

ABSTRACT: Objectives : We provide a review of the literature on posttraumatic stress disorder (PTSD) in older adults, focusing largely on older U.S. military veterans in two primary areas: 1) assessment and diagnosis and 2) non-pharmacological treatment of PTSD in late life. Methods : We performed a search using PubMed and Academic Search Premier (EBSCO) databases and reviewed reference sections of selected papers. We also drew on our own clinical perspectives and reflections of seven expert mental health practitioners. Results : Rates of PTSD are lower in older compared with younger adults. The presence of sub-syndromal/partial PTSD is important and may impact patient functioning. Assessment requires awareness and adaptation for potential differences in PTSD experience and expression in older adults. Psychotherapies for late-life PTSD appear safe, acceptable and efficacious with cognitively intact older adults, although there are relatively few controlled studies. Treatment adaptations are likely warranted for older adults with PTSD and co-morbidities (e.g., chronic illness, pain, sensory, or cognitive changes). Conclusions : PTSD is an important clinical consideration in older adults, although the empirical database, particularly regarding psychotherapy, is limited. Clinical Implications : Assessment for trauma history and PTSD symptoms in older adults is essential, and may lead to increased recognition and treatment.