Hostname: page-component-586b7cd67f-g8jcs Total loading time: 0 Render date: 2024-11-22T06:58:02.508Z Has data issue: false hasContentIssue false
  • English
  • Français

Age differences in PTSD among Canadian veterans: age and health as predictors of PTSD severity

Published online by Cambridge University Press:  09 September 2014

Candace Konnert  and
May Wong
Candace Konnert*
Affiliation:
Department of Psychology, University of Calgary, Calgary, Alberta T2N 1N4, Canada
May Wong
Affiliation:
Carewest Operational Stress Injury Clinic, Calgary, Alberta T3A 0E2, Canada
*
Correspondence should be addressed to: Candace Konnert, Department of Psychology, University of Calgary, 2500 University Drive NW, Calgary, Alberta T2N 1N4, Canada. Phone: +403-220-4976; Fax: +403-282-8249. Email: [email protected].
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

To date, few studies have investigated age differences in posttraumatic stress disorder (PTSD) symptoms and none has examined age differences across symptom clusters: avoidance, re-experiencing, and hyperarousal. The first objective of this study was to investigate age differences in PTSD and its three symptom clusters. The second objective was to examine age and indices of health as predictors of PTSD symptom severity.

Methods:

Participants were 104 male veterans, aged 22 to 87 years, receiving specialized mental health outpatient services. Assessments included measures of health-related quality of life, pain severity, number of chronic health conditions, and symptoms of PTSD, both in total and on the symptom clusters.

Results:

There were significant age differences across age groups, with older veterans consistently reporting lower PTSD symptom severity, both in total and on each of the symptom clusters. Hierarchical regression analyses indicated that the inclusion of health indices accounted for significantly more variance in PTSD symptoms over and above that accounted for by age alone. Pain severity was a significant predictor of PTSD total and the three symptom clusters.

Conclusions: This is the first study to report lower levels of PTSD severity among older veterans across symptom clusters. These findings are discussed in relation to age differences in the experiencing and processing of emotion, autobiographical memory, and combat experiences. This study also emphasizes the importance of assessing pain in those with symptoms of PTSD, particularly older veterans who are less likely to receive specialized mental healthcare.

Keywords

PTSDage differencesphysical healthpainveterans
Type
Research Article
Information
International Psychogeriatrics , Volume 27 , Issue 2 , February 2015 , pp. 297 - 304
Copyright
Copyright © International Psychogeriatric Association 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association. (1994). Diagnostic and Statistical Manual of Mental Disorders: Fourth Edition Text Revision. Washington, DC: American Psychiatric Association.Google Scholar
Asmundson, G. J. G. and Taylor, S. (2006). PTSD and chronic pain: cognitive-behavioral perspectives and practical implications. In Young, G., Kane, A. and Nicholson, K. (eds.), Psychological Knowledge in Court (pp. 225–241). New York, NY: Springer.Google Scholar
Beckman, J. C., Moore, S. D., Feldman, M. E., Hertzberg, M. A., Kirby, A. C. and Fairbank, J. A. (1998). Health status, somatization, and severity of post-traumatic stress disorder in Vietnam combat veterans with posttraumatic stress disorder. American Journal of Psychiatry, 155, 1565–1569.Google Scholar
Briere, J. (2001). Detailed Assessment of Posttraumatic Stress. Odessa, FL: Psychological Assessment Resources.Google Scholar
Brooks, M. S. and Fulton, L. (2010). Evidence of poorer life-course mental health outcomes among veterans of the Korean War cohort. Aging & Mental Health, 14, 177–183.Google Scholar
Carlson, E. B., Lauderdale, S., Hawkins, J. and Sheikh, J. I. (2008). Posttraumatic stress and aggression among veterans in long-term care. Journal of Geriatric Psychiatry and Neurology, 21, 61–71. doi:10.1177/0891988707311557.Google Scholar
Cicchetti, D. V. (1994). Guidelines, criteria, and rules of thumb for evaluating normed and standardized assessment instruments in psychology. Psychological Assessment, 6, 284–290.Google Scholar
Cleeland, C. S. (1989). Measurement of pain by subjective report. In Chapman, C. R. and Loeser, J. D. (eds.), Advances in Pain Research and Therapy, vol. 12 Issues in Pain Management (pp. 391–403). New York, NY: Raven Press.Google Scholar
Cohen, J. (1992). A power primer. Psychological Bulletin, 112, 155–159.Google Scholar
Cook, J. M. (2002). Traumatic exposure and PTSD in older adults: introduction to the special issue. Journal of Clinical Geropsychology, 18, 149–152.Google Scholar
Cook, J. M., Biyanova, T. and Elmore, D. L. (2012). Traumatic stress in older adults. In Beck, J. G. and Sloan, D. M. (eds.), The Oxford Handbook of Traumatic Stress Disorders (pp. 119–127). New York, NY: Oxford University Press. doi:10.1093/oxfordhb/9780195399066.001.0001.Google Scholar
Davison, E. H. et al. (2006). Late-life emergence of early-life trauma. Research on Aging, 28, 84–114. doi:10.1177/0164027505281560.Google Scholar
Durai, U. N. et al. (2011). Exposure to trauma and posttraumatic stress disorder symptoms in older veterans attending primary care: comorbid conditions and self-rated health status. Journal of the American Geriatrics Society, 59, 1087–1092.Google Scholar
Erikson, E. H. (1982). The Life Cycle Completed. New York, NY: Norton.Google Scholar
Fontana, A. and Rosenheck, R. (1994). Traumatic was stressors and psychiatric symptoms among World War II, Korean, and Vietnam War veterans. Psychology and Aging, 9, 27–33.Google Scholar
Frueh, B. C., Grubaugh, A. L., Acierno, R., Elhai, J. D., Cain, G. and Magruder, K. M. (2007). Age differences in posttraumatic stress disorder, psychiatric disorders, and healthcare service use among veterans in veterans affairs primary care clinics. American Journal of Geriatric Psychiatry, 15, 660–672. doi:10.1097/01.JGP.0000260855.42209.31.Google Scholar
Hyer, L. and Yeagerii, C. A. (2012). PTSD at life: context and treatment. In Beck, J. G. and Sloane, D. M. (eds.), The Oxford Handbook of Traumatic Stress Disorders (pp. 491–503). New York, NY: Oxford University Press.CrossRefGoogle Scholar
Ikin, J. F., Creamer, M. C., Sim, M. R. and McKenzie, D. P. (2010). Comorbidity of PTSD and depression in Korean War veterans: prevalence, predictors, and impairment. Journal of Affective Disorders, 125, 279–286. doi:10.1016/j.jad.2009.12.005.CrossRefGoogle ScholarPubMed
Karlin, B. E., Duffy, M. and Gleaves, D. H. (2008). Patterns and predictors of mental health service use and mental illness among older and younger adults in the United States. Psychological Services, 5, 275–294. doi:10.1037/1541-1559.5.3.275.Google Scholar
King, L. A., King, D. W., Vickers, K., Davison, E. H. and Spiro III, A. (2007). Assessing the late-onset symptomatology among aging male combat veterans. Aging & Mental Health, 11, 175–191. doi:10/1080/13607860600844424.Google Scholar
Koenen, K. C., Stellman, J. M., Stellman, S. D. and Sommer, J. F. Jr. (2003). Risk factors for course of posttraumatic stress disorder among Vietnam veterans: a 14-year follow-up of American legionnaires. Journal of Consulting and Clinical Psychology, 71, 980–986. doi:10.1037/0022-006X.71.6.980.Google Scholar
Lachs, M. S., Williams, C. S., O’Brien, S., Pillemer, K. A. and Charlson, M. E. (1998). The mortality of elder mistreatment. Journal of the American Medical Association, 280, 428–432.Google Scholar
Lapp, L. K., Agbokou, C. and Ferreri, F. (2011). PTSD in the elderly: the interaction between trauma and aging. International Psychogeriatrics, 23, 858–868. doi:10.1017/S1041610211000366.Google Scholar
Maglione, J. E. and Ancoli-Israel, S. (2012). Sleep disorders in the elderly. In Morin, C. M. and Esple, C. A. (eds.), The Oxford Handbook of Sleep and Sleep Disorders (pp. 769–786). New York, NY: Oxford University Press.Google Scholar
McFall, M. E., Smith, D., Roszell, D. K., Tarver, D. J. and Malas, K. L. (1990). Convergent validity measures of PTSD in Vietnam combat veterans. American Journal of Psychiatry, 147, 645–648.Google Scholar
Molinari, V. and Williams, W. (1995). An analysis of aging World War II POWs with PTSD: implications for practice and research. Journal of Geriatric Psychiatry, 28, 99–114.Google Scholar
Otis, J. D., Gregor, K., Hardway, C., Morrison, J., Scioli, E. and Sanderson, K. (2010). An examination of the co-morbidity between chronic pain and posttraumatic stress disorder on US veterans. Psychological Services, 7, 126–135. doi:10.1037/a0020512.Google Scholar
Pietrzak, R. H., Goldstein, R. B., Southwick, S. M. and Grant, B. F. (2012). Psychiatric comorbidity of full and partial posttraumatic stress disorder among older adults in the United States: results from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions. American Journal of Geriatric Psychiatry, 20, 380–390.Google Scholar
Settersten, R. A. (2006). When nations call: how wartime military service matters for the life course and aging. Research on Aging, 28, 12–36. doi:10.1177/0164027505281577.Google Scholar
Sharp, T. J. and Harvey, A. G. (2001). Chronic pain and posttraumatic stress disorder: mutual maintenance? Clinical Psychology Review, 21, 857–877.Google Scholar
Skevington, S. M., Lofty, M. and O’Connell, K. A. (2004). The World Health Organization's WHOQOL-BREF quality of life assessment: psychometric properties and results of the international field trial. A report from the WHOQOL Group. Quality of Life Research, 13, 299–310. doi:10.1023/B:QURE.0000018486.91360.00.Google Scholar
Solomon, Z., Helvitz, H. and Zerach, G. (2009). Subjective age, PTSD and physical health among war veterans. Aging & Mental Health, 13, 405–413. doi:10.1080/13607860802459856.Google Scholar
Spaniol, J., Voss, A. and Grady, C. L. (2008). Aging and emotional memory: cognitive mechanisms underlying the positivity effect. Psychology and Aging, 23, 859–872.CrossRefGoogle ScholarPubMed
Spiro, A., Schnurr, P. P. and Aldwin, C. M. (1994). Combat-related posttraumatic stress disorder in older men. Psychology and Aging, 9, 17–26.Google Scholar
Thompson, J. M. et al. (2011, 4 Jan). Survey on Transition to Civilian Life: Report on Regular Force Veterans. Charlottetown, Canada: Research Directorate, Veterans Affairs Canada; Ottawa, Canada: Department of National Defense, Director General Military Personnel Research and Analysis, 103 p.Google Scholar
Van Zelst, W. H. and Beekman, A. T. F. (2012). Psychometric concerns in the assessment of trauma-related symptoms in older adults. In Beck, J. G. and Sloane, D. M. (eds.), The Oxford Handbook of Traumatic Stress Disorders (pp. 282–301). New York, NY: Oxford University Press.Google Scholar
Van Zelst, W. H., de Beurs, E., Beekman, A. T. F., van Dyck, R. and Deeg, D. D. H. (2006). Well-being, physical functioning, and use of health services in the elderly with PTSD and subthreshold PTSD. International Journal of Geriatric Psychiatry, 21, 180–188. doi:10.1002/gps.1448.Google Scholar
Wetherall, J. L. et al. (2009). Older adults are less accurate than younger adults at identifying symptoms of anxiety and depression. Journal of Mental and Nervous Disease, 197, 623–626. doi:10.1097/NMD.0b013e3181b0c081.Google Scholar
WHOQOL Group (1998). Development of the World Health Organization WHOQOL-BREF quality of life assessment. Psychological Medicine, 28, 551–558.Google Scholar
Williams, J. M. G. et al. (2007). Autobiographical memory specificity and emotional disorder. Psychological Bulletin, 133, 122–148. doi:10.1037/0033-2909.133.1.122.Google Scholar