Hostname: page-component-586b7cd67f-rdxmf Total loading time: 0 Render date: 2024-11-26T18:40:16.589Z Has data issue: false hasContentIssue false
  • English
  • Français

Peritraumatic distress but not dissociation predicts posttraumatic stress disorder in the elderly

Published online by Cambridge University Press:  22 February 2013

Alain Brunet ,
Steven Sanche ,
Aude Manetti ,
Bruno Aouizerate ,
Régis Ribéreau-Gayon ,
Sandrine Charpentier ,
Philippe Birmes  and
Christophe Arbus
Alain Brunet
Affiliation:
McGill University and Douglas Mental Health University Institute, Montréal, Quebec, Canada
Steven Sanche
Affiliation:
St. Mary's Research Centre, St. Mary's Hospital, Montréal, Quebec, Canada
Aude Manetti
Affiliation:
PRES Sorbonne Paris Cité, Assistance Publique-Hôpitaux de Paris, Department of Psychiatry, Corentin Celton Hospital, Issy les Moulineaux, Paris Descartes University, Paris, France
Bruno Aouizerate
Affiliation:
Academic Department of Adult Psychiatry, Charles Perrens Hospital, Bordeaux Segalen University, Bordeaux, France
Régis Ribéreau-Gayon
Affiliation:
Adult Emergency Department, Pellegrin Hospital, Bordeaux, France
Sandrine Charpentier
Affiliation:
INSERM 558, Emergency Department, Purpan University Hospital, Toulouse University, Toulouse, France
Philippe Birmes
Affiliation:
Department of Psychiatry and Medical Psychology, Traumatic Stress Laboratory (EA 4560), Purpan University Hospital, Paul Sabatier University (UPS), Toulouse, France
Christophe Arbus*
Affiliation:
Department of Psychiatry and Medical Psychology, Traumatic Stress Laboratory (EA 4560), Purpan University Hospital, Paul Sabatier University (UPS), Toulouse, France
*
Correspondence should be addressed to: Christophe Arbus, MD, PhD, Department of Psychiatry and Medical Psychology, Purpan-Casselardit Hospital, 31059 Toulouse, France. Phone: +33-5-6177-2351; Fax: +33-5-6177-7646. Email: [email protected].
Get access Rights & Permissions [Opens in a new window]

Abstract

Background: Post-traumatic stress disorder (PTSD) is a severe anxiety disorder whose symptoms include re-experiencing, avoidance, and hyperarousal after a particularly intense event. In view of the aging of the population, increased clinical knowledge is required for better understanding of PTSD in the elderly. Extending previous research in this field in adults and children, the aim of our study was to assess the utility of peri-traumatic dissociation and distress as a predictor of PTSD in the elderly.

Methods: A prospective longitudinal study was conducted in a consecutive cohort of subjects aged 65 years and over admitted to emergency departments after a physical assault or a road traffic accident. Peri-traumatic responses of distress and of dissociation were measured. One, 6, and 12 months after trauma exposure, PTSD symptoms and diagnosis were assessed using both a dimensional and a semistructured interview.

Results: Thirty-nine male and female participants with an average age of 72.4 years were recruited. Mixed model regression analyses did not detect a significant effect of age, sex, nor time. Significant associations were detected between peri-traumatic distress and the self-report PTSD Checklist (p = 0.008), as well as the Clinician-administered PTSD scale (p = 0.03). No association was detected between peri-traumatic dissociation and PTSD.

Conclusions: Peri-traumatic distress predicts PTSD symptoms and diagnosis in the elderly, thereby suggesting its systematic evaluation at the emergency department would be a worthwhile thing to do.

Keywords

traumaagingperi-traumatic responsesdistressdissociative experiencerisk factors
Type
Research Article
Information
International Psychogeriatrics , Volume 25 , Issue 6 , June 2013 , pp. 1007 - 1012
Copyright
Copyright © International Psychogeriatric Association 2013

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

Acierno, R., Ruggiero, K. J., Kilpatrick, D. G., Resnick, H. S. and Galea, S. (2006). Risk and protective factors for psychopathology among older versus younger adults after the 2004 Florida hurricanes. The American Journal of Geriatric Psychiatry, 14, 1051–1059.CrossRefGoogle ScholarPubMed
American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders, 4th edn, revised. Washington, DC: American Psychiatric Association.Google Scholar
Averill, P. M. and Beck, J. G. (2000). Posttraumatic stress disorder in older adults: a conceptual review. Journal of Anxiety Disorder, 14, 133–156.CrossRefGoogle ScholarPubMed
Birmes, P., Carreras, D., Charlet, J. P., Warner, B. A., Lauque, D. and Schmitt, L. (2001). Peritraumatic dissociation and posttraumatic stress disorder in victims of violent assault. The Journal of Nervous and Mental Disease, 189, 796–798.CrossRefGoogle ScholarPubMed
Birmes, P.et al. (2005a). Validation of the Peritraumatic Dissociative Experiences Questionnaire self-report version in two samples of French-speaking individuals exposed to trauma. European Psychiatry, 20, 145–151.CrossRefGoogle ScholarPubMed
Birmes, P. J.et al. (2005b). Symptoms of peritraumatic and acute traumatic stress among victims of an industrial disaster. Psychiatric Services, 56, 93–95.CrossRefGoogle ScholarPubMed
Böttche, M., Kuwert, P. and Knaevelsrud, C. (2012). Posttraumatic stress disorder in older adults: an overview of characteristics and treatment approaches. International Journal of Geriatric Psychiatry, 27, 230–239.CrossRefGoogle ScholarPubMed
Brown, H. and Prescott, R. (2001). Applied Mixed Models in Medicine. West Sussex, UK: John Wiley and Sons Ltd.Google Scholar
Brunet, A.et al. (2000). An overview of the Peritraumatic Distress Scale. Dialogues in Clinical Neuroscience, 2, 44–45.CrossRefGoogle ScholarPubMed
Brunet, A.et al. (2001). The Peritraumatic Distress Inventory: a proposed measure of PTSD criterion A2. The American Journal of Psychiatry, 158, 1480–1485.CrossRefGoogle ScholarPubMed
Bui, E.et al. (2010). Peritraumatic reactions and posttraumatic stress symptoms in school-aged children victims of road traffic accident. General Hospital Psychiatry, 32, 330–333.CrossRefGoogle ScholarPubMed
Chen, Y. L.et al. (2011). Risk factors for PTSD after Typhoon Morakot among elderly people in Taiwanese aboriginal communities. International Psychogeriatrics, 23, 1686–1691.CrossRefGoogle ScholarPubMed
Chung, M. C., Werrett, J., Easthope, Y. and Farmer, S. (2004). Coping with post-traumatic stress: young, middle-aged and elderly comparisons. International Journal of Geriatric Psychiatry, 19, 333–343.CrossRefGoogle ScholarPubMed
Elklit, A. and O'Connor, M. (2005). Post-traumatic stress disorder in a Danish population of elderly bereaved. Scandinavica Journal of Psychology, 46, 439–445.CrossRefGoogle Scholar
Harel, O. and Zhou, X. H. (2007). Multiple imputation: review of theory, implementation and software. Statistics in Medicine, 26, 3057–3077.CrossRefGoogle ScholarPubMed
Harrell, F. E. (2001). Regression Modeling Strategies: With Applications to Linear Models, Logistic Regression, and Survival Analysis. New York: Springer Verlag Inc.CrossRefGoogle Scholar
Jehel, L., Brunet, A., Paterniti, S. and Guelfi, J. D. (2005). Validation of the Peritraumatic Distress Inventory's French translation. Canadian Journal of Psychiatry, 50, 67–71.CrossRefGoogle ScholarPubMed
Jia, Z., Tian, W., Liu, W., Cao, Y., Yan, J. and Shun, Z. (2010). Are the elderly more vulnerable to psychological impact of natural disaster? A population-based survey of adult survivors of the 2008 Sichuan earthquake. BMC Public Health, 10, 172.CrossRefGoogle ScholarPubMed
Lapp, L. K., Agbokou, C. and Ferreri, F. (2011). PTSD in the elderly: the interaction between trauma and aging. International Psychogeriatrics/IPA, 22, 1–11.Google Scholar
Marmar, C. R., Weiss, D. S. and Metzler, T. (1998). Peritraumatic Dissociation and Posttraumatic Stress Disorder. Washington, DC: American Psychiatric Press.Google Scholar
O'Connor, M. (2010). A longitudinal study of PTSD in the elderly bereaved: [corrected] prevalence and predictors. Aging and Mental Health, 14, 310–318.CrossRefGoogle ScholarPubMed
O'Hara, R. (2006). Stress, aging, and mental health. The American Journal of Geriatric Psychiatry, 14, 295–298.CrossRefGoogle ScholarPubMed
Seedat, S. and Stein, M. B. (2001). Post-traumatic stress disorder: a review of recent findings. Current Psychiatry Reports, 3, 288–294.CrossRefGoogle ScholarPubMed
Shalev, A. Y. (2009). Posttraumatic stress disorder and stress-related disorders. The Psychiatric Clinics of North America, 32, 687–704.CrossRefGoogle ScholarPubMed
Sheehan, D. V.et al. (1998). The Mini-International Neuropsychiatric Interview (MINI): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. The Journal of Clinical Psychiatry, 59 (Suppl. 20), 22–33; quiz 34–57.Google ScholarPubMed
Thomas, E., Saumier, D. and Brunet, A. (2012). Peritraumatic distress and the course of posttraumatic stress disorder symptoms: a meta-analysis. Canadian Journal of Psychiatry, 57, 122–129.CrossRefGoogle ScholarPubMed
van der Hart, O., Nijenhuis, E. R. and Steele, K. (2005). Dissociation: an insufficiently recognized major feature of complex posttraumatic stress disorder. Journal of Traumatic Stress, 18, 413–423.CrossRefGoogle ScholarPubMed
Wahlstrom, L., Michelsen, H., Schulman, A. and Backheden, M. (2008). Different types of exposure to the 2004 tsunami are associated with different levels of psychological distress and posttraumatic stress. Journal of Traumatic Stress, 21, 463–470.CrossRefGoogle Scholar
Weathers, F., Litz, B., Herman, D., Huska, J. and Keane, T. (1993). The PTSD Checklist (PCL): reliability, validity, and diagnostic utility. Annual Convention of the International Society for Traumatic Stress Studies. San Antonio, TX.Google Scholar
Weathers, F. W., Keane, T. M. and Davidson, J. R. (2001). Clinician-administered PTSD scale: a review of the first ten years of research. Depression and Anxiety, 13, 132–156.CrossRefGoogle Scholar