SUPPORT GROUPS FOR OLDER ADULTS SUFFERING FROM PTSD

Support Groups for Older Adults Suffering From PTSD

Support Groups for Older Adults Suffering From PTSD

Studies examining the psychological impact of exposure to extreme stress suggest that pretrauma psychological functioning is the overall best predictor of emotional outcomes after a trauma. For example, Yehuda et al. (1995) examined the impact of recent stress on older Holocaust survivors with and without PTSD and comparison participants. Results indicated that recent stressful events were associated with a greater severity of trauma-related symptoms, particularly avoidance symptoms, but only in those individuals with a PTSD diagnosis. Similarly, in a study of 200 older (aged 55+) survivors of two consecutive floods (Phifer, 1990), pretrauma levels of anxiety, depression, and general distress accounted for 30% to 40% of the variance in postflood symptom levels. Demographic factors, including age, accounted only for 3% of the variance in symptoms. In fact, individuals aged 55 to 64 showed the highest levels of psychological distress relative to participants aged 65 and older in this study. Although both psychological and physical consequences were related to the severity of the flood (Phifer & Norris, 1989), preflood psychological functioning was the best predictor of outcome. Thus the psychological effects of trauma exposure in older adults depend heavily on the individual's premorbid functioning, particularly with regard to anxiety, depression, and extant PTSD.

Some authors have speculated that experience with a previous trauma contributes to positive adaptation with a subsequent extreme stressor (e.g., Norris and Phifer). For example, Norris and Murrell (1988) examined a sample of elderly flood victims and noted evidence for both direct tolerance (exposure to a specific stressor inoculates the individual to the subsequent effects of the same type of stressor) and cross tolerance (exposure to a specific stressor inoculates the individual to the subsequent effects of a different stressor). However, characteristics of the stressor and individual differences in coping skills appeared significant in this report. In this same vein, Solomon and Prager (1992) noted that the psychological effects of exposure to the Persian Gulf War were considerably greater on older Israeli citizens who were Holocaust survivors relative to citizens who did not have this background. In particular, Holocaust survivors reported greater perceptions of danger, more psychological distress, and higher levels of both state and trait anxiety. Again, trauma characteristics and individual differences appeared significant in this study. As discussed by Lyons (1991), perceptions of control, interpretations of the meaning of the initial trauma, and social support after trauma exposure most likely influence coping with subsequent stressors.

Physical consequences of trauma exposure are an additional dimension that deserves discussion when considering the impact of stressors on the elderly. It is well-established that specific laboratory stress tasks create excessive physiological reactivity that eventually may contribute to the development of physical disorders such as cardiovascular disease, diabetes, headaches, and chronic pain (e.g., McNeilly & Anderson, 1996). However, little work has examined these interrelationships directly in the elderly, an omission that limits our understanding of the long-term, radiating impact of stress ...