About a decade ago we proposed the notion of late-onset stress symptomatology, to characterize the later-life emergence of symptoms related to early-life warzone trauma among aging combat Veterans. We hypothesized that aging-related challenges (role transition and loss, death of family members and friends, physical and cognitive decline) might lead to increased reminiscence, and possibly distress, among Veterans who had previously dealt successfully with earlier traumatic events. Recently, we have reexamined our earlier ideas, to better reflect our developing understanding of this phenomenon, and to incorporate more contemporary perspectives on posttraumatic growth and resilience. As a result, we have broadened our conceptualization to later-adulthood trauma reengagement (LATR). We suggest that in later life many combat Veterans confront and rework their wartime memories in an effort to find meaning and build coherence. Through reminiscence, life review, and wrestling with issues such as integrity versus despair, they intentionally reengage with experiences they avoided or managed successfully earlier in life, perhaps without resolution or integration. This article links LATR to classic gerontologic notions, and elaborates how the LATR process can lead positively to personal growth or negatively to increased symptomatology. We also address the role of preventive intervention in enhancing positive outcomes for Veterans who reengage with their wartime memories in later life.

This study's goal was to develop a measure of late-onset stress symptomatology (LOSS). LOSS is a phenomenon observed in aging combat veterans who (a) were exposed to highly stressful combat events in their early adult years, (b) have functioned successfully throughout midlife with no history of chronic stress-related disorders, but (c) begin to register increased combat-related thoughts, feelings, and reminiscences commensurate with the changes and challenges of aging. Several samples of older male combat veterans from World War II, the Korean Conflict, and the Vietnam War served as participants. We developed a LOSS Scale that demonstrated a high degree of internal consistency reliability (coefficient alpha = 0.97). Scores were stable over brief intervals but were sensitive to developmental change over an extended period. Factor analysis suggested a single LOSS factor. Bivariate associations between LOSS score and other variables (e.g., indicators of contemporary life stressors, resilience, quality of life) were consistent with hypotheses, and there was support for the incremental validity of LOSS vis-à-vis posttraumatic stress symptoms and symptoms of general distress. Discussion of the potential uses of the scale, future directions for psychometric research, and suggestions for generalizing the LOSS construct to other trauma populations are provided.