Assessing late-onset stress symptomatology among aging male combat veterans

Abstract

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.

Understanding the Impact of Early-Life Trauma in Nursing Home Residents

“…Studies focusing on combat veterans have found that aging can induce delayed-onset PTSD years after the initial combat trauma (for a review, see Averill & Beck, 2000). Several studies have also found symptoms congruent with LOSS in combat veterans as they age (Davison et al, 2006;King et al, 2007). Studies examining the well-being of aging Holocaust survivors have also found high levels of emotional and psychological distress, including depression, suicide, and PTSD (Barak et al, 2005;Kahana, Harel, & Kahana, 2005;Trappler, Cohen, & Tulloo, 2007).…”

Distinguishing late-onset stress symptomatology from posttraumatic stress disorder in older combat veterans

“…This investigation was conducted as a supplement to the previous study of LOSS (King et al, 2007). To lend additional support to findings suggesting that LOSS is a construct distinct from PTSD, our present goal was to further assess the discriminant validity of the LOSS Scale.…”

“…Guided by Davison et al (2006) conceptualization of LOSS, King, King, Vickers, Davison, and Spiro (2007) developed the LOSS Scale (published in this journal) and demonstrated its reliability and validity in a sequence of studies using multiple samples of aging veterans. One finding was that scores on the LOSS Scale and the PTSD Checklist -Civilian Version (PCL-C; Weathers, Litz, Herman, Huska, & Keane, 1993) were only moderately associated, with shared variance just below 50%.…”

War Leaves an Enduring Legacy in Combatants’ Lives

“…Constant repetition of stress gradually depletes coping resources and makes the veteran more vulnerable to subsequent stressors. This may lead to depression, combat stress reaction, and, for some, PTSD (Briere, 2004) or in later years, Late Onset Stress Symptomatology (Andrews, Brewin, Philpott, & Stewart, 2007;Davison et al, 2006;L. A.…”