Occurrence and treatment of post‐traumatic stress disorder in an elderly patient after a traffic accident

Burgmer, Markus; Heuft, Gereon

doi:10.1002/gps.1047

Cited by 15 publications

(6 citation statements)

References 36 publications

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“…This literature is best characterized by case studies (e.g., Burgmer & Heuft, 2004; Maercker, 2002), summaries of clinical experience (e.g., Bonwick, 1998; Bonwick & Morris, 1996), and uncontrolled clinical trials (e.g., Games & Hayden, 1991; Lipton & Schaffer, 1986). Interestingly, some in this literature express reservations regarding the utility of CBT in older trauma populations.…”

Section: Treatment Of Ptsd: Controversy In Older Adultsmentioning

confidence: 99%

“…Some caution that older adults may be less amenable to cognitive interventions due to age-related declines in cognitive capacity (e.g., Cook, Ruzek, & Cassidy, 2003; Flint, 2004). Others suggest that older adults are less “psychologically minded” and less responsive to psychosocial treatment in general (e.g., Burgmer & Heuft, 2004). At present, these concerns are limited to clinical speculation given the absence of systematic research examining the efficacy of CBT specifically among older trauma survivors.…”

Section: Treatment Of Ptsd: Controversy In Older Adultsmentioning

confidence: 99%

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Treatment of PTSD in Older Adults: Do Cognitive-Behavioral Interventions Remain Viable?

Clapp

Beck

2012

Cognitive and Behavioral Practice

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The literature examining trauma among older adults is growing, but little is known about the efficacy of empirically supported interventions for PTSD within this population. Clinical writing on this topic often implies that cognitive-behavioral treatments may be ineffective or inappropriate for older adults with PTSD given physical and/or cognitive vulnerabilities. Review of the limited research in this area, however, provides little support for the claim that cognitive-behavioral interventions are ineffective in treating PTSD among the elderly. In an effort to explicate specific issues related to treatment process and outcome among older survivors of trauma, a case series is presented outlining the treatment of three older adults within the context of a structured, cognitivebehavioral group intervention. Observations from this case series suggests that cognitivebehavioral interventions continue to be useful in treating PTSD with this population. Specific treatment issues unique to older adults are explored and recommendations for future research are discussed. Keywords PTSD; older adults; cognitive behavior therapyResearch over the past decade has advanced our understanding of posttraumatic stress disorder (PTSD) considerably, and treatment development efforts have resulted in a number of therapeutic approaches with robust support for their efficacy (Keane, Marshall, & Taft, 2006). Review of this literature, however, indicates that treatment efforts primarily have targeted young to middle-aged adults. As such, our understanding of how to treat PTSD among older adults -generally conceptualized as those individuals age 65 and olderremains in its nascent stages. In this review, we examine literature pertaining to the treatment of PTSD in older adults and highlight the potential strengths of this population. We then present a case series detailing treatment process and outcome in three older individuals within a cognitive-behavioral group intervention. We conclude with a discussion of possible next steps in developing the literature on the treatment of PTSD in older trauma survivors.

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Section: Treatment Of Ptsd: Controversy In Older Adultsmentioning

confidence: 99%

Section: Treatment Of Ptsd: Controversy In Older Adultsmentioning

confidence: 99%

Treatment of PTSD in Older Adults: Do Cognitive-Behavioral Interventions Remain Viable?

Clapp

Beck

2012

Cognitive and Behavioral Practice

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“…Older adults differ from younger adults in that they are less likely to perceive the need for mental health services (Karlin, Duffy, & Gleaves, 2008) and may be less psychologically minded (e.g., Burgmer & Heuft, 2004), potentially indicating less positive expectancies for psychotherapy. Cognitive limitations in some older adults may produce difficulty in understanding or completing therapy tasks such as cognitive restructuring.…”

Section: Introductionmentioning

confidence: 99%

Predictors of CBT outcome in older adults with GAD

Hundt

Amspoker

Kraus-Schuman

et al. 2014

Journal of Anxiety Disorders

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The current study is a secondary analysis of data from a randomized controlled trial of CBT for late-life GAD (Stanley et al., 2014) which provided an opportunity to examine predictors of outcome among those who received CBT. Participants were 150 older adults who were randomized to receive 10 sessions of CBT. Completer analyses found that homework completion, number of sessions attended, lower worry severity, lower depression severity, and recruitment site predicted 6-month worry outcome on the PSWQ-A, whereas homework completion, credibility of the therapy, lower anxiety severity, and site predicted better 6-month anxiety outcome on the STAI-T. In intent-to-treat multivariate analyses, however, only initial worry and anxiety severity, site, and number of sessions completed predicted treatment outcome. These results are largely consistent with predictors of outcome in younger adults and suggest that lower initial symptom severity and variables consistent with greater engagement in treatment predict outcome.

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“…However, the variables that predict satisfaction may be different in older adults and in integrated primary care programs. For example, older adults are less likely to perceive the need for mental health services (Karlin, Duffy, & Gleaves, 2008) and may be less psychologically minded (e.g., Burgmer & Heuft, 2004), indicating that the role of expectancies may be different. Although older adults report high levels of satisfaction with mental health treatment (Lippens & Mackenzie, 2011), not all psychosocial treatments have as large an effect for older adults (e.g., Wolitsky-Taylor, Castriotta, Lenze, Stanley, & Craske, 2010), so the role of clinical improvement may differ.…”

mentioning

confidence: 99%

Predictors of treatment satisfaction among older adults with anxiety in a primary care psychology program

Hundt

Armento

Porter

et al. 2013

Evaluation and Program Planning

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Increasing numbers of patients are treated in integrated primary care mental health programs. The current study examined predictors of satisfaction with treatment in patients from a randomized clinical trial of late-life generalized anxiety disorder (GAD) in primary care. Higher treatment satisfaction was associated with receiving CBT rather than enhanced usual care. Treatment credibility, treatment expectancies, social support, and improvements in depression and anxiety symptoms predicted higher treatment satisfaction in the total sample. In the CBT group, only credibility and adherence with treatment predicted satisfaction. This suggests that older patients receiving CBT who believe more strongly in the treatment rationale and follow the therapist’s recommendations more closely are likely to report satisfaction at the end of treatment. In addition, this study found that adherence mediated the relationship between treatment credibility and treatment satisfaction. In other words, patients’ perceptions that the treatment made sense for them led to greater treatment adherence which then increased their satisfaction with treatment.

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Occurrence and treatment of post‐traumatic stress disorder in an elderly patient after a traffic accident

Cited by 15 publications

References 36 publications

Treatment of PTSD in Older Adults: Do Cognitive-Behavioral Interventions Remain Viable?

Treatment of PTSD in Older Adults: Do Cognitive-Behavioral Interventions Remain Viable?

Predictors of CBT outcome in older adults with GAD

Predictors of treatment satisfaction among older adults with anxiety in a primary care psychology program

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