Posttraumatic stress disorder, complex PTSD and subtypes of loneliness among older adults

Fox, Robert; Hyland, Philip; Coogan, Andrew N.; Cloitre, Marylène; Power, Joanna McHugh

doi:10.1002/jclp.23225

Cited by 14 publications

(23 citation statements)

References 120 publications

(155 reference statements)

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“…We did not observe an interaction effect between age and event type for the anxiety, depression, and substance abuse subdomains. Research conducted prepandemic demonstrated a decline in overall PTSD in older adults, although no difference in the number of PTEs in comparison to other age groups was reported (Fox et al., 2021). The findings on age differences in the association between COVID‐19–related PTEs and mental health have been mixed.…”

Section: Discussionmentioning

confidence: 98%

“…The finding that older adults in this sample more often experienced symptoms of insomnia is also consistent with the existing literature showing insomnia rates of around 70% in older adults (Jaussent et al., 2011). This could be associated with the symptoms of hypervigilance and loneliness reported among older adults with PTSD (Fox et al., 2021) but could also be the result of normal changes in sleeping patterns in older age (e.g., an increased number and duration of awakenings and decreased amounts of deep slow‐wave sleep; Van Cauter et al., 2000). In addition, the results show that older adults are more likely to have alcohol‐related symptoms (i.e., substance abuse), which is in line with the literature.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, Fox et al. (2021) found that older adults reported PTEs that occurred in adulthood more frequently than those that occurred during childhood, whereas the reverse was true for younger age groups. During the pandemic, contact with friends, family, and caregivers was limited, and access to protective factors was blocked (Gruber et al., 2020; Vahia et al., 2020).…”

Section: Discussionmentioning

confidence: 99%

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The mental health impact of the COVID‐19 pandemic and exposure to other potentially traumatic events up to old age

Havermans

Hoeboer

Sobczak

et al. 2023

Journal of Traumatic Stress

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We investigated whether the impact of potentially traumatic events (PTEs) on trauma‐related symptoms changes across the transitional adult lifespan (i.e., 16–100 years old) and if this association differs for self‐reported COVID‐19–related PTEs compared to other PTEs. A web‐based cross‐sectional study was conducted among 7,034 participants from 88 countries between late April and October 2020. Participants completed the Global Psychotrauma Screen (GPS), a self‐report questionnaire assessing trauma‐related symptoms. Data were analyzed using linear and logistic regression analyses and general linear models. We found that older age was associated with lower GPS total symptom scores, B = −0.02, p < .001; this association remained significant but was substantially weaker for self‐reported COVID‐19–related PTEs compared to other PTEs, B = 0.02, p = .009. The results suggest an association between older age and lower ratings of trauma‐related symptoms on the GPS, indicating a blunted symptom presentation. This age‐related trend was smaller for self‐reported COVID‐19–related PTEs compared to other PTEs, reflecting the relatively higher impact of the COVID‐19 pandemic on older adults.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

The mental health impact of the COVID‐19 pandemic and exposure to other potentially traumatic events up to old age

Havermans

Hoeboer

Sobczak

et al. 2023

Journal of Traumatic Stress

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“…There might be an interaction between these areas such as that a negative self-concept increases the risk of social withdrawal and in turn a lack of positive relational experiences reinforces the negative self-concept . Overall, refugees have a higher risk of loneliness and low social support, factors that have been repeatedly related to higher levels of mental distress [ 62 ], CPTSD [ 63 ] and lower quality of life [ 64 ]. Additionally, we suggest that numbness due to affective dysregulation and an associated reduced self-awareness or ability to engage in interpersonal relationships might further promote disturbances in relationships and a negative self-concept .…”

Section: Discussionmentioning

confidence: 99%

The boundaries between complex posttraumatic stress disorder symptom clusters and post-migration living difficulties in traumatised Afghan refugees: a network analysis

et al. 2022

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Background Psychological distress due to the ongoing war, violence, and persecution is particularly common among Afghan asylum seekers and refugees. In addition, individuals face a variety of post-migration living difficulties (PMLDs). Complex posttraumatic stress symptoms are among the most common mental health problems in this population, and were associated with the overall burden of PMLDs. The complex interplay of posttraumatic symptoms has been investigated from a network perspective in previous studies. However, individuals are embedded in and constantly react to the environment, which makes it important to include external factors in network models to better understand the etiology and maintaining factors of posttraumatic mental health problems. PMLDs are a major risk factor for posttraumatic distress and considering their impact in interventions might improve response rates. However, the interaction of these external factors with posttraumatic psychopathological distress is not yet fully understood. Thus, we aimed to illuminate the complex interaction between PMLDs and CPTSD symptom clusters. Objective The main objective is the exploration of the network structure and the complex interplay of ICD-11 CPTSD symptom clusters and distinct forms of PMLDs. Method The symptom clusters of CPTSD and PMLDs were collected within a randomised controlled trial among 93 treatment-seeking Afghan asylum seekers and refugees via a fully structured face-to-face and interpreter assisted interview. Using a network analytical approach, we explored the complex associations and network centrality of the CPTSD symptom clusters and the PMLD factors: discrimination & socio-economical living conditions, language acquisition & barriers, family concerns, and residence insecurity. Results The results suggest direct links within and between the constructs (CPTSD, PMLD). Almost all PMLD factors were interrelated and associated to CPTSD, family concerns was the only isolated variable. The CPTSD symptom cluster re-experiencing and the PMLD factor language acquisition & barriers connected the two constructs. Affective dysregulation had the highest and avoidance the lowest centrality. Conclusions Re-experiencing and affective dysregulation have the strongest ties to PMLDs. Thus, these domains might explain the strong association of posttraumatic psychopathology with PLMDs and, consequently, prioritization of these domains in treatment approaches might both facilitate treatment response and reduce burden caused by PMLDs.

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“…Loneliness, defined as the personal perception of unfulfilled intimate, emotional, and social needs (Dykstra, 2009), is known for its detrimental mental and physical health outcomes in the older population (Courtin and Knapp, 2015). Previous studies reported associations between loneliness and PTSD (Shevlin et al, 2015;Itzhaky et al, 2017), with loneliness playing a significant role in contributing to or maintaining CPTSD symptoms (Murphy et al, 2021;Fox et al, 2022). Nevertheless, research regarding the association between loneliness and CPTSD is scarce (Fox et al, 2022), particularly in the older population.…”

Section: Loneliness and Posttraumatic Reactionsmentioning

confidence: 99%

Factors associated with ICD-11 posttraumatic stress disorder and complex posttraumatic stress disorder among older adults during the COVID-19 pandemic

Greenblatt‐Kimron¹,

Ben–Ezra²,

Shacham³

et al. 2023

Camb. prisms Glob. ment. health

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ICD-11 posttraumatic stress disorder (PTSD) and complex PTSD have been understudied in the older population. The study focused on the associations between traumatic exposure before the pandemic, COVID-19 worries, depression, and loneliness with current PTSD and CPTSD among older adults. A random sample of five hundred and twelve Israeli older adults (Mage = 72.67 ± 3.81, range 68-87) was recruited using a Web-based survey company (Ipanel, Israel). Participants completed questionnaires of demographic details, self-rated health, COVID-19 worries, trauma exposure, depressive symptoms, level of loneliness, PTSD, and CPTSD. Univariate logistic regression revealed that trauma exposure, COVID-19 worries, depression, and loneliness were associated with PTSD. Multinomial regression revealed that only trauma exposure was associated with PTSD among older adults with PTSD compared with those not reaching the PTSD cutoff level. In the comparison between older adults suffering from CPTSD with those not reaching the PTSD cutoff level, being married, higher levels of trauma exposure, COVID-19 worries, depression, and loneliness were associated with a higher risk of CPTSD. Results suggest that specific factors may be significant psychological correlates of CPTSD symptoms among older adults during the COVID-19 pandemic. Identifying these factors could assist practitioners in tailoring more effective interventions. Impact statementPosttraumatic stress disorder (PTSD) and ICD-11 complex PTSD (CPTSD) are considered under-researched disorders in the older population, particularly factors associated with CPTSD in old age. This study is unique as it aims to provide insight into the differences between older adults suffering from PTSD with those suffering from CPTSD. The study focused on factors associated with current PTSD and CPTSD among older adults exposed to a traumatic event before the COVID-19 pandemic. This study differentiated between three groups of older adults at the end of the fifth wave of the COVID-19 pandemic in Israel: those with no diagnosis of PTSD, those who reached the PTSD cutoff, and those who exhibited CPTSD. Participants with PTSD reported higher levels of trauma exposure, COVID-19 worries, depression, and loneliness relative to those not reaching the PTSD cutoff level. Moreover, participants with CPTSD displayed higher levels of loneliness, COVID-19 worries, exposure to trauma, and depression relative to those not reaching the PTSD cutoff level. The study underscores that older adults suffering from trauma are at risk for adverse outcomes in the face of global disasters, such as the COVID-19 pandemic. Furthermore, there is a significant risk for those suffering from CPTSD, distinguishing them as particularly vulnerable to the adverse effects of global disasters. It seems that complex trauma is significantly more related to mental health factors among older adults, which has clinical implications for practitioners. The study highlights the need for further research in the field of CPTSD among older adults to enha...

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Posttraumatic stress disorder, complex PTSD and subtypes of loneliness among older adults

Cited by 14 publications

References 120 publications

The mental health impact of the COVID‐19 pandemic and exposure to other potentially traumatic events up to old age

The mental health impact of the COVID‐19 pandemic and exposure to other potentially traumatic events up to old age

The boundaries between complex posttraumatic stress disorder symptom clusters and post-migration living difficulties in traumatised Afghan refugees: a network analysis

Factors associated with ICD-11 posttraumatic stress disorder and complex posttraumatic stress disorder among older adults during the COVID-19 pandemic

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