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PYC4802 - Psychopathology Articles Summarized

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PYC4802 - Psychopathology Articles Summarized PYC4802 - Psychopathology Articles Summarized

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PYC4802 - Psychopathology Articles
Summarized
THEME 2: TRAUMA AND STRESSOR RELATED DISORDERS

ARTICLES

AVERILL – POST TRAUMATIC STRESS DISORDER IN OLDER ADULTS: A CONCEPTUAL REVIEW

— This review – 1) Summarize and integrate the extant literature on PTSD in older adults; 2) To
spotlight special concerns that are involved in understanding PTSD in older adults; 3) To set the stage
for future research in the relatively neglected area.
— Initiated by exposure to extraordinarily stressful life events
— 3 categories of symptoms
a) Reexperiencing Symptoms
b) Avoidance and numbing symptoms
c) Increased physiological arousal
— DSM-5: Individual is exposed to trauma; trauma is persistently reexperiencing; pervasive avoidance
of cues associated with the trauma and numbing of general responsiveness; persistent symptoms of
hyperarousal; lasted at least 1 month and cause significant distress.
— People experience trauma young tend to ‘mask symptoms’ until later in life.
— As they aged PTSD symptoms exacerbation was common
— Sleep disturbances and memory impairment are seen commonly in OLDER adults in general and
may not be associated with trauma exposure per se.
— Among older veterans, the most salient PTSD symptoms were distress when exposed to trauma-
related events and diminished interest in usual activities.
— Suggesting, older adults with PTSD may be prone to symptom exacerbation/worsening when
faced with trauma-related triggers.
— Suggest PTSD like other anxiety disorders decline with advancing age
— Some older adults have a history of chronic PTSD, others indicated that symptomatology resurfaced
after a period of symptom-free functioning and yet others report the onset of combat-related PTSD
in later life
— Not much information on PTSD in older women, mostly men from war etc.
— Many combat soldiers experience symptoms 40-50years later
— Difficult to study prevalence on war soldiers and holocaust survivors as most are dead
— Scotland air disaster – elderly had similar rate of PTSD to younger participants; 84% and 100% of
both participants met criteria for PTSD
— Relationship between severity of trauma and age
— Delayed-onset could be due to as the person ages, physical and mental resilience over time decreases
— Normal stressors such as retirement and bereavement may precipitate delayed onset PTSD may
not have the psychological resources to cope
— Co-Morbid – likely to experience MAJOR DEPRESSIVE DISORDER, other anxiety disorders, somatic
conditions (feel extreme anxiety over physical symptoms SSD), cognitive disturbances and
ALCOHOLISM
— 53% reported cases alcoholism among veterans
— Alcohol is rationalized as a means of self-medication to reduce symptoms such as
nightmares, insomnia, and anxiety - a lot more research is needed
— Radiating effects of exposure to trauma on the elderly – Advancing age potentially represents a
differential vulnerability factor that moderates the impact of exposure to a stressor
— Presumably if older persons are more susceptible to the effects of a stressor, greater negative
effects of their psychosocial functioning could be expected, regardless of the type of trauma to
which they are exposed
— General Psychological Effects – depend heavily on the individual’s premorbid functioning, particularly
with regard to anxiety, depression and extant PTSD. Characteristics of the stressor and individual

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differences in coping skills appeared significant in this report.
— Physical Effects – Older adults are more likely to manifest trauma-related symptoms somatically
— Coping Strategies – younger soldiers were more likely to experience stress reactions after
combat exposure, suggesting that emotional maturity may increase resilience in coping
strategies

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— Much more research is needed – specific symptoms may differ in older adults. The
potential differences could lead to misdiagnosis




BROWN – SUBSTANCE ABUSE AND POST-TRAUMATIC STRESS DISORDER COMORBITY

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