Treating trauma-related disorders in later life

Abstract

Abstract Background. Older adults present a growing population in society and in mental health services. Among seniors, post-traumatic stress disorder (PTSD) frequently presents a hidden disorder, calling for effective psychotherapy. In the field of psychological treatment for older adults PTSD patients, insufficient evidence regarding treatment efficacy for this population was found. Aim: to expand the evidence about psychological treatment for older PTSD patients. Method: The effectiveness of narrative exposure therapy (NET) across varying studies was meta-analytically evaluated, outcomes of NET and Present Centered Therapy (PCT) were compared in an RCT with older adults (≥ 55 years of age), treatment-related cognitions and emotions in NET participants were qualitatively explored and finally, advancing age and other life-span factors were investigated using a predictor analysis in a naturalistic sample involving refugees of varying age. Results: Good treatment results from NET were found for older adults. For older PTSD patients, both NET and PCT show the potential to significantly reduce PTSD symptoms; in addition, PCT can improve psychosocial adjustment. Older adults can change long-standing self-directed beliefs, even after long-past childhood trauma. Neither advancing age, nor pre-treatment distress predicted treatment response. Discussion: This study highlights the importance of psychosocial adaptation, personal history and self-perceptions in recovering from PTSD. Both NET and PCT are safe and effective treatment interventions. These findings suggest that pessimistic expectations about psychotherapy with older PTSD patients are unfounded. Just as PTSD is considered a hidden variable the lives of older adults, resilience may be a hidden factor in treatment and recovery.