Brief ReportProlonged Exposure Therapy for Older Veterans With Posttraumatic Stress Disorder: A Pilot Study
Section snippets
Participants
All participants sought care from the PTSD Clinical Team at the VA San Diego Healthcare System. Study inclusion criteria included 1) PTSD due to a military event; 2) age 55 years or older; and 3) no change in type or dosage of psychotropic medications in the past 2 months. Exclusion criteria were 1) lifetime history of psychosis or manic episode; 2) alcohol or other substance dependence in past 6 months; and 3) alternate psychotherapy for PTSD concurrent with the study.
Clinician-Administered PTSD Scale7
The
RESULTS
Twenty-three subjects were referred to the study. Of the 12 Veterans who were referred but not enrolled, 3 did not complete the screening process and 9 were not eligible, mostly because they did not meet full PTSD criteria. Among the 11 Veterans enrolled, 3 dropped out before completing treatment (1 moved out of state, 1 had scheduling conflicts, and 1 was diagnosed with cancer and chose not to continue) and did not return for posttreatment assessment. This dropout rate (27%) is similar to that
DISCUSSION
This study suggests the feasibility of recruitment, assessment, and exposure-based treatment of older Veterans with PTSD from distant military-related events. The traumatic events identified by the Veterans in our samples had occurred, on average, four decades prior to the study. Despite the chronic nature of the PTSD, Veterans who completed 6 weeks of PE showed a significant reduction in clinician-rated and self-reported PTSD symptoms. Using the interpretation of CAPS scores suggested by
References (19)
- et al.
A meta-analytic review of prolonged exposure for posttraumatic stress disorder
Clin Psychol Rev
(2010) - et al.
Meta-analysis comparing different behavioral treatments for late-life anxiety
Am J Geriatr Psychiatry
(2009) - Bottche M, Kuwert P, Knaevelsrud C: Posttraumatic stress disorder in older adults: an overview of characteristics and...
- et al.
Assessing late-onset stress symptomatology among aging male combat veterans
Aging Ment Health
(2007) - et al.
Prolonged exposure for PTSD in a Veterans Health Administration PTSD clinic
J Trauma Stress
(2009) - et al.
Cognitive behavioral therapy for posttraumatic stress disorder in women: a randomized controlled trial
JAMA
(2007) - et al.
Prolonged exposure therapy for older combat veterans in the VA Healthcare System
- et al.
The development of a Clinician-Administered PTSD Scale
J Trauma Stress
(1995) - et al.
The assessment of posttraumatic stress disorder: with the Clinician Administered PTSD Scale: Dutch results
J Clin Psychol
(1994)
Cited by (58)
Prolonged Exposure Therapy With an Older Adult: An Extended Case Example
2022, Cognitive and Behavioral PracticeCognitive treatment of post-traumatic stress disorder in the elderly. A longitudinal study
2021, EncephaleCitation Excerpt :In the cases studied, PTSD symptoms were qualitatively and quantitatively reduced during treatment. Indeed, a recent literature review indicates that treatment of PTSD in the elderly, based on exposure techniques, provides at least significant systematic improvements in trauma symptoms [36], while a pilot study conducted on 11 war veterans showed that six sessions of trauma exposure improved short-term symptomatology [32]. However, the data are still scarce and no longer-term scientific research seems to have validated the initial results from these case studies [37].
Examining military population and trauma type as moderators of treatment outcome for first-line psychotherapies for PTSD: A meta-analysis
2019, Journal of Anxiety DisordersCitation Excerpt :Participants with exposure to terror-related trauma were assigned to the mixed trauma category because this was the only study that included terror-related trauma. Studies by Rauch et al. (2009) and Thorp et al. (2012) also reported combat, assault, and mixed trauma type categories. However, only the combat trauma participants were included for these two studies because of small sample size (n < 3) in the other trauma categories (see Fig. 3).
A randomized controlled trial of prolonged exposure therapy versus relaxation training for older veterans with military-related PTSD
2019, Journal of Anxiety DisordersPost-traumatic stress disorder secondary to Alzheimer's disease: Emergence of an underlying pathology in the oldest old
2017, Annales Medico-PsychologiquesEfficacy and Feasibility of a Therapist-Guided Internet-Based Intervention for Older Persons with Childhood Traumatization: A Randomized Controlled Trial
2017, American Journal of Geriatric PsychiatryCitation Excerpt :Research with other samples of German World War II survivors also indicates low levels of depressive and anxiety symptoms,35,36 which might point to a specificity of the subgroup. Therefore, no comorbidity with typical trauma-related mental symptoms could be identified that is contrary to the literature.2,12 Integrative TT was associated with a significant increase in quality of life and self-efficacy from pre- to post-treatment with moderate within-effect sizes.
Dr. Thorp was awarded seed funding for this project from the Advanced Center for Innovation in Services and Interventions Research (PI: DVJ). Dr. Thorp's work is currently supported by a Career Development Award from the VA.
There are no disclosures to report.