Aging

If untreated, the psychological impact of violence can remain throughout one's life. Elderly populations display high levels of symptomatology related to early trauma.

Facts and Discussion Points:

* Approximately 818,000 elderly Americans were victims of domestic abuse in 1994. Two thirds of the victims were women.1

* Negative life events in childhood lead to a strong association between the number of negative life events experienced in adulthood and depressive symptoms in later life.2

* In a study of 14 elderly women (ages 68-83) with a history of severe depression, most were shown to have experienced significant childhood trauma.3

* Unresolved childhood sexual abuse in elderly women is characterized by chronic depression, re-victimization, and misdiagnosis of residual abuse trauma as dementia or mental illness.4

* Posttraumatic Stress Disorder may present many years after the original trauma. Elderly PTSD consumers often avoid talking about traumatic experiences due to associated distress. Without taking a military and trauma history from elderly consumers, a diagnosis of PTSD may be missed.5

* As external and internal resources diminish in the elderly population, psychological effects of trauma may reappear.6

* Elderly consumers who encounter psychological trauma earlier in life may have persisting symptoms including: marked disruptions of sleep and dreaming, intrusive memories, impairment of trust, avoidance of stressors, and heightened vulnerability to various types of age-associated retraumatization.7

Recommendations:

1---Health care and mental health care providers should take a comprehensive trauma history from elderly consumers, including military and interpersonal violence, and abuse experiences in childhood and adulthood. A diagnosis of PTSD should be followed by treatments known to be effective with elderly persons.

2---Statistics should be obtained (possibly through Medicare records) regarding the very high incidence of older women who are subjected to ECT.8

Aging References

1-Tatara, T., & Blumerman, L. (1996). Summaries of the statistical data on elder abuse in domestic settings: An exploratory study of state statistics for FY 95 and 96. Washington, DC: NCEA.

2-Kraaif, V., & de Wilde, E. J. (February 2001). Negative life events and depressive symptoms in the elderly: A life span perspective. Aging and Mental Health. Vol. 5(1).

3-Mullan, E., & Orrell, M. (March 1996). Early life experience in elderly women with a history of depression: A pilot study using the brief parenting interview. Irish Journal of Psychological Medicine, Vol. 13(1).

4-Allers, C. T., Benjack, K. J., Allers, N. T. (September-October 1992). Unresolved childhood sexual abuse: Are older adults affected? Journal of Counseling & Development, Vol. 71, Issue 1, p. 14.

5-Hilton, C. (August 1997). Media triggers of post-traumatic stress disorder 50 years after the Second World War. International Journal of Geriatric Psychiatry, Vol. 12, (8), pp. 862-7.

6-van der Kolk, B. A. (July 1996). Dissociation, somatization, and affect dysregulation: The complexity of adaptation of trauma. American Journal of Psychiatry, Vol. 153, (7 Suppl), pp. 83-93.

7-Sadavoy, J. (Fall 1997). Survivors. A review of the late-life effects of prior psychological trauma. American Journal of Geriatric Psychiatry, Vol. 5 (4), pp. 287-301.

8-R. Mazelis (personal communication, April 2002).