Information Processing of Sexual Abuse in Elders

Ann W. Burgess; Paul T. Clements

Disclosures

J Foren Nurs. 2006;2(3):113-120. 

In This Article

PTSD in Elders

PTSD as a formal psychiatric entity appeared in the Diagnostic and Statistical Manual of Mental Disorders in 1980. Until that time, it was recognized that traumatic events could leave a distinct collection of symptoms. For example, rape trauma syndrome was introduced into the literature in 1974 (Burgess & Holmstrom). Until 1980, the symptoms included manifestations of shell shock, combat fatigue, war neurosis, and railroad shock and the majority of persons studied represented younger adults in contrast to person's aged 60 and older.

Averill & Beck (2000) note there is no prevalence data on PTSD in elders who have been victimized by others as in a crime or other forms of abuse. However, the literature suggests elder victims may meet the diagnostic criteria for PTSD and, of note, Falk, van Hasselt, & Hersen (1997) suggest older victims of rape are particularly likely to experience PTSD. Delayed onset of PTSD is an infrequently diagnosed variant of the disorder and is receiving attention among older combat veterans (Sleek, 1998). One explanation is that older adults may experience a reduction in physical and mental resilience over time that reduces their ability to "ward off" trauma-related memories and feelings (Aarts & Op Den Velde, 1996). Another explanation is that older adults have more time to reflect on events that occurred earlier in their life after the demands of job and families are lessened, especially with retirement (Averill & Beck, 2000; Ceci & Tabor, 1981; Kahana, 1996; Kahana, Howard, Zaromb, & Wingfield, 2002).

Another reality with older adults is comorbid disorders. There are many medical conditions attributed to elders including cardiac, respiratory, and cognitive problems as well as psychiatric disorders including depression, substance misuse, and personality disorders many of which may mimic diagnoses on the anxiety continuum, including PTSD (Iancu, Sasson, Dannon, & Zohar, 1998; Morrison, 1997).

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