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Comparison of Clinician‐ and Self‐Assessments of Posttraumatic Stress Symptoms in Older Versus Younger Veterans

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Journal of Traumatic Stress

Published online on

Abstract

Assessment of posttraumatic stress disorder (PTSD) in older adults has received limited investigation. The purpose of this study was to compare the severity of PTSD symptoms in treatment‐seeking older and younger U.S. veterans with PTSD. Participants were 360 male and 284 female veterans enrolled in 2 separate clinical trials of psychotherapy for PTSD. About 4% of the participants were age 60 years or older. Symptoms were assessed before treatment using clinician‐rated and self‐report measures. For men, only numbing symptoms were lower in older veterans; this was so in clinician ratings, d = 0.76, and self‐reports, d = 0.65. For women, clinician‐rated hyperarousal symptoms were lower in older veterans, d = 0.57. Clinician‐rated and self‐reported symptoms were strongly related, Bs = 0.95 and 0.80 in the male and female samples, respectively. Among men, clinician‐rated and self‐reported reexperiencing and hyperarousal symptoms were associated only in younger veterans. Accurate assessment of PTSD symptoms in older adults is essential to identifying and implementing effective treatment. Our findings suggest that some symptoms may be lower in older men, and that some symptoms of PTSD may be underdetected in older women. Future research should assess the combined effect of gender and age on PTSD symptom presentation. 標題:年長和年輕退役軍人中醫生評核和自我評估的創傷後壓力症狀的比較。 撮要:我們對年長成人的創傷後壓力症(PTSD)評估只有有限度研究。本文旨在比較尋求治療而患有PTSD的年長和年輕退役兵的PTSD症狀。樣本是360名男性和284名女性退役軍,分別從2個獨立的PTSD臨床心理治療研究中錄取,而其中4%是年齡60或以上。治療前先以醫生評估和自我報告量度症狀。男士中年長者只有麻木症狀有較低程度(醫生評估,d=0.76,和自我報告,d=0.65);而女士中年長者只有醫生評估過激症狀有較低程度,d=0.57。醫生評估和自我報告症狀強烈地相連,分別在男和女樣本中Bs=0.95和.80。男性中只有年輕者的醫生評估和自我報告再經歷及過激症狀有相關。準確的PTSD症狀評估在年長者是必須的,有助辨識和採用有效療法。結果指出在年長男士中有些症狀可能較輕,而年長女士中PTSD的某些症狀較難發現。未來研究必須評估性別和年齡對PTSD症狀表現的綜合效果。 标题:年长和年轻退役军人中医生评核和自我评估的创伤后压力症状的比较。 撮要:我们对年长成人的创伤后压力症(PTSD)评估只有有限度研究。本文旨在比较寻求治疗而患有PTSD的年长和年轻退役兵的PTSD症状。样本是360名男性和284名女性退役军,分别从2个独立的PTSD临床心理治疗研究中录取,而其中4%是年龄60或以上。治疗前先以医生评估和自我报告量度症状。男士中年长者只有麻木症状有较低程度(医生评估,d=0.76,和自我报告,d=0.65);而女士中年长者只有医生评估过激症状有较低程度,d=0.57。医生评估和自我报告症状强烈地相连,分别在男和女样本中Bs=0.95和.80。男性中只有年轻者的医生评估和自我报告再经历及过激症状有相关。准确的PTSD症状评估在年长者是必须的,有助辨识和采用有效疗法。结果指出在年长男士中有些症状可能较轻,而年长女士中PTSD的某些症状较难发现。未来研究必须评估性别和年龄对PTSD症状表现的综合效果。