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Typologies of posttraumatic stress disorder in treatment-seeking older adults

Published online by Cambridge University Press:  19 September 2014

Maria Böttche ,
Robert H. Pietrzak ,
Philipp Kuwert  and
Christine Knaevelsrud
Maria Böttche*
Affiliation:
Berlin Center for Torture Victims, Berlin, Germany Freie University Berlin, Department of Clinical Psychology and Psychotherapy, Germany
Robert H. Pietrzak
Affiliation:
United States Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, USA Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
Philipp Kuwert
Affiliation:
Ernst-Moritz-Arndt-University, Department of Psychiatry and Psychotherapy at the HELIOS Hansehospital Stralsund, Germany
Christine Knaevelsrud
Affiliation:
Berlin Center for Torture Victims, Berlin, Germany Freie University Berlin, Department of Clinical Psychology and Psychotherapy, Germany
*
Correspondence should be addressed to: Maria Böttche, Treatment Centre for Torture Victims, Turmstraße 21, 10559 Berlin, Germany. Phone: +0049/30/303 906 32; Fax: +0049/30/306 143 71. Email: m.boettche@bzfo.de.
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Abstract

Background:

While it is well known that posttraumatic stress disorder (PTSD) is characterized by heterogeneous symptom clusters, little is known about predominant typologies of PTSD symptoms in older adults.

Methods:

Latent profile analyses (LPAs) were employed to evaluate predominant typologies of PTSD symptoms in a sample of 164 treatment-seeking older adults with childhood war-related trauma. Multinomial logistic regressions were conducted to evaluate predictors of class membership.

Results:

LPAs revealed that a 3-class solution best fit the data. These included an Intermediate Disturbance class (50.0%) and two Pervasive Disturbance classes, which differed with respect to severity of avoidance symptoms (Pervasive Disturbance-Low Avoidance: 33.5%, Pervasive Disturbance-High Avoidance: 16.5%). A greater number of traumatic events predicted membership in the Pervasive Disturbance classes. The Pervasive Disturbance-Low Avoidance class had a higher level of education than the Pervasive Disturbance-High Avoidance class. Compared to the Intermediate Disturbance class, the Pervasive Disturbance classes had the highest levels of depression, anxiety and somatization symptoms.

Conclusion:

These results suggest that PTSD in treatment-seeking older adults may be characterized by three predominant typologies, which are differentiated by overall severity and avoidance symptoms, lifetime trauma burden, education level, and comorbid depression, anxiety, and somatization symptoms. These results underscore the importance of considering heterogeneity in the phenotypic presentation of PTSD in assessment and treatment approaches for this disorder in older adults.

Keywords

latent profile analysistypologyolder adultsearly-life traumatizationPTSD
Type
Research Article
Information
International Psychogeriatrics , Volume 27 , Issue 3 , March 2015 , pp. 501 - 509
Copyright
Copyright © International Psychogeriatric Association 2014 

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