Davison Eve H, Kaiser Anica Pless, Spiro Avron, Moye Jennifer, King Lynda A, King Daniel W
National Center for Posttraumatic Stress Disorder, VA Boston Healthcare System, Boston, Massachusetts. Department of Psychiatry, Boston University School of Medicine, Massachusetts.
Massachusetts Veterans Epidemiology Research and Information Center, VA Boston Healthcare System, Boston, Massachusetts. Department of Epidemiology, Boston University School of Public Health, Massachusetts.
Gerontologist. 2016 Feb;56(1):14-21. doi: 10.1093/geront/gnv097. Epub 2015 Nov 9.
About a decade ago we proposed the notion of late-onset stress symptomatology, to characterize the later-life emergence of symptoms related to early-life warzone trauma among aging combat Veterans. We hypothesized that aging-related challenges (role transition and loss, death of family members and friends, physical and cognitive decline) might lead to increased reminiscence, and possibly distress, among Veterans who had previously dealt successfully with earlier traumatic events. Recently, we have reexamined our earlier ideas, to better reflect our developing understanding of this phenomenon, and to incorporate more contemporary perspectives on posttraumatic growth and resilience. As a result, we have broadened our conceptualization to later-adulthood trauma reengagement (LATR). We suggest that in later life many combat Veterans confront and rework their wartime memories in an effort to find meaning and build coherence. Through reminiscence, life review, and wrestling with issues such as integrity versus despair, they intentionally reengage with experiences they avoided or managed successfully earlier in life, perhaps without resolution or integration. This article links LATR to classic gerontologic notions, and elaborates how the LATR process can lead positively to personal growth or negatively to increased symptomatology. We also address the role of preventive intervention in enhancing positive outcomes for Veterans who reengage with their wartime memories in later life.
大约十年前,我们提出了迟发性应激症状学的概念,以描述老年退伍军人中因早年战区创伤而在晚年出现的相关症状。我们假设,与衰老相关的挑战(角色转变与丧失、家人和朋友离世、身体和认知能力下降)可能会导致那些曾成功应对早期创伤事件的退伍军人的回忆增加,甚至可能引发痛苦。最近,我们重新审视了我们早期的观点,以更好地反映我们对这一现象不断发展的理解,并纳入对创伤后成长和复原力的更多当代观点。因此,我们将概念扩展为成年后期创伤再接触(LATR)。我们认为,在晚年,许多退伍军人会直面并重新审视他们的战时记忆,试图从中找到意义并建立连贯性。通过回忆、人生回顾,以及与诸如完整性与绝望等问题作斗争,他们有意再次接触那些他们早年曾回避或成功应对的经历,或许这些经历当时并未得到解决或整合。本文将LATR与经典老年学概念联系起来,并阐述了LATR过程如何可能积极地导致个人成长,或消极地导致症状增加。我们还探讨了预防性干预在为晚年重新接触战时记忆的退伍军人增强积极结果方面的作用。