National Center for PTSD, VA Boston Healthcare System.
VA New England Geriatric Research Education and Clinical Center, VA Boston Healthcare System.
Psychol Serv. 2023 Nov;20(4):863-875. doi: 10.1037/ser0000736. Epub 2023 Jan 26.
Later in life Veterans may report increased thoughts and memories of traumatic military experience in the context of age-related changes, a process called Later-Adulthood Trauma Reengagement (LATR); this process may lead to resilience or distress. We describe the development of a 10-session group intervention with goals of providing psychoeducation about LATR, enhancing stress management and coping skills, and fostering meaning making. We characterize implementation and outcome characteristics for seven group cohorts over 5 years; groups were completed in-person or virtually. Outcomes were measured with the Connor-Davidson Resilience Scale, Meaning in Life Scale, Satisfaction with Life Scale, Positive Appraisals of Military experience (PAMES), Posttraumatic Stress Disorder Checklist-5, and Patient Health Questionnaire-9. Forty-seven Veterans (aged 65-93) began the group, 37 (87%) completed at least six sessions. These 37 Veterans reported an average of eight stressful events in the prior year, mostly major illness, death of a friend, and decline in memory and enjoyable activities, which may have set the stage for LATR. Veterans resonated with the LATR concept on standardized scales and qualitative comments. In pre-post comparisons, participants reported higher levels of PAMES (η² = .225), resilience (η² = .208), and meaning in life (η² = .145), with fewer symptoms of PTSD (η² = .199) and depression (η² = .124). There were no significant differences in outcomes for those who completed the group in-person or virtually. The LATR protocol may provide a framework for working with older adults reporting emergence or exacerbation of thoughts and memories of earlier trauma in later life, fostering positive adaptation. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
晚年退伍军人可能会在与年龄相关的变化背景下报告创伤性军事经历的增加的想法和记忆,这一过程称为成年后期创伤再体验(LATR);这个过程可能会导致适应力或困扰。我们描述了一个 10 节小组干预的发展,其目标是提供关于 LATR 的心理教育,增强压力管理和应对技能,并培养意义。我们描述了在 5 年内完成的 7 个小组的实施和结果特征;小组是亲自或虚拟完成的。结果通过 Connor-Davidson 韧性量表、生活意义量表、生活满意度量表、对军事经历的积极评价量表(PAMES)、创伤后应激障碍检查表-5 和患者健康问卷-9 进行测量。47 名退伍军人(年龄 65-93 岁)开始参加小组,37 名(87%)至少完成了 6 次。这 37 名退伍军人报告称,在前一年中经历了 8 次压力事件,主要是重大疾病、朋友去世、记忆力和娱乐活动下降,这些可能为 LATR 奠定了基础。退伍军人在标准化量表和定性评论上对 LATR 概念产生共鸣。在前后比较中,参与者报告称 PAMES(η² =.225)、韧性(η² =.208)和生活意义(η² =.145)水平更高,创伤后应激障碍(η² =.199)和抑郁(η² =.124)症状更少。亲自或虚拟完成小组的参与者在结果上没有显著差异。LATR 方案可以为报告晚年出现或加剧早期创伤思想和记忆的老年人提供一个框架,促进积极适应。(PsycInfo 数据库记录(c)2023 APA,保留所有权利)。