Culver Clare, Carter Emily, Fiallo Olivia, Wang Nancy, Waxenberg Talya, Banerjee Samprit, Rollandi Isabel, Sirey Jo Anne
Institute of Geriatric Psychiatry, Department of Psychiatry (CC, NW, TW, IR, JS), Weill Cornell Medicine, White Plains, NY.
Department of Population Health Sciences (EC, SB), Weill Cornell Medicine, White Plains, NY.
Am J Geriatr Psychiatry. 2025 Jun 18. doi: 10.1016/j.jagp.2025.06.010.
High rates of depression and suicidal ideation among elder abuse (EA) victims have been documented, but few studies have examined post-traumatic stress disorder (PTSD) symptoms in this population. This study assessed PTSD symptom rates and presentation among EA victims with depression and evaluated PTSD symptom trajectories throughout PROTECT, a brief behavioral intervention.
Depressed (PHQ-9 ≥ 10) EA victims with no cognitive impairment (Mini MoCA ≥ 11) were referred by partner agencies and consented by research staff. Eligible participants received nine weeks of PROTECT and were assessed at baseline, weeks 6 and 9. The study was approved by the Weill Cornell IRB (Protocol #19-09020854).
EA victims with depression in NYC were referred to study team for 9 weeks of psychotherapy in NIMH funded trial P50 MH113838.
40 elder abuse victims with depression and no cognitive impairment.
PROTECT is a brief behavioral psychotherapy delivered remotely in nine weekly 45-minute sessions.
PTSD Checklist for DSM-5 (PCL-5) and Life Events Checklist (LEC) assessed trauma symptoms and history; MADRS assessed depression severity. Mixed-effects models examined presence and change in PTSD symptoms across treatment, adjusting for covariates.
60% of participants met the criteria for probable PTSD (PCL-5 ≥ 31) at baseline. These individuals had significantly higher baseline depression scores. PTSD symptoms significantly decreased across treatment, even after adjusting for demographic or trauma-related variables.
PTSD symptoms are highly prevalent among depressed EA victims. Participants who received the PROTECT psychotherapy intervention demonstrated reductions in PTSD symptoms. Results underscore the potential utility of brief, remotely delivered psychotherapy in addressing trauma-related distress among EA victims and highlight the importance of integrating PTSD-focused care into services for this high-risk population.
已有文献记载老年虐待（EA）受害者中抑郁症和自杀意念的发生率很高，但很少有研究调查该人群的创伤后应激障碍（PTSD）症状。本研究评估了伴有抑郁症的EA受害者的PTSD症状发生率和表现，并在一项简短行为干预“保护计划”（PROTECT）中评估了PTSD症状轨迹。
由合作机构转介且经研究人员同意的无认知障碍（简易蒙特利尔认知评估量表[Mini MoCA]≥11）的抑郁（患者健康问卷-9[PHQ-9]≥10）EA受害者。符合条件的参与者接受为期九周的“保护计划”，并在基线、第6周和第9周接受评估。该研究获得了威尔康奈尔机构审查委员会的批准（协议编号19 - 09020854）。
在由美国国立精神卫生研究所资助的试验P50 MH113838中，纽约市患有抑郁症的EA受害者被转介到研究团队接受为期9周的心理治疗。
40名患有抑郁症且无认知障碍的老年虐待受害者。
“保护计划”是一种简短的行为心理治疗，通过每周一次、每次45分钟的远程方式进行，共九次。
《精神疾病诊断与统计手册》第5版创伤后应激障碍检查表（PCL - 5）和生活事件检查表（LEC）评估创伤症状和病史；蒙哥马利-艾森伯格抑郁评定量表（MADRS）评估抑郁严重程度。混合效应模型检查了整个治疗过程中PTSD症状的存在情况和变化，并对协变量进行了调整。
60%的参与者在基线时符合可能患有PTSD的标准（PCL - 5≥31）。这些个体的基线抑郁评分显著更高。即使在对人口统计学或创伤相关变量进行调整后，PTSD症状在整个治疗过程中仍显著下降。
PTSD症状在患有抑郁症的EA受害者中非常普遍。接受“保护计划”心理治疗干预的参与者的PTSD症状有所减轻。研究结果强调了简短的远程心理治疗在解决EA受害者创伤相关困扰方面的潜在效用，并突出了将以PTSD为重点的护理纳入针对这一高危人群的服务中的重要性。
