Predictors and (in-)stability of ICD-11 complex posttraumatic stress disorder in older adults: findings from a longitudinal study in Switzerland

Eur J Psychotraumatol. 2024;15(1):2299618. doi: 10.1080/20008066.2023.2299618. Epub 2024 Jan 23.

Abstract

Objective: There is a lack of research on complex post-traumatic stress disorder (CPTSD) in older individuals, with little known about the temporal course of CPTSD. Therefore, this study assessed and compared the demographic characteristics, adverse childhood experiences (ACE), and well-being of Swiss older adults with and without probable CPTSD. The (in-)stability of probable CPTSD was also examined in relation to the predictive value of various emotion-related factors.Methods: A longitudinal study was conducted in Switzerland with N = 213 participants (Mage = 69.98 years, SD = 10.61; 45.5% female). Data was collected via face-to-face assessments at baseline and follow-up, 21 months apart. The German version of the International Trauma Questionnaire was used to screen for (C)PTSD. Standardized instruments were used to assess ACE as well as the predictors anger, embitterment, emotion regulation, and meaning in life.Results: From the total sample, n = 16 participants (7.5%) were identified as having probable CPTSD, with only five of these (31.25%) having probable CPTSD at both baseline and follow-up. Individuals with and without probable CPTSD differed significantly regarding age and employment status. Significant predictors of probable CPTSD were anger (β = 0.16), embitterment (β = 0.06), cognitive reappraisal (β = -0.41), and the presence of meaning in life (β = -0.10).Conclusions: Probable CPTSD appears to be relatively unstable over the course of a 21-month period in older individuals. The links between CPTSD and emotion-related predictors highlight potential targets for intervention.

Objetivo: Hay una falta de investigación sobre el trastorno de estrés postraumático complejo (TEPTC) en las personas mayores, y se sabe poco sobre el curso temporal del TEPTC. Por lo tanto, este estudio evaluó y comparó las características demográficas, las experiencias adversas de la infancia (ACE), y el bienestar de los adultos mayores suizos con y sin probable TEPTC. La (in)estabilidad del probable TEPTC también se examinó en relación con el valor predictivo de varios factores relacionados con las emociones.

Método: Se realizó un estudio longitudinal en Suiza con N = 213 participantes (Media de Edad = 69.98 años, DE = 10.61; 45.5% mujeres). Los datos se recopilaron mediante evaluaciones cara a cara al inicio y en el seguimiento, con 21 meses de diferencia. Se utilizó la versión alemana del Cuestionario Internacional de Trauma para detectar TEPT(C). Se utilizaron instrumentos estandarizados para evaluar las ACE, así como los predictores de ira, amargura, regulación de las emociones, y significado de la vida.

Resultados: De la muestra total, se identificó que n = 16 participantes (7.5%) tenían probable TEPTC, y solo cinco de ellos (31.25%) tenían probable TEPTC tanto al inicio como en el seguimiento. Los individuos con y sin TEPTC probable diferían significativamente en cuanto a edad y situación laboral. Los predictores significativos de probable TEPTC fueron la ira (β = 0.16), la amargura (β = 0.06), la reevaluación cognitiva (β = −0.41) y la presencia de significado en la vida (β = −0.10).

Conclusiones: El probable TEPTC parece ser relativamente inestable en el transcurso de un período de 21 meses en las personas mayores. Los vínculos entre el TEPTC y los predictores relacionados con las emociones resaltan objetivos potenciales para la intervención.

Keywords: Adverse childhood experiences; Experiencias adversas en la infancia; adultos mayores; complex post-traumatic stress disorder; emotion-related factors; estudio longitudinal; factores relacionados con las emociones; longitudinal study; older adults; trastorno de estrés postraumático complejo.

Plain language summary

Older adults with and without probable CPTSD differ in terms of age, employment status, adverse childhood experiences, psychiatric comorbidities, well-being, and life satisfaction.Temporal (in-)stability: In older adults, probable CPTSD appears to be unstable over a 21-month period with around one-third of the participants showing a stable course.Treatment targets: The identified significant predictors anger, embitterment, cognitive reappraisal, and the presence of meaning in life beliefs are potential treatment targets.

MeSH terms

  • Aged
  • Emotions
  • Female
  • Humans
  • International Classification of Diseases
  • Longitudinal Studies
  • Male
  • Stress Disorders, Post-Traumatic* / epidemiology
  • Switzerland / epidemiology

Grants and funding

This work was supported by the Swiss Government Excellence Scholarship [grant number ESKAS-Nr. 2016.0109]; Schweizerischer Nationalfonds [grant number 407640_177355/1]; Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung [grant number 407640_177355/1].