Cumulative trauma: The intersection between continuous security threats and the COVID-19 pandemic among Israeli older adults.

Abstract

Introduction: Research on cumulative traumatic events and their consequences for older adults have yielded inconclusive findings, especially when the traumatic events are different types of events and happen simultaneously. Objective: To explore older adults' perceptions of cumulative trauma, specifically exposure to continuous security threats via living in a war zone and COVID-19. Method: Seventeen in-depth, openended, and semistructured interviews were conducted with older adults living near Israel's border with Gaza. We used ATLAS.ti software to perform thematic analysis. Results: Various perceptions of continuous security-related stress and COVID-19, indicative of categorical differences in the perceptions of the two, were found. Namely, the characteristics, difficulties, and emotions that accompanied each of the two abovementioned traumas revealed three trajectories: negative cumulative; positive cumulative; and unrelated. Conclusions: We suggest conceptualizing cumulative trauma responses as an intersecting trajectory model, between the effects of previous traumatic events and those of the current one, reflecting a combination of individuals' resilience and vulnerability. Suitable policies/practices in which each specific traumatic event is seen alone, as well as in tandem with others, should be implemented. Clinical Impact StatementThis article proposes a new conceptualization of cumulative trauma responses as an intersecting model between the effects of previous traumatic events and those of the current one, reflecting a combination of individuals' resilience and vulnerability. This model suggests seeing each specific traumatic event (i.e., COVID-19 and missile attacks) alone, and with others, and identifying the trajectory of cumulative effects. Our results highlight the need for policymakers and professionals to see the older population as comprising unique individuals: to identify those who experience distress and are highly vulnerable, as opposed to those who are resilient, in the aftermath of their traumas.