Health status and treatment-seeking stigma in older adults with trauma and posttraumatic stress disorder

Abstract

Abstract-This study compared health status across four trauma/posttraumatic stress disorder (PTSD) groups of older adults with depression, anxiety, and/or at-risk drinking who attended primary care appointments (N = 1,199; mean age = 73.5 yr), mostly at Department of Veterans Affairs hospitals. The trauma and PTSD categories were PTSD (n = 81), partial PTSD (n = 127), trauma only (n = 323), and no trauma (n = 668). Physical and mental health-related quality of life (HQL), indices of social and economic impairment and stigma regarding treatment-seeking were compared among groups. Group differences were found for several indicators of functional impairment; the PTSD group had fewer close friends and higher treatment-seeking stigma beliefs related to having a disorder. Linear mixed modeling examined associations between trauma/PTSD group and HQL. After accounting for covariates, the trauma/PTSD groups differed across the Medical Outcome Study Short Form-36 scales and component scores (indicated by significant group by scale interaction). Differences among groups were confined to mental health measures; those with PTSD had worse HQL. Post hoc analyses examined the number of comorbid psychiatric diagnoses by trauma/PTSD group. Overall, findings indicate that mental HQL varies among older adults with trauma and PTSD and that although treatmentrelated stigma does not differ among groups, it does affect HQL.

The relationship between depression and sexual health service utilization among men who have sex with men (MSM) in Côte d'Ivoire, West Africa

“…Social stigma included feeling like police refused to protect, being arrested on charges of homosexuality, ever being jailed, being scared to walk in public, being verbally harassed, blackmailed, or physically hurt because of having sex with men. The cumulative, dichotomized “yes”/“no” responses, for each category of stigma [43] (i.e., family/friend, health care and social stigma) were used in the logistic regression models. Health care stigma was further categorized using as perceived or enacted.…”

Practice Considerations for Trauma-Informed Care at End of Life

“…Trauma-related symptoms may impact social support networks and communication with healthcare providers. People with PTSD often have stressed social relationships and fewer social supports (King et al, 2006), which can result in fewer informal caregivers available to help at end of life (Glick et al, 2018;Kaiser et al, 2016). They also often have difficulty trusting authority figures, such as medical providers, which can make the difficult conversations that must occur near end of life even harder (Glick et al).…”

Geriatric Mental Health

“…But a subset of those exposed continue to experience symptoms like hypervigilance, nightmares, avoidance, flashbacks, distressing memories, and negative alterations in cognitions even after 3 months. Older adults may report somatic complaints more than the classic psychological symptoms (Kaiser et al 2016). Depressive disorder, generalized anxiety disorder, and substance use disorders are the most prevalent psychiatric comorbidities in older patients with PTSD (citation).…”