Subjective Age as a Moderator in the Reciprocal Effects Between Posttraumatic Stress Disorder Symptoms and Self-Rated Physical Functioning

Abstract

It is now widely acknowledged that physical decline may increase among middle-aged and older adults who suffer from posttraumatic stress disorder (PTSD). Much less is known about the temporal sequencing of PTSD and physical decline relationship over time. While PTSD can lead to physical decline, physical decline may preserve or augment existing PTSD symptoms. Both problems can also mutually affect each other forming a vicious cycle. Additionally, it is important to address variables that can mitigate these longitudinal effects. Following the recovery capital framework, we consider how the existence or lack of capital in the form of young age identity may affect the recovery process. Therefore, the current study aimed to examine the reciprocal effects of PTSD symptoms and self-rated physical functioning and further test whether one’s subjective age moderates these effects. Using in-region random digit dialing, we collected a stratified sample of community dwelling older adult residing in south Israel. Of that sample (N at T1 = 339), 132 older adults (age range = 51–88, mean age = 66.90, SD = 9.14) were interviewed 4 months after the 2014 Israel–Gaza conflict (T2) and 1 year later (T3). Participants responded to PTSD symptoms scale, and reported their physical functioning and subjective age. PTSD symptoms and self-rated physical functioning were tested as both predictors and outcomes in a cross-lagged model. The moderating effect of subjective age was assessed by examining whether T2 variables interacted with subjective age in predicting T3 outcomes. Results showed that higher PTSD symptoms at T2 were associated with subsequent lower self-rated physical functioning at T3, yet self-rated physical functioning at T2 did not predict PTSD symptoms at T3, thereby highlighting the PTSD self-rated physical function direction. Moreover, subjective age moderated this latter association, so that this relationship was significant only for those who felt relatively older. In addition to clarifying the temporal sequencing of the PTSD self-rated physical functioning association, the study further suggests that an older subjective age (i.e., lack of recovery capital) could render middle-aged and older adults more susceptible to physical decline following PTSD symptoms. We therefore propose to develop interventions aimed at coping with an older age identity and facilitating a younger age identity among traumatized older individuals.

Cultural differences in the association between subjective age and health: evidence from the Israeli component of the Survey of Health, Ageing and Retirement in Europe (SHARE-Israel)

“…In line with our first hypothesis, a younger subjective age was positively linked with all six outcome variables examining objective health, subjective health and psychological health. These findings are in line with a large amount of research demonstrating the beneficial association between one's younger age identity and one's physical (Westerhof et al, 2014;Shrira et al, 2018;Stephan et al, 2018) and psychological (Shrira et al, 2014(Shrira et al, , 2018Ayalon et al, 2016) health. As previously stated, Levy's stereotype embodiment theory (Levy, 2009) stipulates that holding negative age stereotypes may be harmful to older adults' physical and psychological health.…”

The Prevalence of PTSD and Depression Among Gaza Children

“…Despite the fact that depression among preschool-age is extremely rare (Kaplan & Sadock, 2007), our results show that 23.8 % of the children met the criteria of severe depression diagnosis (see Table 2 above; also, for discuss on relation between age and mental health, see Shrira et al, 2018). According to Kaplan and Sadock (2007), the rate of depression is 0.3 %in preschoolers.…”

Ageism and older people’s health and well-being during the Covid-19-pandemic: the moderating role of subjective aging

“…Besides the direct effect of subjective aging on health outcomes, those perceptions can also function as moderator in the relationship between predictors and health outcomes in later life. In the context of post-traumatic stress disease (PTSD) for example, people who felt comparatively older had a stronger negative relationship between PTSD symptoms and for instance physical functioning (Shrira et al 2018). Feeling older also increased the relationship between depressive symptoms and physical morbidity in a longitudinal study (Segel-Karpas et al 2017).…”