The COVID-19 Pandemic as a Traumatic Stressor: Mental Health Responses of Older Adults With Chronic PTSD

• Published in: The American journal of geriatric psychiatry Vol. 29; no. 2; p. 105
• Main Authors: Rutherford, Bret R, Choi, C Jean, Chrisanthopolous, Marika, Salzman, Chloe, Zhu, Carlen, Montes-Garcia, Carolina, Liu, Ying, Brown, Patrick J, Yehuda, Rachel, Flory, Janine, Neria, Yuval, Roose, Steven P
• Format: Journal Article
• Language: English
• Published: England 01.02.2021
• Subjects: Adaptation, Psychological; Aged; COVID-19 - epidemiology; COVID-19 - psychology; Depression - diagnosis; Depression - ethnology; Female; Humans; Life Change Events; Loneliness - psychology; Male; Mental Health; Middle Aged; New York - epidemiology; Protective Factors; Psychiatric Status Rating Scales; Resilience, Psychological; Risk Factors; SARS-CoV-2; Stress Disorders, Post-Traumatic - diagnosis; Stress Disorders, Post-Traumatic - ethnology; Stress Disorders, Post-Traumatic - physiopathology; Stress, Psychological - diagnosis; Stress, Psychological - etiology; Stress, Psychological - prevention & control; Stress, Psychological - psychology; New York; COVID-19; older adult; post-traumatic stress disorder; loneliness
• ISSN: 1545-7214
• DOI: 10.1016/j.jagp.2020.10.010

Individuals with post-traumatic stress disorder (PTSD) who experience additional traumas or stressful life events may undergo symptomatic worsening, but no data exist on whether exposure to the COVID-19 pandemic in a high infection area worsens mental health among older adults with chronic PTSD. Seventy-six older adults (N = 46 with PTSD and N = 30 trauma-exposed comparison subjects [TE]) for whom prepandemic data were available were interviewed between April 1 and May 8, 2020 to quantify depressive (Hamilton Rating Scale for Depression [HRSD]) and PTSD symptom (Post-traumatic Stress Disorder Checklist [PCL-5]) levels. Group differences in baseline characteristics as well as pre-post pandemic symptom levels were examined, and participant characteristics were assessed as moderators of symptom change. Compared to TEs, individuals with PTSD more often reported living alone and experiencing a physical illness (χ  = 5.1, df = 1, p = 0.02). PCL-5 scores among individuals with PTSD decreased during the COVID-19 pandemic by 7.1 points (t(69) = -3.5, p = 0.0008), whereas the TE group did not change significantly. Overall no significant differences in HRSD were found between groups, but a race or ethnicity variable was found to moderate HRSD symptom change. Non-black or Hispanic individuals with PTSD experienced significantly increased HRSD scores during the pandemic compared to black or Hispanic PTSD participants. The findings are indicative of complexity in the responses of older individuals with PTSD to further stressful life events as well as possibly unique aspects to the COVID-19 pandemic as a stressor. Sources of resilience may exist based on experience with prior traumas as well as increasing age promoting more adaptive coping styles.