Post-trauma factors associated with Posttraumatic Stress Disorder severity in older adults: a systematic review; and, The mediating role of early maladaptive schemas in the relationship between childhood traumatic events and Complex Posttraumatic Stress Disorder symptoms in older adults (>64 years)
Background: Research in Posttraumatic Stress Disorder (PTSD) and Complex PTSD (CPTSD) has traditionally focused on either children or adults, while older adults tend to be under-represented in trauma research. This has led researchers to argue that PTSD/CPTSD is under-diagnosed and under-treated within this population. A better understanding of the presentation and correlates of posttraumatic symptoms in later life is needed in order to inform assessment and the development of targeted interventions for older adults. Method: A systematic review was conducted to explore factors associated with PTSD/CPTSD severity in older adults. This review identified gaps in the literature, including a dearth of research exploring childhood trauma. The subsequent empirical study attempts to address this gap by investigating the link between childhood trauma, Early Maladaptive Schemas (EMS), and CPTSD symptoms. Results: The systematic review showed that coping/response, physiological and psychopathological factors exhibited the most consistent associations with PTSD severity. The empirical study added to this literature by demonstrating that EMS mediated the relationship between childhood trauma and CPTSD symptom severity. As CPTSD is a relatively new construct, this is the first study exploring its association with EMS and offers preliminary evidence on the potential efficacy of schema informed interventions following traumatisation. Conclusion: Both the empirical study and the systematic review highlight factors affecting posttraumatic symptom severity in older people and have important implications for PTSD/CPTSD identification and treatment.