A meta-analysis of cognitive functioning in older adults with PTSD.

A meta-analysis was conducted to summarize and integrate the literature on the cognitive functioning of older adults with posttraumatic stress disorder (PTSD). We hypothesized that those with PTSD would exhibit worse performance in each of the cognitive domains studied when compared to older adults without PTSD. Major databases were queried and eleven articles met criteria for review. As predicted, there was evidence of worse performance across cognitive measures in older adult samples with PTSD relative to older samples without PTSD. The strongest effect across samples was found for lower test scores in the broad domain of memory among older adults with PTSD, and there was evidence that trauma exposure is uniquely associated with worse performance on tests specific to learning. We outline factors thought to contribute to the interactions among PTSD, cognitive deficits, and the aging process. These findings highlight the need for thorough evaluation of cognitive functioning in older adults with PTSD, particularly in the areas of processing speed, learning, memory, and executive functioning.

Abbreviated Posttraumatic Stress Screen for Ethnically Diverse Older Women.

It is difficult for busy health care providers to perform routine screening for older women's posttraumatic stress symptomatology, due, at least partially, to a paucity of instruments specifically tested on such a population. To address this issue, in this preliminarily study we tested an abbreviated screen from the set of 20 items comprising the Distressing Event Questionnaire (DEQ; Kubany, Leisen, Kaplan, & Kelly, 2000) on a convenience sample of 94 ethnically diverse older women (ages 52-105). This new 5-item derivation, named "Brief Posttraumatic Stress Screening Scale (BPSSS)", assesses posttraumatic stress based on the Diagnostic and Statistical Manual of Mental Disorders - IV (DSM-IV; American Psychiatric Association, 1994). Its conciseness reduces the likelihood that older women would become fatigued during assessment, making it ideal for use in busy health care settings. Because the BPSSS has only five items, a single factor was hypothesized to account for a large proportion of the variance in its items, in view of the hypothesized cohesiveness of the tool's five items. We also expected that scores on the screen would correlate (to a certain extent) with those on measures of depression and perceived stress of a non-traumatic and non-medical nature. A standardized alpha of .86 demonstrated high internal consistency of the BPSSS and the exploratory factor analysis showed that one factor accounted for 58% of the five items' variance. Moreover, the correlations of BPSSS scores with scores on non-traumatic stress and depression were moderate yet significant (r = .37, p < .01 and r = .50, p < .01, respectively).