The Holocaust Experience and Its Role in the Association Between Meaning in Life, Depressive Symptoms and Life Satisfaction.

Holocaust survivors often reveal long-term depressive symptoms, while demonstrating life satisfaction. The present study examined the role of meaning in life (MIL) of Holocaust survivors in this context. Survivors (n = 44) and comparisons (n = 51) provided background information and completed MIL, depressive symptoms, and life satisfaction scales. MIL was associated with lower depressive symptoms and higher life satisfaction. Moreover, the MIL-depressive symptoms/life satisfaction links were stronger among Holocaust survivors. Results provide insight for tailoring treatment interventions for older adults who have been exposed to prolonged traumatic experiences or genocide, that focus on MIL, to enhance mental health.

Reclaiming hope: Subjective nearness to death as a moderator between posttraumatic stress symptoms and hope among older adults.

Perceiving one's remaining time until death, can serve as a source of resilience when faced with adversity in the second half of life. The current work is based on a prospective study and examines whether subjective nearness-to-death (SNtD) moderates the association between posttraumatic-stress symptoms (PTSS) and hope among adults in the second half of life. The first wave was conducted after the end of a military conflict in the south of Israel, and included 170 participants (M = 66.61, SD = 9.16; age range 51-91), 115 of whom also participated in Wave 2. Participants filled out self-reported questionnaires regarding background information, PTSS, SNtD and hope. A moderation effect was found, revealing that high levels of PTSS predicted lower levels of hope among those who felt close to their death, but not among those who felt far from their death. We suggest that one's evaluation of little time remaining to live, especially in old age, may be a significant factor exacerbating the negative consequences of PTSS on hope. The importance of the results to the research field is discussed.

The experience of aging before one's time during the coronavirus pandemic among war veterans in Israel.

Subjective age, the personal sense of how old one feels, is an important concomitant of posttraumatic outcomes in the second half of life. The present study aims to disentangle the interrelationships between posttraumatic stress disorder symptoms (PTSS) and subjective age, during the COVID-19 pandemic, among a sample of Israeli older adults who are veterans of the 1973 Yom Kippur War. Participants were interviewed in 2015 (T1; N = 259; mean age = 65.23, SD = 5.32) and in 2020, during the COVID-19 outbreak in Israel (T2). We assessed subjective age, PTSS, fear of COVID-19, self-rated health, and COVID-19 related accelerated subjective aging. A cross-lagged path analysis showed that while higher PTSS at T1 were associated with an increase in subjective age from T1 to T2, subjective age at T1 was not associated with PTSS at T2. PTSS at T1, but not subjective age, were associated with higher COVID-19 related accelerated subjective aging at T2. Older adults with continued PTSS due to past traumas, might be susceptible to the stressors of COVID-19 expressed in the personal subjective experience of having aged quickly in a short period of time. Our findings also suggest that in the context of stress and trauma, subjective age is more appropriately conceived as an outcome variable rather than a predictor of PTSS.

The Toll of Feeling Older: Subjective Age Moderates the Associations Between Anxiety Sensitivity and Symptoms of Anxiety and Depression During the COVID-19 Epidemic.

OBJECTIVES: The coronavirus disease 2019 (COVID-19) pandemic is an ongoing stressor that may have detrimental effects on mental health. Theoretical and empirical literature implies that individuals who are characterized by catastrophic appraisals of somatic cues, a tendency known as anxiety sensitivity, as well as by older subjective age, might be particularly vulnerable to depression and anxiety during the pandemic. Furthermore, subjective age might moderate the relations between anxiety sensitivity with depression and anxiety symptoms. Yet, research to date has not explored the contribution of both anxiety sensitivity and subjective age in explaining distress following stress in general, nor in light of the current COVID-19 pandemic. METHOD: Filling this gap, a convenience sample of 828 participants (Mage = 43.98, SD = 14.06) filled questionnaires measuring background variables, COVID-19-related stressors, anxiety sensitivity, subjective age, and anxiety and depression symptoms during the pandemic. RESULTS: Positive associations were found between anxiety sensitivity and subjective age, on the one hand, and anxiety and depression symptoms, on the other. Furthermore, subjective age moderated the relations between anxiety sensitivity with depression and anxiety symptoms. Although higher levels of anxiety sensitivity were related to depression and anxiety during the pandemic, these relations were significantly stronger among participants with an older subjective age. DISCUSSION: The findings are consistent with theories that view subjective age as an intraindividual construct involved in modulating important mental health outcomes in the context of coping with stress.

Aging together in the aftermath of war: marital adjustment and subjective age of veterans and their spouses.

OBJECTIVES: Trauma has long-term effects on those directly exposed to it, but it also impacts those closest to them, particularly one's spouse, as the marital relationship is of central importance for late-life development. Furthermore, traumatic experiences have been shown to be involved in an acceleration of aging, whether through physical health, or via psychological pathways, through an older subjective age. The present work seeks to examine the mutual connections between marital adjustment and the psychological accelerated aging of both spouses among military veterans of the Israeli 1973 Yom Kippur War. METHOD: Data from two assessments were drawn from a larger longitudinal study. In 2008 (T1) and again in 2015 (T2), 247 veterans and their wives were interviewed on their subjective age, marital adjustment, and PTSD symptoms. RESULTS: An actor-partner interdependence model combined with an autoregressive cross-lagged model, controlling for T1 PTSD symptoms revealed that men's subjective age at T1 was associated with women's subjective age at T2, and women's subjective age at T1 was associated with men's subjective age at T2. Women's marital adjustment at T1 was associated with men's marital adjustment at T2 but not the other way around. CONCLUSION: Spousal relationships are an important arena in the lives of older adult veterans. The present study contributes new knowledge regarding the paths that predict subjective age by taking account of the subjective age of one's spouse, as well as levels of marital adjustment. Insights regarding secondary traumatization, as well as gender differences, for the aging process are discussed.

Shorter Telomeres Among Individuals With Physical Disability: The Moderating Role of Perceived Stress.

OBJECTIVES: Evidence suggests that individuals with physical disability may suffer from psychological distress and accelerated cellular aging, manifested by shortened telomere length (TL), compared with healthy individuals. Studies indicate that high levels of perceived stress and depression may increase the physiological susceptibility and, thus, may contribute to a short TL. However, the moderating role of perceived stress and depression within the relationship between physical disability and TL remains unknown. METHOD: The participants consisted of 119 male subjects (mean age 54.36 years, range 35-70). Of them, 30 were able-bodied and 89 had a physical disability: 34 were due to poliomyelitis (polio) and 55 were due to spinal cord injury. Blood samples for TL analysis were collected; the participants completed questionnaires and underwent disability evaluation. RESULTS: Participants with disability had a shorter TL as well as elevated levels of perceived stress and depression compared with able-bodied controls. Both the perceived stress and depression were correlated with a shorter TL. Nonetheless, perceived stress, rather than depression, moderated the relationship between disability and TL; among participants with higher perceived stress levels, in particular, individuals with physical disability had a shorter TL than the able-bodied controls. DISCUSSION: The present findings suggest that individuals with physical disability and who exhibit high levels of perceived stress may be particularly vulnerable for accelerated cellular aging, suggesting that perceived stress can be used as a valuable target for intervention.

"I Didn't Meet My Mother; I Saw My Mother": The Challenges Facing Long-Term Care Residents and Their Families in the Age of COVID-19.

The present research examines the effects of protective measures due to the coronavirus disease 2019 (COVID-19) pandemic within long-term care (LTC) settings on residents and their family members. Open-ended qualitative interviews were conducted with 14 family members of older adults who resided in LTC settings during the first wave of the pandemic in Israel. The first theme identified is Rupture, including the physical disconnect; the disruption in routine treatment to residents; and decline in the satisfaction with the setting. The second theme is Response, including sharing viewpoints and involvement in decision-making, as well as an intense ambivalence shared by family members. Our findings highlight the distress caused to residents and family members by the isolation and restrictions in LTC settings during the pandemic and underscore values and priorities that are central to them and their family members, including maintaining continuity, transparency, and working in unison with their families, staff, and management.

'We have become prisoners of our own age': from a continuing care retirement community to a total institution in the midst of the COVID-19 outbreak.

BACKGROUND AND OBJECTIVES: during the coronavirus disease 2019 pandemic in Israel, people residing in continuing care retirement communities (CCRC) found themselves under strict instructions to self-isolate, imposed by the CCRC managements before, during and after the nationwide lockdown. The present study explored the personal experiences of CCRC residents during the lockdown. RESEARCH DESIGN AND METHODS: in-depth interviews were conducted with 24 CCRC residents from 13 different CCRCs. Authors performed a thematic analysis of interview transcripts, using constant comparisons and contrasts. RESULTS: three major themes were identified: (i) 'Us vs. them: Others are worse off'. Older residents engaged in constant attempts to compare their situation to that of others. The overall message behind these downward comparisons was that the situation is not so bad, as others are in a worse predicament; (ii) 'Us vs. them: Power imbalance'. This comparison emphasised the unbalanced power-relations between older adults and the staff and management in the setting and (iii) 'We have become prisoners of our own age'. Interviewees described strong emotions of despair, depression and anger, which were intensified when the rest of society returned back to a new routine, whilst they were still under lockdown. DISCUSSION AND IMPLICATIONS: the measures imposed on residents by managements of CCRCs during the lockdown, and the emotional responses of distress among some of the residents, revealed that CCRCs have components of total institutions, not normally evident. This underscores the hidden emotional costs of the lockdown among those whose autonomy was compromised.

The longitudinal associations between attitudes to aging and attachment insecurities among combat veterans.

For combat veterans, the trauma of war can have lasting effects, that may later extend to attitudes toward one's own aging (ATOA). The present study sought to examine whether attachment insecurities may help to predict ATOA in later life, while also exploring the moderating role of combat exposure concerning the effects of attachment insecurities on subsequent ATOA. A cohort of 171 veterans of the Israeli 1973 Yom Kippur War (mean age = 68.4, SD = 5.1) were interviewed in 1991 (Time 1; T1) and again in 2018 (Time 2; T2). The present study examined the moderating role of combat exposure, within the associations between T1 attachment insecurities and T2 ATOA. A regression analysis revealed that T1 attachment insecurities, T2 health problems, and post-traumatic stress disorder (PTSD) symptoms predicted more negative T2 ATOA. A significant interaction was found between combat exposure and attachment avoidance, suggesting that the effect of attachment avoidance on ATOA was only significant among participants with high levels of combat exposure. The present findings point to the importance of attachment insecurities for ATOA among veterans, and to the role of combat exposure in moderating these associations. Results indicate possible avenues of intervention and policy for those most vulnerable to negative ATOA. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

What predicts unremitting suicidal ideation? A prospective examination of the role of subjective age in suicidal ideation among ex-prisoners of war.

OBJECTIVE: Research has demonstrated that traumatic experiences have significant links to suicidal ideation (SI), particularly among older adults. The present study examined SI among older adults with a history of war trauma and the role of perceptions relating to one's age (subjective age) in predicting SI. METHOD: Drawing from a larger longitudinal study, we analyzed data based on interviews with 125 ex-prisoners of war (ex-POWS) from Israel's 1973 Yom Kippur War and a control group of 101 veterans from the same war who did not fall captive (mean age at most recent measurement was 65.05, SDage = 5.29). Participants were interviewed in 2008 (T1) and again in 2015 (T2). RESULTS: Findings revealed significantly higher levels of SI among ex-POWs than evident among controls and significantly higher levels of SI and subjective age among ex-POWs with PTSD. Furthermore, a sequential mediation analysis indicated that among ex-POWs, the path from T1 PTSD symptoms to subsequent SI was mediated by subjective age at T1, and subjective age at T2, after controlling for age, self-rated health, and SI at T1. CONCLUSION: A subset of ex-POWs are exposed to continuous suicidal risk throughout their later life, more than 40 years after the war. Furthermore, an older subjective age mediated these associations, independent of the levels of T1 SI, actual age, and self-rated health. These findings suggest debilitating long-term effects of trauma for SI in later life and their connections to advanced psychological aging. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

The Moderating Role of Views of Aging in the Longitudinal Relationship Between Physical Health and Mental Distress.

OBJECTIVES: Some degree of mental distress is commonly present in old age, and it is often exacerbated in later life following changes in physical health. This work presents in 2 studies among samples that have been exposed to stressful experiences in the past, a prospective examination of how the association between physical health and mental distress is attenuated by 2 forms of views on aging, evaluations of age, and evaluations of one's future. METHOD: Study 1 (N = 226) was conducted in 2008 (Time 1) and 2014 (Time 2), among Israeli war veterans (mean age 64.90, SD = 5.04); Study 2 (N = 132) was conducted in 2014 (Time 1) and 2015 (Time 2) among older adults who were exposed to ongoing rocket fire in the south of Israel (mean age 66.44, SD = 9.77). Participants reported on their subjective age, subjective life expectancy (SLE [in Study 1]/distance to death [DtD; in Study 2]), health, and mental distress. RESULTS: Both studies showed that after controlling for exposure to trauma and for Time 1 mental distress, Time 1 subjective age, but not SLE/DtD, moderated the association between Time 1 physical health and Time 2 mental distress. DISCUSSION: Subjective age and SLE represent distinct features of views of aging. Subjective age may reflect perceptions of one's aging process, associated more directly with health-related outcomes over time. SLE reflects future, death-related perceptions, therefore perhaps less directly associated with such outcomes.

Telomere Length and Depression Among Ex-Prisoners of War: The Role of Subjective Age.

OBJECTIVES: Exposure to captivity increases the risk for multiple disturbances that may intensify during old age. In later phases of life, former-prisoners-of-war (ex-POWs) may suffer from depression as well as from accelerated aging, manifested in older subjective age and leukocyte telomere shortening. The current study assesses the link between these varied facets of increased vulnerability during old age and explores (a) the associations between subjective age and telomere length; (b) the mediating role of changes in subjective age over time within the associations between depression and telomere length. METHODS: Eighty-eight ex-POWs were assessed prospectively 30 (T1), 35 (T2), and 45 (T3) years after the 1973 Israeli Yom-Kippur War. Depression was assessed at T1; subjective age was assessed at T2 and T3; and telomere length and control variables were assessed at T3. RESULTS: Older subjective age at T3 was associated with concurrent shorter telomeres, beyond the effect of chronological age. Change in subjective age between T2 and T3 mediated the relations between depression at T1 and shorter telomeres at T3 beyond the effects of control variables. DISCUSSION: Findings suggest that the detrimental ramifications of accelerated subjective age involve premature cellular senesces, and may explain the relation between depression and accelerated aging processes among trauma victims. Hence, clinical interventions may seek to address accelerated subjective age among trauma survivors who suffer from depression.

Understanding the long-term connections between posttraumatic stress, subjective age, and successful aging among midlife and older adults.

Background: The nature of the reciprocal relationships between posttraumatic stress disorder (PTSD) symptoms, proportional subjective age, and their effects on successful aging are important issues that have been so far under-studied. Clarifying the relationships between these variables has many theoretical and practical implications for the understanding of how individuals age in the shadow of traumatic exposure. Objective: The present study examined the reciprocal relationships between PTSD symptoms and proportional subjective age in a longitudinal design, and how these variables predict successful aging. Method: Using in-region random digit dialling, we collected a stratified sample of community-dwelling older adults residing in the south of Israel. Of that sample, 132 midlife and older adults (T1 age range = 50-87, mean age = 65.84, SD = 9.12) were interviewed three times across a period of two years and four months (2014-2016). Participants completed measures of PTSD symptoms and proportional subjective age in the first two interviews (T1 and T2) and successful aging indices in the third interview (T3). PTSD symptoms and proportional subjective age measured at both T1 and T2 served as predictors and outcomes in a cross-lagged model and as predictors of successful aging at T3. Results: T1 PTSD symptoms predicted an older proportional subjective age at T2, whereas the reverse relationship (i.e. T1 proportional subjective age to T2 PTSD symptoms) was non-significant. Moreover, higher PTSD symptoms and an older proportional subjective age at T2 predicted lower successful aging at T3. Conclusions: In addition to clarifying the temporal sequencing of PTSD and proportional subjective age, the study further suggests that PTSD and proportional subjective age identity could each render midlife and older adults more susceptible to less successful aging. Accordingly, we advocate to further explore the mechanisms underlining these complicated relationships.

La naturaleza de las relaciones recíprocas entre el trastorno de estrés postraumático (TEPT) y los efectos de la edad subjetiva proporcional sobre el envejecimiento exitoso son asuntos importantes que, a la fecha, han sido poco estudiados. El esclarecer las relaciones entre estas variables tiene muchas repercusiones teóricas y prácticas para la comprensión de cómo envejecen las personas bajo la sombra de la exposición traumática.Objetivo: El presente estudio evaluó las relaciones recíprocas entre los síntomas del TEPT y la edad subjetiva proporcional mediante un diseño longitudinal, además de evaluar cómo estas variables predicen el envejecimiento exitoso.Métodos: Mediante un proceso de marcación aleatoria de números telefónicos, se recolectó una muestra estratificada de adultos mayores residentes en comunidades al sur de Israel. De aquella muestra, se entrevistó a 132 adultos en la edad media y a adultos mayores (rango de edad en T1 = 50 ­ 87 años, edad promedio = 65,84 años, desviación estándar = 9,12), los cuales fueron entrevistados en tres oportunidades a lo largo de un periodo de dos años y cuatro meses (2014 ­ 2016). Los participantes completaron mediciones para síntomas de TEPT y para la edad subjetiva proporcional en las primeras dos entrevistas (T1 y T2), e índices para envejecimiento exitoso en la tercera entrevista (T3). Los síntomas del TEPT y la edad subjetiva proporcional medidas tanto en T1 como en T2 fueron usados como predictores y como resultados empleando un modelo de referencias cruzadas, y en T3 ambos fueron usados como predictores de envejecimiento exitoso.Resultados: Los síntomas de TEPT en T1 predijeron una edad subjetiva proporcional mayor en T2, mientras que la relación inversa (esto es, partir de una edad subjetiva proporcional en T1 y correlacionarlo con los síntomas del TEPT en T2) no fue significativa. Asimismo, una mayor cantidad de síntomas del TEPT y una mayor edad subjetiva proporcional en T2 predijeron un envejecimiento exitoso menor en T3.Conclusiones: Además de esclarecer la secuencia temporal del TEPT y la edad subjetiva proporcional, el estudio también sugiere que el TEPT y la edad subjetiva proporcional podrían, cada una, predisponer a adultos en la edad media y a adultos mayores a ser más susceptibles a un envejecimiento menos exitoso. Consecuentemente, abogamos por explorar con mayor profundidad los mecanismos subyacentes a estas complicadas relaciones.

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

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.

On the edge: The association between extreme values of proportional felt-age and functioning.

The present study examined whether endorsing a felt-age that is extremely divergent from one's actual age (whether older or younger) is related to worse functioning four years later. Data were drawn from 4938 participants, who completed the 2008 and 2012 questionnaires of the Health-and-Retirement-Study (HRS). Participants were divided into four groups according to their reported proportional-felt-age: the normative-young (N = 2229), reported a normative felt-age at the median or younger; normative-old (N = 2226), reported normative felt-age at the median and older; and the extremely young and extremely old proportional-felt-age (upper and lower 5% of felt-age; N's = 242 and 241, respectively). These groups were compared on chronic medical conditions, depressive symptoms, activities of daily living (ADL), instrumental activities of daily living (IADL), functional limitations, and loneliness. While extremely younger proportional-felt-age participants did not reveal worse (or better) outcomes compared with the normative-young group, extremely old proportional-felt-age participants reported worse physical health, mental health, and functioning in cross-sectional, as well as longitudinal comparisons. Extreme values of older proportional-felt-age are usually not reported randomly and reflect less adaptive adjustment. The findings underscore the importance of studying participants at the extreme values of felt-age, especially extreme old proportional-felt-age, and the need for further inspection of the mechanisms underlying these evaluations.

Perception Counts: The Relationships of Inner Perceptions of Trauma and PTSD Symptoms Across Time.

Objective: This study examined how inner perceptions that develop in the aftermath of exposure to trauma attenuate the association between posttraumatic symptoms across time and what the reciprocal relations between inner perceptions of trauma and posttraumatic symptoms are. Method: The present article is based on two studies. The data in Study 1 are drawn from three waves of a longitudinal study of community-dwelling midlife adults and older adults residing in the south of Israel. In Wave 1, 339 participants were interviewed (mean age = 65.44, SD = 9.77). Of these participants, 170 and 132, respectively, participated in Waves 2 (one year later) and 3 (two years later). Posttraumatic stress symptoms were self-reported in all three waves. Inner perceptions of trauma were assessed with the Subjective Traumatic Outlook scale (STO) and Centrality of Event Scale (CES), administered at Wave 3. Study 2 is drawn from two waves of research of young adults. Wave 1 included 138 participants (mean age = 32.01, SD = 10.57) from a convenience sample. At Wave 2, 128 participants were interviewed again a month later. Participants reported their level of posttraumatic stress symptoms and completed the STO and the CES in both waves. Results: In Study 1, analyses showed stronger associations between posttraumatic symptoms across waves among those who reported higher subjective traumatic outlook and higher centrality of events. In Study 2, significant reciprocal relationships between PTSD and STO were found, but whereas the W1 PTSD-W2 CES path was significant, the W1 CES-W2 PTSD path was not. Conclusions: The findings emphasize that overintegration and especially disintegration of the pretraumatic identity with traumatic experiences are associated with the deleterious effects of long-lasting exposure to traumatic events.

Grip strength and quality of life in the second half of life: hope as a moderator.

OBJECTIVES: The purpose of the current study was to investigate grip strength, hope, and their interaction as predictors of quality of life four years later in a nationally representative sample of older adults. METHOD: Data were derived from the first (2005-2006) and second wave (2009) of the Israeli component of the Survey of Health Ageing and Retirement in Europe (SHARE; N = 344). Hope was measured by three items from the Hope   Scale, and quality of life was measured by the CASP-12 (Control, Autonomy, Self-Realization, and Pleasure). Multiple regression analyses were conducted. RESULTS: Grip strength at T1 predicted QoL in T2, but hope was not a significant predictor. Furthermore, hope moderated the effect of handgrip on QoL, such that the effect was weaker for higher levels of hope. CONCLUSION: As hypothesized, hope acted as a moderator, such that poor grip strength was associated with worse QoL for less hopeful older adults, but grip strength was not associated with QoL for more hopeful older adults. Findings are consistent with a theoretical conceptualization of hope as a buffer between physical challenges and negative outcomes like QoL. Encouraging a hopeful perspective could enhance QoL for older adults with decreased muscle strength.

Guilt as a mediator between depressive symptoms and subjective age: A 17-year longitudinal study of Israeli ex-prisoners of war.

This longitudinal study assesses the trajectories of depressive symptoms and subjective age and the mediating role of guilt in the association between them. Two groups of aging Israeli combat veterans (M age = 57), 128 ex-prisoners of war (ex-POWs), and 106 comparable combat veterans (controls), were assessed at 3 times: 18 (Time 1 [T1]), 30 (Time 2 [T2]), and 35 (Time 3 [T3]) years after the war. They filled out self-report questionnaires on depression, guilt, and subjective age. Results revealed that significantly more ex-POWs had chronic or delayed clinical levels of depressive symptoms than did controls and that chronic and delayed depressive symptoms were associated with a higher subjective age at T3. Furthermore, the path between depressive symptoms at T1 for predicting subjective age at T3 was fully explained by levels of guilt-distress at T2. Although the mediation effect was found in both study groups, it was significantly stronger among ex-POWs than among controls. These findings suggest that not only is depression a long-term sequela of traumatic stress, it is also a risk factor for psychological aging among war veterans. Furthermore, guilt-distress appears to play an important role in advancing subjective age, especially among ex-POWs. (PsycINFO Database Record