Clinical trial NCT03821259: Post-traumatic Stress Disorder (PTSD) Symptoms in Later Life
Official title: Post-traumatic Stress Disorder (PTSD) Symptoms in Later Life: the Contribution of Cumulative Trauma Exposure, Emotion Regulation, Group Identifications, and Socioeconomic Deprivation
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Post Traumatic Stress Disorder
Lead sponsor: University of Edinburgh
Sponsor class: OTHER
Collaborators: name: NHS Tayside
First posted: 2019-01-29
Enrollment: 88
Sex: ALL
Minimum age (years): 65
Standard ages: OLDER_ADULT
Accepts healthy volunteers: no
Observational model: CASE_ONLY
Time perspective: CROSS_SECTIONAL
Sampling method: NON_PROBABILITY_SAMPLE
Study population: An opportunistic clinical sample of older adults, aged 65 and over, in receipt of psychological treatment for PTSD, anxiety or depression in the Older People Psychological Therapies Service in NHS Tayside will be recruited.

Brief summary: Older adults are becoming a growing proportion of people utilising mental health services. However, the needs of this population are poorly understood despite the evidence that mental health conditions are manifested differently in old age. One of those conditions is Post Traumatic Stress Disorder (PTSD) which has been associated with an increased risk of adverse outcomes in old age, including health problems, difficulties in daily functioning, less satisfaction with life and multiple psychiatric co-morbidities, such as depression and anxiety. Despite the serious consequences, PTSD symptoms in old age tend to be underreported or misperceived as a physical illness or part of an ageing process.

Traumatic life experiences do not necessarily lead to PTSD. Psychological resources, including emotional stability and social support, allow individuals to find appropriate coping strategies and maintain well-being in old age. Group identification, defined as a sense of belonging to a specific group, influences the response to social support and may be important in predicting distress in old age. On the other hand, socioeconomic deprivation is likely to increase this distress as exposure to traumatic events is more prevalent in disadvantaged populations.

The present study will investigate the impact of those factors on PTSD symptoms in later life. The researcher will recruit 85 older adults from the Older People Psychological Therapies Service, who are in receipt of psychological treatment for PTSD, anxiety or depression. Participants will be asked to provide basic demographic information, which will be used to describe the participant characteristics and to estimate the degree of socioeconomic deprivation. Participants will also complete five measures to screen for cognitive impairment and measure PTSD symptoms, lifetime trauma exposure, emotion regulation and group identification.

The findings will help improve the diagnostic process and development of psychological treatments for PTSD in older adults by expanding our knowledge of this condition in later life.

Detailed description: Aim of the study:

To investigate the importance and relative contribution of interpersonal and intra-individual factors, including lifetime trauma exposure, emotion regulation, social group belonging and socioeconomic deprivation in predicting PTSD symptoms in older adults.

Primary research questions:

1. Will greater lifetime trauma exposure predict higher levels of PTSD symptoms in older adults?
2. Will greater difficulties in emotion regulation predict higher levels of PTSD symptoms in older adults?
3. Will a lower number of group identifications predict higher levels of PTSD symptoms in older adults?
4. Will higher levels of socioeconomic deprivation predict higher levels of PTSD symptoms in older adults?

Secondary research questions:

1. What is the relative contribution of lifetime trauma exposure in predicting levels of PTSD symptoms in older adults?
2. What is the relative contribution of difficulties in emotion regulation in predicting levels of PTSD symptoms in older adults?
3. What is the relative contribution of group identifications in predicting levels of PTSD symptoms in older adults?
4. What is the relative contribution of socioeconomic deprivation in predicting levels of PTSD symptoms in older adults?

Design:

The study will employ a cross-sectional, within-groups design. An opportunistic clinical sample of older adults, aged 65 and over, in receipt of psychological treatment for PTSD, anxiety or depression in the Older People Psychological Therapies Service in NHS Tayside will be recruited. Participants will be asked to provide basic demographic information and to complete five measures, screening for cognitive impermanent and measuring PTSD symptoms, lifetime trauma exposure, emotion regulation and group identification. Correlation and multiple regression analyses will be used to answer the research hypotheses.

Eligibility criteria: Inclusion Criteria:

* Aged 65 years and over
* In receipt of psychological treatment for PTSD, anxiety or depression
* Fluent English speaker
* Ability to give consent

Exclusion Criteria:

* Cognitive impairment (MoCA ≤20)
* Under investigation for or a confirmed diagnosis of dementia
* Currently experiencing an episode of a serious mental illness, e.g. psychosis
* Ongoing substance misuse
* Ongoing serious risk issues (i.e. risk of harm to self and others, suicidality)

Primary outcomes:
measure: The Trauma History Questionnaire (THQ; Green, 1996)
timeFrame: through study completion, an average of 6 months
measure: The Difficulties in Emotion Regulation Scale (DERS; Gratz & Roemer, 2004)
timeFrame: through study completion, an average of 6 months
measure: The Civilian Version of the PTSD Checklist (PCL-C; Weathers, Litz, Huska & Keane, 1994)
timeFrame: through study completion, an average of 6 months
measure: The Group Identification Scale (GIS; Sani et al., 2012)
timeFrame: through study completion, an average of 6 months
measure: The Scottish Index of Multiple Deprivation (SIMD; Scottish Executive, 2016)
timeFrame: through study completion, an average of 6 months
Secondary outcomes:
Other outcomes:
Locations:
city: Dundee
country: United Kingdom
facility: Tayside Older People Psychological Therapies service
Study officials:
affiliation: NHS Tayside/University of Edinburgh
name: Klaudia Suchorab, MSc
role: PRINCIPAL_INVESTIGATOR
References: