Health status and treatment-seeking stigma in older adults with trauma and posttraumatic stress disorder

J Rehabil Res Dev. 2016;53(3):391-402. doi: 10.1682/JRRD.2015.03.0039.

Abstract

This study compared health status across four trauma/posttraumatic stress disorder (PTSD) groups of older adults with depression, anxiety, and/or at-risk drinking who attended primary care appointments (N = 1,199; mean age = 73.5 yr), mostly at Department of Veterans Affairs hospitals. The trauma and PTSD categories were PTSD (n = 81), partial PTSD (n = 127), trauma only (n = 323), and no trauma (n = 668). Physical and mental health-related quality of life (HQL), indices of social and economic impairment and stigma regarding treatment-seeking were compared among groups. Group differences were found for several indicators of functional impairment; the PTSD group had fewer close friends and higher treatment-seeking stigma beliefs related to having a disorder. Linear mixed modeling examined associations between trauma/PTSD group and HQL. After accounting for covariates, the trauma/PTSD groups differed across the Medical Outcome Study Short Form-36 scales and component scores (indicated by significant group by scale interaction). Differences among groups were confined to mental health measures; those with PTSD had worse HQL. Post hoc analyses examined the number of comorbid psychiatric diagnoses by trauma/PTSD group. Overall, findings indicate that mental HQL varies among older adults with trauma and PTSD and that although treatment-related stigma does not differ among groups, it does affect HQL.

Keywords: aging; comorbidity; health-related quality of life; linear mixed modeling; mental health; physical health; posttraumatic stress disorder; stigma; trauma; treatment-seeking.

MeSH terms

  • Aged
  • Alcoholism
  • Anxiety
  • Comorbidity
  • Depression
  • Female
  • Health Status*
  • Humans
  • Male
  • Patient Acceptance of Health Care*
  • Quality of Life
  • Social Stigma*
  • Stress Disorders, Post-Traumatic / rehabilitation*
  • Veterans