Comparing Intensive Trauma-Focused Treatment Outcome on PTSD Symptom Severity in Older and Younger Adults

Ellen M J Gielkens; Ad de Jongh; Sjacko Sobczak; Gina Rossi; Agnes van Minnen; Eline M Voorendonk; Linda Rozendaal; Sebastiaan P J van Alphen

doi:10.3390/jcm10061246

Comparing Intensive Trauma-Focused Treatment Outcome on PTSD Symptom Severity in Older and Younger Adults

J Clin Med. 2021 Mar 17;10(6):1246. doi: 10.3390/jcm10061246.

Authors

Ellen M J Gielkens^{1

2}, Ad de Jongh^{3

4

5

6

7}, Sjacko Sobczak^{1

8}, Gina Rossi², Agnes van Minnen^{3

9}, Eline M Voorendonk^{3

9}, Linda Rozendaal³, Sebastiaan P J van Alphen^{1

2

10}

Affiliations

¹ Clinical Center of Excellence for Older Adults with Personality Disorders, Mondriaan, 6419 PJ Heerlen-Maastricht, The Netherlands.
² Personality and Psychopathology Research Group (PEPS), Vrije Universiteit Brussel (VUB), 1050 Brussels, Belgium.
³ Psychotrauma Expertise Centre (PSYTREC), 3723 MB Bilthoven, The Netherlands.
⁴ Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, 1081 LA Amsterdam, The Netherlands.
⁵ School of Health Sciences, Salford University, Manchester M6 6PU, UK.
⁶ Institute of Health and Society, University of Worcester, Worcester WR2 6AJ, UK.
⁷ School of Psychology, Queen's University, 18-30 Malone Road, Belfast BT9 5 BN, UK.
⁸ Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Maastricht University, 6226 NB Maastricht, The Netherlands.
⁹ Behavioural Science Institute (BSI), Radboud University Nijmegen, 6525 HR Nijmegen, The Netherlands.
¹⁰ Department of Medical and Clinical Psychology, Tilburg University, 5037 AB Tilburg, The Netherlands.

Abstract

Objective: To examine the treatment outcome of an intensive trauma-focused treatment program for post-traumatic stress disorder (PTSD) in older and younger adults.

Methods: A non-randomized outcome study was conducted with 62 consecutively admitted older PTSD patients (60-78 years) and 62 younger PTSD patients (19-58 years), matched on gender and availability of follow-up data. Patients participated in an intensive eight-day trauma-focused treatment program consisting of eye movement desensitization and reprocessing (EMDR), prolonged exposure (PE), physical activity, and group psycho-education. PTSD symptom severity (Clinician-Administered PTSD Scale-5 (CAPS-5)) was assessed, at pre- and post-treatment, and for a subsample (n = 31 older; n = 31 younger patients) at six-month follow-up.

Results: A repeated-measures ANCOVA (centered CAPS pre-treatment score as covariate) indicated a significant decrease in CAPS-5-scores from pre- to post-treatment for the total sample (partial η² = 0.808). The treatment outcome was not significantly different across age groups (partial η² = 0.002). There were no significant differences in treatment response across age groups for the follow-up subsample (pre- to post-treatment partial η² < 0.001; post-treatment to follow-up partial η² = 0.006), and the large decrease in CAPS-5 scores from pre- to post-treatment (partial η² = 0.76) was maintained at follow-up (partial η² = 0.003).

Conclusion: The results suggest that intensive trauma-focused treatment is applicable for older adults with PTSD with a large within-effect size comparable to younger participants. Further research on age-related features is needed to examine whether these results can be replicated in the oldest-old (>80).

Keywords: EMDR therapy; intensive treatment; older adults; post-traumatic stress disorder; prolonged exposure; trauma-focused treatment.