Journal of Rehabilitation Research & Development (JRRD)

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Volume 53 Number 3, 2016
   Pages 391 — 402

Abstract — Health status and treatment–seeking stigma in older adults with trauma and posttraumatic stress disorder

Anica Pless Kaiser, PhD;1–2* Antonia Seligowski, MA;1 Avron Spiro III, PhD;2–4 Mohit Chopra, MD2,5

1Department of Veterans Affairs (VA) National Center for PTSD, VA Boston Healthcare System, Boston, MA; 2Department of Psychiatry, Boston University School of Medicine, Boston, MA; 3Massachusetts Veterans Epidemiology Research and Information Center, VA Boston Healthcare System, Boston, MA; 4Department of Epidemiology, Boston University School of Public Health, Boston, MA; 5Department of Psychiatry, Harvard Medical School, Boston, MA

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.

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


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This article and any supplementary material should be cited as follows:
Pless Kaiser A, Seligowski A, Spiro A 3rd, Chopra M. Health status and treatment-seeking stigma in older adults with trauma and posttraumatic stress disorder. J Rehabil Res Dev. 2016;53(3):391–402.
http://dx.doi.org/10.1682/JRRD.2015.03.0039
ORCID: Anica Pless Kaiser, PhD: 0000-0002-4803-0191; Avron Spiro III, PhD: 0000-0003-4080-8621; Mohit Chopra, MD: 0000-0002-9208-7224
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