SURVIVORS - A REVIEW OF THE LATE-LIFE EFFECTS OF PRIOR PSYCHOLOGICAL TRAUMA

The author reviews the literature on the epidemiology, symptom picture , and treatment of elderly patients who have encountered serious Psych ological trauma earlier in life. Data are predominantly derived from s tudies of aging Holocaust survivors and combat veterans from World War II, the Korean Conflict, and Vietnam. Survivor syndromes persist into old age, but patterns of expression vary. Holocaust survivors appear to have adapted well to instrumental aspects of life, whereas combat w arriors may show less functional life-adaptation. Persisting symptoms in all groups include marked disruptions of sleep and dreaming, intrus ive memories, impairment of trust, avoidance of stressors, and heighte ned vulnerability to various types of age-associated retraumatization. There is a deficiency of controlled treatment studies of traumatized elderly patients, but successful group, individual, and family clinica l interventions have been described.