POSTTRAUMATIC-STRESS-DISORDER IN ELDERLY AND YOUNGER ADULTS AFTER THE1988 EARTHQUAKE IN ARMENIA

Objective: This study was undertaken 1 1/2. years after the 1988 earth quake in Armenia to assess the frequency and severity of posttraumatic stress reactions among elderly and younger adult victims and to asses s the relation of exposure, age, sex, and death of a family member to these reactions. Method: One hundred seventy-nine subjects of both sex es were evaluated with the Posttraumatic Stress Disorder (PTSD) Reacti on Index. A subgroup of 60 individuals were also assessed for PTSD wit h the DSM-III-R criteria. Results: There was a strong association betw een the presence of severe symptoms on the index and a DSM-III-R diagn osis of PTSD. Elderly and younger adult victims in cities closer to th e epicenter (higher exposure) had significantly higher index scores th an elderly and adult victims in more distant locations. In comparison with previous studies of natural disasters, much greater rates of chro nic severe posttraumatic stress reactions were found among the highly exposed individuals. Although there was no difference in total mean sc ore on the Posttraumatic Stress Disorder Reaction Index, a significant difference in symptom profile was found between the elderly and young er adults; the elderly scored higher on arousal symptoms and lower on intrusive symptoms. There was a positive correlation between loss of f amily members and severity of posttraumatic stress reaction. Conclusio ns: These findings indicate that after a major natural disaster with s ubsequent multiple adversities, a substantial proportion of the adult population may experience severe and chronic posttraumatic stress reac tions. The risk factors identified in this study may prove useful in s creening exposed individuals for appropriate treatment.