A longitudinal and retrospective study of PTSD among older prisoners of war

Objective: The authors examined the longitudinal changes in posttraumatic s tress disorder (PTSD) symptom levels and prevalence rates over a 4-year tim e period among American former prisoners of war (POWs) from World War II an d the Korean War. Retrospective symptom reports by World War II POWs dating back to shortly after repatriation were examined for 1) additional evidenc e of changing PTSD symptom levels and 2) evidence of PTSD cases with a long -delayed onset. Method: PTSD prevalence rates and symptom levels were measured by the Missi ssippi Scale for Combat-Related Posttraumatic Stress Disorder. For the long itudinal portion of the study, participants were 177 community-dwelling Wor ld War II and Korean POWs. For the retrospective portion, participants were 244 community-dwelling World War II POWs. Results: PTSD prevalence rates and symptom levels increased significantly o ver the 4-year measurement interval. Retrospective symptom reports indicate d that symptoms were highest shortly after the war, declined for several de cades, and increased within the past two decades. Long-delayed onset of PTS D symptoms was rare. Demographic and psychosocial variables were used to ch aracterize participants whose symptoms increased over 4 years and different iate participants who reported a long-delayed symptom onset. Conclusions: Both longitudinal and retrospective data support a PTSD sympto m pattern of immediate onset and gradual decline, followed by increasing PT SD symptom levels among older survivors of remote trauma.