The COVID-19 Pandemic as a Traumatic Stressor: Mental Health Responses of Older Adults with Chronic PTSD

Abstract

Objective Individuals with Posttraumatic stress disorder (PTSD) who experience additional traumas or stressful life events may undergo symptomatic worsening, but no data exist on whether exposure to the COVID-19 pandemic in a high infection area worsens mental health among older adults with chronic PTSD.

Methods Seventy-six older adults (N=46 with PTSD and N=30 trauma-exposed comparison subjects [TE]) for whom pre-pandemic data were available were interviewed between April 1 and May 8, 2020 to quantify depressive (Hamilton Rating Scale for Depression [HRSD]) and PTSD symptom (Posttraumatic Stress Disorder Checklist [PCL-5]) levels. Group differences in baseline characteristics as well as pre-post pandemic symptom levels were examined, and participant characteristics were assessed as moderators of symptom change.

Results Compared to TEs, individuals with PTSD more often reported living alone and experiencing a physical illness (χ2=5.1, df=1, p=0.02). PCL-5 scores among individuals with PTSD decreased during the COVID-19 pandemic by 7.1 points (t(69)=-3.5, p=.0008), whereas the TE group did not change significantly. Overall no significant differences in HRSD was found between groups, but a race/ethnicity variable was found to moderate HRSD symptom change. Non-black/Hispanic individuals with PTSD experienced significantly increased HRSD scores during the pandemic compared to black/Hispanic PTSD participants.

Conclusions The findings are indicative of complexity in the responses of older individuals with PTSD to further stressful life events as well as possibly unique aspects to the COVID-19 pandemic as a stressor. Sources of resilience may exist based on experience with prior traumas as well as increasing age promoting more adaptive coping styles.