Metaphors and Related Expressions in Older Adults in the Field of Trauma and Stress-related Disorders: A Scoping Review

Figures & data

Table 1. Rating system used for the assessment of suitable studies about CPTSD.

Rating	Interpretation
1/5	The context is not suitable for a CPTSD diagnosis and/or the research question does not focus on the experiencing of symptoms that fit a CPTSD diagnosis.
2/5	The context is suitable for a CPTSD diagnosis, but the research question does not focus (enough) on the experiencing of symptoms that fit a CPTSD diagnosis.
3/5	The context is suitable for a CPTSD diagnosis, but the research question focuses only moderately on the experiencing of symptoms that fit a CPTSD diagnosis.
4/5	The context is suitable for a CPTSD diagnosis and the research question focuses on the experiencing of symptoms that fit a CPTSD diagnosis.
5/5	The study directly addresses CPTSD or indirectly addresses CPTSD by describing a context and an experiencing of symptoms that fulfil the CPTSD diagnosis criteria.

Figure 1. Flowchart depicting the exclusion process of the selected studies.

Table 2. List of the selected studies, including information about their research topic, sample, and methodology.

	Study	Research Topic	Sample Size	Sample Age	Study Country	Methods
PTSD
1	Bowland (2015)	African American trauma survivors in mixed-age housing	N = 25 (women)	49–77	USA	interview
2	Davison et al. (2006)	late-onset stress symptomatology among aging combat veterans	N = 47	54–89	USA	focus group interview
3	Dennis (2016)	insights into traumatic experiences of Lakota elders	N = 25	55–98	USA	interview
4	Duchin and Wiseman (2019)	memoirs of child survivors of the Holocaust: processing and healing of trauma through writing	N = 13	77–90	Israel	interview
5	Hiskey and McPherson (2013)	older adults’ constructs of trauma	N = 42	67–91	UK	focus group interview
6	Nivala and Sarvimäki (2015)	lifelong struggle of Finnish World War II veterans	N = 20 (men)	77–87	Finland	interview
7	O’Rourke et al. (2016)	Holocaust survivors’ memories of past trauma and the functions of reminiscence	N = 269	M = 80.4, SD = 6.87	Israel	open-ended questions based on Reminiscence Functions Scale (Robitaille, Cappeliez, Coulombe, & Webster, 2010), answered verbally
8	Palgi, Bensimon, and Bodner (2017)	impairment in mentalization among older adults exposed in adulthood to potentially traumatic life events	N = 16	65–90	Israel	interview
9	Pope et al. (2020)	trauma experiences of older homeless men	N = 18 (men)	50–71	USA	interview
10	Sixsmith, Sixsmith, Callender, and Corr (2014)	wartime experiences and their implications for the everyday lives of older people	N = 40	80–90	UK	interview
11	Stanko et al. (2018)	when reliance on religion falters: religious coping and post-traumatic stress symptoms in older adults after multiple disasters	N = 119	no age range indicated	USA	open-ended questions on a sheet, answered verbally
CPTSD
12	Band-Winterstein (2015)	elderly women’s “lived experience” of lifelong intimate partner violence	N = 31 (women)	60–83	Israel	interview
13	Bowland, Biswas, Kyriakakis, and Edmond (2011)	spiritual struggles and resilience in older female trauma survivors	N = 36 (women)	55–83	USA	spiritually focused intervention, participants’ expressed thoughts and responses to topics covered during each group sessions were noted
14	Park et al. (2016)	Korean survivors of the Japanese “comfort women” system	N = 16 (women)	83–95	South Korea	interview
15	Souto et al. (2015)	older Brazilian women’s experience of psychological domestic violence	N = 11 (women)	66–85	Brazil	interview
16	Teshuva and Wells (2014)	experiences of aging and aged care in Australia of older survivors of genocide	N = 21	65+	Australia	interview
PGD
17	Bennett and Vidal-Hall (2000)	widowhood in later life, narratives of death	N = 19 (women)	60+	UK	individual & group interview
18	Costello and Kendrick (2000)	grief and older people: the making or breaking of emotional bonds following partner loss in later life	N = 12	M = 74	UK	interview
19	Damianakis and Marziali (2012)	older adults’ response to the loss of a spouse: the function of spirituality in understanding the grieving process	N = 24	65–82	Canada	group therapy intervention, all sessions were audio recorded
20	Dimond, Caserta, and Lund (1994)	understanding depression in bereaved older adults	N = 10	57–73	USA	interview
21	Farinasso and Labate (2015)	the bereavement experience in elderly widows	N = 6 (women)	no age range indicated	Brazil	interview
22	Fenge (2014)	developing understanding of same-sex partner bereavement for older lesbian and gay people: implications for social work practice	N = 4 older LGBT people N = 3 agencies working with older LGBT people	no age range indicated	UK	interview
23	Hybholt et al. (2020)	life after bereavement by suicide	N = 20	61–79	Denmark	interview
24	Jenkins, Edmundson, Averett, and Yoon (2014)	older lesbians and bereavement: experiencing the loss of a partner	N = 55 (women)	55–82	USA	online survey with open-ended questions
25	Moore (2008)	older poor parents who lost an adult child to AIDS in Togo, West Africa	N = 7	54–80	West Africa	interview
26	Pilkington (2005)	grieving a loss: the lived experience for elders residing in an institution	N = 10	70–92	Canada	dialogue, audio recorded
27	Smith et al. (2011)	elders’ experiences of the death of an adult child	N = 31	M = 72.63	USA	focus group interview
28	van Humbeeck, Dillen, Piers, Grypdonck, and Van Den Noortgate (2016)	the suffering in silence of older parents whose child died of cancer	N = 9	70+	Belgium	interview
29	Wilson and Supiano (2011)	experiences of veterans’ widows following conjugal bereavement	N = 6 (women)	59–82	USA	interview
AjD
30	Allen and Roberto (2014)	how older women in rural Appalachia with gynecological cancer construct and interpret their experience with cancer	N = 20 (women)	51–82	USA	interview
31	Borkan et al. (1991)	injury narratives from elderly hip fracture patients	N = 80	M = 80	USA	interview
32	Forssén (2012)	lifelong significance of disempowering experiences in prenatal and maternity care	N = 20 (women)	no age range indicated	Sweden	interview
33	Lee et al. (2013)	narrative exploration of older people’s transitions into residential care	N = 8	65–97	UK	interview
34	Moult et al. (2020)	how older adults understand and manage distress	N = 18	65–91	UK	interview
35	Nielsen, Minet, Zeraiq, Rasmussen, and Sodemann (2017)	everyday life conditions experienced by older migrants and their reasons for specific age- and health-related behavior during the conduct of everyday life.	N = 16	56–96	Denmark	interview
36	Perez (2013)	older Cuban American exiles’ ambiguous loss of leaving the homeland	N = 20	67–97	USA	interview
37	Schnell, Patel, Steinhauser, Ammarell, and Tulsky (2012)	discussions of the kidney disease trajectory by elderly patients and nephrologists	N = 29 patients N = 11 nephrologists	65–88	USA	individual & focus group interview
38	Singh et al. (2018)	mental health problems and idioms of distress among older adult internally displaced persons in Georgia	N = 75 older adults N = 45 key informants	60+	USA	interview
39	Sun et al. (2020)	adaptation of older adults’ transition to nursing homes in mainland China	N = 11 residents N = 5 staff members	76–93	China	interview

Table 3. Themes identified in the studies related to PTSD, CPTSD, PGD and AjD.

	PTSD	CPTSD	PGD	AjD
body and damage	x	x	x	x
path	x	x	x	x
loss	x	x	x
death	x	x		x
fight	x	x
containment	x			x
breaking/fixing	x			x
aloneness		x	x
hell	x
nature		x
numbness			x
void			x

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