Distinguishing late-onset stress symptomatology from posttraumatic stress disorder in older combat veterans

Abstract

Objective: To assess the discriminant validity of late-onset stress symptomatology (LOSS) in terms of its distinction from posttraumatic stress disorder (PTSD).

Method: The LOSS Scale, PTSD Checklist – Civilian Version, and related psychological measures were administered to 562 older male combat veterans via a mailed questionnaire. Analyses focused on: (a) comparing associations of LOSS and PTSD with other psychological variables and (b) examining a hypothesized curvilinear relationship between LOSS and PTSD scores.

Results: Compared to PTSD, LOSS was more strongly associated with concerns about retirement and less strongly associated with depression, anxiety, sense of mastery, and satisfaction with life. LOSS also demonstrated a curvilinear relationship with PTSD, such that the positive association between LOSS and PTSD diminished at higher levels of PTSD.

Conclusion: LOSS is conceptually and statistically more strongly associated with a normative late-life stressor than is PTSD, but is less strongly related to mental health symptoms and emotional well-being. Additionally, LOSS seems more related to subthreshold PTSD than it is to clinically significant PTSD. The present findings support the discriminant validity of LOSS.

Keywords:

• aging male combat veterans
• war experiences
• re-engagement
• discriminant validity

Acknowledgements

The views expressed in this article are those of the authors and do not necessarily represent the views of the US Department of Veterans Affairs. This research was supported by funding from the US Department of Veterans Affairs, the R.E. Mitchell Center for Prisoner of War Studies, Pensacola, FL, and by a Research Career Science and Merit Review award from the US. Department of Veterans Affairs. The Normative Aging Study (NAS) and the Veterans Health Study (VHS) graciously provided access to samples of their veteran participants. The NAS is supported by the Cooperative Studies Program/Epidemiology Research and Information Centers, US Department of Veterans Affairs, and is a research component of the Massachusetts Veterans Epidemiology Research and Information Center. The VHS was supported by grant SDR 91006-S from the Health Services Research and Development Service, US Department of Veterans Affairs. Additional support was provided by grant R01-AG18436 (Dan Mroczek, Principal Investigator) from the National Institute on Aging. The authors express their appreciation to colleagues of the Stress, Health, and Aging Research Program (SHARP), VA Boston Healthcare System; SHARP is supported by the National Center for PTSD and the Massachusetts Veterans Epidemiology Research and Information Center, VA Boston Healthcare System.

Notes

Note

1. For a copy of the LOSS Scale, please contact Anica Pless Kaiser, program coordinator for the SHARP, Clinical Research Psychologist, VA Boston Healthcare System (116B2), 150 S. Huntington Ave, Boston, MA 02130. Email: [email protected].