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Posttraumatic Stress and Aggression Among Veterans in Long-term Care

National Center for Posttraumatic Stress Disorder, Palo Alto Health Care System, Department of Veterans Affairs, Menlo Park, California, eve.carlson{at}va.gov

Sean Lauderdale, PhD

Department of Psychology and Counseling, Pittsburgh State University, Pittsburgh, Pennsylvania

James Hawkins, MD

Palo Alto Health Care System, Department of Veterans Affairs, Menlo Park, California

Javaid I. Sheikh, MD

Palo Alto Health Care System, Department of Veterans Affairs, Menlo Park, California, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California

Because stresses associated with long-term care settings may exacerbate distress and aggression related to past trauma, we investigated self-report and staff reports of posttraumatic stress disorder symptoms and staff observations of verbal and physical aggression in 32 elderly males who were patients in a long-term care unit for veterans. Feelings of anger and irritability were reported by 47% of patients; levels of anger and irritability were significantly correlated with observed aggressive behaviors (r = 0.43, P < .02); and observed aggressive behaviors were significantly more frequent among those reporting past traumatic stressors (t = 2.84, P < .008). Patient-reported posttraumatic stress disorder symptoms were significantly correlated with the frequency of past traumatic stressors (r = 0.48, P < .006). Observer-reported posttraumatic stress disorder symptoms and patient reports of anger were strongly correlated (r = 0.73, P < .001). No patient or staff reports were related to level of cognitive function. These findings are consistent with the hypothesis that posttraumatic symptoms can contribute to aggressive behaviors in elderly, medically ill, and cognitively impaired patients.

Key Words: posttraumatic stress • aggression • elderly • long-term care

Journal of Geriatric Psychiatry and Neurology, Vol. 21, No. 1, 61-71 (2008)
DOI: 10.1177/0891988707311557


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