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Chapter 7 - Long-Term Course of PTSD and Depression Among Adults, Mediating and Moderating Factors in Recovery, and Current Trends for Treatment

Published online by Cambridge University Press:  20 May 2022

Armen Goenjian
Affiliation:
David Geffen School of Medicine; UCLA/Duke University National Center for Child Traumatic Stress
Alan Steinberg
Affiliation:
UCLA/Duke University National Center for Child Traumatic Stress
Robert Pynoos
Affiliation:
UCLA/Duke University National Center for Child Traumatic Stress
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Summary

At 1.5 years post-Spitak-earthquake, elderly survivors had significantly less intrusive and more hyperarousal symptoms (e.g., startle, hypervigilance, irritability, insomnia) than younger adults, indicating that treatment for the elderly requires more focus on hyperarousal symptoms (e.g., use of anxiety management techniques).

At 1.5- and 4.5-years post-earthquake, two groups of adults, exposed to severe trauma (earthquake and political violence), experienced comparably high levels of PTSD and depressive symptoms. The results dispelled the prior notion that natural disasters result in less severe reactions and underscore the importance of using objective and subjective measurements to determine exposure severity. They also showed that previous exposure to political violence had an additive effect on subsequent earthquake exposure-related PTSD severity.

The twenty-three-year prospective study among adult survivors of the earthquake showed that a substantial portion of the population (11.6%) still had PTSD related to the earthquake, and another 9.9% had PTSD related to post-earthquake traumas (e.g., fights, accidents, etc.). Risk factors for PTSD at twenty-three-year follow-up included baseline depression, job loss, post-earthquake traumas, and chronic medical illnesses. The chapter also presents important findings from other disaster studies, including the effect of cumulative trauma, delayed onset PTSD, increased mortality associated with PTSD and depression, and comparisons of recommended treatments for PTSD and depression and their limitations.

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Lessons Learned in Disaster Mental Health
The Earthquake in Armenia and Beyond
, pp. 111 - 136
Publisher: Cambridge University Press
Print publication year: 2022

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