Skip to main content Accessibility help
×
Hostname: page-component-848d4c4894-mwx4w Total loading time: 0 Render date: 2024-06-20T22:52:54.143Z Has data issue: false hasContentIssue false

6 - Does Trauma Linger into Old-Old Age? Using the Holocaust Experience as a Paradigm

Published online by Cambridge University Press:  05 August 2012

Dov Shmotkin
Affiliation:
Tel Aviv University
Amit Shrira
Affiliation:
Tel Aviv University
Yuval Palgi
Affiliation:
Tel Aviv University
Leonard W. Poon
Affiliation:
University of Georgia
Jiska Cohen-Mansfield
Affiliation:
Tel-Aviv University
Get access

Summary

ABSTRACT

Trauma that lingers from early to very late life poses a special threat to the labile conditions of adaptation while facing imminent frailty and death. This chapter examines long-term effects of trauma in three modes of survival into old-old age: (a) dementia-molded survival, which raises a question as to whether cognitive impairment sensitizes traumatic memories or blunts them, (b) embattled survival, which involves either a chronic confrontation with the past trauma or else its reactivation in the adverse conditions of late life, and (c) robust survival, which maintains the capacity to stay well in the face of age-related challenge as well as past trauma. Coping with past trauma under robust survival typically generates a delicate balance between general resilience and specific vulnerabilities. This chapter dwells on research of old and old-old Holocaust survivors, who provide a paradigm for the special challenge of long-term effects of extreme trauma.

LIFETIME TRAUMA AND SURVIVAL IN OLD-OLD AGE

A key issue that developmental models need to account for is the combined impact of distal influences, such as adverse events early in life, and proximal influences, such as recent experiences and resources (Martin & Martin, 2002; see Chapter 5). As developmental trajectories become increasingly obscured and labile in old-old age (Baltes, 1997; Poon & Perls, 2007), the interactive effects of distal trauma and proximal age-related experiences are particularly intricate or unpredictable.

Type
Chapter
Information
Publisher: Cambridge University Press
Print publication year: 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Averill, P. M., & Beck, J. G. (2000). Posttraumatic stress disorder in older adults: A conceptual review. Journal of Anxiety Disorders, 14, 133–156.CrossRefGoogle ScholarPubMed
Ayalon, L., & Covinsky, K. E. (2007). Late-life mortality in older Jews exposed to the Nazi regime. Journal of the American Geriatrics Society, 55, 1380–1386.CrossRefGoogle ScholarPubMed
Bachner, Y. G., Carmel, S., & Sagi, D. (2007). Physical health and psychological resources: A comparison between Holocaust survivors under the Nazi regime and survivors of the Soviet labor camps. Gerontology: Journal of Aging Studies, 34, 63–77 (in Hebrew).Google Scholar
Baltes, P. B. (1997). On the incomplete architecture of human ontogeny: Selection, optimization, and compensation as foundation of developmental theory. American Psychologist, 52, 366–380.CrossRefGoogle ScholarPubMed
Barel, E., IJzendoorn, M. H., Sagi-Schwartz, A., & Bakermans-Kranenburg, M. J. (2010). Surviving the Holocaust: A meta-analysis of the long-term sequelae of a genocide. Psychological Bulletin, 136, 677-698.CrossRefGoogle ScholarPubMed
Bishop, A. J., Martin, P., & Poon, L. W. (2006). Happiness and congruence in older adulthood: A structural model of life satisfaction. Aging and Mental Health, 10, 445–453.CrossRefGoogle ScholarPubMed
Bleich, A., Gelkopf, M., Melamed, Y., & Solomon, Z. (2005). Emotional impact of exposure to terrorism among young-old and old-old Israeli citizens. American Journal of Geriatric Psychiatry, 13, 705–712.CrossRefGoogle ScholarPubMed
Brom, D., Durst, N., & Aghassy, G. (2002). The phenomenology of posttraumatic distress in older adult Holocaust survivors. Journal of Clinical Geropsychology, 8, 189–201.CrossRefGoogle Scholar
Budson, A. E., Simons, J. S., Sullivan, A. L., Beier, J. S., Solomon, P. R., Scinto, L., et al. (2004). Memory and emotions for the September 11, 2001, terrorist attack in patients with Alzheimer's disease, patients with mild cognitive impairment, and healthy older adults. Neuropsychology, 18, 315–327.CrossRefGoogle Scholar
Butler, R. N. (1963). The life review: An interpretation of reminiscence in the aged. Psychiatry, 26, 65–76.CrossRefGoogle ScholarPubMed
Butters, N., & Delis, D. C. (1995). Clinical assessment of memory disorders in amnesia and dementia. Annual Review of Psychology, 46, 493–523.CrossRefGoogle ScholarPubMed
Byrne-Davis, L. M. T., Bennett, P. D., & Wilcock, G. K. (2006). How are quality of life ratings made? Toward a model of quality of life in people with dementia. Quality of Life Research, 15, 855–865.CrossRefGoogle Scholar
Cohen, K., & Shmotkin, D. (2007). Emotional ratings of anchor periods in life and their relation to subjective well-being among Holocaust survivors. Personality and Individual Differences, 43, 495–506.CrossRefGoogle Scholar
Cohen-Mansfield, J. (2000). Heterogeneity in dementia: Challenges and opportunities. Alzheimer Disease and Associated Disorders, 14, 60–63.CrossRefGoogle ScholarPubMed
Cohen-Mansfield, J., & Lipson, S. (2002). Pain in cognitively impaired nursing home residents: How well are physicians diagnosing it? Journal of the American Geriatrics Society, 50, 1039–1044.CrossRefGoogle Scholar
Cohen-Mansfield, J., Parpura-Gill, A., & Golander, H. (2006). Salience of self-identity roles in persons with dementia: Differences in perceptions among elderly persons, family members and caregivers. Social Science and Medicine, 62, 745–757.CrossRefGoogle ScholarPubMed
Cook, J. M., Ruzek, J. I., & Cassidy, E. (2003). Possible association of posttraumatic stress disorder with cognitive impairment among older adults. Psychiatric Services, 54, 1223–1225.CrossRefGoogle ScholarPubMed
Danieli, Y. (1981). On the achievement of integration in aging survivors of the Nazi Holocaust. Journal of Geriatric Psychiatry, 14, 191–210.Google ScholarPubMed
Dekel, R., & Hobfoll, S. E. (2007). The impact of resource loss on Holocaust survivors facing war and terrorism in Israel. Aging and Mental Health, 11, 159–167.CrossRefGoogle ScholarPubMed
Eitinger, L. (1964). Concentration camp survivors in Norway and Israel. Oslo: Oslo University Press.Google Scholar
Erikson, E. H. (1998). The life cycle completed: Extended version with new chapters on the ninth stage by Joan M. Erikson. New York: Norton.Google Scholar
Erskine, J. A. K., Kvavilashvili, L., Conway, M. A., & Myers, L. (2007). The effects of age on psychopathology, well-being, and repressive coping. Aging and Mental Health, 11, 394–404.CrossRefGoogle ScholarPubMed
Ferri, C. P., Prince, M., Brayne, C., Brodaty, H., Fratiglioni, L., Ganguli, M., et al. (2005). Global prevalence of dementia: A Delphi consensus study. Lancet, 366, 2112–2117.CrossRefGoogle ScholarPubMed
Frankl, V. E. (1963). Man's search for meaning: An introduction to logotherapy. New York: Washington Square Press.Google Scholar
Golier, J. A., Harvey, P. D., Legge, J., & Yehuda, R. (2006). Memory performance in older trauma survivors: Implications for the longitudinal course of PTSD. Annals of the New York Academy of Sciences, 1071, 54–66.CrossRefGoogle ScholarPubMed
Grady, C. L., Furey, M. L., Pietrini, P., Horwitz, B., & Rapoport, S. I. (2001). Altered brain connectivity and impaired short-term memory in Alzheimer's disease. Brain, 124, 739–756.CrossRefGoogle ScholarPubMed
Grossman, A. B., Levin, B. E., Katzen, H. L., & Lechner, S. (2004). PTSD symptoms and onset of neurologic disease in elderly trauma survivors. Journal of Clinical and Experimental Neuropsychology, 26, 698–705.CrossRefGoogle ScholarPubMed
Gutmann, D. (1998). The psychoimmune system in later life: The problem of the late-onset disorders. In Lomranz, J. (Ed.), Handbook of aging and mental health (pp. 281–295). New York: Plenum Press.CrossRefGoogle Scholar
Hamann, S. (2001). Cognitive and neural mechanisms of emotional memory. Trends in Cognitive Science, 5, 394–400.CrossRefGoogle ScholarPubMed
Hantman, S., & Solomon, Z. (2007). Recurrent trauma: Holocaust survivors cope with aging and cancer. Social Psychiatry and Psychiatric Epidemiology, 42, 396–402.CrossRefGoogle ScholarPubMed
Helmreich, W. B. (1992). Against all odds: Holocaust survivors and the successful lives they made in America. New York: Simon and Schuster.Google Scholar
Herman, J. L. (1992). Complex PTSD: A syndrome in survivors of prolonged and repeated trauma. Journal of Traumatic Stress, 5, 377–391.CrossRefGoogle Scholar
Hyer, L., & Sacks, A. (2008). PTSD (post-traumatic stress disorders) in later life. In Gallagher-Thompson, D., Steffen, A. M., & Thompson, L. W. (Eds.), Handbook of behavioral and cognitive therapies with older adults (pp. 278–294). New York: Springer.CrossRefGoogle Scholar
Jennings, P. A., Aldwin, C. M., Levenson, M. R., Spiro, A., & Mroczek, D. K. (2006). Combat exposure, perceived benefits of military service, and wisdom in later life. Research on Aging, 28, 115–134.CrossRefGoogle Scholar
Joffe, C., Brodaty, H., Luscombe, G., & Ehrlich, F. (2003). The Sydney Holocaust study: Posttraumatic stress disorder and other psychosocial morbidity in an aged community sample. Journal of Traumatic Stress, 16, 39–47.CrossRefGoogle Scholar
Johnston, D. (2000). A series of cases of dementia presenting with PTSD symptoms in World War II combat veterans. Journal of the American Geriatrics Society, 48, 70–72.CrossRefGoogle ScholarPubMed
Kahana, B. (1992). Late-life adaptation in the aftermath of extreme stress. In Wykle, M. L., Kahana, E., & Kowal, J. (Eds.), Stress and health among the elderly (pp. 151–171). New York: Springer.Google Scholar
Kahana, B., Harel, Z., & Kahana, E. (2005). Holocaust survivors and immigrants: Late life adaptations. New York: Springer.CrossRefGoogle Scholar
Kensinger, E. A. (2006). Remembering emotional information: Effects of aging and Alzheimer's disease. In Welsh, E. M. (Ed.), Frontiers in Alzheimer's disease research (pp. 213–226). Hauppauge, NY: Nova Science.Google Scholar
Kraaij, V., & Wilde, E. J. (2001). Negative life events and depressive symptoms in the elderly: A life span perspective. Aging and Mental Health, 5, 84–91.CrossRefGoogle ScholarPubMed
Krause, N. (2005). Traumatic events and meaning in life: Exploring variations in three age cohorts. Aging and Society, 25, 501–524.CrossRefGoogle Scholar
Landau, R., & Litwin, H. (2000). The effects of extreme early stress in very old age. Journal of Traumatic Stress, 13, 473–487.CrossRefGoogle ScholarPubMed
Laufer, R. S. (1988). The serial self: War trauma, identity, and adult development. In Wilson, J. P., Harel, Z., & Kahana, B. (Eds.), Human adaptation to extreme stress: From the Holocaust to Vietnam (pp. 33–53). New York: Plenum.CrossRefGoogle Scholar
Lomranz, J. (2005). Amplified comment: The triangular relationships between the Holocaust, aging, and narrative gerontology. International Journal of Aging and Human Development, 60, 255–267.CrossRefGoogle ScholarPubMed
Martin, P., da Rosa, G., Siegler, I. C., Davey, A., MacDonald, M., & Poon, L. W. (2006). Personality and longevity: Findings from the Georgia Centenarian Study. Age, 28, 343–352.CrossRefGoogle ScholarPubMed
Martin, P., & Martin, M. (2002). Proximal and distal influences on development: The model of developmental adaptation. Developmental Review, 22, 78–96.CrossRefGoogle Scholar
McAdams, D. P. (2001). The psychology of life stories. Review of General Psychology, 5, 100–122.CrossRefGoogle Scholar
Müller, U., & Barash-Kishon, R. (1998). Psychodynamic-supportive group therapy model for elderly Holocaust survivors. International Journal of Group Psychotherapy, 48, 461–475.CrossRefGoogle ScholarPubMed
Palgi, Y., & Shmotkin, D. (2007). The relations of experiences in World War II and affect types of subjective well-being with functioning and mortality at old-old age. Gerontology: Journal of Aging Studies, 34, 35–62 (in Hebrew).Google Scholar
Peretz, T., Baider, L., Ever-Hadani, P., & Kaplan De-Nour, A. (1994). Psychological distress in female cancer patients with Holocaust experience. General Hospital Psychiatry, 16, 413–418.CrossRefGoogle ScholarPubMed
Poon, L. W., & Perls, T. T. (2007). The trials and tribulations of studying the oldest old. In Poon, L. W. & Perls, T. T. (Eds.), Biopsychosocial approaches to longevity. Vol. 27: Annual Review of Gerontology and Geriatrics (pp. 1–10). New York: Springer.Google Scholar
Ryff, C. D., Singer, B., Love, G. D., & Essex, M. J. (1998). Resilience in adulthood and later life: Defining features and dynamic processes. In Lomranz, J. (Ed.), Handbook of aging and mental health: An integrative approach (pp. 69–99). New York: Plenum Press.CrossRefGoogle Scholar
Ryn, Z. (1990). The evolution of mental disturbances in the concentration camp syndrome (KZ-syndrome). Genetic, Social, and General Psychology Monographs, 116, 21–36.Google Scholar
Schnurr, P. P., Spiro, A., Vielhauer, M. J., Findler, M. N., & Hamblen, J. L. (2002). Trauma in the lives of older men: Findings from the Normative Aging Study. Journal of Clinical Geropsychology, 8, 175–187.CrossRefGoogle Scholar
Shamai, M., & Levin-Megged, O. (2006). The myth of creating an integrative story: The therapeutic experience of Holocaust survivors. Qualitative Health Research, 16, 692–712.CrossRefGoogle ScholarPubMed
Shanan, J. (1989). Surviving the survivors: Late personality development of Jewish Holocaust survivors. International Journal of Mental Health, 17, 42–71.CrossRefGoogle Scholar
Shmotkin, D. (2003). Vulnerability and resilience intertwined: A review of research on Holocaust survivors. In Jacoby, R. & Keinan, G. (Eds.), Between stress and hope: From a disease-centered to a health-centered perspective (pp. 213–233). Westport, CT: Praeger.Google Scholar
Shmotkin, D. (2005). Happiness in face of adversity: Reformulating the dynamic and modular bases of subjective well-being. Review of General Psychology, 9, 291–325.CrossRefGoogle Scholar
Shmotkin, D., & Barilan, Y. M. (2002). Expressions of Holocaust experience and their relationship to mental symptoms and physical morbidity among Holocaust survivor patients. Journal of Behavioral Medicine, 25, 115–134.CrossRefGoogle ScholarPubMed
Shmotkin, D., Berkovich, M., & Cohen, K. (2006). Combining happiness and suffering in a retrospective view of anchor periods in life: A differential approach to subjective well-being. Social Indicators Research, 77, 139–169.CrossRefGoogle Scholar
Shmotkin, D., Blumstein, T., & Modan, B. (2003). Tracing long-term effects of early trauma: A broad-scope view of Holocaust survivors in late life. Journal of Consulting and Clinical Psychology, 71, 223–234.CrossRefGoogle ScholarPubMed
Shmotkin, D., & Lomranz, J. (1998). Subjective well-being among Holocaust survivors: An examination of overlooked differentiations. Journal of Personality and Social Psychology, 75, 141–155.CrossRefGoogle ScholarPubMed
Shmotkin, D., & Shrira, A. (in press). On the distinction between subjective well-being and meaning in life: Regulatory versus reconstructive functions in the face of a hostile world. In Wong, P. T. P. (Ed.), The human quest for meaning: A handbook of psychological research and clinical applications (2nd ed.). New York: Routledge.
Shrira, A., Palgi, Y., Ben-Ezra, M., & Shmotkin, D. (in press). Functioning and mortality of Holocaust survivors: Physical resilience and psychosocial vulnerabilities. Journal of Loss and Trauma.
Shrira, A., & Shmotkin, D. (2008). Can past keep life pleasant even for old-old trauma survivors? Aging and Mental Health, 12, 807–819.CrossRefGoogle ScholarPubMed
Solomon, Z., & Prager, E. (1992). Elderly Israeli Holocaust survivors during the Persian Gulf War: A study of psychological distress. American Journal of Psychiatry, 149, 1707–1710.Google ScholarPubMed
Tedeschi, R. G., & Calhoun, L. G. (2004). Posttraumatic growth: Conceptual foundations and empirical evidence. Psychological Inquiry, 15, 1–18.CrossRefGoogle Scholar
Terno, P., Barak, Y., Hadjez, J., Elizur, A., & Szor, H. (1998). Holocaust survivors hospitalized for life: The Israeli experience. Comprehensive Psychiatry, 39, 364–367.CrossRefGoogle ScholarPubMed
Verma, S., Orengo, C. A., Maxwell, R., Kunik, M. E., Molinari, V. A., Vasterling, J. J., et al. (2001). Contribution of PTSD/POW history to behavioral disturbances in dementia. International Journal of Geriatric Psychiatry, 16, 356–360.CrossRefGoogle ScholarPubMed
Vogt, L. J. K., Human, B. T., Hoesen, G. W., & Damasio, A. R. (1990). Pathological alterations in the amygdala in Alzheimer's disease. Neuroscience, 37, 377–385.CrossRefGoogle Scholar

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×