Psychopathology and resilience in older adults with posttraumatic stress disorder : a randomized controlled trial comparing narrative exposure therapy and present-centered therapy

Objective: Using data from a randomized controlled trial on psychotherapy for posttraumatic stress disorder (PTSD) in older adults (aged >55), this study aimed at analysing the efficacy of two psychological interventions in terms of self-reported symptoms, comorbid  psychopathology and resilience outcomes.

Method: Thirty-three outpatients (age 55–81) with PTSD were randomly assigned to eleven sessions of narrative exposure therapy or present-centered therapy. Self-reported symptom severity of PTSD, depression and general psychopathology, along with measures of resilience
(self-efficacy, quality of life and posttraumatic growth cognitions), were target outcomes. Harvard Trauma Questionnaire, Beck Depression Inventory, Brief Symptom Inventory, General Efficacy Scale, World Health Organization Quality of Life Assessment and Meaning of War Scale
(personal growth) were assessed pre-treatment, post-treatment and at four months follow-up. Because of variable inter-assessment intervals, a piecewise mixed effects growth model was used to investigate treatment effects.

Results: Neither post-treatment, nor at mean follow-up, between-group effects were found. At follow-up, significant medium to large within-group effect sizes were found in the NET-group for psychopathology (self-reported PTSD: Cohen’s d = 0.54, p < .01; depression: Cohen’s
d = 0.51, p = .03; general psychopathology: Cohen’s d = 0.74, p = .001), but not so in the PCTgroup. Resilience (self-efficacy, quality of life and personal growth cognitions) did not significantly change in either group.

Conclusions: In older adults with PTSD, the efficacy of NET extended beyond PTSD, reducing not only self-reported symptoms of PTSD but also comorbid depression and general psychopathology.

HIGHLIGHTS

• This study showed that recovering from trauma-related pathology in later life with help of narrative exposure therapy is not limited to PTSD symptoms but extends to comorbid pathology.