The purpose of this project is to develop an intervention to improve psychosocial functioning and quality of life for older Veterans with partial and full PTSD. This project will develop, implement, and evaluate a group protocol geared toward restoring older Veterans with PTSD to better, fuller functioning. Data collected as part of the proposed project will be used as pilot data (and to calculate effect size estimates) in support of a future clinical trial to evaluate the effectiveness of the intervention. Specifically, the aims of the current study are to 1) Develop a group-based intervention for older Veterans with PTSD that targets areas of psychosocial functional impairment, 2) Conduct focus groups with older Veterans with PTSD and revise the intervention after review of feedback provided by the expert panel and in the focus groups, 3) Implement pilot groups, examine feasibility, acceptability, retention, and satisfaction, and revise protocol as indicated, and 4) Implement and evaluate the intervention protocol through comparison of the intervention with a support group control. Consult expert panel and finalize intervention protocol. The intervention protocol will consist of 10 weekly 90-minute group sessions. Groups will include 8-10 Veterans aged 60 and older with PTSD symptoms. After an initial protocol development phase, two focus groups with older Veterans with PTSD will be conducted. Two pilot groups will be conducted to examine feasibility and Veteran satisfaction with the intervention. Three intervention and three support groups will be conducted to facilitate comparison on primary and secondary outcomes such as psychosocial functioning, quality of life, and PTSD and depressive symptoms. An expert panel of PTSD clinicians and researchers will be consulted throughout this project to guide content development of the intervention and to contribute to the revision of the intervention protocol. Advanced training and education is sought by Dr. Pless Kaiser to improve her knowledge base in the following areas: 1) development of skills in the effective facilitation of focus groups as well as group treatment with older adults, 2) enhance knowledge of clinical issues, intervention development, and appropriate assessment measures and strategies relevant to working with older Veterans, 3) improve her understanding of qualitative and quantitative research methodology and data analysis and (4) further her knowledge of intervention outcome research methodology and clinical trial research, in preparation for future investigations. The combination of seminars, didactics, graduate-level courses, collaborations with mentors, meetings, and directed readings proposed in this application will facilitate the applicant?s long- term goal of becoming an independent VA investigator with a dual focus on furthering our understanding between stress, aging, PTSD, and reactions to trauma as well as working to develop additional interventions to improve quality of life for older Veterans. .
The demographic profile of Veterans in the United States is changing as increasing numbers of Veterans advance into older age. An important mental health issue for aging Veterans is posttraumatic stress disorder (PTSD). Older Veterans are seeking treatment for PTSD at the VA in increasing numbers, some for the first time. There are many comorbidities (e.g., physical health problems, depression) associated with PTSD, many of which may worsen with age, especially as Veterans experience late-life stressors such as retirement and bereavement. Veterans with PTSD often experience difficulties with psychosocial functioning in areas such as social activity, interpersonal relationships, and anger and stress management. The proposed CDA-2 will develop, implement, and evaluate an intervention to improve psychosocial functioning and quality of life among older Veterans with PTSD.
|Pless Kaiser, Anica; Kabat, Daniel H; Spiro 3rd, Avron et al. (2017) Women at war: The crucible of Vietnam. SSM Popul Health 3:236-244|