title: From Late-Onset Stress Symptomatology to Later-Adulthood Trauma Reengagement in Aging Combat Veterans: Taking a Broader View.
abstract: About a decade ago we proposed the notion of late-onset stress symptomatology, to characterize the later-life emergence of symptoms related to early-life warzone trauma among aging combat Veterans. We hypothesized that aging-related challenges (role transition and loss, death of family members and friends, physical and cognitive decline) might lead to increased reminiscence, and possibly distress, among Veterans who had previously dealt successfully with earlier traumatic events. Recently, we have reexamined our earlier ideas, to better reflect our developing understanding of this phenomenon, and to incorporate more contemporary perspectives on posttraumatic growth and resilience. As a result, we have broadened our conceptualization to later-adulthood trauma reengagement (LATR). We suggest that in later life many combat Veterans confront and rework their wartime memories in an effort to find meaning and build coherence. Through reminiscence, life review, and wrestling with issues such as integrity versus despair, they intentionally reengage with experiences they avoided or managed successfully earlier in life, perhaps without resolution or integration. This article links LATR to classic gerontologic notions, and elaborates how the LATR process can lead positively to personal growth or negatively to increased symptomatology. We also address the role of preventive intervention in enhancing positive outcomes for Veterans who reengage with their wartime memories in later life.
authors.affiliation: National Center for Posttraumatic Stress Disorder, VA Boston Healthcare System, Boston, Massachusetts. Department of Psychiatry, Boston University School of Medicine, Massachusetts. eve.davison@va.gov.
authors.forename: Eve H
authors.initials: EH
authors.lastname: Davison
authors.affiliation: National Center for Posttraumatic Stress Disorder, VA Boston Healthcare System, Boston, Massachusetts. Department of Psychiatry, Boston University School of Medicine, Massachusetts.
authors.forename: Anica Pless
authors.initials: AP
authors.lastname: Kaiser
authors.affiliation: Massachusetts Veterans Epidemiology Research and Information Center, VA Boston Healthcare System, Boston, Massachusetts. Department of Epidemiology, Boston University School of Public Health, Massachusetts.
authors.forename: Avron
authors.initials: A
authors.lastname: Spiro
authors.affiliation: VA Boston Healthcare System, Brockton, Massachusetts. Department of Psychiatry, Harvard Medical School, Boston, Massachusetts.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Moye
authors.affiliation: National Center for Posttraumatic Stress Disorder, VA Boston Healthcare System, Boston, Massachusetts. Departments of Psychology and Psychiatry, Boston University School of Medicine, Massachusetts.
authors.forename: Lynda A
authors.initials: LA
authors.lastname: King
authors.affiliation: National Center for Posttraumatic Stress Disorder, VA Boston Healthcare System, Boston, Massachusetts. Departments of Psychology and Psychiatry, Boston University School of Medicine, Massachusetts.
authors.forename: Daniel W
authors.initials: DW
authors.lastname: King
mesh_terms: D017668:Age of Onset; D000368:Aged; D000375:Aging / Q000523:psychology*; D006801:Humans; D008016:Life Change Events; D008568:Memory / Q000502:physiology*; D008875:Middle Aged; D013313:Stress Disorders, Post-Traumatic / Q000503:physiopathology / Q000523:psychology*; D011795:Surveys and Questionnaires; D014481:United States; D014728:Veterans / Q000523:psychology*
keywords: Life course/life span; Life review; Meaning-making; Posttraumatic growth; Veterans