title: Narratives of Self-Neglect: Patterns of Traumatic Personal Experiences and Maladaptive Behaviors in Cognitively Intact Older Adults.
abstract: To identify patterns of personal experience or behavior in self-neglect by exploring narratives of cognitively intact older adults.
  
  
  
  Descriptive study involving semistructured interviews and unstructured narratives.
  
  
  
  A parent study of self-neglect characteristics.
  
  
  
  Cognitively intact, self-neglecting older adults referred from 11 community-based senior services agencies (N = 69).
  
  
  
  Interviews included a comprehensive psychiatric assessment using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Axis-I and II Disorders and an unstructured interview that allowed subjects to describe important elements of their life stories. Content analysis was used to identify personal experiences and behavior patterns in each subject's narrative.
  
  
  
  Four types of traumatic personal experiences (psychologically traumatic loss, separation or abandonment (29%); violent victimization, physical trauma, or sexual abuse (19%); exposure to war or political violence (9%); prolonged mourning (7%)) and five behavior patterns (significant financial instability (23%), severe lifelong mental illness (16%), mistrust of people or paranoia (13%), distrust and avoidance of the medical establishment (13%), substance abuse or dependence (13%)) were identified in the life stories.
  
  
  
  Patterns of traumatic personal experiences and maladaptive behaviors that self-neglecters frequently report were identified. Experiences, perceptions, and behaviors developed over a lifetime may contribute to elder self-neglect. Further exploration and better understanding of these patterns may identify potential risk factors and areas for future targeted screening, intervention, and prevention.
authors.affiliation: Division of Geriatrics and Palliative Care, Weill Cornell Medical College, New York, New York.
authors.forename: Cynthia
authors.initials: C
authors.lastname: Lien
authors.affiliation: Division of Emergency Medicine, Weill Cornell Medical College, New York, New York.
authors.forename: Tony
authors.initials: T
authors.lastname: Rosen
authors.affiliation: Division of Geriatrics and Palliative Care, Weill Cornell Medical College, New York, New York.|Division of Emergency Medicine, Weill Cornell Medical College, New York, New York.
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Bloemen
authors.affiliation: Department of Psychiatry, Weill Cornell Medical College, New York, New York.
authors.forename: Robert C
authors.initials: RC
authors.lastname: Abrams
authors.affiliation: Mercy Clinic Geriatrics, St. Louis, Missouri.
authors.forename: Maria
authors.initials: M
authors.lastname: Pavlou
authors.affiliation: Division of Geriatrics and Palliative Care, Weill Cornell Medical College, New York, New York.
authors.forename: Mark S
authors.initials: MS
authors.lastname: Lachs
mesh_terms: D000368:Aged; D035841:Behavioral Research / Q000379:methods; D001526:Behavioral Symptoms / Q000175:diagnosis*; D003071:Cognition; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004552:Elder Abuse / Q000517:prevention & control / Q000523:psychology; D005260:Female; D015577:Geriatric Assessment / Q000379:methods; D006801:Humans; D007406:Interview, Psychological / Q000379:methods; D008016:Life Change Events; D008297:Male; D008609:Mental Status Schedule; D033262:Narration; D018570:Risk Assessment; D012307:Risk Factors; D000068099:Trauma and Stressor Related Disorders / Q000175:diagnosis / Q000209:etiology / Q000523:psychology; D014754:Violence / Q000517:prevention & control / Q000523:psychology
keywords: elder abuse; self-neglect; traumatic life events