Psychometric Concerns in the Assessment of Trauma-Related Symptoms in Older Adults

Assessment of posttraumatic stress disorder (PTSD) in older adults is still in its infancy despite reflections on this subject in past literature. Factors that influence assessment are traumas that occurred long in the past, lower prevalence, the fact that older people complain less, more misinterpretation of avoiding and intrusion symptoms, more somatic comorbidity, and higher risk of cognitive impairment. The Clinician Administered PTSD Scale is mostly used to diagnose PTSD, but is less researched in older individuals. Only two screening instruments have been validated specifically for older adults, the PTSD Checklist (PCL) and the Self-Rating Inventory for PTSD. The PCL scale has been used more often, has been translated in various languages, and is also suitable for clinician rating, which is considered more appropriate for older adults. The PCL-5, based on the new Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, criteria was researched in older veterans but needs further validation. Biological measures have not yet been adapted for assessment in the complex biological systems of older age. Multimethod assessment and computerized screening are becoming more important and can address many of the difficulties in this field. Finally, much can be learned from knowledge already acquired from younger adults.