Eve H. Davison

Late-Life Emergence of Early-Life Trauma The Phenomenon of Late-Onset Stress Symptomatology Among Aging Combat Veterans

This study aimed to provide preliminary evidence for, and explore potential antecedents and correlates of, a phenomenon observed in aging combat veterans termed late-onset stress symptomatology (LOSS). LOSS is a hypothesized phenomenon among older veterans who (a) experienced highly stressful combat events in early adulthood; (b) functioned successfully throughout their lives, with no chronic stress-related disorders; but (c) begin to register increased combat-related thoughts, feelings, reminiscences, memories, or symptoms commensurate with the changes and challenges of aging, sometimes decades after their combat experiences. Using a qualitative focus group methodology with 47 World War II, Korean Conflict, and Vietnam War veterans, the authors obtained preliminary evidence for the presence of LOSS as defined, identified some of its features, revealed some normative late-life stressors that may precipitate LOSS, and uncovered potential intrapersonal risk and resilience factors for LOSS. The authors present illustrative quotations from the group discussions and discuss the implications and future directions of this research.

Military Sexual Trauma in Treatment-Seeking Women Veterans

As the number of women serving in the military continues to grow, it is increasingly important to explore the sequelae of military sexual trauma (MST) among female veterans. The current study included 232 female veterans who sought outpatient mental health treatment at an urban Veterans Affairs hospital. The studys aims were to (a) describe and compare the demographic characteristics, health behaviors, and psychological symptoms of female veterans who have experienced MST to those veterans who do not report this experience; and (b) examine the associations between psychological symptoms and health behaviors in this sample, stratified by MST status. Results indicate that treatment-seeking women veterans who reported experiencing MST endorsed more psychological distress compared to those who did not report experiencing MST. In addition, psychological symptoms were associated with engaging in problematic health behaviors, such as binge eating and infrequent physical exercise among both those women who experienced MST and those who did not.

Assessing late-onset stress symptomatology among aging male combat veterans

This studys goal was to develop a measure of late-onset stress symptomatology (LOSS). LOSS is a phenomenon observed in aging combat veterans who (a) were exposed to highly stressful combat events in their early adult years, (b) have functioned successfully throughout midlife with no history of chronic stress-related disorders, but (c) begin to register increased combat-related thoughts, feelings, and reminiscences commensurate with the changes and challenges of aging. Several samples of older male combat veterans from World War II, the Korean Conflict, and the Vietnam War served as participants. We developed a LOSS Scale that demonstrated a high degree of internal consistency reliability (coefficient alpha = 0.97). Scores were stable over brief intervals but were sensitive to developmental change over an extended period. Factor analysis suggested a single LOSS factor. Bivariate associations between LOSS score and other variables (e.g., indicators of contemporary life stressors, resilience, quality of life) were consistent with hypotheses, and there was support for the incremental validity of LOSS vis-à-vis posttraumatic stress symptoms and symptoms of general distress. Discussion of the potential uses of the scale, future directions for psychometric research, and suggestions for generalizing the LOSS construct to other trauma populations are provided.

From Late-Onset Stress Symptomatology to Later-Adulthood Trauma Reengagement in Aging Combat Veterans: Taking a Broader View

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.

Distinguishing late-onset stress symptomatology from posttraumatic stress disorder in older combat veterans.

Objective: To assess the discriminant validity of late-onset stress symptomatology (LOSS) in terms of its distinction from posttraumatic stress disorder (PTSD). Method: The LOSS Scale, PTSD Checklist – Civilian Version, and related psychological measures were administered to 562 older male combat veterans via a mailed questionnaire. Analyses focused on: (a) comparing associations of LOSS and PTSD with other psychological variables and (b) examining a hypothesized curvilinear relationship between LOSS and PTSD scores. Results: Compared to PTSD, LOSS was more strongly associated with concerns about retirement and less strongly associated with depression, anxiety, sense of mastery, and satisfaction with life. LOSS also demonstrated a curvilinear relationship with PTSD, such that the positive association between LOSS and PTSD diminished at higher levels of PTSD. Conclusion: LOSS is conceptually and statistically more strongly associated with a normative late-life stressor than is PTSD, but is less strongly related to mental health symptoms and emotional well-being. Additionally, LOSS seems more related to subthreshold PTSD than it is to clinically significant PTSD. The present findings support the discriminant validity of LOSS.

Stressful and positive experiences of women who served in Vietnam

ABSTRACT Experiences of women who served during the Vietnam War have been described in interviews/anecdotal reports but rarely in empirical literature. Potential positive (versus negative) aspects of service or its impact on well-being are seldom considered. We describe stressful and positive experiences reported by approximately 1,300 female military personnel, Red Cross workers, and others deployed to Vietnam. Prominent stressful (e.g., negative living/working conditions) and positive (e.g., interpersonal relationships) themes and differences based on trauma history, Vietnam experiences, and group membership are explored. We evaluate associations between themes and psychological well-being. Findings provide insight into experiences of this understudied group of women.

Late-onset stress symptomatology (LOSS) scale – short form: development and validation

Abstract Objectives: Late-onset stress symptomatology (LOSS) is a phenomenon observed in older combat veterans who experience increased combat-related thoughts, feelings, and reminiscences corresponding with the changes and challenges of aging. Previously, we developed the LOSS Scale to assess LOSS. This paper describes the development and validation of a LOSS Scale short form (LOSS-SF) to screen veterans in various settings who may be actively re-examining their past wartime experiences. Method: Three studies examined the reliability and validity of the LOSS-SF in separate samples of male combat veterans age 55 and older (total N = 346). Veterans were administered measures via telephone and mail survey. Correlation and regression analyses examined the reliability and validity of the LOSS-SF. Results: The LOSS-SF exhibited strong internal consistency (alpha = .93), test-retest reliability (2 week interval on average; r = .88), and good concurrent validity with the LOSS Scale (r = .81). Convergent and divergent validity were supported by the pattern of correlations between the LOSS-SF and other construct measures. Conclusion: The LOSS-SF is a reliable and valid measure to quickly assess thoughts, feelings, and reminiscences about past combat experiences in older veterans and identify those veterans in distress who may benefit from psychological interventions..

Women at war: The crucible of Vietnam

Relatively little has been written about the military women who served in Vietnam, and there is virtually no literature on deployed civilian women (non-military). We examined the experiences of 1285 American women, military and civilian, who served in Vietnam during the war and responded to a mail survey conducted approximately 25 years later in which they were asked to report and reflect upon their experiences and social and health histories. We compare civilian women, primarily American Red Cross workers, to military women stratified by length of service, describe their demographic characteristics and warzone experiences (including working conditions, exposure to casualties and sexual harassment), and their homecoming following Vietnam. We assess current health and well-being and also compare the sample to age- and temporally-comparable women in the General Social Survey (GSS), with which our survey shared some measures. Short-term (<10 years) military service women (28%) were more likely to report their Vietnam experience as “highly stressful” than were career (>20 years; 12%) and civilian women (13%). Additional differences regarding warzone experiences, homecoming support, and health outcomes were found among groups. All military and civilian women who served in Vietnam were less likely to have married or have had children than women from the general population, χ2 (8) = 643.72, p < .001. Career military women were happier than women in the general population (48% were “very happy”, as compared to 38%). Civilian women who served in Vietnam reported better health than women in the other groups. Regression analyses indicated that long-term physical health was mainly influenced by demographic characteristics, and that mental health and PTSD symptoms were influenced by warzone and homecoming experiences. Overall, this paper provides insight into the experiences of the understudied women who served in Vietnam, and sheds light on subgroup differences within the sample.