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

Assessment of 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, more somatic comorbidity and higher risk of cognitive impairment. The Clinician Administered PTSD Scale (CAPS) is mostly used to diagnose PTSD, but less researched in older age. Only two screening instruments have been validated, the PTSD Checklist (PCL) and the Self Rating Inventory for PTSD (SRIP), but cross-validation has still to be done. The PCL scale has been used more often and is also suitable for clinician rating, which is considered more appropriate for older adults. Biological measures have not yet been adapted for assessment in the complex biological systems of older age. Multimethod assessment is 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.