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Harmonizing Cognitive and Psychosocial Needs in Cognitive Training: Lessons Learned from Piano Training in Persons Living with Mild Cognitive Impairment.
IF 2.6 3区 医学 Q3 GERIATRICS & GERONTOLOGY Pub Date : 2025-01-09 DOI: 10.1080/07317115.2024.2447839
Rose Lin, Laura M Robinson, Jing Jing Su, Elinor Freer, Sally Norton, Benzi M Kluger, Kathi L Heffner

Objectives: This qualitative study explored the potential of piano training as a holistic intervention to enhance both cognitive and emotional well-being. The study aims to detail the experiences of older adults living with mild cognitive impairment (MCI) in a piano training program and recommend strategies to boost engagement.

Methods: Fourteen individuals (seven older adults with MCI and their family members) participated in individual semi-structured interviews before and after a 12-week group-based piano training program. These interviews were recorded, transcribed, open-coded, and analyzed by conventional content analysis.

Results: Participants with MCI reported improvements in mood, cognitive function, and social interaction. The learning process elicited mixed emotions, with both enjoyment and frustration occurring during the learning phases. Skill mastery and positive social interactions were crucial for sustained engagement throughout the program, although group settings sometimes led to negative self-comparisons.

Conclusions: Findings highlighted the need to address both cognitive and emotional needs in interventions for MCI. Neglecting these aspects can exacerbate feelings of low self-esteem and other negative emotions.

Clinical implications: Recommendations for cognitive training programs include positive reinforcement, personalized support, mental preparation for challenges, and rapport building to enhance participant motivation and adherence.

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引用次数: 0
Child Maltreatment Among Older Adults: A Narrative Review of Psychotherapeutic Interventions and Clinical Considerations. 老年人中儿童虐待:心理治疗干预和临床考虑的叙述性回顾。
IF 2.6 3区 医学 Q3 GERIATRICS & GERONTOLOGY Pub Date : 2025-01-01 Epub Date: 2023-05-31 DOI: 10.1080/07317115.2023.2219671
Rachel Zack Ishikawa, Ilana Ander, Dominique L Popescu, Chirag M Vyas, Olivia I Okereke

Objectives: The goals of this narrative review are to review the literature on psychotherapeutic interventions for older adults with histories of child maltreatment (CM) and to examine the unique considerations for assessing, diagnosing, and treating older adults with CM histories.

Methods: Online database searches were conducted to identify the extant research into the efficacy of psychotherapeutic interventions for older adults with CM-related trauma.

Results: Eight studies met inclusion criteria. The primary target diagnoses were post-traumatic stress disorder and depression. Psychotherapeutic interventions included Narrative Exposure Therapy, exposure-based treatments, Life Review Therapy, integrated treatments, and a spiritually-focused group therapy.

Conclusions: While limited in number and generalizability due to study design and sample size and characteristics, the studies provide preliminary evidence of potentially effective psychotherapeutic treatments for older adults with CM histories. Further research is needed to determine the most effective psychotherapeutic interventions for this population.

Clinical implications: Many older adults suffer for decades with the repercussions of CM. Due to knowledge gaps regarding best practices for treating older adults with CM histories, many clinicians are poorly equipped to treat this population. Therefore, awareness of CM-related pathology and familiarity with effective psychotherapeutic interventions are essential for clinicians to meet the needs of this population.

目的:这篇叙述性综述的目的是回顾对有儿童虐待史的老年人进行心理治疗干预的文献,并研究评估、诊断和治疗有儿童虐待史的老年人的独特考虑因素。方法:对在线数据库进行检索,以确定现有的关于心理治疗干预对老年cm相关创伤的疗效的研究。结果:8项研究符合纳入标准。主要目标诊断为创伤后应激障碍和抑郁症。心理治疗干预包括叙事暴露疗法、暴露治疗、生活回顾疗法、综合治疗和以精神为中心的团体治疗。结论:虽然由于研究设计、样本量和特征的限制,这些研究的数量和普遍性有限,但这些研究为有CM病史的老年人提供了潜在有效的心理治疗的初步证据。需要进一步研究来确定对这一人群最有效的心理治疗干预措施。临床意义:许多老年人遭受数十年的CM的影响。由于关于治疗有CM病史的老年人的最佳实践的知识差距,许多临床医生在治疗这一人群方面装备不足。因此,对cm相关病理的认识和对有效的心理治疗干预的熟悉对于临床医生满足这一人群的需求至关重要。
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引用次数: 0
Modified Prolonged Exposure Therapy for Posttraumatic Stress Disorder with an 85-Year-Old Native American Cajun Man With Late-Onset Deafness: A Case Report. 改良延长暴露疗法治疗创伤后应激障碍:一名 85 岁患有晚期耳聋的美国原住民卡真人:病例报告。
IF 2.6 3区 医学 Q3 GERIATRICS & GERONTOLOGY Pub Date : 2025-01-01 Epub Date: 2023-02-02 DOI: 10.1080/07317115.2023.2173693
Adam M Lewis

Objectives: Few studies of exposure therapy with adults 85 years and older exist. This case report presents results of prolonged exposure (PE) for posttraumatic stress disorder (PTSD) modified for an 85-year-old Native American Cajun man with late-onset deafness, who used a cochlear implant, and reported high Western/non-Native American acculturation. The following modifications were made primarily in response to the client's individual, disability-related barriers to completing the standard PE protocol: (a) inclusion of the client's spouse in aspects of treatment planning and homework assignments; (b) variable session length and frequency; (c) homework was limited to the daily practice of breathing retraining and in vivo exposure to triggering images; and (d) therapist reliance on nonverbal indicators of distress during imaginal exposures.

Methods: The PTSD Checklist for DSM-5 (PCL-5) and 15-item Geriatric Depression Scale (GSD-15) were primary progress and outcome measures.

Results: The modified treatment was associated with clinically significant decreases in baseline PTSD (19 points) and depressive (8 points) symptoms.

Conclusions: PE protocol modifications did not compromise treatment outcomes for this client.

Clinical implications: PE protocols should be modified based on the individual needs of diverse older adults underrepresented in efficacy research.

研究目的针对 85 岁及以上成年人的暴露疗法研究很少。本病例报告介绍了针对创伤后应激障碍(PTSD)的长时间暴露疗法(PE)的治疗结果,该疗法针对一名 85 岁的美国原住民卡琼人(Cajun)进行了修改,该人患有晚期耳聋,使用人工耳蜗,并报告了较高的西方/非美国原住民文化适应度。主要针对该患者在完成标准创伤后应激障碍治疗方案时遇到的与残疾有关的障碍,对该方案进行了以下修改:(a)让患者的配偶参与治疗计划和家庭作业;(b)疗程长度和频率不固定;(c)家庭作业仅限于每天练习呼吸再训练和活体暴露于触发图像;以及(d)在想象暴露过程中,治疗师依赖于非语言的痛苦指标:方法:DSM-5创伤后应激障碍核对表(PCL-5)和15项老年抑郁量表(GSD-15)是主要的进展和结果测量指标:结果:修改后的治疗与创伤后应激障碍基线症状(19 分)和抑郁症状(8 分)的临床显著下降相关:临床意义:临床意义:应根据疗效研究中代表性不足的不同老年人的个人需求修改 PE 方案。
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引用次数: 0
Perceived Need, Mental Health Literacy, Neuroticism and Self- Stigma Predict Mental Health Service Use Among Older Adults. 感知需求、心理健康素养、神经质和自我污名预测老年人心理健康服务的使用。
IF 2.6 3区 医学 Q3 GERIATRICS & GERONTOLOGY Pub Date : 2025-01-01 Epub Date: 2022-04-10 DOI: 10.1080/07317115.2022.2058440
Corey S Mackenzie, Lily Pankratz

Objectives: Older adults are the least likely age group to seek mental health services. However, few studies have explored a comprehensive range of sociodemographic, psychological, and social barriers and facilitators to seeking treatment in later life.

Methods: A cross-sectional, national sample of Canadian older adults (55+, N = 2,745) completed an online survey including reliable and valid measures of predisposing, enabling, and need characteristics, based on Andersen's behavioral model of health, as well as self-reported use of mental health services. Univariate and hierarchical logistic regressions predicted past 5-year mental health service use.

Results: Mental health service use was most strongly and consistently associated with greater perceived need (OR = 11.48) and mental health literacy (OR = 2.16). Less self-stigma of seeking help (OR = .65) and greater neuroticism (OR = 1.57) also predicted help-seeking in our final model, although their effects were not as strong or consistent across gender, marital status, and age subgroups.

Conclusions: The need category was crucial to seeking help, but predisposing psychological factors were also significant barriers to treatment.

Clinical implications: Interventions that target older adults high in neuroticism by improving perceptions of need for treatment, mental health literacy, and self-stigma of seeking help may be particularly effective ways of improving access to mental health services.

目的:老年人是最不可能寻求心理健康服务的年龄组。然而,很少有研究探讨了在晚年寻求治疗的社会人口学、心理和社会障碍和促进因素的综合范围。方法对加拿大老年人(55岁以上,N = 2745)进行横断面在线调查,包括可靠有效的易感、使能和需求特征测量,基于Andersen的健康行为模型,以及自我报告的心理健康服务使用情况。单变量和分层逻辑回归预测过去5年的心理健康服务使用情况。结果心理健康服务的使用与更大的感知需求(OR = 11.48)和心理健康素养(OR = 2.16)的关系最为强烈和一致。在我们的最终模型中,更少的寻求帮助的自我耻辱(OR = 0.65)和更大的神经质(OR = 1.57)也预测了寻求帮助,尽管它们的影响在性别、婚姻状况和年龄亚组中并不强烈或一致。结论需求类别对寻求帮助至关重要,但易感心理因素也是影响治疗的重要障碍。临床意义通过提高对治疗需求的认识、心理健康素养和寻求帮助的自我耻辱感来针对高神经质老年人的干预措施可能是改善获得心理健康服务的特别有效的方法。
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引用次数: 0
The Relationship Between Adverse Childhood Experiences and Subjective Cognitive Decline Based on Sexual Orientation. 儿童期不良经历与基于性取向的主观认知能力下降的关系
IF 2.6 3区 医学 Q3 GERIATRICS & GERONTOLOGY Pub Date : 2025-01-01 Epub Date: 2023-11-13 DOI: 10.1080/07317115.2023.2282484
Yan Xu, Yanfang Wang, Yana Chen, Yuan Zhang, Li Tong, Yue He, Jiaxin Fang, Runhong Li, Xinyao Zhang, Lina Jin

Objectives: Research indicates adverse childhood experiences (ACEs) were associated with subjective cognitive decline (SCD), with higher ACEs reported by sexual minoritized individuals (i.e. lesbian, gay, and bisexual; LGB). This study aimed to explore the relationships between ACEs and SCD based on sexual orientation in middle-aged and older adults.

Methods: The study included 76,592 participants from the 2019-2020 Behavioral Risk Factor Surveillance Survey (BRFSS). Multivariate logistic regressions analyzed ACEs status, score, and type associations with SCD.

Results: 2.18% of the participants identified as sexual minoritized individuals. More sexual minoritized individuals reported SCD compared to heterosexual individuals (10.70% for heterosexuals; 17.27% for sexual minoritized individuals). Positive association between SCD and ACEs status (OR = 2.18, 95%CI: 1.09-4.40) was identified among sexual minoritized individuals.

Conclusions: The association between ACEs and SCD was strong in both heterosexual and sexual minoritized populations. Given the higher experience of ACEs among sexual minoritized adults, the subsequent frequency of SCD among these adults also may be higher.

Clinical implications: Sexual minoritized older adults may have a history of numerous ACEs, which could contribute to a greater burden of SCD. Clinicians and other stakeholders may wish to consider relationships between ACEs and SCD based on sexual orientation.

研究表明,不良童年经历(ace)与主观认知能力下降(SCD)有关,性少数群体(即女同性恋、男同性恋和双性恋)报告的ace较高;性恋)。本研究旨在探讨基于性取向的中老年ace与SCD之间的关系。方法:该研究纳入了2019-2020年行为风险因素监测调查(BRFSS)的76592名参与者。多变量logistic回归分析ace状态、评分和类型与SCD的关联。结果:2.18%的参与者被确定为性少数群体。与异性恋者相比,更多的性少数群体报告了SCD(异性恋者为10.70%;性少数群体占17.27%)。在性少数群体中,SCD与ace状态呈正相关(OR = 2.18, 95%CI: 1.09-4.40)。结论:ace和SCD之间的关联在异性恋和性少数人群中都很强。考虑到性少数群体的成年人有较高的ace经历,这些成年人随后发生SCD的频率也可能更高。临床意义:性少数的老年人可能有多次ace病史,这可能会增加SCD的负担。临床医生和其他利益相关者可能希望考虑基于性取向的ace和SCD之间的关系。
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引用次数: 0
Trends in Positive Life Orientation Among 70-Year-Olds: A Comparison of Two Finnish Cohorts Born 20 Years Apart. 70 岁老人积极生活取向的趋势:相隔 20 年出生的两组芬兰人的比较。
IF 2.6 3区 医学 Q3 GERIATRICS & GERONTOLOGY Pub Date : 2025-01-01 Epub Date: 2024-02-27 DOI: 10.1080/07317115.2024.2320927
Ville L Langén, Adriana Emidio, Jenni Vire, Matti Viitanen, Konsta Teppo

Objectives: We assessed if positive life orientation (PLO) has increased among older individuals and explored gender disparities in PLO changes.

Methods: Two cohorts of 70-year-olds from Turku, Finland were included: the 1920 birth cohort (examined in 1991; n = 1,032) and the 1940 birth cohort (examined in 2011; n = 956). Participants completed an identical questionnaire assessing life satisfaction, feeling needed, future plans, zest for life, depression, and loneliness. A composite PLO score (range 0-1) was computed.

Results: The 2011 cohort had a higher mean PLO score than the 1991 cohort (.87 vs. .83, p < .001). The 2011 cohort reported higher sense of being needed, more future plans, and reduced loneliness (all p < .001). No significant differences were found in life satisfaction, zest for life, or depression. Gender disparities in PLO persisted across both cohorts, with men scoring slightly higher but following similar trends as women.

Discussion: PLO appears to have increased among older individuals.

Clinical implications: Recognizing the rising trend of PLO in recent decades may influence the development of societal and healthcare policies to further improve overall well-being among older individuals.

目的我们评估了老年人的积极生活取向(PLO)是否有所增加,并探讨了积极生活取向变化中的性别差异:研究对象包括来自芬兰图尔库的两个 70 岁组群:1920 年出生组群(1991 年研究;n = 1,032 人)和 1940 年出生组群(2011 年研究;n = 956 人)。参与者填写了一份相同的问卷,评估生活满意度、被需要感、未来计划、生活热情、抑郁和孤独感。结果显示,2011 年出生的人群的综合 PLO 得分(范围 0-1)更高:结果:2011 年组群的 PLO 平均得分高于 1991 年组群(.87 vs. .83,p p 讨论:PLO似乎在老年人中有所增加:临床意义:认识到近几十年来 PLO 的上升趋势可能会影响社会和医疗保健政策的制定,从而进一步改善老年人的整体福祉。
{"title":"Trends in Positive Life Orientation Among 70-Year-Olds: A Comparison of Two Finnish Cohorts Born 20 Years Apart.","authors":"Ville L Langén, Adriana Emidio, Jenni Vire, Matti Viitanen, Konsta Teppo","doi":"10.1080/07317115.2024.2320927","DOIUrl":"10.1080/07317115.2024.2320927","url":null,"abstract":"<p><strong>Objectives: </strong>We assessed if positive life orientation (PLO) has increased among older individuals and explored gender disparities in PLO changes.</p><p><strong>Methods: </strong>Two cohorts of 70-year-olds from Turku, Finland were included: the 1920 birth cohort (examined in 1991; <i>n</i> = 1,032) and the 1940 birth cohort (examined in 2011; <i>n</i> = 956). Participants completed an identical questionnaire assessing life satisfaction, feeling needed, future plans, zest for life, depression, and loneliness. A composite PLO score (range 0-1) was computed.</p><p><strong>Results: </strong>The 2011 cohort had a higher mean PLO score than the 1991 cohort (.87 vs. .83, <i>p</i> < .001). The 2011 cohort reported higher sense of being needed, more future plans, and reduced loneliness (all <i>p</i> < .001). No significant differences were found in life satisfaction, zest for life, or depression. Gender disparities in PLO persisted across both cohorts, with men scoring slightly higher but following similar trends as women.</p><p><strong>Discussion: </strong>PLO appears to have increased among older individuals.</p><p><strong>Clinical implications: </strong>Recognizing the rising trend of PLO in recent decades may influence the development of societal and healthcare policies to further improve overall well-being among older individuals.</p>","PeriodicalId":10376,"journal":{"name":"Clinical Gerontologist","volume":" ","pages":"121-127"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139982570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The impact of personality traits on the course of frailty. 人格特征对虚弱过程的影响。
IF 2.6 3区 医学 Q3 GERIATRICS & GERONTOLOGY Pub Date : 2025-01-01 Epub Date: 2023-01-10 DOI: 10.1080/07317115.2023.2165469
Elizabeth G T Bos, Jamila Douairi, Rob M Kok, Isis Koolhoven, Nathaly Rius Ottenheim, Didi Rhebergen, Richard C Oude Voshaar

Objectives: Determinants of frailty are generally explored within context of somatic healthcare and/or lifestyle characteristics. To examine the impact of personality traits on change in frailty and the potential role of depression.

Methods: A 2-year follow-up study including 285 patients with a depressive disorder and 116 never-depressed controls. Multiple linear regression analyses were conducted to regress the Big Five personality traits (independent variables) on different frailty measures (dependent variables), including the Frailty Index, Frailty phenotype, gait speed, and handgrip strength. Analyses were adjusted for confounders (with and without depressive disorder) and baseline frailty severity. Interactions between personality traits and depressive disorder were examined.

Results: All personality traits were associated with change in at least one frailty marker over time. Over time, a higher level of neuroticism was associated with an accelerated increase of frailty, whereas a higher level of extraversion, agreeableness, conscientiousness and openness were associated with an attenuated increase of frailty. None of the associations were moderated by depression. Additional adjustment for depression decreased the strength of the association of neuroticism, extraversion and conscientiousness with frailty.

Conclusions: Personality traits have impact on frailty trajectories in later life.

Clinical implications: Underlying pathways and potential modification by psychotherapy merit further study.

目的:虚弱的决定因素通常是在躯体保健和/或生活方式特征的背景下进行探讨的。目的:研究人格特征对虚弱程度变化的影响以及抑郁症的潜在作用:一项为期 2 年的随访研究,包括 285 名抑郁症患者和 116 名从未患过抑郁症的对照组患者。对五大人格特质(自变量)和不同的虚弱度测量指标(因变量)进行了多元线性回归分析,包括虚弱指数、虚弱表型、步速和手握强度。分析对混杂因素(有无抑郁障碍)和基线虚弱严重程度进行了调整。还研究了人格特质与抑郁障碍之间的交互作用:结果:随着时间的推移,所有人格特质都与至少一种虚弱标记的变化有关。随着时间的推移,神经质水平越高,虚弱程度增加越快,而外向性、宜人性、自觉性和开放性水平越高,虚弱程度增加越慢。这些关联都不受抑郁的影响。对抑郁的额外调整降低了神经质、外向性和自觉性与虚弱的关联强度:结论:人格特质对晚年的虚弱轨迹有影响:临床意义:心理治疗的潜在改变途径值得进一步研究。
{"title":"The impact of personality traits on the course of frailty.","authors":"Elizabeth G T Bos, Jamila Douairi, Rob M Kok, Isis Koolhoven, Nathaly Rius Ottenheim, Didi Rhebergen, Richard C Oude Voshaar","doi":"10.1080/07317115.2023.2165469","DOIUrl":"10.1080/07317115.2023.2165469","url":null,"abstract":"<p><strong>Objectives: </strong>Determinants of frailty are generally explored within context of somatic healthcare and/or lifestyle characteristics. To examine the impact of personality traits on change in frailty and the potential role of depression.</p><p><strong>Methods: </strong>A 2-year follow-up study including 285 patients with a depressive disorder and 116 never-depressed controls. Multiple linear regression analyses were conducted to regress the Big Five personality traits (independent variables) on different frailty measures (dependent variables), including the Frailty Index, Frailty phenotype, gait speed, and handgrip strength. Analyses were adjusted for confounders (with and without depressive disorder) and baseline frailty severity. Interactions between personality traits and depressive disorder were examined.</p><p><strong>Results: </strong>All personality traits were associated with change in at least one frailty marker over time. Over time, a higher level of neuroticism was associated with an accelerated increase of frailty, whereas a higher level of extraversion, agreeableness, conscientiousness and openness were associated with an attenuated increase of frailty. None of the associations were moderated by depression. Additional adjustment for depression decreased the strength of the association of neuroticism, extraversion and conscientiousness with frailty.</p><p><strong>Conclusions: </strong>Personality traits have impact on frailty trajectories in later life.</p><p><strong>Clinical implications: </strong>Underlying pathways and potential modification by psychotherapy merit further study.</p>","PeriodicalId":10376,"journal":{"name":"Clinical Gerontologist","volume":" ","pages":"141-148"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10859007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Features and Needs of Autistic Older Adults: A Delphi Study of Clinical Experiences. 孤独症老年人的特征与需求:临床经验的德尔菲研究。
IF 2.6 3区 医学 Q3 GERIATRICS & GERONTOLOGY Pub Date : 2025-01-01 Epub Date: 2022-04-15 DOI: 10.1080/07317115.2022.2060157
S M J Heijnen-Kohl, B Hitzert, R Schmidt, H M Geurts, S P J van Alphen

Objectives: In geriatric psychiatry Autism Spectrum Disorders (ASD) are increasingly recognized. This study explores what clinicians know about diagnostic and/or therapeutic aspects of autistic older adults and how aging plays a role in the course of ASD.

Methods: A Delphi study outlines the point of view of 11 clinical experts in the Netherlands and Belgium (Flanders).

Results: Regarding diagnostics, age-specific aspects need to be considered. Age-related characteristics (cognitive differences, life events, co-occurring conditions) influence detecting autistic features in older adults. Regarding treatment, counseling methods need to be adapted. Psychoeducation, family therapy, couples therapy, behavioral counseling and psychopharmaca can be helpful in meeting the needs of autistic older adults. There was no consensus on the effects of aging on autistic older adults.

Conclusions: Diagnosis and treatment of ASD need adaptation for autistic older adults. Further research is needed on the validation of measurement tools, recorded treatment, therapy, psychoeducation, and the effects of aging among people on the autism spectrum.

Clinical implications: Available knowledge helps clinicians to detect ASD in older adults and adapt to the specific features and needs of autistic older adults. The effects of aging on the course of ASD are unclear yet.

目的在老年精神病学中,自闭症谱系障碍(ASD)得到了越来越多的认可。这项研究探讨了临床医生对自闭症老年人的诊断和/或治疗方面的了解,以及衰老如何在ASD过程中发挥作用。方法德尔福研究概述了荷兰和比利时(佛兰德斯)11位临床专家的观点。年龄相关特征(认知差异、生活事件、共同发生的条件)影响老年人自闭症特征的检测。关于治疗,需要调整咨询方法。心理教育、家庭治疗、夫妻治疗、行为咨询和心理药物治疗可以帮助满足自闭症老年人的需求。对于衰老对患有自闭症的老年人的影响,目前还没有达成共识。结论自闭症老年人ASD的诊断和治疗需要适应。需要进一步研究测量工具的验证、记录的治疗、治疗、心理教育,以及衰老对自闭症谱系的影响。临床意义现有知识有助于临床医生检测老年人的ASD,并适应自闭症老年人的特定特征和需求。衰老对ASD病程的影响尚不清楚。
{"title":"Features and Needs of Autistic Older Adults: A Delphi Study of Clinical Experiences.","authors":"S M J Heijnen-Kohl, B Hitzert, R Schmidt, H M Geurts, S P J van Alphen","doi":"10.1080/07317115.2022.2060157","DOIUrl":"10.1080/07317115.2022.2060157","url":null,"abstract":"<p><strong>Objectives: </strong><i>I</i>n geriatric psychiatry Autism Spectrum Disorders (ASD) are increasingly recognized. This study explores what clinicians know about diagnostic and/or therapeutic aspects of autistic older adults and how aging plays a role in the course of ASD.</p><p><strong>Methods: </strong>A Delphi study outlines the point of view of 11 clinical experts in the Netherlands and Belgium (Flanders).</p><p><strong>Results: </strong><i>R</i>egarding diagnostics, age-specific aspects need to be considered. Age-related characteristics (cognitive differences, life events, co-occurring conditions) influence detecting autistic features in older adults. Regarding treatment, counseling methods need to be adapted. Psychoeducation, family therapy, couples therapy, behavioral counseling and psychopharmaca can be helpful in meeting the needs of autistic older adults. There was no consensus on the effects of aging on autistic older adults.</p><p><strong>Conclusions: </strong><i>D</i>iagnosis and treatment of ASD need adaptation for autistic older adults. Further research is needed on the validation of measurement tools, recorded treatment, therapy, psychoeducation, and the effects of aging among people on the autism spectrum.</p><p><strong>Clinical implications: </strong><i>A</i>vailable knowledge helps clinicians to detect ASD in older adults and adapt to the specific features and needs of autistic older adults. The effects of aging on the course of ASD are unclear yet.</p>","PeriodicalId":10376,"journal":{"name":"Clinical Gerontologist","volume":"1 1","pages":"110-120"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49163088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Marital Quality and Loneliness Among Aging Vietnam-Era Combat Veterans: The Moderating Role of PTSD Symptom Severity. 越南退伍军人的婚姻质量和孤独感:创伤后应激障碍症状严重程度的调节作用。
IF 2.6 3区 医学 Q3 GERIATRICS & GERONTOLOGY Pub Date : 2025-01-01 Epub Date: 2023-10-27 DOI: 10.1080/07317115.2023.2274052
Christina M Marini, Jeremy B Yorgason, Anica Pless Kaiser, Lance D Erickson

Objectives: We examined links between marital quality and loneliness among aging veterans and explored whether veterans' PTSD symptom severity moderated these associations.

Methods: Data came from 269 Vietnam-Era combat veterans who had a spouse/partner (M age = 60.50). Utilizing two waves of data spanning six years, we estimated multiple regression models that included positive and negative marital quality, PTSD symptom severity, and loneliness in 2010 as predictors of loneliness in 2016.

Results: Facets of positive (but not negative) marital quality were associated with veterans' loneliness. Companionship - spousal affection and understanding - was associated with lower subsequent loneliness among veterans with low/moderate - but not high - PTSD symptom severity. Conversely, sociability - the degree to which one's marriage promotes socializing with others - was associated with lower subsequent loneliness regardless of PTSD symptom severity.

Conclusions: Companionship and sociability were each associated with veterans' subsequent loneliness. Whereas benefits of companionship were attenuated at higher levels of PTSD symptom severity, benefits of sociability were not.

Clinical implications: For veterans with higher PTSD symptoms, recommending mental health treatment to decrease symptom severity may help them to reap the benefits of close/intimate relationships. However, bolstering veterans' social participation more broadly may provide an additional means of reducing their loneliness.

目的:我们研究了老年退伍军人的婚姻质量和孤独感之间的联系,并探讨了退伍军人的创伤后应激障碍症状严重程度是否调节了这些联系。方法:数据来自269名越南时代的退伍军人,他们有配偶/伴侣(M年龄 = 60.50)。利用跨越六年的两波数据,我们估计了多元回归模型,其中包括积极和消极的婚姻质量、创伤后应激障碍症状严重程度和2010年的孤独感,作为2016年孤独感的预测因素。结果:积极(而非消极)的婚姻质量与退伍军人的孤独感有关。在创伤后应激障碍症状严重程度较低/中度但不高的退伍军人中,伴侣关系——配偶的爱和理解——与较低的后续孤独感有关。相反,无论创伤后应激障碍症状的严重程度如何,社交能力(一个人的婚姻促进与他人社交的程度)都与随后较低的孤独感有关。结论:陪伴和社交能力均与退伍军人随后的孤独感有关。PTSD症状严重程度越高,陪伴的好处就越小,而社交的好处就没有。临床意义:对于创伤后应激障碍症状较高的退伍军人,建议进行心理健康治疗以降低症状的严重程度可能有助于他们从亲密关系中获益。然而,更广泛地支持退伍军人的社会参与可能会为减少他们的孤独感提供额外的手段。
{"title":"Marital Quality and Loneliness Among Aging Vietnam-Era Combat Veterans: The Moderating Role of PTSD Symptom Severity.","authors":"Christina M Marini, Jeremy B Yorgason, Anica Pless Kaiser, Lance D Erickson","doi":"10.1080/07317115.2023.2274052","DOIUrl":"10.1080/07317115.2023.2274052","url":null,"abstract":"<p><strong>Objectives: </strong>We examined links between marital quality and loneliness among aging veterans and explored whether veterans' PTSD symptom severity moderated these associations.</p><p><strong>Methods: </strong>Data came from 269 Vietnam-Era combat veterans who had a spouse/partner (M age = 60.50). Utilizing two waves of data spanning six years, we estimated multiple regression models that included positive and negative marital quality, PTSD symptom severity, and loneliness in 2010 as predictors of loneliness in 2016.</p><p><strong>Results: </strong>Facets of positive (but not negative) marital quality were associated with veterans' loneliness. Companionship - spousal affection and understanding - was associated with lower subsequent loneliness among veterans with low/moderate - but not high - PTSD symptom severity. Conversely, sociability - the degree to which one's marriage promotes socializing with others - was associated with lower subsequent loneliness regardless of PTSD symptom severity.</p><p><strong>Conclusions: </strong>Companionship and sociability were each associated with veterans' subsequent loneliness. Whereas benefits of companionship were attenuated at higher levels of PTSD symptom severity, benefits of sociability were not.</p><p><strong>Clinical implications: </strong>For veterans with higher PTSD symptoms, recommending mental health treatment to decrease symptom severity may help them to reap the benefits of close/intimate relationships. However, bolstering veterans' social participation more broadly may provide an additional means of reducing their loneliness.</p>","PeriodicalId":10376,"journal":{"name":"Clinical Gerontologist","volume":" ","pages":"60-74"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"54227952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Treating Symptoms of Posttraumatic Stress in People with Dementia: Expert Consensus Using the Delphi Method. 治疗痴呆症患者的创伤后应激症状:使用德尔菲法达成专家共识。
IF 2.6 3区 医学 Q3 GERIATRICS & GERONTOLOGY Pub Date : 2025-01-01 Epub Date: 2023-02-02 DOI: 10.1080/07317115.2023.2170842
S Driessen, R Ponds, S P J van Alphen, A Nederstigt, K Deckers, S Sobczak

Objectives: Posttraumatic stress disorder is frequently present in people with dementia, but the symptoms are difficult to recognize and suitable treatments are lacking. The aim of the present study was to investigate which trauma-focused treatments are applicable to these patients.

Methods: The Delphi method is a process which is used to reach consensus from a panel of experts. The study was conducted online and consisted of three rounds with statements about support for treatment, treatment, and implementation.

Results: There are several treatment options available, but it depends on the symptoms, and the severity of PTSD and dementia which treatment is most suitable.

Conclusions: The outcomes offer some practical tips for health care workers, and they provide a fundamental base for future research.

Clinical implications: Clinicians should pay attention to the treatment of PTSD symptoms in people with dementia and it is necessary to examine the type and severity of both PTSD symptoms and dementia. Taking these factors into account, clinicians are able to focus on the best treatment option in order to improve the quality of life of these specific type of patients.

目的:创伤后应激障碍经常出现在痴呆症患者身上,但其症状难以识别,也缺乏合适的治疗方法。本研究旨在调查哪些以创伤为重点的治疗方法适用于这些患者:德尔菲法是一种由专家小组达成共识的方法。研究在网上进行,包括三轮,分别就支持治疗、治疗和实施进行陈述:有几种治疗方法可供选择,但哪种治疗方法最适合取决于创伤后应激障碍和痴呆症的症状和严重程度:研究结果为医护人员提供了一些实用建议,也为今后的研究提供了基本依据:临床意义:临床医生应重视对痴呆症患者创伤后应激障碍症状的治疗,有必要研究创伤后应激障碍症状和痴呆症的类型和严重程度。考虑到这些因素,临床医生就能专注于最佳治疗方案,以改善这类特殊患者的生活质量。
{"title":"Treating Symptoms of Posttraumatic Stress in People with Dementia: Expert Consensus Using the Delphi Method.","authors":"S Driessen, R Ponds, S P J van Alphen, A Nederstigt, K Deckers, S Sobczak","doi":"10.1080/07317115.2023.2170842","DOIUrl":"10.1080/07317115.2023.2170842","url":null,"abstract":"<p><strong>Objectives: </strong>Posttraumatic stress disorder is frequently present in people with dementia, but the symptoms are difficult to recognize and suitable treatments are lacking. The aim of the present study was to investigate which trauma-focused treatments are applicable to these patients.</p><p><strong>Methods: </strong>The Delphi method is a process which is used to reach consensus from a panel of experts. The study was conducted online and consisted of three rounds with statements about support for treatment, treatment, and implementation.</p><p><strong>Results: </strong>There are several treatment options available, but it depends on the symptoms, and the severity of PTSD and dementia which treatment is most suitable.</p><p><strong>Conclusions: </strong>The outcomes offer some practical tips for health care workers, and they provide a fundamental base for future research.</p><p><strong>Clinical implications: </strong>Clinicians should pay attention to the treatment of PTSD symptoms in people with dementia and it is necessary to examine the type and severity of both PTSD symptoms and dementia. Taking these factors into account, clinicians are able to focus on the best treatment option in order to improve the quality of life of these specific type of patients.</p>","PeriodicalId":10376,"journal":{"name":"Clinical Gerontologist","volume":" ","pages":"95-109"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9205293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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