PTSD in Elder Abuse Survivors: Trauma Symptom Presentation and Treatment Outcomes With the PROTECT Intervention

Am J Geriatr Psychiatry. 2025 Jun 18:S1064-7481(25)00379-3. doi: 10.1016/j.jagp.2025.06.010. Online ahead of print.

ABSTRACT

OBJECTIVES: High rates of depression and suicidal ideation among elder abuse (EA) victims have been documented, but few studies have examined post-traumatic stress disorder (PTSD) symptoms in this population. This study assessed PTSD symptom rates and presentation among EA victims with depression and evaluated PTSD symptom trajectories throughout PROTECT, a brief behavioral intervention.

DESIGN: Depressed (PHQ-9 ≥ 10) EA victims with no cognitive impairment (Mini MoCA ≥ 11) were referred by partner agencies and consented by research staff. Eligible participants received nine weeks of PROTECT and were assessed at baseline, weeks 6 and 9. The study was approved by the Weill Cornell IRB (Protocol #19-09020854).

SETTING: EA victims with depression in NYC were referred to study team for 9 weeks of psychotherapy in NIMH funded trial P50 MH113838.

PARTICIPANTS: 40 elder abuse victims with depression and no cognitive impairment.

INTERVENTION: PROTECT is a brief behavioral psychotherapy delivered remotely in nine weekly 45-minute sessions.

MEASUREMENTS: PTSD Checklist for DSM-5 (PCL-5) and Life Events Checklist (LEC) assessed trauma symptoms and history; MADRS assessed depression severity. Mixed-effects models examined presence and change in PTSD symptoms across treatment, adjusting for covariates.

RESULTS: 60% of participants met the criteria for probable PTSD (PCL-5 ≥ 31) at baseline. These individuals had significantly higher baseline depression scores. PTSD symptoms significantly decreased across treatment, even after adjusting for demographic or trauma-related variables.

CONCLUSIONS: PTSD symptoms are highly prevalent among depressed EA victims. Participants who received the PROTECT psychotherapy intervention demonstrated reductions in PTSD symptoms. Results underscore the potential utility of brief, remotely delivered psychotherapy in addressing trauma-related distress among EA victims and highlight the importance of integrating PTSD-focused care into services for this high-risk population.

PMID:40619282 | DOI:10.1016/j.jagp.2025.06.010