Posttraumatic stress disorder in surviving spousal caregivers to Alzheimer\u27s patients

This study was undertaken to determine the presence of Posttraumatic Stress Disorder (PTSD) in a sample of 45 spousal caregivers to deceased Alzheimer\u27s patients in the period of six months to three years following the death of their afflicted spouse. Thirty-five female and ten male caregivers were interviewed. Caregivers in this study were invested in long-term marriages, were in their seventh decade when they began their caregiving responsibilities, and continued caregiving for an average of seven years. The Posttraumatic Stress Disorder Interview (PTSD-I) was administered to determine the presence of PTSD in the sample. Also administered were the Symptom Checklist-90-Revised (SCL-90-R), Minnesota Multiphasic Personality Inventory-2, Repression Subscale (MMPI-2, R-scale), Texas Revised Inventory of Grief (TRIG), and a Demographic-Psychographic Interview. Results indicated the presence of PTSD related to the traumatic stressor of caregiving to Alzheimer\u27s patients in six of forty-five surviving spousal caregivers, all of whom were female, for a prevalence of 13.3% in this sample. PTSD has been reported at a prevalence of 1% in the general population, 20% in wounded Vietnam veterans and 3.5% in civilians exposed to physical attack. In a disaster-affected logging community, a prevalence of 2.9% for men and 3.3% for women has been reported. Twenty-five of forty-five respondents (55.5%) reported caregiving as a traumatic stressor. For each of the 17 characteristic symptom criteria for PTSD, fewer than 50% of the caregivers scored at or above the mid-range, (a score $\ge$5), for all but one of the criteria on the Posttraumatic Stress Disorder Interview (PTSD-I). Results of other instrument scores indicate that many caregivers were psychologically distressed, minimized the significance of their psychological symptoms, and were still in the bereavement process six months to three years after the death of their Alzheimer\u27s afflicted spouse. Implications for use of the Posttraumatic Stress Disorder Interview and the Symptom-Checklist-90-Revised as screening instruments in the primary and secondary prevention of PTSD in spousal caregivers to Alzheimer\u27s patients, specific recommendations for primary interventions to caregivers, and recommendations for future research are discussed