Understanding heterogeneity in late-life post-traumatic reactions

Abstract

There are two contradicting theoretical frameworks regarding the effect of traumatic exposure on older adults. One framework, synthesized in the vulnerability hypothesis, suggests amplified post-traumatic reactions among older adults due to age-related losses and cumulative life adversity. The second framework, synthesized in the maturation and the inoculation hypotheses, predicts impressive resilience driven by age-related gains, such as life experience. In this Perspective, we introduce the heterogeneous resilience model, which integrates these contradictory frameworks to understand older adults’ varied reactions to traumatic events from a lifespan perspective. The model incorporates insights from gerontology and traumatology, showing that adults generally become more resilient as they age, but variability in their reactions to traumatic events also increases with age. We propose that older adults’ reactions range between resilience, fragile resilience and vulnerability, depending on age-related factors such as improved emotional regulation and learning from past experiences, declines in physical and cognitive reserves, and positive and negative views of ageing. The diversity of reactions and factors highlighted in the heterogeneous resilience model can enhance understanding and treatment of traumatized older adults. Older adults’ coping with traumatic events has traditionally been conceptualized as either more vulnerable or more resilient compared with younger adults. In this Perspective, Palgi et al. integrate gerontology and traumatology literatures to provide a more nuanced description of post-traumatic reactions in old age.