CLINICAL FEATURES OF DELAYED-ONSET AND TEMPORALLY FLUCTUATING POST-TRAUMATIC STRESS DISORDER SYMPTOMS IN OLDER VIETNAMESE ADULTS: A COMMUNITY-BASED STUDY
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Abstract
Background: Post-traumatic stress disorder (PTSD) may follow diverse symptom trajectories, including delayed onset and fluctuating severity over time. These patterns are clinically important among older adults with cumulative lifetime trauma exposure, yet evidence from community settings in low- and middle-income countries remains limited.
Methods: This cross-sectional study used data from the second wave of the Vietnam Health and Aging Study (2021-2022). Trauma-exposed participants aged ≥60 years (N = 296) were assessed using the Vietnamese PCL-5 (validated cutoff ≥11). Delayed onset was defined as symptom emergence ≥6 months post-trauma. Wilcoxon signed-rank tests compared worst-month versus past-month severity; Mann-Whitney U tests compared immediate- versus delayed-onset groups.
Results: Of 296 participants, 39 (13.2%) met the PCL-5 threshold; 11 of 39 (28.2%) reported delayed onset. Immediate-onset cases had significantly higher total PCL-5 scores (20.14 ± 13.77 vs. 10.18 ± 7.88; p = 0.038), driven by the avoidance cluster (p = 0.013). Worst-month severity exceeded past-month severity across all four DSM-5 clusters (all p < 0.05), with the largest difference observed for intrusive memories (mean difference = 0.43; p = 0.006).
Conclusions: Nearly one-third of symptomatic older adults reported delayed PTSD onset, and symptom severity showed significant temporal fluctuation. Periodic screening and longitudinal monitoring of trauma-related symptoms are warranted in aging populations.
Keywords
post-traumatic stress disorder, delayed-onset PTSD, older adults, trauma, symptom trajectory, PCL-5, Vietnam.
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References
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