From fantasy to dementia: The misdiagnosis and mistreatment of older adult women living in nursing homes with a history of untreated or undisclosed childhood sexual abuse

Fay Reich (1996)

Although mental health professionals have recently increased their understanding and treatment of the long-term impacts of childhood sexual abuse on adolescents and adults, little has been written regarding the difficulty that women over 65 experience in coping with untreated childhood sexual abuse symptoms. It is the contention of this study that the symptoms of childhood sexual abuse, when intermingled with the aging process, often result in a complicated array of symptoms that are too often misunderstood and misdiagnosed, resulting in inappropriate and ineffective mental health services. For this research regarding misdiagnosis of Post-Traumatic Stress Disorder in older adult women residents of nursing homes, 30 psychologists diagnosed (using the DSM IV) a female patient presenting with numerous psychological disturbances, including a history of childhood sexual abuse. The case, a compilation of psychosocial histories of female nursing home residents, presented to each clinician was identical except in one-half the stated age of the patient was 30 years, while in the other half the age was 70 years. Although the initial hypothesis, that subjects given the age-30 vignette would diagnosis PTSD more than those given the age-70 vignette was not confirmed, the age of the client in the vignette did indeed have an impact on the diagnosis, simply not in the direction or way hypothesized. Recent trauma literature, as it specifically relates to childhood sexual abuse and its long term implications, will be integrated with adult life-cycle developmental theory and the aging process, in order to provide an understanding of symptoms which older adult women may present.