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This study aimed to analyze the effect of Trauma-Focused Cognitive Behavior Therapy (TF-CBT) on the depression level and quality of life of the elderly in an earthquake-affected district of North Lombok Regency, Indonesia.

A Randomized Controlled Trial (RCT) with a population of two elderly groups living in an earthquake-affected district was used in this study. The intervention comprised giving TF-CBT. There were three research instruments applied to determine the variables, namely, the Clinician-Administered PTSD Scale (CAPS-5), the Geriatric Depression Scale 15 (GDS 15) and the World Health Organization Quality of Life-BREF (WHOQOL-BREF). All instruments were adopted and translated using back translation to Bahasa Indonesia, which is appropriate at the suggestion of the WHO. To investigate the effect of the intervention, we used hierarchical linear models (HLM) with intent-to-treat analysis. The patent parameter effect was tested using the Wald test (t-test) with a confidence Interval of 95 per cent.

The final analysis applied CAPS-5 and showed that there was a decrease in the PTSD of the respondents, which was down to only 8 (17.8 per cent) in the post-test. The same situation happened for the depression variable (2.8 per cent) after it was assessed using GDS-15C. The Quality of life (WHOQoL-BREF) variable was divided into Physical (50.7), Psychological (57.1), Social (53.6) and Environmental (45.7). These components show there to be a significant result in terms of improving the quality of life of the elderly victims of the earthquake. The finding highlights that applying TF-CBT in the elderly population can significantly drop post-traumatic stress disorder and depression level and enhanced quality of life.

The intervention decreased the depression level and improved the quality of life of the elderly as found in the six- week follow-up. Longer training and integration with the structured local wisdom could be necessary to better address the mental health of the elderly affected by the earthquake. Moreover, strengthening the role of the family as the primary caregiver is required to improve the outcome.

This is the first study that has attempted to use TF-CBT as a method of treatment for the elderly to decrease their depression and to increase quality of life among the Indonesian elderly who have experienced an earthquake. This paper provides knowledge on the effectiveness of TF-CBT that can be used by therapists to treat depression problems suffered by the elderly in a post-disaster area.

The purpose of this paper is to analyze factors associated with post-traumatic stress disorder (PTSD) among elderly who live in a post-earthquake area.

This was a cross-sectional study involving 152 elder people who survived the disaster and were selected conveniently. The study was conducted in two worst-affected districts of Lombok Utara regency. PTSD was diagnosed using a modified version of the Clinician-Administered PTSD Scale version 5 (CAPS-5). The demographic data were assessed using a self-developed questionnaire consisting of 13 items. All data were analyzed by descriptive analysis, χ² test and binary logistic regression with p<0.05.

Out of the 152 elder people, 91 (59.9 percent) suffered PTSD. Intrusion symptoms were the most common symptoms experienced by the respondents (94.1 percent). The factors associated with the PTSD in the elderly after the earthquake were having chronic illnesses (OR=2.490; 95% CI=1.151–5.385), public health center utilization (OR=2.200; 95% CI=1.068–4.535) and occupational status before the disaster (OR=2.726; 95% CI=1.296–5.730). These findings highlight that individual factors and access to health care services remain an important aspect of stress identification among the elderly following the disaster event.

Elder people constitute a vulnerable group that is often forgotten and neglected during post-disaster recovery, though they have potentially higher psychosocial distress than younger age groups. This study was conducted to raise awareness about mental health problems suffered by the elderly.

This is the first study to apply CAPS-5 to assess PTSD among Indonesian elderly people following a natural disaster. This paper also provides insights that can be used by governments and other relevant parties to address PTSD problems suffered by many elderly people in a post-disaster area.