PTSD Diagnosed More in Women

Different responses to trauma might explain disparity, study suggests

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By Serena Gordon
HealthDay Reporter

MONDAY, Nov. 20, 2006 (HealthDay News) -- Even though men are more likely to experience a traumatic event, women are nearly twice as likely to be diagnosed with post-traumatic stress disorder (PTSD).

That's one of the conclusions of a new study appearing in the November issue of the American Psychological Association's Psychological Bulletin.

"Men and women might react to traumas in very different ways," explained the study author David Tolin, director of the Anxiety Disorders Center at the Institute of Living, in Hartford, Conn. "The way the diagnosis is currently written may stack the deck for more symptom endorsement in women."

But, he added, "The diagnosis of PTSD is a work in progress. It has changed with each edition of the DSM (Diagnostic and Statistical Manual of Mental Disorders), and that's a good thing. It means we're actively thinking about it and working on it."

Post-traumatic stress disorder is an anxiety disorder caused by a traumatic event, such as a sexual assault, an accident, a combat experience or witnessing or being a victim of other violent events. Symptoms of the disorder include reliving the experience in your mind over and over again, feeling numb emotionally, having difficulty with personal relationships, and sleep difficulties, according to the National Institutes of Mental Health.

Tolin and his colleague, Edna Foa, from the University of Pennsylvania School of Medicine, reviewed 25 years of studies done on PTSD to see if there were any significant gender differences.

The meta-analysis included 290 studies done between 1980 and 2005. During that time period, the researchers found that women had a twofold higher risk of being diagnosed with PTSD compared to men.

The researchers wondered if that was because women experienced more traumatic events than men did. So, they went back to the previous studies and re-examined them to see which gender experienced the most traumatic events. This analysis found that men had a 23 percent higher chance of having been involved in a traumatizing event than women.

This finding caused the researchers to wonder whether women experience certain traumatic events more than men did, and the answer was yes, according to Tolin. "Women and girls were much more likely to be sexually assaulted, raped or be sexually abused during childhood. Men and boys were much more likely to be involved in serious accidents, physically assaulted, or see other people injured or killed," he said.

However, it didn't appear that the type of traumatic event is what causes the higher rates of PTSD in women. "When we look at men and women who have experienced the same kind of traumatic events, we still see a higher rate in women than in men. However, that wasn't true for sexual abuse or assault. PTSD seems to develop equally after those experiences," Tolin said.

Anie Kalayjian, an expert in traumatic stress and author of Disaster & Mass Trauma: Global Perspectives in Post Disaster Mental Health Management, said she thinks men and women likely have similar rates of traumatic stress, but express it differently.

"I feel there is no difference in the experiencing of trauma, just a difference in the expression of that trauma," she said.

For example, she said, "A week ago, one of my client couples, a husband and a wife, were in a car accident. The husband's friends told him, 'Let's go get a drink, forget about it,' and they watched football, yelled, screamed and carried on. The wife called her girlfriend, who came over, and they talked about it. How men and women express and let out the trauma is different."

The good news, said Tolin, is that there are effective treatments that "have proven helpful for both men and women. In most cases, the symptoms of PTSD resolve over time. In some people, the symptoms persist. For those people, there are treatments that work."

More information

To learn more about post-traumatic stress disorder, visit the National Institutes of Mental Health.

SOURCES: David Tolin, Ph.D., director, Anxiety Disorders Center, Institute of Living, and assistant professor, psychiatry, University of Connecticut School of Medicine, Hartford, Conn.; Anie Kalayjian, Ed.D., psychology professor, Fordham University, and author Disaster & Mass Trauma: Global Perspectives in Post Disaster Mental Health Management; November 2006, Psychological Bulletin

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