Gender differences in PTSD symptoms: An exploration of peritraumatic mechanisms

doi:10.1016/j.janxdis.2010.09.004

Journal of Anxiety Disorders

Volume 25, Issue 2, March 2011, Pages 209-216

https://doi.org/10.1016/j.janxdis.2010.09.004 Get rights and content

Abstract

Females are at higher risk than males for developing posttraumatic stress disorder symptoms (PTSS) following exposure to trauma, which may stem from gender differences in initial physiological and psychological responses to trauma. The present study aimed to examine a number of peri- and initial posttraumatic reactions to motor vehicle accidents (MVAs) to determine the extent to which they contributed to gender differences in PTSS. 356 adult MVA survivors (211 males and 145 females) reported on peritraumatic dissociation, perception of life threat and initial PTSS. In addition, heart rate and urinary cortisol levels were collected in-hospital. 6 weeks and 6 months later, PTSS were assessed via clinical interviews. Results suggested that initial PTSS and peritraumatic dissociation were marginally significant mediators at 6-week follow-up and significant mediators at 6-month follow-up, providing partial support for the hypothesis that initial responses to trauma may account for observed gender differences in PTSS development.

Research highlights

▶ Females report more PTSD symptoms than males after motor vehicle accidents. ▶ In hospital, females report higher initial PTSS and dissociation than males. ▶ No gender differences found in cortisol, heart rate or injury severity. ▶ Subjective, not objective responses mediates gender differences in PTSS.

Section snippets

Participants

Three hundred fifty-six non-amnesic MVA victims (211 males and 145 females) were recruited following admission to a hospital trauma unit. The age of participants ranged from 18 to 87 (M = 38.68, SD = 16.16) and average household income was $20,000–30,000 per year. The majority of the sample (89%) was Caucasian, consistent with the demographics of the Northeast Ohio area. At the 6-week follow-up, 251 participants (139 males and 112 females) were retained, and 196 (103 males and 93 females) were

Results

At the 6-week follow-up, 10.36% (6 males and 20 females) met full diagnostic criteria for PTSD and 12.35% (7 males and 24 females) met diagnostic criteria for major depression. At 6 months, 7.14% (2 males and 12 females) met full criteria for PTSD and 12.24% (9 males and 15 females) were clinically depressed. Given the relatively low rates of diagnostic PTSD levels, the following analyses were conducted on continuous PTSS scores.

Discussion

The aim of the present study was to examine peritraumatic and acute-phase factors hypothesized to contribute to gender differences in PTSS following a MVA. Specifically, it was predicted that females would report greater perceived threat, more peritraumatic dissociation, and more initial PTSS than males. It was also hypothesized that PTSS 6-week and 6-month post-MVA would be positively associated with perceived threat, peritraumatic dissociation and initial PTSS, providing further support to

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^☆: Funding for this study was provided by the National Institute of Mental Health (R01 MH62042).

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Gender differences in PTSD symptoms: An exploration of peritraumatic mechanisms☆

Abstract

Research highlights

Section snippets

Participants

Results

Discussion

Journal of Anxiety Disorders

Behaviour Research and Therapy

Behaviour Research and Therapy

Behaviour Research and Therapy

Anxiety Disorders

Behaviour Research and Therapy

Journal of Psychiatric Research

Behavior Therapy

Biological Psychiatry

The injury severity score: a method for describing patients with multiple injuries and evaluating emergency care

Journal of Trauma

The moderator-mediator variable distinction in social psychological research: conceptual, strategic and statistical considerations

Journal of Personality and Social Psychology

EQS 6 structural equations program manual

Prevalence of traumatic events and peritraumatic predictors of posttraumatic stress symptoms in a nonclinical sample of college students

Journal of Traumatic Stress

Symptoms of peritraumatic and acute traumatic stress among victims of an industrial disaster

Psychiatric Services

The development of a clinician-administered PTSD scale

Journal of Traumatic Stress

Emergency room vital signs and PTSD in a treatment-seeking sample of motor vehicle accident survivors

Journal of Traumatic Stress

Trauma and posttraumatic stress disorder in the community: the 1996 Detroit Area Survey of Trauma

Archives of General Psychiatry

Meta-analysis of risk factors for posttraumatic stress disorder in trauma-exposed adults

Journal of Consulting and Clinical Psychology

Prevalence, characteristics and long-term sequelae of natural disaster experience in the general population

Journal of Traumatic Stress

Initial posttraumatic stress responses following motor vehicle accidents

Journal of Traumatic Stress

Gender differences in the relationship between acute stress disorder and posttraumatic stress disorder following motor vehicle accidents

Australian and New Zealand Journal of Psychiatry

A prospective study of psychophysiological arousal, acute stress disorder, and posttraumatic stress disorder

Journal of Abnormal Psychology

Initial cardiovascular predictors are not related to PTSD

Journal of Traumatic Stress

Dissociative reactions to the San Francisco Bay Area earthquake of 1989

American Journal of Psychiatry

Predicting PTSD prospectively based on prior trauma history and immediate biological reactions

Predictors of posttraumatic stress among victims of motor vehicle accidents

Psychosomatic Medicine

Cognitive factors involved in the onset and maintenance of posttraumatic stress disorder (PTSD) after physical or sexual assault

Behaviour Research and Therapy

Psychological predictors of chronic posttraumatic stress disorder after motor vehicle accidents

Journal of Abnormal Psychology

Acute stress disorder in victims of robbery and victims of assault

Journal of Interpersonal Violence