Gender disparities in posttraumatic stress disorder after mass trauma

Although several studies have shown that rates of posttraumatic stress disorder (PTSD) are higher in women than in men, less is known about whether women are more vulnerable to PTSD after a major community-wide traumatic event.

The aim of this study was to examine gender disparities in the prevalence of probable lifetime PTSD and probable PTSD after a mass traumatic event.

A representative sample of men and women living in the New York City metropolitan area was selected using random-digit dialing, and subjects were interviewed by telephone 6 to 9 months after the September 11, 2001 (9/11) terrorist attacks. We assessed probable lifetime PTSD and probable PTSD related to the 9/11 attacks using a brief screening instrument and potential correlates.

A total of 2752 individuals (1479 women, 1273 men) were interviewed. The lifetime prevalence of probable PTSD was significantly higher for women than for men (17.2% vs 12.1%; P = 0.005). Experiences of sexual assault (P < 0.001), preexisting mental health problems (P = 0.04), race/ethnicity (P = 0.01), marital status (P < 0.001), and having had probable peri-event panic in the first few hours after the 9/11 attacks (P < 0.001) were all significantly related to women's greater susceptibility to probable lifetime PTSD. However, the prevalence of probable PTSD related to 9/11 was not significantly different between women and men (6.5% vs 5.4%), although women were significantly more likely to report re-experiencing (P < 0.001) and hyperarousal (P < 0.001) symptoms than were men. Women were more likely than men to experience probable peri-event panic during the 9/11 attacks (P < 0.001); this explained, in part, the greater subsequent likelihood of re-experiencing and hyperarousal symptoms among women compared with men.

More factors explain the risk of PTSD among women and men after interpersonal trauma than after a disaster. Using peri-event panic symptomatology after a traumatic event to determine the risk of posttraumatic symptoms may suggest avenues for intervention that can decrease the burden of PTSD in women.