Disentangling sex differences in PTSD risk factors

Area of Science:

• Psychiatry and Mental Health
• Neuroscience
• Epidemiology

Background:

• Sex and gender differences in posttraumatic stress disorder (PTSD) are well-documented, yet the underlying mechanisms remain unclear.
• Existing research has not fully elucidated the specific risk pathways that contribute to these observed differences.

Purpose of the Study:

• To systematically investigate sex/gender-related risk pathways influencing posttraumatic stress disorder (PTSD) severity.
• To identify potential mediators in the relationship between sex assigned at birth and PTSD severity.

Main Methods:

• Prospective cohort study of 2924 acutely traumatized individuals.
• Assessment of 16 risk factors and 3-month PTSD severity.
• Multiple mediation analysis with regularization to examine mediating pathways.

Main Results:

• Six risk factors were more prevalent or severe in women; none were more pronounced in men.
• Acute stress disorder, neuroticism, lifetime sexual assault exposure, anxiety sensitivity, and pre-trauma anxiety symptoms fully mediated the link between sex assigned at birth and PTSD severity.
• These identified factors uniquely contributed to PTSD severity in a sex-specific manner.

Conclusions:

• The study demonstrates distinct biological and psychological risk mechanisms contributing to PTSD severity in women and men.
• Findings highlight the need for sex- and gender-sensitive approaches in mental health research and clinical interventions for PTSD.
• The systematic methodology can be adapted to explore sex/gender differences in other mental health conditions.