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Sex differences in posttraumatic stress disorder

N Breslau1, G C Davis, P Andreski

  • 1Department of Psychiatry, Henry Ford Health Sciences Center, Detroit, Mich., USA.

Archives of General Psychiatry
|November 21, 1997
PubMed
Summary
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Women experience higher rates of posttraumatic stress disorder (PTSD) than men. This difference is linked to preexisting anxiety or depression and is more pronounced when trauma occurs in childhood.

Area of Science:

  • Psychiatry
  • Epidemiology
  • Trauma Studies

Background:

  • General population surveys indicate higher posttraumatic stress disorder (PTSD) rates in women compared to men.
  • This observed sex difference in PTSD prevalence has been under-researched.
  • This study investigates potential explanations for sex differences in PTSD and their relation to age at trauma exposure.

Purpose of the Study:

  • To examine the extent to which known risk factors explain the higher prevalence of PTSD in women.
  • To determine if the sex difference in PTSD varies based on the age of exposure to traumatic events.

Main Methods:

  • Utilized the NIMH Diagnostic Interview Schedule (NIMH-DIS) to assess DSM-IIIR disorders in a random sample of 1007 young adults.
  • Employed Cox proportional hazards models to analyze the association between sex and PTSD risk, controlling for covariates.

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Main Results:

  • No significant sex differences were found in the lifetime prevalence or number of traumatic event exposures.
  • Women exhibited a significantly higher prevalence of PTSD (HR=2.3) compared to men following traumatic event exposure.
  • Preexisting anxiety and major depressive disorders partially mediated the observed sex difference in PTSD.

Conclusions:

  • Females are more susceptible to developing PTSD than males after experiencing trauma.
  • The sex difference in PTSD development is more pronounced when traumatic events occur in childhood versus after age 15.
  • Individual characteristics and the nature of traumatic experiences likely contribute to the observed sex disparity in PTSD.