Post-traumatic stress disorder (PTSD) is an anxiety disorder that is related to serious traumatic events and is characterized by such symptoms as survivor guilt, reliving the trauma in dreams, numbness, and absence of involvement with reality, or recurrent thoughts and images. Research shows that reliable and modest gender differences exist in the growth of PTSD (Vishnevsky 110). Researchers also found that the risk of PTSD could vary in women because of type of trauma and prior history of trauma. However, the risk for PTSD in men is not much affected by the type of trauma and history of trauma. Moreover, assaultive violence event can result in higher risk for PTSD in women as compared to men (Breslau, and Anthony 610).
Behaviorally, women have elevated sense of threat as well as lower self-efficacy and their tendency to use less efficient coping strategies as compared to men are considered as important factors behind gender differences in developing PTSD (Solomon, Gelkopf, and Bleich 947). Although, males have more chances of experiencing accidents, combat, nonsexual assault, or serious illness, females have more chances of experiencing child sexual abuse and sexual assault that are probably more important contributors in the development of PTSD (Tolin, and Foa 977). Psychobiologically, younger age at the time of exposure to trauma and trauma-related memories are stronger predictors of developing PTSD in females (Olff 183). One the other hand, physiologically, one of the reasons behind the gender differences of getting PTSD and its severity include the decreased level of (glucocorticoids) cortisol in the adrenal cortex. It has an important role in metabolic, immune-related, and neurone-related functions. However, researchers are of opinion that further studies are required to find the relationship of PTSD with cortisol level (Meewisse 387).
The issue of gender differences in experiencing the trauma and the development of PTSD is a complicated as well as sensitive one. This review shows that males and females may experience different types of potentially traumatic events. However, the effect of PTSD on different genders requires more research.
Annotated Bibliography
Breslau, Naomi, and James C. Anthony. "Gender Differences in the Sensitivity to
Posttraumatic Stress Disorder: An Epidemiological Study of Urban Young
Adults." Journal of Abnormal Psychology 116.3 (2007): 607-11. Web. 16
SUBJECTS: 1,698 young adults. Two cohorts of first-grade students in 19 primary schools selected within a public school system of a large mid-Atlantic city in the United States. These individuals were contacted again as young adults, mean age of 21. Women constituted 53.2% of the sample. African Americans constituted 71.0% of the sample and non-Hispanic Whites, 29.0%.
MEASURES and PROCEDURES: An interview process was used to ask the participants about traumatic events and how they felt about them. When more than one traumatic event was listed, the participant is asked which one of the listed ones was worst. Based on DSM guidelines, the traumas listed were commonly known to cause PTSD. Categories of event traumas included- assaultive, non-assaultive, and other.
RESULTS: Of the 23.2 % men who reported assaultive violence exposure 7.1% met criteria for PTSD. Of the 21.4% of women who experienced assaultive violence 23.5% met the criteria for PTSD. Despite more men having experienced this trauma at a higher rate than women and beginning at an earlier age. The sensitizing effect of assault earlier on in life increased the risk of PTSD in a gender specific manner. For men, PTSD did not vary based on type of trauma, but for women there was a significant increase in assaultive violence exposure. Biological, cultural, and developmental factors may be responsible for the increased PTSD in women.
Meewisse, Marie-Louise, Johannes B. Reitsma, Giel-Jean De Vries, Berthold P.R.
Gersons, and Miranda Olff. "Cortisol and Post-traumatic Stress Disorder
Cortisol and Post-traumatic Stress Disorder in Adults." British Journal of
Psychiatry 191 (2007): 387-92. Web. 16 Apr. 2016.
SUBJECTS: The total number of people included from the various studies were 1628, 828 of those with PTSD across all studies, and 800 controls. Median sample size of people across all studies was 20 (range 7-75) for those displaying PTSD, while the median size of the control group was18 (range 7-113).
MEASURES and PROCEDURES: Cortisol levels were measured in both groups to see if there is a correlation between PTSD and increased cortisol. To measure the Cortisol there was either the use of plasma/serum in 24 of the studies, saliva in 8 of the studies, 24 hour urinary free cortisol samples in 7 of the studies, or a combination of the two types of assessment methods was used.
RESULTS: Time of measurement and gender was used in the analysis. Men did not seem to have a variation in cortisol levels in either group; however, women had higher correlations with lower cortisol levels in the PTSD group. Overall no difference existed in cortisol levels in the PTSD group versus the control group, except in the group of female PTSD suffers who’s levels of cortisol were lower than the control group.
Olff, Miranda, Nell Draijeer, Willie Langland, and Berthold P.R. Gersons. "Gender
Differences in Posttraumatic Stress Disorder." Psychological Bulletin 33.2 (2007):
183-204. Web. 16 Apr. 2016.
SUBJECTS: A review of various literature is used in comparing the psychobiological aspect of PTSD in women compared to men to better understand what correlation exists.
MEASURES and PROCEDURES: Comparisons of numerous pieces of literature are examined with the use of the traumatic-stress-coping model and the gender-differentiated-traumatic-stress-coping model to evaluate and analyze the findings.
RESULTS: Higher PTSD in women may be due partially to the type of trauma they experience (more interpersonal violence, particularly of a sexual nature), their young age at the time of the trauma, a strong perception of threat and loss of control, higher levels of peritraumatic dissociation, lack of adequate social support resources, and increased use of alcohol for managing trauma-related symptoms. In addition to these factors, cognitive appraisal and coping processes in one’s reaction to trauma may create gender differences in neuroendocrine response, which may explain a higher risk of PTSD in women.
Solomon, Zahava. "Is Terror Gender-blind? Gender Differences in Reaction to
Terror Events." Social Psychiatry Psychiatric Epidemiology 40 (2005): 947-
54. Web. 16 Apr. 2016.
SUBJECTS: Participants consisted of 250 men and 262 women, who were selected as a fair representation of the adult population of Israel. Age ranges 18-66, and a mean age of 38.35. In terms of their level of religiousness- 11% claimed to be religious, 30.5% stated they were traditional, 4.9% were orthodox, and 53.6% said they were atheist.
MEASURES and PROCEDURES: 51 items were gathered from a collection of widely used questionnaires commonly used in the study of trauma. Participants were asked the following 3 questions- (1) whether they had been exposed to a terrorist attack, (2) whether a friend or family member had been exposed to an attack, and (3) whether they were injured in an attack or a friend or family member was injured or killed. Based on the yes or no answer they were divided into six groups. Sense of safety, self-efficacy, means of coping, trauma-related and stress-related mental health symptoms, as well as feelings of depression were measured with a 5 Point Likert Scale.
RESULTS: In terms of exposure to terror incidents more men reported being exposed than women; No differences in the objective threat measures; in terms of posttraumatic symptomology, more women reported symptoms disruptive to life, woman claimed PTSD symptoms six times more frequently than men; a higher number of women reported symptoms of depression; and more women were willing to try the coping mechanisms suggested. The study confirms that terror is not gender blind, but that men and women respond differently to one another in how they handle trauma.
Tolin, David F., and Edna B. Foa. "Sex Differences in Trauma and Posttraumatic
Stress Disorder: A Quantitative Review of 25 Years of Research."
Psychological Bulletin 132.6 (2006): 959-92. Web. 16 Apr. 2016.
SUBJECTS: Articles from 1980-2005 regarding exposure to PTE and severity of PTSD among male and female participants were collected. 290 were selected from over 2,000 articles for the review.
MEASURES and PROCEDURES: 18 variables were included in the study coding for the review. Data collected from the findings of the studies were analyzed using the Comprehensive Meta-Analysis software.
RESULTS: The self-reporting involved in the collection of data from the various articles is the primary issues with bias reporting. Too many variables exist making it uncertain whether more women than men experience PTSD due to the various reporting style of the two genders. Men often withholding or retracting what they say.
Vishnevsky, Tanya, Arnie Cann, Lawrence G. Calhoun, Richard G. Tedeschi, and
George J. Demakis. "Gender Differences in Self-Reported Post-Traumatic
Growth: A Meta-Analysis." Psychology of Women Quarterly 34 (2010): 110-20.
Web. 16 Apr. 2016.
SUBJECTS: Male and female participants of various ages who suffered post-traumatic stress who used the PTGI or SRGS to measure their response.
MEASURES and PROCEDURES: 70 studies where the Post-Traumatic Growth Inventory (PTGI) and the Stress Related Growth Scale (SRGS) were used to measure PTG and assess if gender results varied based on which scale is used. Five variables were coded- posttraumatic growth measure, mean age, nature of the traumatic event, the language of the measures, and the publication status of the study. Measures were categorized as the PTGI or SRGS. Details about the participants were also coded based on age, language, and several other distinguishing categories.
RESULTS: Only a small to moderate level of difference in post-traumatic growth was found between the two genders. Women showed a slightly higher level of PTG compared to men. When looking at the categorical moderator analyses, the meta-regression indicated that the older the genders got the differences increased with the direction of the differences being seen across all of the moderators.
Summary and Conclusion
After reviewing further research studies about the correlation of a difference in incidents of PTSD based on gender, it is safe to say that there does seem to be evidence that women are more vulnerable to PTSD compared to men. Nothing new or specific was found in the studies that have not been seen before. However, one could assume that biological, psychological, cultural, and environment factors are variables that women respond sensitively to.
The higher rate of PTSD in cases of assaultive violence was seen occurring in women. A lower rate of cortisol was also found in women compared to men. The cognitive appraisal and coping processes in one’s reaction to trauma is different in men and women due to the difference in the neuroendocrine responses. Whether of not there is trauma in the form of terror attacks, both genders have distinct responses to the trauma. The types of trauma that are presented seems to affect men and women differently, but the problem with self-reported results is the tendency for error or bias. Finally when looking at post-traumatic growth, more women had PTG than men, which one could assume is due to a higher rate of PTSD.
Regardless of what type of test or which angle is examined in the response of PTSD in women versus men more structured studies need to be done to find empirical evidence that can be repeatedly found when studied. One could assume that a number of factors influence why women show higher rates of PTSD than men.
Works Cited
Breslau, Naomi, and James C. Anthony. "Gender Differences in the Sensitivity to
Posttraumatic Stress Disorder: An Epidemiological Study of Urban Young
Adults." Journal of Abnormal Psychology 116.3 (2007): 607-11. Web. 16 Apr.
2016.
Meewisse, Marie-Louise, Johannes B. Reitsma, Giel-Jean De Vries, Berthold P.R.
Gersons, and Miranda Olff. "Cortisol and Post-traumatic Stress Disorder Cortisol
and Post-traumatic Stress Disorder in Adults." British Journal of Psychiatry 191
(2007): 387-92. Web. 16 Apr. 2016.
Olff, Miranda, Nell Draijeer, Willie Langland, and Berthold P.R. Gersons. "Gender
Differences in Posttraumatic Stress Disorder." Psychological Bulletin 33.2 (2007):
183-204. Web. 16 Apr. 2016.
Solomon, Zahava. "Is Terror Gender-blind? Gender Differences in Reaction to Terror
Events." Social Psychiatry Psychiatric Epidemiology 40 (2005): 947-54. Web. 16
Apr. 2016.
Tolin, David F., and Edna B. Foa. "Sex Differences in Trauma and Posttraumatic Stress
Disorder: A Quantitative Review of 25 Years of Research." Psychological Bulletin
132.6 (2006): 959-92. Web. 16 Apr. 2016.
Vishnevsky, Tanya, Arnie Cann, Lawrence G. Calhoun, Richard G. Tedeschi, and
George J. Demakis. "Gender Differences in Self-Reported Post-Traumatic
Growth: A Meta-Analysis." Psychology of Women Quarterly 34 (2010): 110-20.
Web. 16 Apr. 2016.
