Gender differences in the sensitivity to posttraumatic stress disorder: An epidemiological study of urban young adults

The authors examine the relationship between 2 separate but interrelated findings in the epidemiology of posttraumatic stress disorder (PTSD): women's greater PTSD risk following traumatic events and the sensitizing effects of a prior trauma on the PTSD response to a subsequent trauma. Data come from a representative sample of 1,698 young adults from a large U.S. city. Analysis was conducted on the subset exposed to traumatic events. Women's risk for PTSD following assaultive violence was higher than men's. When assaultive violence preceded a later nonassaultive trauma in women, there was an increased risk (relative risk = 4.9) for PTSD, which was not observed in men. The relative risk estimate in women was significantly higher than in men. These findings suggest that assaultive violence elicits women's PTSD response directly and by sensitizing them to the effects of subsequent traumatic events of lesser magnitude.     

Gender Disparities in the Mental Health of Urban Survivors of Trauma

Women who experience traumatic events are at higher risk for mental health problems compared to men; however, gaps remain in our understanding of this disparity. A sample of 170 urban adults completed self-report measures. Women were significantly more likely to experience sexual assault and domestic violence compared to men, and they were significantly less likely to experience a robbery or mugging, being threatened with a weapon, or witnessing a death or assault compared to men. Also, women were more likely than men to meet criteria for probable post-traumatic stress disorder (PTSD) and depression after controlling for covariates and trauma level. Our findings suggest a possible differential vulnerability to the development of PTSD and depressive symptoms in women.     

Combat veterans' symptoms of PTSD and partners' distress: the role of partners' perceptions of veterans' deployment experiences

Romantic partners of combat veterans with posttraumatic stress disorder (PTSD) report elevated relationship and psychological distress. One recent study suggests that this association may be weaker when partners perceive that veterans experienced higher levels of traumatic deployment events, but such results have not yet been replicated. We replicated and extended these findings in a sample of 206 National Guard service members who deployed overseas since 2001 and their partners. We used multivariate structural equation models to explore whether partners' perceptions of service members' deployment experiences moderated the associations of severity of service members' overall PTSD and specific PTSD clusters with partners' psychological and relationship distress. The significant association of overall PTSD symptom severity with partners' distress was not moderated by partners' perceptions. When examining PTSD symptoms at the cluster level, only the numbing/withdrawal cluster was significantly associated with distress. However, this association was moderated by partners' perceptions of service members' deployment experiences, such that the associations weakened as these perceptions increased. These results are in line with research indicating that the avoidance cluster of PTSD symptoms is particularly detrimental for partners of those with PTSD. Furthermore, they indicate that such symptoms are associated with less distress in partners who perceive that service members experienced high levels of potentially traumatic deployment events. Such perceptions may be linked with external attributions for symptoms, which suggests that psychoeducation regarding the causes of PTSD and the totality of PTSD symptoms may be useful in intervening with such partners.     

Psychological dimensions associated with suicidal ideation and attempts in the National Comorbidity Survey

Three important psychological dimensions in the suicide literature (neuroticism, self-criticism, and hopelessness) were examined in relation to suicidal ideation and attempts in the U.S. National Comorbidity Survey (Kessler et al., 1994; n = 5,877), after first controlling for the effects of previously identified sociodemographic and psychiatric variables related to suicidality in this nationally representative sample (Kessler, Borges, & Walters, 1999). Analyses were conducted separately for lifetime, current (12-month), and past history of suicidal ideation and attempts. Brief indices of self-criticism and hopelessness were robustly associated with suicide attempts across all three time frames. The results support the value of examining psychological individual differences over sociodemographic and psychiatric diagnoses alone in the comprehensive assessment of factors associated with suicidality in the general population.     

The Politics of Trauma Studies: What Can We Learn From Women Combatants' Experiences of Traumatic Events in Conflict Zones?

Wars, combat, and political developments triggered the study of trauma. Knowledge about trauma initially emerged from the experiences of men combatants in the battlefield. At a later stage, the study of trauma focused on women and children subject to violence and abuse. The current research suggests that additional aspects of trauma can be understood through the study of competent women exposed to traumatic events and not merely as victims of war or abuse. The study offers an analysis of women combatants' narratives of their exposure to traumatic events in conflict zones. Data were obtained from two focus groups and a series of 30 personal interviews of women veterans who served in the IDF. Interviewing women combat soldiers revealed a variety of narratives of their war experiences, including the intertwining of the emotional and the physical. The window to understanding the trauma was opened by analysis of the responses of the women combatants to potentially traumatic events rather than by focusing on post‐traumatic stress disorder (PTSD) per se. We emphasize the need for a critical perspective in the study of trauma and combat trauma and propose that there is value in engaging with and listening to diverse narratives of trauma.     

The enduring impact of borderline personality pathology: risk for threatening life events in later middle-age

Both neuroticism and borderline personality disorder (BPD) are associated with increased frequency of stressful life events in young adults. It is not clear, however, whether this effect extends to later life because BPD is apparently diminished in frequency and severity when people reach middle adulthood. This issue was examined in a representative, community sample of men and women between the ages of 55 and 64 (N = 1,234). Ten DSM-IV PDs and neuroticism were assessed at baseline using a semistructured interview (SIDP-IV) and questionnaire (NEO-PI-R). Life events were measured 6 months later with a self-report questionnaire (LTE-Q) followed by a telephone interview. BPD features and neuroticism predicted increased frequency of life events, based on both self and interviewer-adjusted reports of negative life events. Avoidant and paranoid PD features predicted decreased frequency of negative life events. Approximately 42% of events reported on the LTE-Q were discounted following the telephone interview; higher scores on BPD symptoms were associated with more adjustments to self-report of threatening experiences. These findings indicate that symptoms of BPD and neuroticism continue to have a harmful impact on the lives of older adults.     

Posttraumatic Stress Disorder and Associated Functional Impairments During Pregnancy: Some Consequences of Violence Against Women

Despite the high prevalence of violence in the lives of women of reproductive age, and the adverse consequences posed to pregnant women suffering from PTSD, few studies have examined violence-related trauma and PTSD among pregnant women. A structured research interview was administered to a convenience sample of 85 prenatal care women to collect information regarding their experiences of violence victimization, PTSD symptoms related to violence-related traumatic events, and whether these symptoms impaired various aspects of the women's daily functioning. Results indicated that 69% of the women experienced a violent traumatic event, with the majority of events occurring before the current pregnancy and being perpetrated by the women's intimate partners. The traumatized women evidenced high levels of PTSD symptoms during pregnancy, with 58% of the women meeting criteria for a PTSD diagnosis. Moreover, many of the women with PTSD symptoms reported that the symptoms adversely affected aspects of their daily functioning.     

Psychological trauma and schizotypal personality disorder

Two studies examined the relation between psychological trauma and schizotypal symptoms. In Study 1, in which 1,510 adults completed telephone interviews, both childhood maltreatment and the experience of an injury or life-threatening event were significantly associated with schizotypal symptoms. In Study 2, in which 303 adults (oversampled for having elevated levels of schizotypal symptoms) completed extensive in-person assessments, both childhood maltreatment and meeting posttraumatic stress disorder (PTSD) Criterion A were significantly associated with schizotypal symptoms. The links between schizotypal symptoms and at least some forms of psychological trauma could not be fully accounted for by shared variance with antisocial and borderline personality disorders, absorption/dissociation, PTSD symptom severity, family history of psychotic disorder, or signs of neurodevelopmental disturbance (as indexed by minor physical anomalies and inconsistent hand use). Schizotypal symptoms were more strongly associated with childhood maltreatment among men than among women, whereas schizotypal symptoms were more strongly associated with PTSD Criterion A among women than among men. Finally, among men, the association between childhood maltreatment and schizotypal symptoms was moderated by signs of neurodevelopmental disturbance.     

Post‐Traumatic Symptoms Among Victims of Workplace Bullying: Exploring Gender Differences and Shattered Assumptions

The aims of the present study were twofold: assessing the prevalence and intensity of post‐traumatic stress disorder (PTSD) symptoms in victims of bullying, and exploring whether victims of bullying differ in their basic assumptions compared to a control group. A total of 183 victims of bullying and 183 control group participants took part in the research. The results showed that 42.6% of the total sample met all DSM‐IV‐TR criteria for PTSD, whereas 54.1% did not fulfill the A1 criterion. Post‐traumatic symptoms were more prevalent among women (49%), as compared to men (35.3%). Furthermore, victims showed significantly more negative beliefs about the world, the people, and themselves, compared to their non‐bullied controls. These results fit well with cognitive theory of trauma.     

Frequency and impact of trauma in older women: A military and nonmilitary sample

Understanding the impact of trauma on late-life functioning in older females is needed in order to provide best care. We explored the impact of trauma on late-life psychological and physical health and functioning among older women (n = 48) who served in the military, or participated in a military lifestyle. Eleven of these women were not veterans, but married to military personnel. Number of traumatic exposures and types of events experienced was associated with increased trauma symptom severity. Trauma symptom severity was associated with decreased physical functioning and increased pain. Increased numbing and avoidance was significantly associated with poorer physical functioning and increased pain. Older women in this study remained at risk of experiencing negative consequences of trauma in terms of increased quantity and severity of trauma symptoms and physical decline and pain. Clinical and research implications are discussed.     

Memory consistency for traumatic events in Dutch soldiers deployed to Iraq

Retrospective accounts of traumatic events are consistently associated with symptoms of post-traumatic stress disorder (PTSD). This has often been interpreted as causal impact of such events on psychological functioning, but recent studies suggest that the causal direction is (partly) reversed: high levels of PTSD symptoms may be associated with amplified recollections of precipitating traumatic events. The aim of this prospective study was to index the consistency with which Dutch Army soldiers reported traumatic stressors and nontraumatic stressors on their deployment to Iraq, and to examine to what extent PTSD symptoms and pre-existing reporting biases, such as that arising from neuroticism, affect memory inconsistency. Retrospective accounts of stressors were highly variable over time. Individuals with higher levels of PTSD symptoms and neuroticism, lower levels of extraversion, and fewer prior missions, were more prone to increased reporting over time.     

Sexual Assault History and Health-Related Outcomes in a National Sample of Women

This study examined correlates of past-year chronic medical conditions and lifetime contact with health care professionals for mental health and substance abuse problems in women with differing histories of sexual victimization  ( N  = 627)  identified from the National Comorbidity Survey (e.g., assault in childhood, adulthood, or both life phases). Posttraumatic stress disorder (PTSD) and stressful life events were associated with greater odds of chronic medical conditions among women sexually assaulted in childhood only. Additional traumatic events were associated with greater odds of chronic medical conditions among victims of adult sexual assault. Older age and being married were associated with greater odds of lifetime health care professional contact for mental health/substance abuse issues among certain victim subgroups. Stressful life events were related to greater help-seeking for child victims, and traumatic events were related to greater help-seeking in adult victims. Alcohol dependence symptoms and PTSD were each associated with greater odds of lifetime health care professional contact among women victimized in both life phases, whereas depression was related to greater odds of help-seeking for women victimized in one life phase only. Psychosocial factors may play unique roles in health outcomes for women with different sexual assault histories.     

Changes in Neuroticism Following Trauma Exposure

Using longitudinal data, the present study examined change in midlife neuroticism following trauma exposure. Our primary analyses included 670 participants (M_age = 60.55; 65.22% male, 99.70% Caucasian) who completed the NEO Personality Inventory at ages 42 and 50 and reported their lifetime exposure to traumatic events approximately 10 years later. No differences in pre‐ and post‐trauma neuroticism scores were found among individuals who experienced all of their lifetime traumas in the interval between the personality assessments. Results were instead consistent with normative age‐related declines in neuroticism throughout adulthood. Furthermore, longitudinal changes in neuroticism scores did not differ between individuals with and without histories of midlife trauma exposure. Examination of change in neuroticism following life‐threatening traumas yielded a comparable pattern of results. Analysis of facet‐level scores largely replicated findings from the domain scores. Overall, our findings suggest that neuroticism does not reliably change following exposure to traumatic events in middle adulthood. Supplemental analyses indicated that individuals exposed to life‐threatening traumas in childhood or adolescence reported higher midlife neuroticism than individuals who experienced severe traumas in adulthood. Life‐threatening traumatic events encountered early in life may have a more pronounced impact on adulthood personality than recent traumatic events.     

Measurement differences from rating posttraumatic stress disorder symptoms in response to differentially distressing traumatic events

The authors explored differences in posttraumatic stress disorder (PTSD) symptoms as a result of rating symptoms from two separate, differentially distressing traumatic events. In an initial sample of 400 nonclinical participants, the authors inquired through a web survey about previous psychological trauma, instructing participants to nominate their most distressing and second most distressing traumatic events experienced. Using the PTSD Checklist, participants rated their PTSD symptoms separately from these worst and second worst events. Using the four-factor emotional numbing PTSD model in confirmatory factor analysis, results demonstrated evidence supporting separation of PTSD symptom rating sets from two differentially distressing traumas-specifically, the worst and second worst events. Measurement invariance tests revealed that factor loadings did not vary between the worst and second worst event PTSD ratings; item thresholds (indexing symptom severity) differed. Results generally support the recommended PTSD assessment protocol instructing participants to rate PTSD symptoms from a single, worst index event.     

Psychological consequences of trauma in MVA perpetrators – Relationship between post-traumatic growth,PTSD symptoms and individual characteristics

The study explores two problems rarely discussed in literature. Firstly, it presents the psychological consequences of traumatic stress in perpetrators of motor vehicle accidents (MVAs). The attention of both clinicians and researchers is very seldom focused on this group of MVA participants, as in the natural way, people have a tendency to empathise with victims and distancing from those who make harm to others. MVA perpetrators usually feel no right to complain about experienced symptoms of poor well-being, and guilt prevent them against searching for any help. Such a situation may lead to further problems related to traffic safety, as persistent and untreated symptoms of PTSD or other anxiety disorders may negatively affect driving behaviour. Secondly, apart from post-traumatic psychopathology, the symptoms of post-traumatic growth (PTG) in MVA perpetrators together with factors related to them are analysed in the study. The examination results from the comprehensive sample of MVA perpetrators (n = 236) referred to Occupational Medicine Centres in the catchment area of Mazowieckie Voivodship, Poland, indicate that both PTSD and PTG symptoms are experienced by MVA perpetrators. The key predictors of PTG are neuroticism, conscientiousness, agreeableness and intensity of PTSD symptoms. Moreover, sex and perpetrators’ injuries during the accident seem to play a vital role in the process of post-traumatic growth. Those of subjects who were women or were injured generally declared more positive changes in their life as a consequences of the accident they caused.     

价值观对蓄意创伤受害者创伤后应激障碍症状的影响

探讨价值观对蓄意创伤受害者创伤后应激障碍（Posttraumatic Stress Disorder ,简称PTSD）症状的影响方式。方法：采用事件冲击量表、受害人认可评价量表、施瓦兹价值观量表作为测查工具,测查了163 名蓄意创伤受害者。结果：（1）蓄意创伤受害者的PTSD三大症状表现有显著差异,闯入症状水平最高,回避症状水平次之,高警觉症状水平最低。（2）蓄意创伤受害者所持的价值观和对外界接纳的评价能较好地预测PTSD三大症状。（3）内敛价值类型通过诸如社会接纳等反映外在标准的因素影响PTSD的闯入症状。结论：蓄意创伤受害者PTSD症状表现有其自身的特点,对外界接纳的评价和自身所持的价值观对其PTSD症状有直接或间接的影响     

Consequences of Child and Adult Sexual and Physical Trauma among Deaf Adults

The purpose of this study was to evaluate the consequences of sexual and physical trauma among a sample of deaf adults. Thirty-two men and 45 women completed the Life Event Checklist (LEC), the Clinician Administered PTSD Scale (CAPS), the Trauma Symptom Inventory (TSI), the Somatoform Dissociation Questionnaire–20 (SDQ–20) and a sociodemographic questionnaire. In this sample, 40.6% of the male participants and 53.3% of the female participants had experienced some type of sexual trauma during their lifetimes. Physical trauma was reported by 75% of males and 71.1% of female participants. For those who had experienced childhood sexual trauma, the odds ratio of revictimization in adulthood was 6.69. Sexual trauma also rarely occurred by itself. Two thirds of all participants with sexual trauma histories also reported some type of physical abuse. Participants with sexual trauma histories displayed significantly more symptoms of PTSD and depression than people without such trauma history. Physical and sexual abuse represent significant problems in the deaf community. The authors include a call for the development of targeted intervention attempts to prevent further victimization in deaf child and adolescent populations.     

Trauma in the Lives of Older Men: Findings from the Normative Aging Study

Research on the prevalence of traumatic exposure has tended to focus on younger populations, limiting our knowledge about trauma and its effects in older adults. In this study, lifetime trauma exposure was assessed in a sample of 436 male military veterans of World War II and the Korean Conflict (age 59–92). A clinician-administered screening measure, the Brief Trauma Interview, was developed to assess lifetime exposure to 10 categories of trauma using DSM-IV criteria. PTSD was assessed in interview and questionnaires. Despite a high prevalence of trauma exposure, symptom levels were relatively low. Few men met criteria for current or lifetime PTSD. Secondary analyses found that lifetime symptom severity was higher in men who met the DSM-IV A.2 criterion, in contrast with men who did not meet A.2. Findings indicate that trauma is highly prevalent among older men, although many may be asymptomatic.     

Protective role of coping flexibility in PTSD and depressive symptoms following trauma

The aim of the study was to examine whether coping flexibility would function as a protective factor for PTSD and depressive symptoms in trauma-exposed adults in Korea. A total of 510 adults with a lifetime history of traumatic events completed the Perceived Ability to Cope with Trauma (PACT), the Korea version of the Posttraumatic Stress Diagnostic Scale (PDS-K), and the Patient Health Questionnaire (PHQ-9). Hierarchical regression indicated that coping flexibility was associated with a reduced level of PTSD or depressive symptoms after controlling for comorbid symptoms, age, and elapsed time since the most distressing traumatic event. The interaction of traumatic events and coping flexibility was significant only on PTSD symptom severity but not on depressive symptom severity. Specifically, individuals with low coping flexibility reported higher levels of PTSD symptoms as the number of traumatic events increased. These findings supported the hypothesis that coping flexibility is a protective factor for PTSD and depression following trauma, and lack of coping flexibility may aggravate the risk for PTSD among people with multiple trauma.     

Post-Traumatic Stress Disorder in Vietnamese Women

This article describes the extraordinary events Vietnamese women immigrants and refugees experienced prior to their resettlement in the United States. Oral history data illustrate the need for sensitization to issues of Post-Traumatic Stress Disorder and the historical-cultural background of this special population. Oral history narratives from five Vietnamese women suggest differences in the way men and women define wartime trauma, and that women's biological makeup may precipitate some stress reactions unique to women. These narratives are examined in terms of Post-Traumatic Stress Disorder (PTSD), a diagnosis that has been applied primarily to male veterans in treating their physical and psychological problems resulting from war, not to Vietnamese women who lived under war conditions.