Sex differences in trauma and posttraumatic stress disorder: A quantitative review of 25 years of research.

Tolin, David F.; Foa, Edna B.

doi:10.1037/1942-9681.s.1.37

Cited by 385 publications

(370 citation statements)

References 91 publications

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“…Moreover, it was striking that whereas in the A1 event group women showed significantly higher PTSD symptoms than men (29.9 versus 15.4% met PTSD B, C and D criteria), in line with previous studies (e.g. Tolin & Foa, 2008), in the non-A1 event group there were no gender differences in PTSD symptoms (women: 28.2%; men: 31.3%).…”

Section: Discussionsupporting

confidence: 89%

“…Furthermore, women are approximately twice as likely to meet criteria for PTSD than men, even though women are less likely to experience an A1 event (Olff, Langeland, Draijer, & Gersons, 2007; Tolin & Foa, 2008). Men and women tend to experience different types of A1 events but, even after controlling for type of experienced A1 event, the gender differences in PTSD prevalence remain (Christiansen & Hansen, 2015; Moser, Hajcak, Simons, & Foa, 2007; Tolin & Foa, 2008).…”

Section: Introductionmentioning

confidence: 99%

“…Men and women tend to experience different types of A1 events but, even after controlling for type of experienced A1 event, the gender differences in PTSD prevalence remain (Christiansen & Hansen, 2015; Moser, Hajcak, Simons, & Foa, 2007; Tolin & Foa, 2008). It is still unknown whether the increased vulnerability in women to develop PTSD after experiencing A1 events also extends to the experience of non-A1 events.…”

Section: Introductionmentioning

confidence: 99%

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A new perspective on PTSD symptoms after traumatic vs stressful life events and the role of gender

Berg

Tollenaar

Spinhoven

et al. 2017

European Journal of Psychotraumatology

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Background: There is an ongoing debate about the validity of the A1 criterion of PTSD. Whereas the DSM-5 has opted for a more stringent A1 criterion, the ICD-11 will leave it out as a key criterion. Objective: Here we investigated whether formal DSM-IV-TR traumatic (A1) and stressful (non-A1) events differ with regard to PTSD symptom profiles, and whether there is a gender difference in this respect. Method: This was examined in a large, mostly clinical sample from the Netherlands Study of Depression and Anxiety (n = 1433). Participants described their most bothersome (index) event and were assigned to either an A1 or non-A1 event group according to this index event. Results: Remarkably, in men PTSD symptoms were even more severe after non-A1 than A1 events, whereas in women symptoms were equally severe after non-A1 and A1 events. Moreover, while women showed significantly higher PTSD symptoms after A1 events than men (29.9 versus 15.4% met PTSD criteria), there was no gender difference after non-A1 events (women: 28.2%; men: 31.3%). Furthermore, anxiety and perceived impact were higher in women than men, which was associated with PTSD symptom severity. Conclusion: In sum, while women showed similar levels of PTSD symptoms after both event types, men reported even higher levels of PTSD symptoms after non-A1 than A1 events. These findings shed a new light on the role of gender in PTSD symptomatology and the clinical usefulness of the A1 criterion.

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Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

A new perspective on PTSD symptoms after traumatic vs stressful life events and the role of gender

Berg

Tollenaar

Spinhoven

et al. 2017

European Journal of Psychotraumatology

View full text Add to dashboard Cite

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“…The results proffered support for the betrayal theory. First, a substantially higher proportion of women reported experiencing interpersonal trauma events compared to men, indicating that women are indeed at a higher risk than men of experiencing medium- or high-betrayal trauma (Ghafoori et al, 2013; Tolin & Foa, 2008). In addition, gender did moderate the link between interpersonal trauma and PTSD, but not the link between non-interpersonal trauma and PTSD.…”

Section: Discussionmentioning

confidence: 99%

“…Low-betrayal traumatic events are experiences that are not interpersonal in nature, such as natural disasters or car accidents. Research supports this supposition, showing that women are more likely to experience interpersonal (or medium-/high-betrayal) traumas, such as sexual assault or domestic violence, while men are more likely to experience non-interpersonal (or low-betrayal) trauma, such as being in an automobile accident or witnessing death or injury (Ghafoori, Barragan, & Palinkas, 2013; Tolin & Foa, 2008). In addition, one study found that high-betrayal trauma mediated the link between gender and PTSD (Tang & Freyd, 2012).…”

Section: Introductionmentioning

confidence: 98%

Deployment-related trauma and post-traumatic stress disorder: does gender matter?

Frank

Zamorski

Lee

et al. 2018

European Journal of Psychotraumatology

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Objective: Military research has attempted to identify whether women have an increased vulnerability to mental health issues following deployment-related trauma, but findings have been mixed. Most studies have controlled for childhood abuse, but not other non-deployment trauma (e.g. life-threatening illness), which may partly explain previous mixed results. This study assessed gender differences in the association between deployment-related trauma and post-traumatic stress disorder (PTSD) while controlling for non-deployment trauma.Methods: Data came from the 2013 Canadian Forces Mental Health Survey. Regular or reserve personnel who had been deployed at least once were included in this study (n = 5980). Logistic regression was used to examine the interaction between gender and deployment-related trauma in predicting lifetime PTSD.Results: After controlling for non-deployment trauma, the association of gender with PTSD went from being significant to being marginally significant. The interaction between gender and deployment-related trauma was not significant.Conclusion: Though controlling for non-deployment trauma did not completely dissipate gender differences in PTSD, such differences were greatly reduced, indicating that these may be partly related to traumatic experiences outside deployment. As gender did not moderate the link between deployment-related trauma and PTSD, the findings suggest that trauma experienced while on deployment does not disproportionately affect women compared to their male counterparts.

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Disparities in Adverse Childhood Experiences Among Individuals With a History of Military Service

et al. 2014

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IMPORTANCE Adverse childhood experiences (ACEs) are associated with several adulthood health problems, such as self-directed violence. For some individuals, enlistment in the military may be an instrumental act to escape adverse household environments; however, to our knowledge prevalence of ACEs among persons with a history of military service has not been documented in the United States using population-based data.OBJECTIVE To compare the prevalence of ACEs among individuals with and without a history of military service. DESIGN, SETTING, AND PARTICIPANTS Data are from the 2010 Behavioral Risk Factor Surveillance System. Computer-assisted telephone interviews were conducted with population-based samples of noninstitutionalized US adults from January 1 through December 31, 2010. Analyses were limited to respondents who received the ACE module (n = 60 598). Participants were categorized by history of military service and whether a respondent was 18 years of age in 1973.MAIN OUTCOMES AND MEASURES History of military service was defined by active duty service, veteran status, or training for the Reserves or National Guard. The ACE inventory assessed 11 negative experiences before the age of 18 years. Weighted χ 2 tests and multiple logistic regression analyses were used to examine differences in ACEs by history of military service, era of service, and sex. RESULTSThose with military experience had greater odds of any difference in prevalence of ACEs. In the all-volunteer era, men with military service had a higher prevalence of ACEs in all 11 categories than men without military service. Notably, in the all-volunteer era, men with military service had twice the odds of reporting forced sex before the age of 18 years (odds ratio, 2.19; 95% CI, 1.34-3.57) compared with men without military service. In the draft era, the only difference among men was household drug use, in which men with a history of military service had a significantly lower prevalence than men without a history of military service (2.1% vs 3.3%; P = .003). Fewer differences were observed among women in the all-volunteer and draft eras. CONCLUSIONS AND RELEVANCEDifferences in ACEs by era and sex lend preliminary support that enlistment may serve as an escape from adversity for some individuals, at least among men. Further research is needed to understand how best to support service members and veterans who may have experienced ACEs.

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Sex differences in trauma and posttraumatic stress disorder: A quantitative review of 25 years of research.

Cited by 385 publications

References 91 publications

A new perspective on PTSD symptoms after traumatic vs stressful life events and the role of gender

A new perspective on PTSD symptoms after traumatic vs stressful life events and the role of gender

Deployment-related trauma and post-traumatic stress disorder: does gender matter?

Disparities in Adverse Childhood Experiences Among Individuals With a History of Military Service

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