Risk factors predict post-traumatic stress disorder differently in men and women
Tóm tắt
About twice as many women as men develop post-traumatic stress disorder (PTSD), even though men as a group are exposed to more traumatic events. Exposure to different trauma types does not sufficiently explain why women are more vulnerable. The present work examines the effect of age, previous trauma, negative affectivity (NA), anxiety, depression, persistent dissociation, and social support on PTSD separately in men and women. Subjects were exposed to either a series of explosions in a firework factory near a residential area or to a high school stabbing incident. Some gender differences were found in the predictive power of well known risk factors for PTSD. Anxiety predicted PTSD in men, but not in women, whereas the opposite was found for depression. Dissociation was a better predictor for PTSD in women than in men in the explosion sample but not in the stabbing sample. Initially, NA predicted PTSD better in women than men in the explosion sample, but when compared only to other significant risk factors, it significantly predicted PTSD for both men and women in both studies. Previous traumatic events and age did not significantly predict PTSD in either gender. Gender differences in the predictive value of social support on PTSD appear to be very complex, and no clear conclusions can be made based on the two studies included in this article.
Tài liệu tham khảo
Rosner R, Powell S, Butollo W: Posttraumatic stress disorder three years after the siege of Sarajevo. J Clin Psychol. 2003, 59: 41-55. 10.1002/jclp.10116.
Zlotnick C, Zimmerman M, Wolsdorf BA, Mattia JI: Gender differences in patients with posttraumatic stress disorder in a general psychiatric practice. Am J Psychiatry. 2001, 158: 1923-1925. 10.1176/appi.ajp.158.11.1923.
Punamäki RL, Komproe IH, Quota S, Elmasri M, de Jong JTVM: The role of peritraumatic dissociation and gender in the association between trauma and mental health in a Palestinian community sample. Am J Psychiatry. 2005, 162: 545-551. 10.1176/appi.ajp.162.3.545.
Breslau N, Chilcoat HD, Kessler RC, Peterson EL, Lucia VC: Vulnerability to assaultive violence: further specification of the sex difference in post-traumatic stress disorder. Psychol Med. 1999, 29: 813-821. 10.1017/S0033291799008612.
Breslau N, Kessler RC, Chilcoat HD, Schultz LR, Davis GC, Andreskri P: Trauma and posttraumatic stress disorder in the community: the Detroit area survey of trauma. Arch Gen Psychiatry. 1998, 55: 626-632. 10.1001/archpsyc.55.7.626.
Norris FH, Perilla JL, Ibanez GE, Murphy AD: Sex differences in symptoms of posttraumatic stress: does culture play a role. J Traum Stress. 2001, 14: 7-27. 10.1023/A:1007851413867.
McNally RJ, Bryant RA, Ehlers A: Does early psychological intervention promote recovery from posttraumatic stress?. Psychol Sci Pub Int. 2003, 4: 45-79. 10.1111/1529-1006.01421.
Saxe GN, Stoddard F, Hall E, Chawla N, Lopez C, Hall E, Sheridan R, King D, King L: Pathways to PTSD, part I: children with burns. Am J Psychiatry. 2005, 162: 1299-1304. 10.1176/appi.ajp.162.7.1299.
Kaplow JB, Dodge KA, Amaya-Jackson L, Saxe GN: Pathways to PTSD part II: sexually abused children. Am J Psychiatry. 2005, 162: 1305-1310. 10.1176/appi.ajp.162.7.1305.
Taylor SE, Klein LC, Lewis BP, Gruenewald TL, Gurung RAR, Underfraff JA: Biobehavioral responses to stress in females: tend-and-befriend, not fight-or-flight. Psychol Rev. 2000, 107: 411-429. 10.1037/0033-295X.107.3.411.
Olff M, Langeland W, Draijer N, Gersons BPR: Gender differences in posttraumatic stress disorder. Psychol Bull. 2007, 133: 183-204. 10.1037/0033-2909.133.2.183.
Hapke U, Schumann A, Rumph HJ, John U, Meyer C: Post-traumatic stress disorder – the role of trauma, pre-existing psychiatric disorders, and gender. Eur Arch Psychiatry Clin Neurosci. 2006, 256: 299-306. 10.1007/s00406-006-0654-6.
Bromet E, Sonnega A, Kessler RC: Risk factors for DSM-III-R posttraumatic stress disorder: findings from the national comorbidity survey. Am J Epidemiol. 1998, 147: 353-361.
De Bellis MD, Keshavan MS: Sex differences in brain maturation in maltreatment-related pediatric posttraumatic stress disorder. Neurosci Biobehav Rev. 2003, 27: 103-117. 10.1016/S0149-7634(03)00013-7.
De Bellis MD, Keshavan MS, Shifflet H, Iyengar S, Beers SR, Hall J, Moritz G: Brain structures in pediatric maltreatment-related posttraumatic stress disorder: a sociodemographically matched study. Biol Psychiatry. 2002, 52: 1066-1078. 10.1016/S0006-3223(02)01459-2.
Ahern J, Galea S, Fernandez WG, Koci B, Waldman R, Vlahov D: Gender, social support, and posttraumatic stress in postwar Kosovo. J Nerv Ment Dis. 2004, 192: 762-770. 10.1097/01.nmd.0000144695.02982.41.
Seligman MEP, Walker EF, Rosenhan DL: Mood disorders. Abnormal psychology. 2001, New York: W.W. Norton and Company, 4
Kirmayer LJ, Robbins JM, Paris J: Somatoform disorders: personality and the social matrix of somatic distress. J Abnorm Psychol. 1994, 103: 125-136. 10.1037/0021-843X.103.1.125.
Kendler KS, Kuhn J, Prescott CA: The interrelationship of neuroticism, sex, and stressful life events in the prediction of episodes of major depression. Am J Psychiatry. 2004, 161: 631-636. 10.1176/appi.ajp.161.4.631.
Norris FH, Friedman MJ, Watson PJ, Byrne CM, Diaz E, Kaniasty K: 60,000 disaster victims speak: part I. Empirical review of the empirical literature, 1981–2001. Psychiatry. 2002, 65: 207-239.
Fauerbach JA, Lawrence JW, Schmidt CW, Munster AM, Costa PT: Personality predictors of injury-related posttraumatic stress disorder. J Nerv Ment Dis. 2000, 188: 510-517. 10.1097/00005053-200008000-00006.
Hettema JM, Prescott CA, Kendler KS: Genetic and environmental sources of covariation between generalized anxiety disorder and neuroticism. Am J Psychiatry. 2004, 161: 1581-1587. 10.1176/appi.ajp.161.9.1581.
Joiner TE, Blalock JA: Gender differences in depression: the role of anxiety and generalized negative affect. Sex Roles. 1995, 33: 91-108. 10.1007/BF01547937.
van Diest I, De Peuter S, Eertmans A, Bogaerts K, Victoir A, van den Bergh O: Negative affectivity and enhanced symptom reports: differentiating between symptoms in men and women. Soc Sci Med. 2005, 61: 1835-1845. 10.1016/j.socscimed.2005.03.031.
Ehring T, Ehlers A, Glucksman E: Contribution of cognitive factors to the prediction of post-traumatic stress disorder, phobia and depression after motor vehicle accidents. Behav Res Ther. 2006, 44: 1699-1716. 10.1016/j.brat.2005.11.013.
Ehlers A, Mayou RA, Bryant B: Psychological predictors of chronic posttraumatic stress disorder after motor vehicle accidents. J Abnorm Psychol. 1998, 107: 508-519. 10.1037/0021-843X.107.3.508.
Bryant RA, Harvey AG: Gender differences in the relationship between acute stress disorder and posttraumatic stress disorder following motor vehicle accidents. Aust N Z J Psychiatry. 2003, 37: 226-229. 10.1046/j.1440-1614.2003.01130.x.
Andrews B, Brewin CR, Rose S: Gender, social support, and PTSD in victims of violent crime. J Traum Stress. 2003, 16: 421-427. 10.1023/A:1024478305142.
Farhood L, Zurayk H, Chaya M, Saadeh F, Meshefedjian G, Sidani H: The impact of war on the physical and mental health of the family: the Lebanese experience. Soc Sci Med. 1993, 36: 1555-1567. 10.1016/0277-9536(93)90344-4.
Elklit A: Psychological consequences of a firework factory disaster in a local community. Soc Psychiatry Psychiatr Epidemiol. 2007, 42 (8): 664-668. 10.1007/s00127-007-0206-z.
Elklit A, Kurdahl S: De psykosociale følger af knivdrabet på Hasseris Gymnasium. Psykologisk Skriftserie. 2007, 28: 1-94.
Mollica RF, Caspi-Yavin Y, Bollini P, Truong T: The Harvard trauma questionnaire: Validating a cross-cultural instrument for measuring torture, trauma, and posttraumatic stress disorder in Indochinese refugees. J Nerv Ment Dis. 1992, 180: 111-116.
Bach ME: En empirisk belysning og analyse af "emotional numbing" som eventuel selvstændig faktor i PTSD. Psykologisk Studieskriftserie. 2003, 6 (1): 1-199.
Krog T, Duel M: Traume symptom checkliste (TSC): En validering og revidering. Psykologisk Studieskriftserie. 2003, 6 (4): 1-162.
Goldberg D, Williams P: A users guide to the General Health Questionnaire. 1988, Wiltshire, UK: NFER-NELSON
McFarlane AC, Atchison M, Rafalowitcz E, Papay P: Physical symptoms in post-traumatic stress disorder. J Psychosom Res. 1994, 38: 715-726. 10.1016/0022-3999(94)90024-8.
Joseph S, Andrews B, Williams R, Yule W: Crisis support and psychiatric symptomatology in adult survivors of the Jupiter cruise ship disaster. Br J Clin Psychol. 1992, 31: 63-73.
Elklit A, Pedersen SS, Jind L: The crisis support scale: psychometric qualities and further validation. Pers Indiv Differ. 2001, 31: 1291-1302. 10.1016/S0191-8869(00)00220-8.
Kessler RC, Sonnega A, Bromet E, Hughes M, Nelson CB: Posttraumatic stress disorder in the National Comorbidity Survey. Arch Gen Psychiatry. 1995, 52: 1048-1060.