This Article  • References  • Full text PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

Naomi Breslau, PhD; Glenn C. Davis, MD; Patricia Andreski, MA; Edward L. Peterson, PhD; Lonni R. Schultz, PhD

Arch Gen Psychiatry. 1997;54(11):1044-1048.

Abstract
Background
Epidemiologic surveys in the general population documented a higher rate of posttraumatic stress disorder (PTSD) in women than in men. To date, the finding has received little scientific attention. This study examines the extent to which sex differences in PTSD might be explained by previously identified risk factors and whether the sex difference in PTSD varied by age at exposure to traumatic events.

Methods
The NIMH-DIS (NIMH Diagnostic Interview Schedule, Version III Revised) was used to measure DSM-IIIR disorders in a random sample of 1007 young adults. Cox proportional hazards models were used to estimate changes in the hazards ratio for PTSD associated with sex when potential risk factors were included.

Results
Lifetime prevalence of exposure to traumatic events and number of traumatic events did not vary by sex. The prevalence of PTSD was higher for women than for men exposed to traumatic events (hazards ratio, 2.3; 95% confidence interval, 1.5-3.6). Preexisting anxiety disorders or major depressive disorders played a part in the observed sex difference in PTSD. Family history of anxiety disorder and early separation from parents, although significant risk factors for PTSD in subjects of both sexes, were unrelated to the sex difference in PTSD. The sex difference in PTSD was markedly greater if exposure occurred in childhood than later on.

Conclusions
Posttraumatic stress disorder is more likely to develop in females than in males after exposure to a traumatic event. Susceptibility to PTSD in females might be greater in childhood than after age 15 years. Explanations of the sex difference might involve characteristics of individuals and of the traumatic experiences.

Author Affiliations
From the Departments of Psychiatry (Dr Breslau and Ms Andreski) and Biostatistics and Research Epidemiology (Drs Breslau, Peterson, and Schultz) and the Office of Academic Affairs (Dr Davis), Henry Ford Health Sciences Center, Detroit, Mich; Department of Psychiatry, Case Western Reserve University, Cleveland, Ohio (Drs Breslau and Davis); and Department of Psychiatry, University of Michigan, Ann Arbor (Drs Breslau and Davis).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

A Qualitative Study of Clinicians' Use of the Cultural Formulation Model in Assessing Posttraumatic Stress Disorder
Fortuna et al.
Transcultural Psychiatry 2009;46:429-450.
ABSTRACT  

The Epidemiology of Trauma, PTSD, and Other Posttrauma Disorders
Breslau
Trauma Violence Abuse 2009;10:198-210.
ABSTRACT  

Posttraumatic Stress Disorder: A State-of-the-Science Review
Nemeroff et al.
Focus 2009;7:254-273.
ABSTRACT | FULL TEXT  

Toward Validation of the Diagnosis of Posttraumatic Stress Disorder
North et al.
Am. J. Psychiatry 2009;166:34-41.
ABSTRACT | FULL TEXT  

Symptoms of Acute Posttraumatic Stress Disorder After Intensive Care
Wallen et al.
Am J Crit Care 2008;17:534-543.
ABSTRACT | FULL TEXT  

Acute predator stress impairs the consolidation and retrieval of hippocampus-dependent memory in male and female rats
Park et al.
Learn. Mem. 2008;15:271-280.
ABSTRACT | FULL TEXT  

A framework to analyse gender bias in epidemiological research
Ruiz-Cantero et al.
J. Epidemiol. Community Health 2007;61:ii46-ii53.
ABSTRACT | FULL TEXT  

Traumatic Events and Posttraumatic Stress in Childhood
Copeland et al.
Arch Gen Psychiatry 2007;64:577-584.
ABSTRACT | FULL TEXT  

Gender and Age Differences in Posttraumatic Stress Disorder and Depression Among Buffalo Police Officers
Darensburg et al.
Traumatology 2006;12:220-228.
ABSTRACT  

Gender Differences and Acute Stress Reactions Among Rescue Personnel 36 to 48 Hours After Exposure to Traumatic Event
Ben-Ezra et al.
Traumatology 2006;12:139-142.
ABSTRACT  

Biological Underpinnings of Health Alterations in Women With PTSD: A Sex Disparity
Gill et al.
Biol Res Nurs 2005;7:44-54.
ABSTRACT  

The Role of Peritraumatic Dissociation and Gender in the Association Between Trauma and Mental Health in a Palestinian Community Sample
Punamaki et al.
Am. J. Psychiatry 2005;162:545-551.
ABSTRACT | FULL TEXT  

Acute Stress Disorder, Posttraumatic Stress Disorder, and Depression in Disaster or Rescue Workers
Fullerton et al.
Am. J. Psychiatry 2004;161:1370-1376.
ABSTRACT | FULL TEXT  

The Psychological Impact of Terrorism: An Epidemiologic Study of Posttraumatic Stress Disorder and Associated Factors in Victims of the 1995-1996 Bombings in France
Verger et al.
Am. J. Psychiatry 2004;161:1384-1389.
ABSTRACT | FULL TEXT  

Prevalence of Trauma, PTSD, and Dissociation in Court-Referred Adolescents
Brosky and Lally
J Interpers Violence 2004;19:801-814.
ABSTRACT  

Posttraumatic Stress Disorder and Trauma in Youth in Juvenile Detention
Abram et al.
Arch Gen Psychiatry 2004;61:403-410.
ABSTRACT | FULL TEXT  

Psychiatric Morbidity Following Injury
O'Donnell et al.
Am. J. Psychiatry 2004;161:507-514.
ABSTRACT | FULL TEXT  

Posttraumatic Stress Disorder in Female Veterans: Association With Self-reported Health Problems and Functional Impairment
Dobie et al.
Arch Intern Med 2004;164:394-400.
ABSTRACT | FULL TEXT  

Posttraumatic Stress Disorder, Alcohol Use, and Perceived Safety After the Terrorist Attack on the Pentagon
Grieger et al.
Psychiatr. Serv. 2003;54:1380-1382.
ABSTRACT | FULL TEXT  

Genetic and Environmental Influences on Trauma Exposure and Posttraumatic Stress Disorder Symptoms: A Twin Study
Stein et al.
Am. J. Psychiatry 2002;159:1675-1681.
ABSTRACT | FULL TEXT  

Gender Differences in Patients With Posttraumatic Stress Disorder in a General Psychiatric Practice
Zlotnick et al.
Am. J. Psychiatry 2001;158:1923-1925.
ABSTRACT | FULL TEXT  

Prediction of Psychiatric Morbidity in Severely Injured Accident Victims at One-year Follow-up
SCHNYDER et al.
Am. J. Respir. Crit. Care Med. 2001;164:653-656.
ABSTRACT | FULL TEXT  

Predictors of Posttraumatic Stress Among Victims of Motor Vehicle Accidents
Dougall et al.
Psychosom. Med. 2001;63:402-411.
ABSTRACT | FULL TEXT  

Interpersonal Violence and Posttraumatic Symptomatology: The Effects of Ethnicity, Gender, and Exposure to Violent Events
McGRUDER-JOHNSON et al.
J Interpers Violence 2000;15:205-221.
ABSTRACT  

Trauma and Posttraumatic Stress Disorder in the Community: The 1996 Detroit Area Survey of Trauma
Breslau et al.
Arch Gen Psychiatry 1998;55:626-632.
ABSTRACT | FULL TEXT