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According to the American Psychiatric Association (2013), Post-traumatic Stress Disorder (PTSD) is caused by exposure to disturbing events. Such occurrences could include; injury, sexual assault, or death. As a result of the shock and trauma associated with these events, a person experiences mental disturbance, distress, and inability to function or interact normally. The American Psychiatric Association (2013) also acknowledges that traumatic events must be present for patients to be diagnosed with PTSD. Other symptoms associated with the disorder include; negative changes in mood, changes in arousal patterns, and differences in reactivity, evasion, and intrusion. Generally, the disorder affects the quality of life and social interacts of the individuals affected.
Hoge, Clark, and Castro (2007) report that majority of previous research studies have concluded that women are more predisposed to PTSD than men. Research studies supporting these findings argue that violence incidences such as rape occur more in women. Additionally, they point out that depression, anxiety, and trauma incidences are more likely to occur in women. On the contrary, other researchers argue that there is lack of scientific evidence to support the claim that PTSD occurs more in women. Moreover, most of the research does not provide conclusive explanations for the gender variances in PTSD.
Understanding gender variances in PTSD is likely to eliminate any misdiagnosis, as physicians will have evidence that men and women have equal probability of getting PTSD. Currently, physicians tend to concentrate more on diagnosing PTSD in women due to the misconceptions that women get PTSD more than men do. Furthermore, PTSD cases in men tend to be misdiagnosed. In this regard, the aim of the current research is to provide evidence that women have the same probability of getting PTSD as men. This research confirms that gender variations in PTSD are mere misconceptions.
Gender and PTSD
Breslau and Anthony (2007) report that epidemiological studies continue to provide evidence regarding gender variation in PTSD. In a research undertaken by these authors across the United States, young women were reported to have a higher probability of getting PTSD (relative risk=4.9) after exposure to violence compared to men. This means that women were 4.9 times more likely to get PTSD after exposure to violence compared to men. Similar to previous research, their study also concluded that sexual assault or violence in women was the major cause of PTSD. In an empirical research by Tolin and Foa (2006), the authors provide evidence that women are more likely to get PTSD than men.
This research included a systematic review of findings reported in the past twenty-five years. According to the research, women report more occurrences of rape, domestic violence, and child abuse in contrast to men. The authors note that these crimes have been reported to affect women more than they affect men. Consequently, men have a higher possibility of reporting shock after accidents and witnessing violence during wars, and disasters. In the meta-analysis, Tolin and Foa (2006) indicate that regardless of the epidemiological research designs employed and sample sizes, the research articles analyzed found a strong link between the female gender and occurrence of PTSD. The authors also explain that women have a higher probability of being subjected to trauma compared to men.
In an attempt to explain the gender variances related to PTSD, Armour and colleagues (2011) note that the kind of violence (sexual assault) that women are subjected to is more traumatic than the violence experienced by men. However, the authors also indicate that some studies have reported higher rates of PTSD among women even after controlling for sexual assault and domestic violence as potential confounders. In reference to Breslau and Anthony (2007), the gender disparities could also be explained by the fact that the female gender is more open when talking about their symptoms compared to the male gender.
Specifically, women find it easy to discuss the symptoms relating to anxiety and depression than men do. Based on this view, there is a likelihood that the occurrence of PTSD in men is under-reported. Accordingly, Tolin and Foa (2006) acknowledge that the gender disparities in PTSD could be brought about by the high prevalence of psychological disorders among women. In view of this, these authors argue that PTSD like any other psychological disorder is more likely to occur in women. The ‘Criterion A’ used in the diagnosis of PTSD could also explain the gender-based differences in its prevalence (Armour, et al., 2011). According to this criterion, the occurrence of a traumatic incidence and an emotional reaction to it is the main diagnosing feature of the disorder. In this respect, the ability of women to disclose the initial emotional reaction to trauma could explain the findings that the disorder occurs more in women. The acquisition of conditioned fear has also been reported to predispose more women than men to PTSD (Inslichta et al., 2013).
Research has found out that women report more occurrences of conditioned fear. The brain regions responsible for conditioned fear are hippocampus and amygdala. These brain regions contain receptors for sex hormones such as estrogen and testosterone. These receptors elicit conditioned fear more in the presence of estrogen than testosterone and hence the occurrences of this fear more in women than in men. In this view, women who exhibit conditioned fear are likely to develop Post-traumatic Stress Disorders.
Misconceptions regarding gender and PTSD
As mentioned above, PTSD results in grave consequences within the family setting. Therefore, it is crucial that the correlates of the disorder be identified beyond any reasonable doubt. This would ensure that cases of PTSD are not missed during diagnosis. Speculating that women are more predisposed to the condition would result in under-reporting of male cases. In this regard, it is important to determine whether women are actually more predisposed to PTSD compared to men. Although previous epidemiological studies have reported that women have higher possibility of developing PTSD compared to men, very few have attempted to explain these findings (Fullerton and Co-authors, 2001). The lack of epidemiological and scientific evidence is an indication that the findings are just fallacies. Thus, both women and women have equal likelihoods of getting PTSD.
Research supporting the claim that women are more likely to get PTSD indicates that gender differences in PTSD are confounded by depression and anxiety disorders. On the contrary, in a study undertaken by Fullerton et al. (2001), a history of anxiety disorder seemed to predispose men to PTSD compared to women. This is contrary to previous findings that women are more predisposed to anxiety disorder and depression compared to men. In a different research by Armour and colleagues (2011), the researchers found no evidence that depression and anxiety in women makes them more susceptible to PTSD. The researchers concluded that incidences of anxiety and depression occur equally across gender. This is an indication that gender variance in PTSD is a myth.
As mentioned previously, Breslau and Anthony (2007) report that occurrence of child abuse could be used to explain the gender variation in PTSD. On the contrary, research by Stewart, Grant, Ouimette, and Brown (2006) elucidates that the notion that child abuse could result in gender variances in PTSD is misconstrued. This is due to the fact that child abuse reports are not accurate and there are many factors that could interfere with memory accuracy. There is likelihood that child abuse is over reported or under-reported across both genders and should not be used to support gender variance in PTSD. Major depression has also been identified as one of the symptoms in PTSD. In this view, various researchers have reported that the possibility of having major depression is higher in women compared to men (Hoge, Clark, & Castro, 2007). As a result, the prevalence of PTSD is predicted to be higher among females than males. However, research by Fullerton et al. (2001) indicates that major depression does not vary across gender. Similarly, PTSD does not vary across gender.
Majority of the research on gender and PTSD recognizes that more extensive epidemiological investigation needs to be undertaken on the topic. Currently, most research studies provide no conclusive findings to explain the gender inconsistencies in PTSD (Inslichta, et al., 2013). While some authors support the possibility of gender variations in PTSD, others seem to refute these claims. In this respect, one cannot assume that PTSD occurs more in females than males. The current research provides evidence that gender disparities in PTSD are mere misconceptions. Such misconceptions can be confusing and can affect the effectiveness of diagnosis across gender. Specifically, physicians are more likely to diagnose more women with PTSD compared to men. As a result, many cases of PTSD among men in the population are likely to be missed or misdiagnosed. Therefore, this research concludes that there are no gender differences in PTSD and the association can only be justified after further extensive research.
American Psychiatric Association (2013). Posttraumatic Stress Disorder. Web.
Armour, C., Elhai, J. D., Layne, C. M., Shevlin, M., Durakovic-Belko, E., Djapo, N., & Pynoos, R. S. (2011). Gender differences in the factor structure of posttraumatic stress disorder symptoms in war-exposed adolescents. Journal of Anxiety Disorders, 25(4), 604-611. Web.
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Breslau, N., & Anthony, J. C. (2007). Gender differences in the sensitivity to Posttraumatic Stress Disorder: An epidemiological study of urban young adults. Journal of Abnormal Psychology, 116(3), 607–611. Web.
Fullerton, C. S., Ursano, R. J., Epstein, R. S., Crowley, B., Vance, K., Kao, T.-C., Baum, A. (2001). Gender differences in Posttraumatic Stress Disorder after motor vehicle accidents. American Journal of Psychiatry, 158(9), 1486–1491. Web.
Hoge, C. W., Clark, J. C., & Castro, C. A. (2007). Commentary: Women in combat and the risk of post-traumatic stress disorder and depression. International Journal of Epidemiology, 36(12), 327–329. Web.
Inslichta, S. S., Metzler, T. J., Garcia, N. M., Pineles, S. L., Milad, M. R., Orr, S. P., Neylan, T. C. (2013). Sex differences in fear conditioning in Posttraumatic Stress Disorder. Journal of Psychiatric Research, 47(1), 64–71. Web.
Stewart, S. H., Grant, V. V., Ouimette, P., & Brown, P. J. (2006). Are Gender Differences in Post-Traumatic Stress Disorder rates attenuated in Substance Use Disorder patients? Canadian Psychology, 47(2), 110-124. Web.
Tolin, D. F., & Foa, E. B. (2006). Sex differences in trauma and Posttraumatic Stress Disorder: A quantitative review of 25 years of research. Psychological Bulletin, 132(6), 959–992. Web.