PTSD

Gender Group Differences in Coping with Chronic Terror: The Israeli Scene

Citation:

Zeidner, Moshe. 2006. "Gender Group Differences in Coping with Chronic Terror: The Israeli Scene." Sex Roles 54 (3): 297-310.

Author: Moshe Zeidner

Abstract:

Gender group differences in terror–stress, cognitive appraisals, ways of coping with terror, and stress reactions were explored in a sample of Israeli adults following prolonged exposure to political violence. Data were gathered at the height of the Al-Aqsa Intifada uprising (May/July 2002) from a sample of 707 adult participants (60% women and 40% men) residing in Haifa and northern Israel. Israeli women reported that they were more distressed by political violence than the men did, and they also appraised the crisis situation as more threatening and less manageable. Women reported using more problem-focused as well as emotion-focused coping than men did; both men and women used a mixture of coping strategies. Compared to men, women reported that they experienced more somatic symptoms and more frequent posttraumatic stress symptoms than men did. Negative affectivity was found to mediate gender differences in appraisals, coping, and outcomes. Overall, the nexus of relations among key variables was found to be highly similar for men and women. These data suggest that women may be more reactive to chronic political violence situations than men are. The data are discussed and explicated in the context of stress and coping theory and prior research on political violence and community disasters. 

Keywords: trauma, mental health, posttraumatic stress disorder, female civilians, male civilians

Topics: Armed Conflict, Gender, Women, Health, Mental Health, PTSD, Trauma, Terrorism, Violence Regions: MENA, Asia, Middle East Countries: Israel

Year: 2006

Post-Traumatic Stress Disorder and Functioning and Quality of Life Outcomes in Female Vietnam Veterans

Citation:

Zatzick, Douglas F., Daniel S. Weiss, Charles R. Marmar, Thomas J. Metzler, Kenneth Wells, Jacqueline M. Golding, Anita Stewart, William E. Schlenger, and Warren S. Browner. 1997. "Post-Traumatic Stress Disorder and Functioning and Quality of Life Outcomes in Female Vietnam Veterans." Military Medicine 162 (10): 661-65.

Authors: Douglas F. Zatzick, Daniel S. Weiss, Charles R. Marmar, Thomas J. Metzler, Kenneth Wells, Jacqueline M. Golding, Anita Stewart, William E. Schlenger, Warren S. Browner

Abstract:

Assessed whether current posttraumatic stress disorder (PTSD) was associated with impaired daily functioning and quality of life in a nationally representative sample of 432 female Vietnam veterans by performing a secondary analysis of data collected in the National Vietnam Veterans Readjustment Study (R. A. Kulka et at, 1990). A subsample of 87 Ss were diagnosed with PTSD. Logistic models were used to determine the association between PTSD and outcome while adjusting for demographic characteristics and medical and psychiatric co-morbidities. Results show PTSD was associated with significantly elevated odds of poorer functioning in 5 of the 6 outcome domains; only the association between perpetration of violence in the past year and PTSD did not achieve statistical significance. After adjusting for demographics and medical and psychiatric co-morbidities, PTSD remained associated with significantly elevated odds of bed days, poorer physical health, and unemployment. The significantly increased odds of impaired functioning and diminished quality of life suggest that PTSD may be the core problem of the set of problems afflicting female Vietnam veterans. (PsycINFO Database 2012)

Keywords: mental health, posttraumatic stress disorder

Topics: Combatants, Female Combatants, Gender, Women, Health, Mental Health, PTSD, Trauma, Military Forces & Armed Groups Regions: Americas, North America Countries: United States of America

Year: 1997

Posttraumatic Stress Disorder and Functioning and Quality of Life Outcomes in a Nationally Representative Sample of Male Vietnam Veterans

Citation:

Zatzick, Douglas F., Charles R. Marmar, Daniel S. Weiss, Warren S. Browner, Thomas J. Metzler, Jacqueline M. Golding, Anita Stewart, William E. Schlenger, and Kenneth B. Wells. 1997. "Posttraumatic Stress Disorder and Functioning and Quality of Life Outcomes in a Nationally Representative Sample of Male Vietnam Veterans." American Journal of Psychiatry 154 (12): 1690-1695.

Authors: Douglas F. Zatzick, Charles R. Marmar, Daniel S. Weiss, Warren S. Browner, Thomas J. Metzler, Jacqueline M. Golding, Anita Stewart, William E. Schlenger, Kenneth B. Wells

Abstract:

Objective: Although posttraumatic stress disorder (PTSD) is a highly prevalent and often chronic condition, the relationship between PTSD and functioning and quality of life remains incompletely understood. 

Method: The authors undertook an archival analysis of data from the National Vietnam Veterans Readjustment Study. The study subjects consisted of the nationally representative sample of male Vietnam veterans who participated in the National Vietnam Veterans Readjustment Study. The authors estimated PTSD at the time of the interview with the Mississippi Scale for Combat-Related Posttraumatic Stress Disorder. They examined the following outcomes: diminished well-being, physical limitations, bed day in the past 2 weeks, compromised physical health status, currently not working, and perpetration of violence. Logistic models were used to determine the association between PTSD and outcome; adjustment was made for demographic characteristics and comorbid psychiatric and other medical conditions.

Results: The risks of poorer outcome were significantly higher in subjects with PTSD than in subjects without PTSD in five of the six domains. For the outcome domains of physical limitations, not working, compromised physical health, and diminished wellbeing, these significantly higher risks persisted even in the most conservative logistic models that removed the shared effects of comorbid psychiatric and other medical disorders. 

Conclusions: The suffering associated with combat related-PTSD extends beyond the signs and symptoms of the disorder to broader areas of functional and social morbidity. The significantly higher risk of impaired functioning and diminished quality of life uniquely attributable to PTSD suggests that PTSD may well be the core problem in this group of difficult to treat and multiply afflicted patients.

Keywords: male veterans, posttraumatic stress disorder, mental health

Topics: Combatants, Male Combatants, Gender, Men, Health, Mental Health, PTSD, Trauma Regions: Americas, North America Countries: United States of America

Year: 1997

Sexual Harrassment and Assault as Predictors of PTSD Symptomatology among U.S. Female Persian Gulf War Military Personnel

Citation:

Wolfe, Jessica, Erica J. Sharkansky, Jennifer P. Read, Ree Dawson, and James A. Martin, Paige C. Ouimette. 1998. "Sexual Harassment and Assault as Predictors of PTSD Symptomatology among U.S. Female Persian Gulf War Military Personnel." Journal of Interpersonal Violence 13 (1): 40-57.

Authors: Jessica Wolfe, Erica J. Sharkansky, Jennifer P. Read, Ree Dawson, James A. Martin, Paige C. Ouimette

Abstract:

Rates and sequelae of sexual harassment and assault among women in a wartime military sample were examined. A second goal was to explore the comparative impacts of these stressors and combat exposure on posttraumatic stress disorder (PTSD) symptomatology. Army women (n = 160) were interviewed on return from the Persian Gulf War and again 18 to 24 months later. Rates of sexual assault (7.3%), physical sexual harassment (33.1%), and verbal sexual harassment (66.2%) were higher than those typically found in civilian and peacetime military samples. Sexual assault had a larger impact on PTSD symptomatology than combat exposure. Frequency of physical sexual harassment was significantly predictive of PTSD symptomatology. Furthermore, the number of postwar stressful life events mediated the relationship between physical sexual harassment and symptomatology but was not related to combat exposure. Sexual assault, sexual harassment, and combat exposure appear to be qualitatively different stressors for women, with different correlates and mechanisms of action. 

Keywords: military sexual assault, posttraumatic stress disorder, mental health, female soldiers

Topics: Combatants, Female Combatants, Gender, Women, Health, Mental Health, PTSD, Trauma, Military Forces & Armed Groups, Militaries, Sexual Violence, SV against Women

Year: 1998

Symptom Responses of Female Vietnam Veterans to Operation Desert Storm

Citation:

Wolfe, Jessica, Pamela J. Brown, and Maria L. Bucsela. 1992. "Symptom Responses of Female Vietnam Veterans to Operation Desert Storm." The American Journal of Psychiatry 149 (5): 676-79.

Authors: Jessica Wolfe, Pamela J. Brown, Maria L. Bucsela

Abstract:

OBJECTIVE: This study examined the status of symptoms of posttraumatic stress disorder (PTSD) in a cohort of women after the onset of Operation Desert Storm.

METHOD: Seventy-six non-treatment-seeking Vietnam veterans were obtained from lists of those who recently had participated in other research projects conducted at the National Center for Post-Traumatic Stress Disorder. Before the onset of Operation Desert Storm, subjects had completed a set of psychometrically valid instruments measuring general psychological symptoms and PTSD symptoms (e.g., SCL-90-R, Mississippi Scale for Combat-Related Posttraumatic Stress Disorder). On the basis of the latter scale, subjects were divided into groups with and without PTSD symptoms. At the height of the military conflict, subjects were recontacted and asked to complete the SCL-90-R and the Veterans Update Form, a measure assessing changes in PTSD symptoms.

RESULTS: Multivariate analyses indicated that while most female Vietnam veterans experienced some intensification of stress-related symptoms during Operation Desert Storm, those who had previously reported high levels of PTSD were significantly more susceptible to greater distress.

CONCLUSIONS: Results of this survey indicate that female Vietnam veterans with prior wartime exposure are an at-risk population for the intensification of stress symptoms after the recurrence of a military conflict.

Keywords: mental health, female veterans, posttraumatic stress disorder

Topics: Combatants, Female Combatants, Gender, Women, Health, Mental Health, PTSD, Trauma, Military Forces & Armed Groups, Militaries Regions: Americas, North America, Asia, Southeast Asia Countries: United States of America, Vietnam

Year: 1992

Mental Health Care Needs of Female Veterans

Citation:

Willer, Janet K., and Linda S. Grossman. 1995. "Mental Health Care Needs of Female Veterans." Psychiatric Services 46 (9): 938-940.

Authors: Janet K. Willer, Linda S. Grossman

Abstract:

Examined gender differences in diagnosis, demographic and family characteristics, and trauma histories with 97 psychiatric outpatients (51 women) at a VA clinic. More women had affective disorders and schizoaffective disorder; more men had anxiety disorders, schizophrenia, and substance use disorders. Although women had sharply higher rates than men of every type of trauma except combat trauma, more men received a diagnosis of posttraumatic stress disorder (PTSD). Men were 4 times more likely to be married. Women were more likely than men to be the sole caretakers of minor children. Treatment and policy implications are considered. (PsycINFO Database 2012)

Keywords: mental health, female veterans, posttraumatic stress disorder, trauma, substance abuse

Topics: Combatants, Female Combatants, Gender, Women, Health, Mental Health, PTSD, Trauma, Military Forces & Armed Groups Regions: Americas, North America Countries: United States of America

Year: 1995

Gender Differences in Posttraumatic Stress Disorder among Primary Care Patients after the World Trade Center Attack of Sept 11, 2001

Citation:

Weissman, Myrna M., Yuval Neria, Amar Das Adriana Feder, Carlos Blanco, Rafael Lantigua, Shea Steven, Raz Gross, Marc J. Gameroff, Daniel Pilowsky, and Mark Olfson. 2005. "Gender Differences in Posttraumatic Stress Disorder among Primary Care Patients after the World Trade Center Attack of September 11, 2001." Gender Medicine 2 (2): 76-87.

Authors: Myrna M. Weissman, Yuval Neria, Amar Das Adriana Feder, Carlos Blanco, Rafael Lantigua, Shea Steven, Raz Gross, Marc J. Gameroff, Daniel Pilowsky, Mark Olfson

Abstract:

Background: Debate surrounds the nature of gender differences in rates of posttraumatic stress disorder (PTSD).

Objective: The goal of this study was to quantify and explore the reasons for gender differences in rates of PTSD in low income, primary care patients after the World Trade Center (WTC) attack of September 11, 2001.

Methods: A survey was conducted at a large primary care practice in New York City 7 to 16 months after the WTC attack. The study involved a systematic sample of primary care patients aged 18 to 70 years. The main outcome measures were the Life Events Checklist, the Posttraumatic Stress Disorder Checklist-Civilian Version, and the Primary Care Evaluation of Mental Disorders Patient Health Questionnaire, all administered by a bilingual research staff.

Results: A total of 3807 patients were approached at the primary care clinic. Of the 1347 who meteligibility criteria, 1157 (85.9%) consented to participate. After the addition of the WTC/PTSD supplement to the study, the total number of patients was 992, of whom 982 (99.0%) completed the survey. Both sexes had high rates of direct exposure to the WTC attack and high rates of lifetime exposure to stressful life events. Overall, females had lower rates of exposure to the attack compared with males (P < 0.05). Hispanic females had the highest rate of PTSD in the full sample. Gender differences in rates of PTSD were largely accounted for by differences in marital status and education. The rate of current major depressive disorder (MDD) was higher in females than in males (P < 0.001), and the reverse was true for substance abuse (P < 0.001). Gender differences for MDD and substance abuse persisted even after adjustments for demographic differences between the sexes.

Conclusions: The increased rate of PTSD in women attending a primary care clinic was mediatedby their social and economic circumstances, such as living alone without a permanent relationship and with little education or income. The increased rate of MDD in women appeared to be less dependent on these circumstances. These findings have implications for the treatment of women with PTSD in primary care and for research on gender differences in rates of psychiatric disorders.

Keywords: posttraumatic stress disorder, terrorism, depression, substance abuse, mental health

Topics: Gender, Women, Health, Mental Health, PTSD, Trauma, Terrorism Regions: Americas, North America Countries: United States of America

Year: 2005

Gender Differences in Combat-Related Stressors and Their Associations with Postdeployment Mental Health in a Nationally Representative Sample of U.S. OEF/OIF Veterans

Citation:

Vogt, Dawne, Rachel Vaughn, Mark E. Glickman, Mark Schultz, Mari-Lynn Drainoni, Rani Elwy, and Susan Eisen. 2011. "Gender Differences in Combat-related Stressors and Their Association with Postdeployment Mental Health in a Nationally Representative Sample of U.S. OEF/OIF Veterans." Journal of Abnormal Psychology 120 (4): 797-806.

Authors: Dawne Vogt, Rachel Vaughn, Mark E. Glickman, Mark Schultz, Mari-Lynn Drainoni, Rani Elwy, Susan Eisen

Abstract:

Though the broader literature suggests that women may be more vulnerable to the effects of trauma exposure, most available studies on combat trauma have relied on samples in which women's combat exposure is limited and analyses that do not directly address gender differences in associations between combat exposure and postdeployment mental health. Female service members' increased exposure to combat in Afghanistan and Iraq provides a unique opportunity to evaluate gender differences in different dimensions of combat-related stress and associated consequence for postdeployment mental health. The current study addressed these research questions in a representative sample of female and male U.S. veterans who had returned from deployment to Afghanistan or Iraq within the previous year. As expected, women reported slightly less exposure than men to most combat-related stressors, but higher exposure to other stressors (i.e., prior life stress, deployment sexual harassment). No gender differences were observed in reports of perceived threat in the war zone. Though it was hypothesized that combat-related stressors would demonstrate stronger negative associations with postdeployment mental health for women, only one of 16 stressor x gender interactions achieved statistical significance and an evaluation of the clinical significance of these interactions revealed that effects were trivial. Results suggest that female Operation Enduring Freedom/Operation Iraqi Freedom service members may be as resilient to combat-related stress as men. Future research is needed to evaluate gender differences in the longer-term effects of combat exposure.

Keywords: female veterans, male veterans, trauma, mental health

Topics: Armed Conflict, Combatants, Female Combatants, Male Combatants, Gender, Women, Men, Health, Mental Health, PTSD, Trauma, Military Forces & Armed Groups, Militaries Regions: Americas, North America Countries: United States of America

Year: 2011

Relationship of Peritraumatic Dissociation and Posttraumatic Stress: Findings in Female Vietnam Theater Veterans

Citation:

Tichenor, Victoria, Charles R. Marmar, Daniel S. Weiss, Thomas J. Metzler, and Heidi M. Ronfeldt. 1996. "The Relationship of Peritraumatic Dissociation and Posttraumatic Stress: Findings in Female Vietnam Theater Veterans." Journal of Consulting and Clinical Psychology 64 (5): 1054-59.

Authors: Victoria Tichenor, Charles R. Marmar, Daniel S. Weiss, Thomas J. Metzler, Heidi M. Ronfeldt

Abstract:

This study examined the relationship of dissociation at the time of trauma, as assessed by the Peritraumatic Dissociation Experiences Questionnaire, Rater Version (PDEQ-RV; C. R. Marmar, D. S. Weiss, & T. J. Metzler, in press), and posttraumatic stress symptoms in a group of 77 female Vietnam theater veterans. PDEQ-RV ratings were found to be associated strongly with posttraumatic stress symptomatology, as measured by the Impact of Event Scale (M. J. Horowitz, N. Wilner, & W. Alvarez), and also positively associated with level of stress exposure and general dissociative tendencies, measured by the Dissociative Experiences Scale. The PDEQ-RV was unassociated with general psychiatric symptomatology, as assessed by the clinical scales of the Minnesota Multiphasic Personality Inventory-2 (J. N. Butcher, W. G. Dahlstrom, J. R. Graham, A. Tellegen, & B. Kaemmer, 1989). The PDEQ-RV was predictive of posttraumatic stress symptoms beyond the contributions of level of stress exposure and general dissociative tendencies. The findings provide further support for the reliability and validity of the PDEQ-RV as a measure of peritraumatic dissociation. 

Keywords: trauma, posttraumatic stress disorder, female veterans, mental health

Topics: Combatants, Female Combatants, Gender, Women, Health, Mental Health, PTSD, Trauma, Military Forces & Armed Groups Regions: Americas, North America, Asia, Southeast Asia Countries: United States of America, Vietnam

Year: 1996

Sexual Assault in Women Veterans: An Examination of PTSD Risk, Health Care Utilization, and Cost of Care

Citation:

Suris, Alina, Lisa Lind, Michael T. Kashner, Patricia D. Borman, and Frederick Petty. 2004. "Sexual Assault in Women Veterans: An Examination of PTSD Risk, Health Care Utilization, and Cost of Care." Psychosomatic Medicine 66 (5): 749-56.

Authors: Alina Suris, Lisa Lind, Michael T. Kashner, Patricia D. Borman, Frederick Petty

Abstract:

Objective: This study examines the differential impact of military, civilian adult, and childhood sexual assault on the likelihood of developing posttraumatic stress disorder (PTSD). It also examines the relationship of military sexual assault (MSA) to service utilization and health care costs among women who access services through Veterans Affairs (VA). 

Methods: A convenience sample of 270 veteran women receiving medical and/or mental health treatment at the VA North Texas Healthcare System participated in the study. Participants were interviewed using the Clinician Administered PTSD Scale (CAPS) and categorized into a sexual assault group using the Interview of Sexual Experiences (ISE). A chart review was also conducted to determine the frequency of diagnoses among the women. Data regarding health care utilization was obtained from self-report using the Utilization and Cost Patient Questionnaire (UAC-PQ) and VA administrative records.

Results: Compared with those without a history of sexual assault, women veterans were 9 times more likely to have PTSD if they had a history of MSA, 7 times more likely if they had childhood sexual assault (CSA) histories, and 5 times more likely if they had civilian sexual assault histories. An investigation of medical charts revealed that PTSD is diagnosed more often for women with a history of MSA than CSA. CSA was associated with a significant increase in health care utilization and cost for services, but there was no related increase in use or cost associated with MSA.

Conclusion: Women veterans have differential rates of PTSD due to sexual assault, with higher rates found among those assaulted while on active duty. Although women with MSA are more likely to have PTSD, results suggest that they are receiving fewer health care services. 

Keywords: military sexual assault, female veterans, posttraumatic stress disorder, mental health

Topics: Gender, Women, Health, Mental Health, PTSD, Trauma, Military Forces & Armed Groups, Militaries, Sexual Violence, Rape, SV against Women

Year: 2004

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