Assaults Take Greater Psychological Toll on Women

From the WebMD Archives

July 17, 2000 -- Being exposed to a traumatic event can have serious psychological consequences for anyone, but women have a greater risk of developing post-traumatic stress disorder (PTSD) after an assault than men do. They had about the same risk as men when it came to coping with a trauma that did not involve assault, according to a recent study.

Experiencing such a trauma is more common than most people think. Nearly 80% of people in a Canadian community reported that they had been exposed to a serious traumatic event in their lifetimes. "One of the interesting things is that, even in peacetime United States and Canada, the likelihood that any of us will be exposed to at least one traumatic event in our lifetime is very high," Matthew J. Friedman, MD, executive director of the National Center for Post-Traumatic Stress Disorder, tells WebMD.

"Another important thing we learn from this study is that women are at greater risk of developing PTSD following an assaultive trauma situation, whether it's a sexual or nonsexual assault," says Friedman, who is a professor of psychiatry and pharmacology at Dartmouth Medical School in Hanover, N.H.

Post-traumatic stress disorder is the term doctors use for a variety of disturbing, intense psychological symptoms a person may experience following exposure to a traumatic event. These include a serious threat to life or physical health (such as rape or mugging) or involvement, either personally or through the experience of a loved one, in a major catastrophe. Affected individuals often report recurring nightmares or reminders of the traumatic event and may become emotionally numb, Friedman says.

Other symptoms include sleep problems, inability to focus intellectually, feeling anxious and jumpy, and constantly looking over the shoulder. "These people are often miserable and may develop health problems, such as smoking or drinking. For the families, the person can be quite difficult to help or live with," Friedman tells WebMD.

To look at whether women and men react differently to trauma, researchers in Winnipeg surveyed over 1,000 men and women, none of whom had sought help for any psychological problems.

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The people were asked whether they had experienced any severe traumatic events during their lifetimes. These included sexual traumas, such as rape or sexual molestation; non-sexual assault, such as robbery, mugging, or being held up, threatened with a weapon, kidnapped, held captive, or beaten up; or trauma not involving assault, such as being in a serious motor vehicle accident, witnessing a violent death or severe injury, or being involved in a fire or natural disaster. They were also asked about whether they had any symptoms of post-traumatic stress disorder in the previous month.

Results of the study, published in the journal Behavior Research and Therapy, showed that 74% of the women and 82% of the men questioned had been exposed to at least one traumatic event. However, although post-traumatic stress disorder was relatively rare, women were four times more likely to report post-traumatic stress disorder than the men, according to the author of the study, Murray B. Stein, MD, of the University of California, San Diego.

To eliminate the possibility that women are more likely to be sexually assaulted than men and that sexual assault may have more serious effects than other kinds of assault, the researchers excluded data from those people who were sexually assaulted. Women were found to be at increased risk for post-traumatic stress disorder following an assault that was not sexual, but were not at increased risk for post-traumatic stress disorder if the trauma did not involve assault of any nature.

Naomi Breslau, PhD, who has also investigated gender differences in post-traumatic stress disorder, came to a similar conclusion. "This finding is very important, although it needs [to be repeated]. ... It looks like women are more vulnerable than men to develop PTSD following certain types of events that involve intentional or 'assaultive' violence ... but they may not have a greater vulnerability to PTSD if they are exposed to a disaster or accident." Breslau is affiliated with the department of psychiatry of the Henry Ford Health System in Detroit.

Thus, says Breslau, one cannot say that women are simply psychologically weaker than men in handling trauma. Rather, post-traumatic stress disorder might be more likely to develop when a victim is personally threatened by the inequality in strength between the victim and an attacker who is physically stronger.

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Breslau also says that the propensity to develop post-traumatic stress disorder might really be a consequence of pre-existing mental health problems, like anxiety or depression. She says that few people have only post-traumatic stress disorder. "So far, I've come to the conclusion that people who get this disorder are at risk for other reasons -- not particularly that [experiencing] the event is all-powerful or the ultimate explanation of the outcome."

The adverse consequences of post-traumatic stress disorder can range from relatively mild or moderate symptoms that a person can live with in his or her everyday life to symptoms that are completely incapacitating, Friedman says.

"The bad news is that women are more likely to develop PTSD than men. The good news is that we have good treatments for PTSD and they are getting better all the time," Friedman says. He cites the availability of counseling therapies and the recent approval of an antidepressant called Zoloft (sertraline) for the treatment of post-traumatic stress disorder.

Vital Information:

  • Symptoms of post-traumatic stress disorder include recurring nightmares or reminders of the event, becoming emotionally numb, sleep problems, inability to focus intellectually, feeling anxious or jumpy, and frequently looking over your shoulder.
  • A recent survey found that most people were exposed to a serious traumatic event in their lifetime and that post-traumatic stress disorder was a relatively rare outcome, although it affected four times as many women as men.
  • The propensity to develop post-traumatic stress disorder may reflect pre-existing medical conditions, such as anxiety or depression, but there are treatments for the disorder, including counseling and medication.
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