Posted: April 29th, 2018

What are the gender differences in PTSD?

# What are the gender differences in PTSD?

Posttraumatic stress disorder (PTSD) is an anxiety disorder that affects individuals who are exposed to traumatic events. PTSD is characterized by intrusive memories, avoidance of trauma reminders, negative changes in mood and cognition, and increased arousal and reactivity . According to epidemiological studies, women are diagnosed with PTSD approximately twice as often as men, and they also tend to experience more severe and chronic symptoms . This article will explore some of the possible factors that contribute to the gender differences in PTSD, such as trauma type, coping style, hormonal influences, and genetic factors.

## Trauma type

One of the most obvious factors that may explain the gender differences in PTSD is the type of trauma that men and women are exposed to. Women are more likely to experience interpersonal traumas, such as sexual assault, domestic violence, and childhood abuse, which are associated with higher rates of PTSD than other types of traumas, such as accidents, natural disasters, or combat . Moreover, interpersonal traumas often involve repeated or prolonged exposure, betrayal of trust, loss of control, and feelings of shame and guilt, which may increase the risk of developing PTSD .

## Coping style

Coping style for dealing with trauma has been proven to play a critical role in PTSD development. The different coping styles between men and women may be one of the explanations for gender differences in PTSD. Men and women are known to have different coping styles. Men tend to use more problem-focused coping strategies, such as taking action to solve the problem or seeking information and advice, while women tend to use more emotion-focused coping strategies, such as expressing emotions, seeking social support, or using distraction or avoidance . Problem-focused coping strategies are generally considered to be more adaptive and effective in reducing PTSD symptoms than emotion-focused coping strategies .

## Hormonal influences

Another factor that may account for the gender differences in PTSD is the role of sex hormones, such as testosterone, estrogen, progesterone, and their metabolites. Sex hormones are known to modulate the stress response system and influence the brain regions involved in fear conditioning, memory consolidation, and emotion regulation . Studies have shown that sex hormones can have both protective and detrimental effects on PTSD development depending on their levels, timing, and interactions . For example, testosterone may have a protective effect on PTSD by reducing fear acquisition and enhancing fear extinction , while estrogen may have a detrimental effect on PTSD by enhancing fear memory consolidation and impairing fear extinction . Progesterone and its metabolite allopregnanolone (ALLO) may have a protective effect on PTSD by reducing anxiety and enhancing neuroplasticity , but their levels may fluctuate across the menstrual cycle or decrease after menopause in women .

## Genetic factors

A final factor that may contribute to the gender differences in PTSD is the genetic predisposition. Genetic factors are estimated to account for 30–40% of the variance in PTSD susceptibility . Several genes have been identified as potential candidates for influencing PTSD risk or resilience, such as those involved in serotoninergic, dopaminergic, noradrenergic, glucocorticoid, and endocannabinoid systems . Some of these genes may have sex-specific effects on PTSD due to their differential expression or regulation in males and females . For example, a polymorphism in the serotonin transporter gene (5-HTTLPR) has been found to be associated with increased PTSD risk in women but not in men [24], while a polymorphism in the dopamine receptor gene (DRD2) has been found to be associated with decreased PTSD risk in men but not in women [25].

# Conclusion

In summary, there are multiple factors that may explain the gender differences in PTSD, such as trauma type, coping style, hormonal influences, and genetic factors. These factors may interact with each other and with environmental factors to influence the vulnerability or resilience to PTSD in men and women. Understanding these factors may help to improve the prevention, diagnosis, and treatment of PTSD in both genders.

# References

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