Gender differences in posttraumatic stress disorder and help-seeking in the US Army (Abstracts from
Women’s Health 2015

Abstract

Background: Inconsistent findings between studies of gender differences in mental health outcomes in military samples have left open the question of whether combat exposure or other types of trauma confer equal or greater risk of posttraumatic stress disorder (PTSD).<br><br>Objective(s): The objectives of this study were to (1) examine gender differences in PTSD prevalence across 2 study years and using different PCL cutoff criteria, (2) examine trends in military-related and psychosocial risk and protective factors by gender, and (3) examine differences in help-seeking behaviors by men and women meeting screening criteria for PTSD. Given literature suggesting a higher prevalence of physical/sexual abuse among women, the greater role of interpersonal relationships in their perceived well-being, and the greater potential for threat appraisal among women as suggested in the cognitive model of gender differences in trauma processing, it was hypothesized that rates of PTSD may differ between men and women experiencing different types of trauma. In addition, it was expected that trauma associated with victimization (e.g., rape) would be more likely to result in PTSD symptoms than trauma associated with deliberate action conducted as part of one’s occupational duties (e.g., direct combat operations) for both men and women. It was also expected that prior traumas, such as assault or combat, will confer an increased risk of PTSD. Based on previous literature, the relationship between trauma (e.g., combat) and PTSD may be mediated by injury or family strain, and social support will function as a moderator.<br><br>Material/Methods: This study assessed the prevalence and risk factors of screening positive for PTSD for men and women based on two large, representative, population-based Army samples obtained as part of the 2005 and 2008 U.S. Department of Defense Surveys of Health Related Behaviors among Active Duty Military Personnel. Women and officers were oversampled to ensure adequate representation. The final sample consisted of 16,146 personnel in 2005 and 28,546 military personnel from all branches of service in 2008 who completed self-administered questionnaires anonymously.<br><br>Results: The study showed that overall rates of PTSD, as measured by several cutoffs of the PTSD Checklist, are similar between active duty men and women, although rates for women with combat exposure increased between the two study time points. Combat was associated with an equivalent risk of PTSD by gender. Active duty men who reported sexual abuse were more likely than women to meet criteria for PTSD and had higher rates of PTSD than those who reported high combat exposure. There were no significant gender differences in multivariate models controlling for demographic/psychosocial risk factors. Active duty men and women who met criteria for PTSD were equally likely to receive mental health counseling or treatment.<br><br>Conclusions: The study suggests that it is not gender per se that predicts PTSD but rather differential experiences that may be more or less likely depending on gender.<br>