Accounting for sex differences in PTSD: A multi-variable mediation model.
Accounting for sex differences in PTSD: A multi-variable mediation model.
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DOI：
10.3402/ejpt.v6.26068
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发表时间：
2015
影响因子：
5
通讯作者：
Hansen M
中科院分区：
文献类型：
--
作者：
Christiansen DM;Hansen M
被诊断患有创伤后应激障碍的女性大约是男性的两倍。然而，很少有人知道为什么女性比男性报告更多的PTSD症状。以前的研究一般集中在几个潜在的调解人在同一时间，并经常使用的方法，并不理想地适合测试调解效果。先前的研究已经确定了一些可能导致PTSD严重程度性别差异的个体风险因素，尽管这些因素在单独检查时不能完全解释女性症状水平的增加。本研究首次系统地检验了这一假设，即在女性中更普遍的创伤前、创伤后和创伤后风险因素的组合可以解释创伤后应激障碍严重程度的性别差异。该研究是一项准前瞻性问卷调查，评估2010年4月至2011年4月期间73.3%的丹麦银行员工遭遇银行抢劫的PTSD和相关变量。参与者在抢劫后1周（T1，N=450）和6个月（T2，N=368; 61.1%女性）填写问卷。调解进行了审查，使用专门设计的分析，以测试一个多调解人模型。女性报告的PTSD症状比男性多，神经质、抑郁、身体焦虑敏感性、围创伤恐惧、恐怖和无助（A2标准）、紧张性不动、恐慌、解离、对自我和世界的创伤后负面认知以及失望感水平更高。这些变量作为潜在的介质被纳入模型。风险因素的组合显著介导了性别与PTSD严重程度之间的关联，占关联的83%。研究结果表明，女性报告更多的PTSD症状，因为她们经历了更高水平的相关风险因素。研究结果与其他创伤人群以及女性中更常见的其他创伤相关精神疾病（如抑郁和焦虑）有关。
Approximately twice as many females as males are diagnosed with posttraumatic stress disorder (PTSD). However, little is known about why females report more PTSD symptoms than males. Prior studies have generally focused on few potential mediators at a time and have often used methods that were not ideally suited to test for mediation effects. Prior research has identified a number of individual risk factors that may contribute to sex differences in PTSD severity, although these cannot fully account for the increased symptom levels in females when examined individually. The present study is the first to systematically test the hypothesis that a combination of pre-, peri-, and posttraumatic risk factors more prevalent in females can account for sex differences in PTSD severity. The study was a quasi-prospective questionnaire survey assessing PTSD and related variables in 73.3% of all Danish bank employees exposed to bank robbery during the period from April 2010 to April 2011. Participants filled out questionnaires 1 week (T1, N=450) and 6 months after the robbery (T2, N=368; 61.1% females). Mediation was examined using an analysis designed specifically to test a multiple mediator model. Females reported more PTSD symptoms than males and higher levels of neuroticism, depression, physical anxiety sensitivity, peritraumatic fear, horror, and helplessness (the A2 criterion), tonic immobility, panic, dissociation, negative posttraumatic cognitions about self and the world, and feeling let down. These variables were included in the model as potential mediators. The combination of risk factors significantly mediated the association between sex and PTSD severity, accounting for 83% of the association. The findings suggest that females report more PTSD symptoms because they experience higher levels of associated risk factors. The results are relevant to other trauma populations and to other trauma-related psychiatric disorders more prevalent in females, such as depression and anxiety.
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