Sex differences in post-traumatic stress disorder in a high adversity cohort of South African adolescents: an examination of depressive symptoms, age, and trauma type as explanatory factors.
Sex differences in post-traumatic stress disorder in a high adversity cohort of South African adolescents: an examination of depressive symptoms, age, and trauma type as explanatory factors.
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DOI：
10.1080/20008198.2021.1978669
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发表时间：
2021
影响因子：
5
通讯作者：
Halligan SL
中科院分区：
文献类型：
--
作者：
Hiscox LV;Hiller R;Fraser A;Rabie S;Stewart J;Seedat S;Tomlinson M;Halligan SL
背景：来自高收入国家（HIC）的证据表明，女性创伤后应激障碍（PTSD）的发病率高于男性。然而，低收入和中等收入国家（LMIC）PTSD的性别差异数据有限，尽管LMIC青年经历的创伤水平特别高。目的：在南非贫困社区的青少年样本中，我们研究了PTSD的性别差异，以及共同发生的抑郁症，青少年年龄，创伤暴露的类型和程度作为女性脆弱性的潜在因素。方法：参与者从开普敦Khayelitsha地区的高中招募。在797名13-17岁的青少年（62%为女性）中测量了自我报告的创伤暴露、创伤后应激障碍和抑郁症状。泊松回归用于检查基于可能的PTSD诊断的风险比（RR），线性回归用于评估创伤后应激症状（PTSS）的严重程度。结果：92%的青少年报告创伤暴露，其中28%可能有PTSD。女性PTSD患病率高于男性，即使在控制了总创伤暴露（RR = 1.71，p <0.001）和并发抑郁症状（RR = 1.45，p = 0.005）的情况下。相比之下，在控制了共同发生的PTSS后，抑郁症的性别差异被消除了。几乎没有证据表明年龄对性别差异的出现有影响。在较低的阈值的人际创伤，女性表现出较高水平的PTSS相比，男性，但没有性别差异，发现在高水平的曝光。结论：在高逆境LMIC样本中，在青春期女性中观察到更高的PTSD发生率，这表明在国际背景下，性别差异是强大的。创伤后应激障碍的性别差异不太可能用共发的抑郁症来解释，在这种情况下，抑郁症的性别差异可能继发于创伤和创伤后应激障碍。然而，暴露于重大的人际创伤似乎推翻了任何特定的女性脆弱性。在创伤后应激障碍的性别差异，观察在青春期从高逆境LMIC。即使在调整创伤暴露和抑郁症状后，女性的风险也更大。女性也表现出更大的脆弱性，人际创伤的门槛较低。
Background: Evidence from high-income countries (HICs) has documented a higher rate of post-traumatic stress disorder (PTSD) in females than males. However, data are limited on sex differences in PTSD from low- and middle-income countries (LMICs), despite particularly high levels of trauma experienced by LMIC youth. Objectives: In a sample of adolescents from an impoverished South African community, we examined sex differences in PTSD, as well as co-occurring depression, adolescent age, and the type and extent of trauma exposure as potential contributors to female vulnerability. Methods: Participants were recruited from high schools in the Khayelitsha area of Cape Town. Self-reported trauma exposure, PTSD and depressive symptoms were measured in 797 adolescents (62% female) aged 13–17 years. Poisson regressions were used to examine Risk Ratios (RR) based on probable PTSD diagnoses, and linear regressions were applied to assess posttraumatic stress symptom (PTSS) severity. Results: 92% of adolescents reported trauma exposure, of whom 28% had probable PTSD. Prevalence of PTSD was higher for females than for males, even when controlling for total trauma exposure (RR = 1.71, p < .001) and co-occurring depressive symptoms (RR = 1.45, p = .005). By contrast, sex differences in depression were eliminated after controlling for co-occurring PTSS. There was little evidence of age effects on the emergence of sex differences. At lower thresholds of interpersonal trauma, females showed higher levels of PTSS compared to males, but no sex differences were found at high levels of exposure. Conclusion: Higher PTSD rates are observed in adolescent females in a high adversity-LMIC sample suggesting sex differences are robust across international contexts. Sex differences in PTSD are unlikely to be explained by co-occurring depression and in this context sex differences in depression may be secondary to trauma and PTSD. However, exposure to significant interpersonal trauma appears to overrule any specific female vulnerability. Sex differences in post-traumatic stress disorder are observed in adolescence from a high-adversity LMIC. Greater female risk occurs even when adjusting for trauma exposure and depressive symptoms. Females also show greater vulnerability to lower thresholds of interpersonal trauma.
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影响因子：
3.7
作者：
Ditlevsen DN;Elklit A
通讯作者：
Elklit A
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通讯作者：
NELSON, CB