Gender differences in posttraumatic stress disorder after motor vehicle accidents
Gender differences in posttraumatic stress disorder after motor vehicle accidents
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DOI：
10.1176/appi.ajp.158.9.1486
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发表时间：
2001-09-01
影响因子：
17.7
通讯作者：
Baum, A
中科院分区：
文献类型：
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作者：
Fullerton, CS;Ursano, RJ;Baum, A
目的：女性创伤后应激障碍（PTSD）的发病率高于男性。作者研究了既往创伤、创伤后应激障碍、重性抑郁症、焦虑症（不包括创伤后应激障碍）、创伤周围性分离、当前创伤周围性分离和乘客受伤作为严重机动车事故后男女急性创伤后应激障碍发生率不同的可能解释。年龄在18-65岁之间的严重机动车事故受试者（N=122）采用DSM-III-R结构化临床访谈和创伤周围分离经历问卷进行评估。评价者版本1个月后accident.Results：女性没有区别于男性在满足整体再体验标准的诊断创伤后应激障碍（标准B），但女性在更大的风险，具体的再体验症状的强烈的痛苦的感觉，在类似的情况下，机动车事故和机动车事故的记忆的身体反应。女性达到整体回避/麻木标准（标准C）的可能性是男性的4.7倍，达到整体唤醒标准（标准D）的可能性是男性的3.8倍。女性比男性更容易报告标准C症状，即避免与事故相关的想法和情况，对重要活动失去兴趣，以及未来缩短的感觉，以及标准D症状，即睡眠困难，难以集中注意力和夸大的惊吓反应。多元Logistic回归分析表明，急性创伤后应激障碍的性别差异与既往创伤、创伤后应激障碍、创伤周围性分离、重度抑郁或焦虑障碍（不包括创伤后应激障碍）或乘客受伤无关。然而，在事故发生时的创伤周围性分离症状与女性急性PTSD的风险显著高于男性，结论：创伤周围性分离的性别差异可能有助于解释女性和男性的PTSD风险和一些PTSD症状的差异。
Objective: Women have higher rates of posttraumatic stress disorder (PTSD) than men. The authors examined prior trauma, PTSD, major depression, anxiety disorder not including PTSD, and peritraumatic dissociation; current peritraurnatic dissociation; and passenger injury as possible explanations for the different rates of acute PTSD in women and men after a serious motor vehicle accident.Method: Subjects age 18-65 years who had been in a serious motor vehicle accident (N=122) were assessed with the Structured Clinical Interview for DSM-III-R and the Peritraumatic Dissociative Experiences Questionnaire-Rater Version 1 month after the accident.Results: Women did not differ from men in meeting the overall reexperiencing criterion for a diagnosis of PTSD (criterion B), but women were at greater risk for the specific reexperiencing symptoms of intense feelings of distress in situations similar to the motor vehicle accident and physical reactivity to memories of the motor vehicle accident. Women were 4.7 times more likely than men to meet the overall avoidance/numbing criterion (criterion C) and 3.8 times more likely to meet the overall arousal criterion (criterion D). Women were more likely than men to report the criterion C symptoms of avoiding thoughts and situations associated with the accident, loss of interest in significant activities, and a sense of foreshortened future and the criterion D symptoms of trouble sleeping, difficulty concentrating, and exaggerated startle response. Multiple logistic regression analysis indicated that the gender differences in acute PTSD were not associated with prior trauma, PTSD, peritraumatic dissociation, major depression, or anxiety disorder not including PTSD or with passenger injury. However, peritraumatic dissociative symptoms at the time of the accident were associated with a significantly higher risk for acute PTSD in women than in men,Conclusions: Gender differences in peritraumatic dissociation may help explain differences in risk for PTSD and for some PTSD symptoms in women and men.