Post-Traumatic Stress Disorder: Symptom Profiles in Men and Women

Ben Green

Disclosures

Curr Med Res Opin. 2003;19(3) 

In This Article

Results

The groups consisted of 65 men and 38 women. The average age of both groups combined was 41.89 years.

Over half of the cases were secondary to a motor vehicle accident (MVA, 56.3%), about a third (35%) were secondary to personal assault, including rape, gun and knife attacks). About a tenth (8.7%) were secondary to other causes including near fatal occupational traumas such as falls through a factory roof, electrocution, traumatic loss of eye and gas explosions.

A 45-year-old police officer was called to an incident at a family residence where a man on amphetamines had gone berserk. The man had threatened his wife and child with a samurai sword and ran into the street where he threatened unarmed police officers. As the officers tried to escape in a police car the assailant ran up to the vehicle and pierced the windscreen with the sword, narrowly missing one police officer.

A 23-year-old woman was giving birth and had delivered a healthy infant girl. There was a problem with a retained placenta, however. A junior midwife tried gentle traction to remove the placenta. The patient experienced considerable discomfort and pain. Some minutes later the senior midwife tried the same technique, with considerably more traction. The patient experienced much pain. A resident junior obstetrician was called and arrived half an hour later. Despite the protestations of the patient that she was in agony the doctor tried further traction, which did not work. The doctor then tried manual removal by passing her hand into the patient's uterus and attempting to scrape the adherent placenta away from the uterine wall. No anaesthetic was given. The procedure lasted several minutes until the complaints of patient and spouse were listened to and more senior medical help summoned.

A 50-year-old driver on a busy motorway noted smoke issuing from his new car's bonnet. He drove over to an emergency refuge. Smoke billowed out. He thought he could see a flickering flame near the windscreen end of the bonnet and decided to evacuate the car. However, the car's onboard computer system had been involved in the fire and the door locks went into spasm, flicking locked and unlocked at a high frequency. The driver assumed he would be burnt alive. He timed his attempt to open the door in synchrony with the locked/unlocked sequence and managed to flip the handle just as the door unlocked and before it self-locked again. He fell out of the car, scrambled to his feet and ran down the motorway as the car was engulfed in flames and the petrol tank exploded.

Twenty-one subjects (20.4%) had a family history of affective or other psychiatric disorder; four (3.9%) disclosed childhood sexual abuse and 12 (11.6%) had a past psychiatric history. A history of an acute stress reaction or disorder was obtained in 90 patients (87.4%).

The mean length of time separating the original trauma and the research interview was 27.16 months. Most patients had suffered an acute stress reaction immediately following the trauma. Only 18 (17.5%) had delayed onset using DSM-IV criteria.

The frequencies of symptoms from the DSM-IV checklist of PTSD symptoms are presented for the whole group in Table 1 .

The additional questions about mood, lability of mood, libido, alcohol and tobacco use and organic amnesia yielded symptom frequencies as documented in Table 2 .

Symptom frequencies of all the above symptoms were calculated for males and females. By and large these did not differ significantly between the sexes.

There was a trend for males to be more likely to suffer organic amnesia, and also to have hypervigilance. There was a trend for females to report childhood sexual abuse more often than men.

There were two significant differences found using chi-squared tests. Men were significantly more likely to increase their consumption of alcohol. A total of 28 men (out of 65) reported increased use of alcohol compared to nine (out of 38) women. This gives a chi-squared p-value of < 0.05 with one degree of freedom. Of the 65 men, 62 reported increased irritability compared to (31 out of 38) women. This gave a p-value of < 0.05 with one degree of freedom.

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