Publication year
2012
Citation Title
Examining the factor structure of PTSD between male and female veterans in primary care.
Journal Name
Journal of Anxiety Disorders
Journal Volume
26
Issue Number
3
Page Numbers
409-415
DOI
10.1016/j.janxdis.2011.12.015
Summary
Researchers assessed possible gender differences between two prevailing posttraumatic stress disorder (PTSD) models – the emotional numbing (e.g., re-experiencing, avoidance, emotional numbing and arousal) and dysphoria (e.g., re-experiencing, avoidance, dysphoria and arousal) models – in order to establish whether one model is more generalizable with regard to both genders in a sample of trauma-exposed (any lifetime trauma) U.S. Veterans. Results suggest that the “emotional numbing” model may be best for cross-gender comparisons of PTSD.
Key Findings
The emotional numbing model adequately characterized female Veterans as compared to the dysphoria model and better characterized male Veterans which suggests that the emotional numbing model is the most appropriate model for cross-gender comparisons.
Men were more likely to report combat exposure as a traumatic event, whereas women were more likely to report personal events (medical illness of a friend, childhood sexual abuse or rape, rape in adulthood, and physical attack without weapons) as a traumatic event.
For men, younger age, ethnic minority status, and exposure to combat and physical violence were the most important potentially traumatic exposure predictors for PTSD.
For women, adult sexual assault was the single significant experience associated with increased PTSD factor specific symptoms.
Implications for Program Leaders
Provide support groups to Service members coping with PTSD
Offer workshops to Service members and their families about how gender can influence PTSD symptoms
Disseminate information regarding available resources to help Service members and their families who are coping with mental health issues
Implications for Policy Makers
Continue to support research examining the utility and appropriateness of different PTSD screening tools
Support reintegration programs that provide information and resources to Service members coping with mental health issues post-deployment
Recommend professional development regarding how to tailor PTSD treatment for men and women
Methods
Male and female Veterans who had made a health care visit during 1999 from one of four primary care clinics (i.e., Charleston and Columbia, South Carolina; Tuscaloosa and Birmingham, Alabama) were included in the sample.
Participants were excluded if they had known dementia or were over the age of 80 years.
Data from two random stratified studies were utilized for the current study.
Participants
The sample included 878 trauma-exposed U.S. Veterans; 79% Male (average age = 62 years) and 21% Female (average age = 50 years)
The majority of male Veterans were White (65%) or Black (32%); 54% of female Veterans were White and 44% were Black.
Service rank or branch data were not provided.
Limitations
he sample does not adequately represent all minority groups, therefore the results may not generalize.
The collected measure of PTSD was self-report rather than the preferred clinical interview.
These data were collected only at one time point (cross-sectional design), and therefore the stability of the factors over time could not be estimated.
Avenues for Future Research
Replicate the study with Veterans from more recent conflicts
Assess additional traumatic event data such as time since traumatic event exposure, as well as separating traumatic experiences specific to the military from traumatic experiences specific to civilian life
Include socio-demographic information (e.g., race/ethnicity other than White; younger age) and trauma-type (e.g., combat experience, being attacked with a weapon) when comparing symptoms of PTSD between men and women because without such consideration, rates of PTSD based on clinical cut-off scores may incorrectly classify females as having higher symptom levels than males
Focus
Multiple Branches
Target Population
Population Focus
Military Branch
Military Component
Abstract
The present study assessed potential gender differences between the two prevailing PTSD models – the emotional numbing (King, Leskin, King, & Weathers, 1998) and dysphoria (Simms, Watson, & Doebbelling, 2002) models – in order to establish whether one model is superior with regard to its cross-gender generalizability. The sample included 188 female and 690 male trauma-exposed United States Veterans presenting to Veterans Affairs primary care medical clinics. Multigroup confirmatory factor analyses with covariates (MIMIC models) were conducted using the PTSD Checklist. The covariates included were socio-demographic variables and the type of traumatic event experienced. The emotional numbing model was statistically superior for men, but no difference between models was noted for females. After controlling for model covariates, men reported higher item-level severity and women had larger residual error variances and larger factor variances and covariances in the emotional numbing model. These results suggest partial generalizability of the emotional numbing model across gender.
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