Gender differences in posttraumatic stress disorder after motor vehicle accidents

Objective: Women have higher rates of posttraumatic stress disorder (PTSD) than men. The authors examined prior trauma, PTSD, major depression, anxiet y disorder not including PTSD, and peritraumatic dissociation; current peri traurnatic dissociation; and passenger injury as possible explanations for the different rates of acute PTSD in women and men after a serious motor ve hicle accident. Method: Subjects age 18-65 years who had been in a serious motor vehicle ac cident (N=122) were assessed with the Structured Clinical Interview for DSM -III-R and the Peritraumatic Dissociative Experiences Questionnaire-Rater V ersion 1 month after the accident. Results: Women did not differ from men in meeting the overall reexperiencin g criterion for a diagnosis of PTSD (criterion B), but women were at greate r risk for the specific reexperiencing symptoms of intense feelings of dist ress in situations similar to the motor vehicle accident and physical react ivity 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 (criteri on D). Women were more likely than men to report the criterion C symptoms o f avoiding thoughts and situations associated with the accident, loss of in terest in significant activities, and a sense of foreshortened future and t he criterion D symptoms of trouble sleeping, difficulty concentrating, and exaggerated startle response. Multiple logistic regression analysis indicat ed that the gender differences in acute PTSD were not associated with prior trauma, PTSD, peritraumatic dissociation, major depression, or anxiety dis order not including PTSD or with passenger injury. However, peritraumatic d issociative symptoms at the time of the accident were associated with a sig nificantly higher risk for acute PTSD in women than in men, Conclusions: Gender differences in peritraumatic dissociation may help expl ain differences in risk for PTSD and for some PTSD symptoms in women and me n.