Are Gender Differences in Post-Traumatic Stress Disorder Rates Attenuated in Substance Use Disorder Patients?

By Stewart, Sherry H.; Grant, Valerie V. et al. | Canadian Psychology, May 2006 | Go to article overview

Are Gender Differences in Post-Traumatic Stress Disorder Rates Attenuated in Substance Use Disorder Patients?


Stewart, Sherry H., Grant, Valerie V., Ouimette, Paige, Brown, Pamela J., Canadian Psychology


Abstract

We review 15 studies that examined rates of post-traumatic stress disorder (PTSD) in substance use disorder (SUD) patients to determine whether the typical female-greaterthan-male gender difference in PTSD rates is attenuated in SUD samples. Since the majority of studies reviewed did not find a gender difference in PTSD rates, we critically examined methodological factors that might account for this attenuation, but none appeared to completely account for the variability in detection of gender differences across studies. Several factors may contribute to making rates of PTSD among SUD males equivalent to the high rates observed in SUD females: 1) the risky lifestyle associated with men's substance abuse may increase their exposure to traumatic events, 2) a history of more severe trauma characteristics may be apparent among men with SUDs, or 3) attenuated gender differences in rates of other comorbidities that increase PTSD risk (e.g., depression) may exist. Clinical implications are discussed.

According to epidemiological studies, post-traumatic stress disorder (PTSD) is a highly comorbid condition among those with substance use disorders (SUDs; see review by Stewart, 1996). In the National Comorbidity Survey, a large-scale epidemiologic survey conducted in the U.S., Kessler and colleagues (1997) found that those with alcohol dependence were at 3-4 times increased risk of lifetime PTSD as compared to those without alcohol dependence. Moreover, the presence of comorbid PTSD among individuals being treated for SUDs is related to poorer treatment adherence (Hien, Nunes, Rudnick Levin, & Fraser, 2000) and outcomes, including higher relapse rates (e.g., Ouimette, Brown, & Najavits, 1998; Ouimette, Finney, & Moos, 1999). It has been suggested that if patients with comorbid SUD-PTSD were to receive trauma-specific treatment, they might avoid overutilizing or misusing expensive inpatient SUD treatments, thereby reducing the cost of clinical care (e.g., Brown, Recupero, & Stout, 1995).

The delineation of gender variations in the presentation of this comorbidity may identify factors that will improve treatment outcomes (Sonne et al., 2003). A fairly consistent finding across epidemiologic studies on PTSD rates in the general adult population is that women are about twice as likely to have PTSD as men (e.g., Breslau, Chilcoat, Kessler, Peterson, & Lucia, 1999; Breslau, Davis, Andreski, & Peterson, 1991; Breslau, Davis, Andreski, Peterson, & Schultz, 1997; Kessler, Sonnega, Bromet, Hughes, & Nelson, 1995). Moreover, women experience qualitatively different traumatic life experiences than do men. These findings have led to an interest in understanding gender differences in PTSD and their implications for etiology and treatment of the disorder (e.g., Kimerling, Ouimette, & Weitlauf, in press).

Early research on comorbid PTSD-SUDs focused almost exclusively on male veterans whose pathology arose in the context of combat trauma; more recently, a focus has emerged on women with comorbid PTSD-SUDs (Najavits, Weiss, & Shaw, 1997). The major purpose of this article is to examine gender as an important individual difference variable with respect to trauma and PTSD among patients with SUDs. This brief review focuses on rates of trauma and PTSD among clinical samples of male and female SUD patients. Summaries of the methods and findings of the studies reviewed in this article are provided in Tables 1 and 2, for trauma exposure rates and PTSD rates, respectively.

Gender Differences in Adult Samples

Brown et al. (1995) studied the prevalence of trauma histories and comorbid PTSD among 84 adults (48 male; 36 female) seeking treatment at a private hospital inpatient substance-abuse treatment program. Participants completed self-report measures of lifetime trauma exposure and PTSD symptoms. Women were more likely than men to have been physically abused/assaulted (31% vs. …

The rest of this article is only available to active members of Questia

Sign up now for a free, 1-day trial and receive full access to:

  • Questia's entire collection
  • Automatic bibliography creation
  • More helpful research tools like notes, citations, and highlights
  • Ad-free environment

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items

Items saved from this article

This article has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this article

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

1

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited article

Are Gender Differences in Post-Traumatic Stress Disorder Rates Attenuated in Substance Use Disorder Patients?
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Full screen

matching results for page

Cited passage

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited passage

Welcome to the new Questia Reader

The Questia Reader has been updated to provide you with an even better online reading experience.  It is now 100% Responsive, which means you can read our books and articles on any sized device you wish.  All of your favorite tools like notes, highlights, and citations are still here, but the way you select text has been updated to be easier to use, especially on touchscreen devices.  Here's how:

1. Click or tap the first word you want to select.
2. Click or tap the last word you want to select.

OK, got it!

Thanks for trying Questia!

Please continue trying out our research tools, but please note, full functionality is available only to our active members.

Your work will be lost once you leave this Web page.

For full access in an ad-free environment, sign up now for a FREE, 1-day trial.

Already a member? Log in now.