Prevalence and Correlates of Posttrauma Distorted Beliefs: Evaluating DSM‐5 PTSD Expanded Cognitive Symptoms in a National Sample

The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM‐5; American Psychiatric Association [APA], 2013) modified the diagnostic criteria for posttraumatic stress disorder (PTSD), including expanding the scope of dysfunctional, posttrauma changes in belief (symptoms D2—persistent negative beliefs and expectations about oneself or the world, and D3—persistent distorted blame of self or others for the cause or consequences of the traumatic event). D2 and D3 were investigated using a national sample of U.S. adults (N = 2,498) recruited from an online panel. The prevalence of D2 and D3 was substantially higher among those with lifetime PTSD than among trauma‐exposed individuals without lifetime PTSD (D2: 74.6% vs 23.9%; D3: 80.6% vs 35.7%). In multivariate analyses, the strongest associates of D2 were interpersonal assault (OR = 2.39), witnessing interpersonal assault (OR = 1.63), gender (female, OR = 2.11), and number of reported traumatic events (OR = 1.88). The strongest correlates of D3 were interpersonal assault (OR = 3.08), witnessing interpersonal assault (OR = 1.57), gender (female, OR = 2.30), and number of reported traumatic events (OR = 1.91). The findings suggested the expanded cognitive symptoms in the DSM‐5 diagnostic criteria better capture the cognitive complexity of PTSD than those of the DSM‐IV.     

The Impact of Interpersonal and Noninterpersonal Trauma on Psychological Symptoms in Refugees: The Moderating Role of Gender and Trauma Type

Research findings have documented a relationship between the number of types of traumatic events to which refugees were exposed and psychological disorders. It is unclear, however, if gender moderates the impact of trauma on refugee mental health. The participants in this study were 60 male and 31 female refugees and asylum‐seekers resettled in Australia. Participants had a mean age of 34.54 years (SD = 9.70), and were from a variety of countries including Iraq, Iran, and Sri Lanka. We conducted a multigroup path analysis to test if the relationship between psychological outcomes of exposure to trauma (posttraumatic stress disorder [PTSD] symptoms, symptoms of anxiety, and symptoms of depression) was different as a function of the type of traumatic exposure (interpersonal vs. noninterpersonal) or as a function of gender. We found a significant relationship between interpersonal trauma exposure and PTSD symptoms (β = .77) and anxiety symptoms (β = .32) in women, and a significant association between noninterpersonal trauma exposure and PTSD symptoms (β = .59), anxiety (β =.49), and depression symptoms (β = .32) in men. For men, the effect sizes of the relationship between exposure to specific types of noninterpersonal trauma and psychological symptoms ranged from d = 0.14 to 1.01; for exposure to interpersonal trauma, they ranged from d = ?0.53 to 0.43. For women, the effect sizes of the relationship between exposure to specific types of noninterpersonal trauma and psychological symptoms ranged from d = ?0.79 to 0.67; for exposure to interpersonal trauma, they ranged from d = ?0.09 to 1.46. These results suggested supporting refugees in their efforts to overcome the psychological impact of trauma, including the allocation of resources in clinical services to support the psychological recovery of refugees.     

Trauma‐Related Disgust in Veterans With Interpersonal Trauma

Although traditionally conceptualized as an anxiety disorder, variability in posttraumatic stress disorder (PTSD) may be explained by individual differences in peri‐ or posttraumatic disgust. We examined relationships between disgust reactions and other trauma‐related symptoms in 100 veterans with a history of interpersonal trauma and gender differences in these variables. We also evaluated the mediating role of posttraumatic disgust and guilt in the relationship between peritraumatic disgust and PTSD symptoms. Participants completed cross‐sectional self‐report questionnaires of trauma‐related emotions, PTSD, and other psychological symptoms as part of clinical intake procedures. Women and men did not differ on trauma‐related emotions or symptoms. However, the relationship between peri‐ and posttraumatic disgust depended on gender, with men reporting a stronger association between peri‐ and posttraumatic disgust than women (p = .013, ΔR ² = .04). Posttraumatic disgust and guilt mediated the relationship between peritraumatic disgust and PTSD symptoms, controlling for gender (a ₁a ₂ b ₁ = 0.18, SE = 0.09, P_M = .19). Our results converge with those found in other studies suggesting that disgust is a common trauma‐related emotion and that men and women may experience differential relationships between peri‐ and posttraumatic emotional experiences. Further study of the role of trauma‐related emotional responses in PTSD etiology and treatment is warranted.     

Posttraumatic Stress Disorder and Fear of Emotions: The Role of Attentional Control

Individuals with posttraumatic stress disorder (PTSD) experience elevated concerns about their capacity to control, and the consequences of, strong emotions that occur in response to trauma reminders. Anxiety is theorized to compromise attentional control (Eysenck, Derakshan, Santos, & Calvo, 2007). In turn, diminished attentional control may increase vulnerability to threat cues and emotional reactivity (Ehlers & Clark, 2001). Consequently, attentional control may play a role in the fear of emotions frequently experienced by individuals with PTSD. Study participants included 64 men and 64 women with a mean age of 37 years, 86% of whom were White, non‐Hispanic. Participants experienced an average of 7.68 types of traumatic events, most commonly including motor vehicle accidents and intimate partner violence. PTSD symptoms positively correlated with fear of emotions (r = .53) and negatively correlated with attentional control (r = ?.38). Attentional control was negatively correlated with fear emotions (r = ?.77) and partially mediated the link between PTSD and fear of emotions (R² = .22). Given the findings regarding top‐down attentional control, these results have implications for cognitive and emotional processing theories of PTSD and emphasize the importance of clinical consideration of fear of emotions and attentional control in the treatment of PTSD.     

Military Sexual Assault,Gender, and PTSD Treatment Outcomes of U.S. Veterans

This study examined whether gender and military sexual assault (MSA) were associated with psychiatric severity differences at initiation of treatment for posttraumatic stress disorder (PTSD) and whether MSA and gender predicted psychiatric treatment outcomes. Male (n = 726) and female (n = 111) patients were recruited from 7 U.S. Department of Veterans Affairs (VA) PTSD specialty intensive treatment programs and completed an intake survey; 69% (n = 574) of the participants completed a 4‐month postdischarge follow‐up survey. Measures included current PTSD and depressive symptoms, aggressive/violent behaviors, alcohol and drug use severity, and quality of life. Multilevel multivariate regression analyses were conducted to examine the main and interaction effects of gender and MSA on psychiatric treatment outcomes at 4‐month follow‐up, including demographics, baseline severity, hostile fire, and treatment length of stay. Baseline PTSD severity did not differ by gender or MSA status, but women had more severe depressive symptoms (d = 0.40) and less aggressive/violent symptoms (d = ?0.46) than men. Gender, MSA status, and the interaction between gender and MSA did not predict treatment outcomes as hypothesized. Male and female veterans with and without MSA responded equally well to treatment in VA PTSD intensive treatment programs.     

Attention Bias Variability and Symptoms of Posttraumatic Stress Disorder

Cognitive theories implicate information‐processing biases in the etiology of anxiety disorders. Results of attention‐bias studies in posttraumatic stress disorder (PTSD) have been inconsistent, suggesting biases towards and away from threat. Within‐subject variability of attention biases in posttraumatic patients may be a useful marker for attentional control impairment and the development of posttrauma symptoms. This study reports 2 experiments investigating threat‐related attention biases, mood and anxiety symptoms, and attention‐bias variability following trauma. Experiment 1 included 3 groups in a cross‐sectional design: (a) PTSD, (b) trauma‐exposed without PTSD, and (c) healthy controls with no trauma or Axis I diagnoses. Greater attention‐bias variability was found in the PTSD group compared to the other 2 groups ; attention‐bias variability was significantly and positively correlated (r = .37) with PTSD symptoms. Experiment 2 evaluated combat‐exposed and nonexposed soldiers before and during deployment. Attention‐bias variability did not differentiate groups before deployment, but did differentiate groups during deployment ; increased variability was observed in groups with acute posttraumatic stress symptoms and acute depression symptoms only. Attention‐bias variability could be a useful marker for attentional impairment related to threat cues associated with mood and anxiety symptoms after trauma exposure.     

Pupil Response to Threat in Trauma‐Exposed Individuals With or Without PTSD

An infrequently studied and potentially promising physiological marker for posttraumatic stress disorder (PTSD) is pupil response. This study tested the hypothesis that pupil responses to threat would be significantly larger in trauma‐exposed individuals with PTSD compared to those without PTSD. Eye‐tracking technology was used to evaluate pupil response to threatening and neutral images. Recruited for participation were 40 trauma‐exposed individuals; 40.0% (n = 16) met diagnostic criteria for PTSD. Individuals with PTSD showed significantly more pupil dilation to threat‐relevant stimuli compared to the neutral elements (Cohen's d = 0.76), and to trauma‐exposed controls (Cohen's d = 0.75). Pupil dilation significantly accounted for 12% of variability in PTSD after time elapsed since most recent trauma, cumulative violence exposure, and trait anxiety were statistically adjusted. The final logistic regression model was associated with 85% of variability in PTSD status and correctly classified 93.8% of individuals with PTSD and 95.8% of those without. Pupil reactivity showed promise as a physiological marker for PTSD.     

Menstrual Cycle Effects on Psychological Symptoms in Women With PTSD

The menstrual cycle has been implicated as a sex‐specific biological process influencing psychological symptoms across a variety of disorders. Limited research exists regarding the role of the menstrual cycle in psychological symptoms among women with posttraumatic stress disorder (PTSD). The current study examined the severity of a broad range of psychological symptoms in both the early follicular (Days 2–6) and midluteal (6–10 days postlutenizing hormone surge) phases of the menstrual cycle in a sample of trauma‐exposed women with and without PTSD (N = 49). In the sample overall, total psychological symptoms (d = 0.63), as well as depression (d = 0.81) and phobic anxiety (d = 0.81) symptoms, specifically, were increased in the early follicular compared to midluteal phase. The impact of menstrual cycle phase on phobic anxiety was modified by a significant PTSD × Menstrual Phase interaction (d = 0.63). Women with PTSD reported more severe phobic anxiety during the early follicular versus midluteal phase, whereas phobic anxiety did not differ across the menstrual cycle in women without PTSD. Thus, the menstrual cycle appears to impact fear‐related symptoms in women with PTSD. The clinical implications of the findings and future research directions are discussed.     

Comparison of Clinician‐ and Self‐Assessments of Posttraumatic Stress Symptoms in Older Versus Younger Veterans

Assessment of posttraumatic stress disorder (PTSD) in older adults has received limited investigation. The purpose of this study was to compare the severity of PTSD symptoms in treatment‐seeking older and younger U.S. veterans with PTSD. Participants were 360 male and 284 female veterans enrolled in 2 separate clinical trials of psychotherapy for PTSD. About 4% of the participants were age 60 years or older. Symptoms were assessed before treatment using clinician‐rated and self‐report measures. For men, only numbing symptoms were lower in older veterans; this was so in clinician ratings, d = 0.76, and self‐reports, d = 0.65. For women, clinician‐rated hyperarousal symptoms were lower in older veterans, d = 0.57. Clinician‐rated and self‐reported symptoms were strongly related, Bs = 0.95 and 0.80 in the male and female samples, respectively. Among men, clinician‐rated and self‐reported reexperiencing and hyperarousal symptoms were associated only in younger veterans. Accurate assessment of PTSD symptoms in older adults is essential to identifying and implementing effective treatment. Our findings suggest that some symptoms may be lower in older men, and that some symptoms of PTSD may be underdetected in older women. Future research should assess the combined effect of gender and age on PTSD symptom presentation.     

Women's Sexual Desire,Trauma Exposure,and Posttraumatic Stress Disorder

Research suggests that posttraumatic stress disorder (PTSD) is associated with sexual dysfunction; however, there is a paucity of research examining the relations among trauma exposure, PTSD, and low sexual desire, specifically. Thus, the goal of the present study was to investigate whether women with hypoactive sexual desire disorder (HSDD; n = 132) were more likely to meet criteria for a diagnosis of current or lifetime PTSD relative to women with no sexual desire concerns (n = 137). We also sought to compare the type, frequency, and intensity of PTSD symptoms between the two groups. Finally, we examined whether women in the two groups were exposed to more, or different types of, potentially traumatic events. Compared to women with no sexual health concerns, women with HSDD were more likely to meet criteria for current PTSD, odds ratio (OR) = 5.50, 95% CI [1.18, 25.61]; and lifetime PTSD, OR = 2.78, 95% CI [1.56, 4.94]. Women in the HSDD group also had higher odds of meeting criteria for avoidance (5.10 times) and hyperarousal symptoms (4.48 times) and scored higher on measures of past-month PTSD symptom frequency, d = 0.62, and intensity, d = 0.57. No group differences were observed regarding reexperiencing symptoms, the associated features of PTSD, or type or frequency of exposure to potentially traumatic events. The findings indicate PTSD symptomatology may be a predisposing or perpetuating contributor to low sexual desire, and low sexual desire and PTSD may be related through an alteration in stress adaptability.     

Trauma‐Exposed Community‐Dwelling Women and Men Respond Similarly to the DAR‐5 Anger Scale: Factor Structure Invariance and Differential Item Functioning

Anger is associated with the development of posttraumatic stress disorder (PTSD) and with poor treatment outcomes. The Dimensions of Anger Reactions Scale‐5 (DAR‐5) has demonstrated preliminary evidence of unitary factor structure and sound psychometric properties. Gender‐based differences in psychometric properties have not been explored. The current study examined gender‐based factor structure invariance and differential item functioning of the DAR‐5 and gender differences in PTSD symptoms as a function of anger severity using a community sample of adults who had been exposed to trauma. Data were collected from 512 trauma‐exposed community‐dwelling adults (47.9% women). Confirmatory factor analyses, Mantel‐Haenszel χ² tests and a comparison of characteristic curves, and 2‐way analyses of variance, respectively, were used to assess gender‐based factor structure invariance, gender‐based response patterns to DAR‐5 items, and gender differences in PTSD symptoms as a function of anger. The unitary DAR‐5 factor structure did not differ between men and women. Significant gender differences in the response pattern to the DAR‐5 items were not present. Trauma‐exposed individuals with high anger reported greater overall PTSD symptoms (p < .001), regardless of gender. The DAR‐5 can be used to assess anger in trauma‐exposed individuals without concern of gender biases influencing factor structure or item functioning. Findings further suggested that the established relationship between anger and PTSD severity did not differ by gender.     

Effects of Threat Context,Trauma History,and Posttraumatic Stress Disorder Status on Physiological Startle Reactivity in Gulf War Veterans

In the current study, we explored exaggerated physiological startle responses in posttraumatic stress disorder (PTSD) and examined startle reactivity as a biomarker of PTSD in a large veteran sample. We assessed heart rate (HR), skin conductance (SC), and electromyographic (EMG) startle responses to acoustic stimuli under low‐, ambiguous‐, and high‐threat conditions in Gulf War veterans with current (n = 48), past (n = 42), and no history of PTSD (control group; n = 152). We evaluated PTSD status using the Clinician‐Administered PTSD Scale and trauma exposure using the Trauma History Questionnaire. Participants with current PTSD had higher HR, ds = 0.28–0.53; SC, d = 0.37; and startle responses than those with past or no history of PTSD. The HR startle response under ambiguous threat best differentiated current PTSD; however, sensitivity and specificity analyses revealed it to be an imprecise indicator of PTSD status, ROC AUC = .66. Participants with high levels of trauma exposure only showed elevated HR and SC startle reactivity if they had current PTSD. Results indicate that startle is particularly elevated in PTSD when safety signals are available but a possibility of danger remains and when trauma exposure is high. However, startle reactivity alone is unlikely to be a sufficient biomarker of PTSD.     

Efficacy of Behavioral Couples Therapy Versus Individual Recovery Counseling for Addressing Posttraumatic Stress Disorder Among Women With Drug Use Disorders

Behavioral couples therapy (BCT) for substance use disorder shares similar intervention strategies with empirically supported couples therapies for posttraumatic stress disorder (PTSD). Like couples‐based PTSD therapies, BCT includes interventions that may help to improve PTSD, such as increasing positive behavioral exchanges and improving communication. Studies have yet to examine whether BCT, which has demonstrated efficacy for improving substance‐related outcomes, is efficacious for reducing PTSD. We conducted a secondary analysis of a randomized clinical trial comparing individually based treatment (IBT) to BCT plus IBT (BCT+IBT) for women with drug use disorders. Women in both conditions received 26 therapy sessions over 13 weeks. Women completed the PTSD Diagnostic Scale at baseline, posttreatment, and quarterly during the 1‐year follow‐up. Of the 61 women who were randomized to treatment, 51 (83.6%) reported a lifetime traumatic event. Of the 50 women who endorsed a “worst traumatic event,” 25 (50.0%) had a baseline PTSD diagnosis. The treatments did not differ on baseline PTSD severity or diagnosis. Women who received BCT+IBT had significant reductions in PTSD severity from baseline to each of four posttreatment follow‐ups, ds = 0.34–0.80; there were no changes in the IBT group. Generalized estimating equation results showed that women who received BCT+IBT had significantly lower PTSD severity during follow‐up versus those who received IBT, d = 0.35. There were no differences in the proportion of participants diagnosed with PTSD following treatment. This was the first study to show that BCT+IBT is efficacious for reducing PTSD among women with drug use disorders.     

Gender differences in long-term posttraumatic stress disorder outcomes after major trauma: women are at higher risk of adverse outcomes than men

BACKGROUND: The importance of psychological morbidity after major trauma, such as posttraumatic stress disorder (PTSD), is continuing to gain attention in trauma outcomes research. The Trauma Recovery Project is a large prospective epidemiologic study designed to examine multiple outcomes after major trauma, including quality of life (QoL) and PTSD. Patient outcomes were assessed at discharge and at 6, 12, and 18 months after discharge. The specific objectives of the present report are to examine gender differences in prolonged PTSD (L-PTSD) and to assess the impact of PTSD by gender on QoL at the 6-, 12-, and 18-month follow-up time points in the Trauma Recovery Project population. METHODS: Between December 1, 1993, and September 1, 1996, 1,048 eligible trauma patients triaged to four participating trauma center hospitals in the San Diego Regionalized Trauma System were enrolled in the study. The enrollment criteria for the study included the following: age 18 years and older; admission Glasgow Coma Scale score of 12 or greater; and length of stay greater than 24 hours. QoL was measured after injury using the Quality of Well-being (QWB) scale, a sensitive index to the well end of the functioning continuum (range: 0 = death to 1.000 = optimum functioning). Early symptoms of acute stress reaction (SASR) at discharge were assessed using the Impact of Events Scale (score > 30 = SASR). PTSD at 6-, 12-, and 18-month follow-up was diagnosed using standardized Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria. PTSD (L-PTSD) was diagnosed if full or partial (F + P) or full (F) PTSD Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria were present at all follow-up time points. RESULTS: PTSD (L-PTSD) (F + P) was diagnosed in 35% (221 of 627) of patients at follow-up. PTSD (L-PTSD) (F) was present in 32% (153 of 627). Women were at significantly higher risk of PTSD (F + P) (odds ratio = 2.4, p = 0.001) and PTSD (F) (odds ratio = 2.8, p = 0.001) than men. The association of gender with PTSD was independent of mechanism and injury event-related factors such as perceived threat to life. In multivariate logistic regression, female gender, perceived threat to life, and SASR were strongly and independently associated with PTSD risk. Women were also at risk for worse QWB outcomes; beginning at discharge through the 18-month follow-up, women had significantly lower QWB scores at each follow-up time than men, regardless of prolonged PTSD status. CONCLUSION: These results provide important new evidence that high rates of PTSD persist in the long-term aftermath of major trauma. The association of gender with PTSD was independent of mechanism and injury event-related factors such as perceived threat to life. Within categories of specific mechanism of injury and injury event-related factors, women were at significantly higher risk of prolonged PTSD onset. Prolonged PTSD was associated with significantly reduced quality of life in both men and women, with markedly worse QWB outcomes in women regardless of prolonged PTSD status.     

Lifetime Interpersonal Victimization Profiles and Mental Health Problems in a Nationally Representative Panel of Trauma-Exposed Adults From the United Kingdom

Traumatic event exposure has been associated with negative psychological outcomes. There is, however, a dearth of research on revictimization. The current study examined patterns of lifetime interpersonal victimization based on six types of childhood maltreatment, physical and sexual assault, and assault with a weapon during adulthood via latent class analysis (LCA), with gender as covariate. Using a three-step approach, we assessed differences across the latent classes in symptoms and diagnosis of depression, anxiety, and DSM-5 posttraumatic stress disorder (PTSD). A trauma-exposed adult sample representative of the United Kingdom population (N = 1,051) was recruited online through a research panel. The mean participant age 47.18 years (SD = 15.00, range: 18–90 years; 68.4% female). The LCA identified five classes: lifetime polyvictimization (8.3%; 69.5% female), sexual revictimization (13.7%; 96.5% female), physical revictimization (12.5%; 1.5% male), childhood trauma (25.9%; 85.6% female), and limited victimization (39.7%; 40.3% female). Compared to the other classes, the polyvictimization class, followed by the childhood trauma class, demonstrated the highest scores on anxiety, depression, and posttraumatic stress symptoms. The polyvictimization class had nearly a nine- to 33-fold increase in risk of depression, OR = 9.48, 95% CI [3.34, 26.87]; anxiety, OR = 12.10, 95% CI [5.36, 27.36]; and PTSD diagnoses, OR = 33.63, 95% CI [16.35, 69.43], compared to the limited victimization class. The findings facilitate the identification of individuals at risk for revictimization and indicate that evidence-based clinical interventions should be targeted toward those with exposure to revictimization and childhood trauma exposure to alleviate mental health challenges.     

Alcohol problems and posttraumatic stress disorder in female crime victims

Comorbidity between alcohol use and posttraumatic stress disorder (PTSD) has been well documented. However, there are few longitudinal studies with acute trauma samples. The present study examined symptoms of alcohol use disorders (AUDs) and PTSD longitudinally after assault. Female sexual (n = 69) and physical assault victims (n = 39) were assessed 2 to 4 weeks and 3 months post trauma. Women who had lifetime AUD had higher intrusive and avoidance symptoms than those who did not have AUD. Women who had any alcohol problems had higher PTSD symptoms. Participants who had alcohol problems had the same pattern of symptom recovery as those who did not have alcohol problems but remained more symptomatic over the 3 months. These findings suggest that early intervention strategies for women who have previous histories of alcohol problems and seek medical attention early post trauma may be indicated.     

Associations Among Hair Cortisol Concentrations,Posttraumatic Stress Disorder Status,and Amygdala Reactivity to Negative Affective Stimuli in Female Police Officers

Posttraumatic stress disorder (PTSD) is associated with altered hypothalamic‐pituitary‐adrenal (HPA) axis function. Measurement of hair cortisol concentrations (HCC) allows retrospective assessment of HPA axis regulation over prolonged periods of time. Currently, research investigating HCC in PTSD remains sparse. Previous cross‐sectional studies have included only civilian populations, although it is known that trauma type moderates associations between PTSD status and HPA axis function. We investigated differences in HCC between trauma‐exposed female police officers with current PTSD (n = 13) and without current and lifetime PTSD (n = 15). To investigate whether HCC was associated with neural correlates of PTSD, we additionally performed exploratory correlational analyses between HCC and amygdala reactivity to negative affective stimuli. We observed significantly lower HCC in participants with PTSD than in participants without PTSD, d = 0.89. Additionally, within participants with PTSD, we observed positive correlations between HCC and right amygdala reactivity to negative affective (vs. happy/neutral) faces, r = .806 (n = 11) and left amygdala reactivity to negative affective (vs. neutral) pictures, r = .663 (n = 10). Additionally, left amygdala reactivity to negative faces was positively correlated with HCC in trauma‐exposed controls, r = .582 (n = 13). This indicates that lower HCC is associated with diminished amygdala differentiation between negative affective and neutral stimuli. Thus, we observed lower HCC in trauma‐exposed noncivilian women with PTSD compared to those without PTSD, which likely reflects prolonged HPA axis dysregulation. Additionally, HCC was associated with hallmark neurobiological correlates of PTSD, providing additional insights into pathophysiological processes in PTSD.     

Facial recognition performance of female inmates as a result of sexual assault history

This study examined the effect of sexual assault history on facial recognition performance. Gender of facial stimuli and posttraumatic stress disorder (PTSD) symptoms also were expected to influence performance. Fifty-six female inmates completed an interview and the Wechsler Memory Scale-Third Edition Faces I and Faces II subtests (Wechsler, 1997). Women with a sexual assault exhibited better immediate and delayed facial recognition skills than those with no assault history. There were no differences in performance based on the gender of faces or PTSD diagnosis. Immediate facial recognition was correlated with report of PTSD symptoms. Findings provide greater insight into women's reactions to, and the uniqueness of, the trauma of sexual victimization.     

Gender Differences in Subjective Sleep After Trauma and the Development of Posttraumatic Stress Disorder Symptoms: A Pilot Study

Women are at higher risk than men for developing posttraumatic stress disorder (PTSD) following certain types of trauma such as accidents and assaults. Sleep disturbances have been implicated in the development of PTSD. Although gender differences in objective sleep soon after trauma have been found in a prior polysomnographic study, gender differences in subjective sleep soon after trauma and their associations to the development of PTSD have not been examined. This pilot study prospectively examined whether gender moderated the relationship between subjective sleep soon after trauma and PTSD symptom development. Injury patients (17 women, 28 men) completed a sleep questionnaire and a 1‐week sleep diary 2 weeks after their injuries, and the Clinician Administered PTSD Scale at 7‐weeks postinjury. Results showed that women reported greater frequency of nightmares and disruptive nocturnal behaviors (e.g., hot flashes, memories/nightmares about trauma) following the trauma and more severe PTSD symptoms at 7 weeks. Further, gender moderated the relationship between sleep‐onset latency and PTSD symptom severity, such that longer sleep‐onset latency predicted more severe PTSD symptoms in men, but less severe PTSD symptoms in women. These findings suggest that gender‐specific mechanisms may underlie the relationship between sleep impairment and the development of PTSD.