Gender Differences in the PTSD Symptoms of Polytraumatized Youth During Isolated Phases of Trauma-Focused Cognitive Behavioral Therapy

Objective: Gender differences in the development and severity of PTSD have long been observed, but much less is known about gender differences within the context of trauma-focused treatment. This study investigated gender differences in the PTSD symptoms of polytraumatized youth during Trauma-focused Cognitive Behavioral Therapy (TF-CBT). Method: The sample included child welfare-involved youth ages 7-18 (N = 138) who experienced a mean of 4.78 types of trauma and received TF-CBT at a trauma treatment clinic. Mixed ANOVA analyses assessed gender differences in PTSD symptoms from baseline to termination of treatment. PTSD symptoms were then mapped according to the phase of treatment, and factorial ANOVAs examined gender differences during isolated phases of TF-CBT. Potential interactions with sexual violence history were considered. Results: Significant reductions in overall PTSD, intrusive, avoidance and arousal symptoms were found from baseline to termination of TF-CBT for the entire sample, although females reported higher symptom levels across all PTSD symptom domains. Significant gender differences were also revealed during some, but not all, phases of treatment, with variations among PTSD symptom domains noted. Conclusions: Findings suggest TF-CBT is effective in reducing PTSD in youth with poly-trauma exposure, irrespective of gender. Gender differences in symptom severity were revealed, however, and indicate the need to attend to gender within the context of treatment. Findings also suggest the use of measurement-based care, and specifically attending to symptom fluctuation in PTSD symptom domains during treatment, can help inform clinical decision making and individualize treatment. Clinical Impact Statement This study investigated gender differences in the PTSD symptoms of child welfare-involved and polytraumatized youth ages 7-18 from baseline to termination of Trauma-Focused Cognitive Behavioral Therapy (TF-CBT), as well as during isolated phases of treatment. Findings revealed significant reductions across all PTSD symptom domains for both males and females from the beginning to the end of treatment, although females exhibited higher levels of symptoms. Gender differences were also observed during some phases of treatment. Results can help guide clinical decision making, and reinforce the importance of attending to gender, individual PTSD symptom domains and symptom fluctuation during treatment.