Disentangling sex differences in PTSD risk factors

被引:14
作者
Haering, Stephanie [1 ,2 ]
Seligowski, Antonia V. [3 ]
Linnstaedt, Sarah D. [4 ]
Michopoulos, Vasiliki [5 ]
House, Stacey L. [6 ]
Beaudoin, Francesca L. [7 ,8 ]
An, Xinming [4 ]
Neylan, Thomas C. [9 ,10 ]
Clifford, Gari D. [11 ]
Germine, Laura T. [12 ,13 ,14 ]
Rauch, Scott L. [3 ,12 ,14 ]
Haran, John P. [15 ]
Storrow, Alan B. [16 ]
Lewandowski, Christopher [17 ]
Musey, Paul I. [18 ]
Hendry, Phyllis L. [19 ]
Sheikh, Sophia [19 ]
Jones, Christopher W. [20 ]
Punches, Brittany E. [21 ]
Swor, Robert A. [22 ]
Gentile, Nina T. [23 ]
Hudak, Lauren A. [24 ]
Pascual, Jose L. [25 ,26 ]
Seamon, Mark J. [26 ,27 ]
Pearson, Claire [28 ]
Peak, David A. [29 ]
Merchant, Roland C. [30 ]
Domeier, Robert M. [31 ]
Rathlev, Niels K. [32 ]
O'Neil, Brian J. [33 ]
Sanchez, Leon D. [30 ,34 ]
Bruce, Steven E. [35 ]
Harte, Steven E. [36 ,37 ]
Mclean, Samuel A. [38 ,39 ]
Kessler, Ronald C. [40 ]
Koenen, Karestan C. [41 ]
Powers, Abigail [5 ]
Stevens, Jennifer S. [5 ]
机构
[1] Free Univ Berlin, Dept Educ & Psychol, Clin Psychol Intervent, Berlin, Germany
[2] Charite Univ Med Berlin, Charite Ctr Hlth & Human Sci, Gender Med, Berlin, Germany
[3] McLean Hosp, Dept Psychiat, Belmont, MA USA
[4] Univ North Carolina, Inst Trauma Recovery, Dept Anesthesiol, Chapel Hill, NC USA
[5] Emory Univ, Sch Med, Dept Psychiat & Behav Sci, Atlanta, GA 30322 USA
[6] Washington Univ, Sch Med, Dept Emergency Med, St Louis, MO USA
[7] Brown Univ, Dept Epidemiol, Providence, RI USA
[8] Brown Univ, Dept Emergency Med, Providence, RI USA
[9] Univ Calif San Francisco, Dept Psychiat, San Francisco, CA USA
[10] Univ Calif San Francisco, Dept Neurol, San Francisco, CA USA
[11] Emory Univ, Dept Biomed Informat, Sch Med, Atlanta, GA USA
[12] McLean Hosp, Inst Technol Psychiat, Belmont, MA USA
[13] Many Brains Project, Belmont, MA USA
[14] Harvard Med Sch, Dept Psychiat, Boston, MA USA
[15] Univ Massachusetts, Chan Med Sch, Dept Emergency Med, Worcester, MA USA
[16] Vanderbilt Univ, Med Ctr, Dept Emergency Med, Nashville, TN USA
[17] Henry Ford Hlth Syst, Dept Emergency Med, DETROIT, MI USA
[18] Indiana Univ Sch Med, Dept Emergency Med, Indianapolis, IN USA
[19] Univ Florida, Coll Med Jacksonville, Dept Emergency Med, Jacksonville, FL USA
[20] Rowan Univ, Cooper Med Sch, Dept Emergency Med, Camden, NJ USA
[21] Ohio State Univ, Coll Med, Dept Emergency Med, Columbus, OH USA
[22] Oakland Univ, William Beaumont Sch Med, Dept Emergency Med, Rochester, MI USA
[23] Temple Univ, Lewis Katz Sch Med, Dept Emergency Med, Philadelphia, PA USA
[24] Emory Univ, Sch Med, Dept Emergency Med, Atlanta, GA USA
[25] Univ Penn, Dept Surg, Dept Neurosurg, Philadelphia, PA USA
[26] Univ Penn, Perelman Sch Med, Philadelphia, PA USA
[27] Univ Penn, Dept Surg, Div Traumatol Surg Crit Care & Emergency Surg, Philadelphia, PA USA
[28] Ascens St John Hosp, Ascension St John Hosp, Detroit, MI USA
[29] Massachusetts Gen Hosp, Dept Emergency Med, Boston, MA USA
[30] Brigham & Womens Hosp, Dept Emergency Med, Boston, MA USA
[31] Trinity Hlth Ann Arbor, Dept Emergency Med, Ypsilanti, MI USA
[32] Univ Massachusetts, Med Sch Baystate, Dept Emergency Med, Springfield, MA USA
[33] Wayne State Univ, Detroit Receiving Hosp, Dept Emergency Med, Detroit, MI USA
[34] Harvard Med Sch, Dept Emergency Med, Boston, MA USA
[35] Univ Missouri, Dept Psychol Sci, St Louis, MO USA
[36] Univ Michigan, Med Sch, Dept Anesthesiol, Ann Arbor, MI USA
[37] Univ Michigan, Sch Med, Dept Internal Med Rheumatol, Ann Arbor, MI USA
[38] Univ North Carolina, Dept Emergency Med, Chapel Hill, NC USA
[39] Univ North Carolina, Inst Trauma Recovery, Dept Psychiat, Chapel Hill, NC USA
[40] Harvard Med Sch, Dept Hlth Care Policy, Boston, MA USA
[41] Harvard Univ, Harvard TH Chan Sch Publ Hlth, Dept Epidemiol, Boston, MA USA
来源
NATURE MENTAL HEALTH | 2024年 / 2卷 / 05期
关键词
POSTTRAUMATIC-STRESS-DISORDER; GENDER-DIFFERENCES; SOCIAL SUPPORT; ANXIETY; DEPRESSION; DISTRESS; SCIENCE; TRAUMA;
D O I
10.1038/s44220-024-00236-y
中图分类号
R749 [精神病学];
学科分类号
100205 ;
摘要
Despite extensive research on sex/gender differences in posttraumatic stress disorder (PTSD), underlying mechanisms are still not fully understood. Here we present a systematic overview of three sex/gender-related risk pathways. We assessed 16 risk factors as well as 3 month PTSD severity in a prospective cohort study (n = 2924) of acutely traumatized individuals and investigated potential mediators in the pathway between sex assigned at birth and PTSD severity using multiple mediation analysis with regularization. Six risk factors were more prevalent/severe in women, and none was more pronounced in men. Analyses showed that acute stress disorder, neuroticism, lifetime sexual assault exposure, anxiety sensitivity and pretrauma anxiety symptoms fully mediated and uniquely contributed to the relationship between sex assigned at birth and PTSD severity. Our results demonstrate different risk mechanisms for women and men. Such knowledge can inform targeted interventions. Our systematic approach to differential risk pathways can be transferred to other mental disorders to guide sex- and gender-sensitive mental health research.
引用
收藏
页码:605 / 615
页数:15
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