Traumatic Events

Study of the difference between the gender in the expression of distress following traumatic exposure

Introduction

In a lifetime, everyone experiences various and sometimes unpleasant experiences. For more than half a century, interest in these events has increased as it has been discovered that experiencing a few of those can create trauma for the subject. Due to the difficult socio-political context of the last century, researches have shown that some events are more likely than others to psychologically affect individuals, and can trigger significant stress and a wide range of effects (physical, social, psychic …).

Initially these phenomena were seen mostly among war veterans and were known as “war neuroses”, which were thought at that time to be transient. However, it was necessary to wait until 1980 with the publication of the third edition of the Diagnostic and Statistical Manual of Mental Disorders, to find the same type of phenomena recorded in sexually assaulted women, highlighting the dramatic effects caused by this type of events—often described as traumatic—on these people’s lives (DSM-III, Ozer, et al., 2003).

 

Traumatic Event and Posttraumatic stress disorder

This new interest in the study of trauma-related symptoms, and the subsequent increase in research in this area, led to the introduction of the concept of post-traumatic stress disorder (PTSD) into nosography.

Numerous studies have been published since then, making it possible to define the epidemiological place of this disorder both in the general population and in a specific population—attempting to grasp the differences between individuals in the way they experienced, and responded to, these traumatic events.

The findings of these research have shown that exposure to and response to these situations vary according to several factors, including gender, occupation, and the socio-cultural environment in which these studies were conducted.

At the time of the fifth edition of this manual (DSM-5 ; American Psychiatric Association [APA], 2015), the definition has evolved considerably due to many controversies as to the choice of these criteria and in particular the definition of a traumatic event (criterion A), a fundamental condition without which the disorder can not be taken into account. A traumatic event requires exposure threatening the life of the individual. Today, it includes many types of events (disasters, accidents, sexual and physical violence, violent or accidental deaths) and new forms of exposure (direct, indirect, direct vicariant, indirect vicariant). This definition reflects the reality we live in today, being increasingly confronted with events that can be damaging and traumatic.

 

The study

In spite of the large amount of research carried out on the subject, the debate surrounding the differences caused by gender in the nature of the individual’s emotional response to a traumatic event has not been settled yet ?

The purpose of this study is to explore and quantify these differences in the French general population, and to clarify and define the differences between both men and women in experiencing this type of event and in the distress caused by them. The survey, involving a sample of 718 people, aged between 18 and 70, was conducted in public areas in and around Nantes, using the Inventaire des Evénements Traumatogènes  (IET) (Ouagazzal, Boudoukha & Thomas-Ollivier, 2015). The results of this study demonstrate that exposure to a traumatic event is a common and recurrent experience in a lifetime, differentiated between the genders with respect to exposure, the type of event encountered and the nature of the displayed distress. Overall, women have lower exposure frequencies than men, but express greater distress. This difference is present when we look at the type of events but also in the way the subject was exposed to these events.

 

Results and Discussion

The results we obtained are consistent with previous studies. However, we have reserves about this, since our results do not allow us to say that gender is a major determinant in the intensity of distress caused by traumatic events. It is likely that other factors will affect our results. Several lines of explanation are considered, such as sensitivity to anxiety that may exacerbate the distress felt during and after the exposure (Norr, Albanese, Boffa, Short & Schmidt, 2016), the role of the cultural context and norms in the experience of traumatic events but also the role of cognitive assessment and adaptation mechanisms, which are key codifiers of the response to psychological and biological stress (Olff, 2007). Indeed, gender-related differences in neuroendocrine patterns are related to a variety of coping mechanisms, which may explain the higher risk of PTSD in women (Olff, 2007). It would be interesting to study in a future research the influence of neurocognitive disorders on the clinical expression of PTSD in adult subjects.

 

References 

American Psychiatric Association. (2015). DSM–5 : Manuel diagnostique et statistique des troubles mentaux (5th ed.) [Diagnostic and Statistical Manual of Mental Disorders]. Paris, France : Masson, 320-331.

Norr, A., Albanese, B., Boffia, J. W., Short, N. A. & Schmidt, N. B. (2016). The relationship between gender and PTSD symptoms: Anxiety sensitivity as a mechanism. Personality and Individual Differences, 90, 210-213.

Ozer, E. J., Best, S. R., Lipsey, T.L., & Weiss, D. S. (2003). Predictor of posttraumatic stress disorder and symptoms in adults: A meta-analysis. Psychological Bulletin, 129(1), 52-73.