Cultural and Gender Differences in PTSD Ms. Carmelitano

Symptomology of PTSD Affective: Behavioral: Cognitive: Somatic: Ahedonia, emotional numbing Behavioral: Hyper-vigilance, passivity, nightmares, flashbacks, exaggerated startle response Cognitive: Intrusive memories, inability to concentrate, hyper vigilant Somatic: Lower back pain, headaches, stomach aches, insomnia, regression, losing developmental skills

Cultural difference in Diagnosis The expression of cognitive symptoms of PTSD is a western phenomena People in many other cultures initiate treatment because of somatic complaints The DSM-IV states that somatic symptoms are “a-typical” However, Kleinman (1987) argued that this was an ethnocentric assumption Non-westerners typically report body-memory symptoms category fallacy - when one presumes that what the mental health constructs will translate and be evident in other cultures. It is irrational and ethnocentric to assume that non-western forms of the disorder are atypical- the form commonly seen in the West being assumed the norm.

Hanscom 2001 Worked with Guatemalan women who had been raped and tortured during a civil war Found that the women were more likely to report somatic symptoms Body memory symptoms The women reported feeling “dizzy spells” rather than “cognitive flashbacks” When they had been attacked they were forced to drink large amounts of alcohol to intoxicate them

Gender Differences in PTSD Research has shown significant differences in reporting of PTSD when it comes to gender Women: 10% of women will develop PTSD Men: 5% of men will develop PTSD Why?

Symptoms in men and women Men: Suffer from irritability , impulsiveness and substance abuse Women: Numbing, avoidance, anxiety and depression

Breslau et al (1991) Longitudinal study of 1007 young adults who lived in a violent community Found that 11.3% of women suffered from PTSD and only 6% of men suffered from PTSD Is this due to a biological reason, or is there a social reason for these differences?

Horowitz et al (1995) Reviewed a number of studies and found that women are 5 times more likely to develop PTSD than males are after experiencing a traumatic event

Why is there a difference? Different types of traumas carry different risks for developing PTSD Rape is experienced more in women than men, and this carries the highest chance for developing PTSD 50%

Socialization differences Girls are more likely to internalize problems while boys externalize them (Nolen-Hoeksema 1994) Achenbach 1991 Gave parents a Child Behavioral Checklist to complete in order to understand the different behaviors boys and girls exhibit when they have PTSD He found that boys were more likely to exhibit delinquent traits and aggression, while girls were more likely to develop depression He concluded that the males displayed external symptoms, while the females displayed internal ones