Women, Trauma and PTSD

Trauma is common in women; five out of ten women experience a traumatic event. Women tend to experience different traumas then men. While both men and women report the same symptoms of PTSD (hyperarousal, reexperiencing, avoidance, and numbing), some symptoms are more common for women or men.

History

Most early information on trauma and PTSD came from studies of male veterans mostly Vietnam veterans. Researchers began to study the effects of sexual assault and found that women's reactions were similar to male combat veterans. Women's experiences of trauma can also cause PTSD. This finding led to more research on women's exposure to trauma and PTSD.

Risk of Experiencing Trauma

Findings from a large national mental health study show that a little more than half of all women will experience at least one traumatic event in their life. Women are slightly less likely to experience trauma than men. The most common trauma for women is sexual assault or child sexual abuse. About 1 in 3 women will experience a sexual assault in their lifetime. Rates of sexual assault are higher for women than men. Women are also more likely to be neglected or abused in childhood, to experience domestic violence, or to have a loved one suddenly die.

What Happens After Trauma

After a trauma, some women may feel depressed, start drinking or using drugs, or develop PTSD. Women are more than twice as likely to develop PTSD than men (10% for women and 4% for men). There are a few reasons women might get PTSD more than men:

• Women are more likely to experience sexual assault.
• Sexual assault is more likely to cause PTSD than many
• other events.
• Women may be more likely to blame themselves for
• trauma experiences than men.

Why are some women at higher risk for PTSD?

Not all women who experience a traumatic event develop PTSD. Women are more likely to develop PTSD if they:

• Have a past mental health problem (e.g., depression or anxiety)
• Experienced a very severe or life-threatening trauma
• Were sexually assaulted
• Were injured during the event
• Had a severe reaction at the time of the event
• Experienced other stressful events afterwards
• Do not have good social support

What PTSD is Like for Women

Some PTSD symptoms are more common in women than men. Women are more likely to be jumpy, to have more trouble feeling emotions, and to avoid things that remind them of the trauma than men. Men are more likely to feel angry and to have trouble controlling their anger then women. Women may take longer to recover from PTSD and are four times more likely than men to have long-lasting PTSD. Women with PTSD also are more likely to feel depressed and anxious, while men with PTSD are more likely to have problems with alcohol or drugs. Both women and men who experience PTSD may develop physical health problems.

Treatment for PTSD

There are good treatments for PTSD. However, not everyone who experiences a trauma seeks treatment. Women may be more likely than men to seek help after a traumatic event. At least one study found that women respond to treatment as well as or better than men. This may be because women are generally more comfortable sharing feelings and talking about personal things with others than men.

Women in the Military

Women in the military are at high risk for exposure to traumatic events, especially during times of war. Currently, about 15% of all military personnel in Iraq are women. Although men are more likely to experience combat, a growing number of women are now being exposed to combat. Women in the military are at higher risk for exposure to sexual harassment or sexual assault than men. Future studies are needed to better understand the effects of women's exposure to both combat and sexual assault.

Rape of Women in a War Zone

"A nation is not conquered until the women's hearts lay on the ground." -- Cheyenne Indian saying

In war, rape is an assault on both the individual woman and her family and community. Many hundreds of thousands of women have been raped in wars in this century alone, as reported in areas as diverse as Korea, Bangladesh, Liberia, Southeast Asia, and Uganda. Bosnian refugees have described how, in the former Yugoslavia, military forces publicly raped women to systematically force families to flee their villages, contributing to the goal of "ethnic cleansing." Assaults are often gang-related and sadistic, including other forms of physical torture. These women may also experience loss of home and community, dislocation, injury, and untreated illness, and these women may witness the murder, injury, or rape of loved ones. The effects of these types of trauma are immeasurable, long lasting, and shattering to both inner and outer worlds.

The situation is worsened by the religious and cultural attitudes surrounding rape. In a Muslim culture, the honor of the woman reflects upon the entire family; rape victims of Muslim faith may believe that the rape is a punishment for some sin that they have committed. Even if they do not blame themselves, they may feel such a strong cultural responsibility to protect their family that they often remain silent about the trauma. Many of the Bosnian rape victims told nobody, or very few people, about what happened to them.

The number of women being subjected to rape in Kosovo is not yet known. Rates of rape and sexual assault ranged from 3% to 6% in Bosnian refugee women. Long-term emotional, mental, and physical consequences of rape are found in up to 60% of U.S. female survivors. Similar posttraumatic symptoms were found in up to 75% of Bosnian refugees, even in women who did not report a rape, It is estimated that the long-term consequences of rape will be present in the majority of women subjected to war-related rape in Kosovo.

Consequences of rape

Immediate consequences of rape, affecting the majority of women who are raped, include:

• Emotional symptoms: shock, intense fear, tearfulness, anger, shame, helplessness, nervousness, numbness
• Psychological symptoms: confusion, disorientation, unwanted memories, decreased concentration, self-blame
• Physical symptoms: bodily injury; sexually transmitted diseases; muscular tension; fatigue; edginess; change in sleep, appetite, and sex drive; gastrointestinal problems; racing heart; bodily aches and pains

Long-term consequences of rape can be complex and severe, including injury and sexually transmitted diseases; marked interpersonal changes such as distrust, anger, and isolation; and psychiatric disorders such as:

• Posttraumatic Stress Disorder (PTSD): reexperiencing the trauma in memories and dreams, avoiding anything reminiscent of the event, memory loss, emotional numbing, sleep disturbance, anxiety
• Depression: loss of hope, self-worth, motivation, or purpose in life; fatigue; decreased pleasure in previously enjoyed activities; changes in sleep and appetite; suicidal thoughts or actions
• Alcohol and substance abuse

Treatment

While the consequences of rape are severe and complex, treatments are available that significantly reduce symptoms and improve quality of life. See our section on treatment for more information.