5 - Posttraumatic stress disorder in women

Summary

The diagnosis of posttraumatic stress disorder (PTSD) has been the focus of considerable attention since it first appeared in the diagnostic nomenclature in 1980. Since that time, the diagnostic criteria have been refined, with both the diagnostic and statistical manual of mental disorders DSM-IV (American Psychiatric Association, 1994) and international classification of diseases (ICD-10) (World Health Organization, 1993) recognizing the condition. In recent years, a major focus of interest has been the impact of gender on the risk of developing PTSD and related conditions following traumatic exposure. Indeed, the fact that a whole book has recently been devoted to a comprehensive review of issues concerning PTSD and gender (Kimerling et al., 2002) is an indication of the importance placed on this relationship. While interested readers are referred to that volume for a more in-depth analysis of the area, the purpose of this chapter is to provide an overview of the key issues concerning women and PTSD.

The nature of PTSD

The first criterion to be met for a diagnosis of PTSD is the experience of a traumatic event (Criterion A1), usually defined as involving actual or threatened physical threat to the self or others. The person's response to the event must have involved a powerful emotional reaction, such as fear, helplessness, or horror (Criterion A2). Three broad clusters of symptoms characterize the disorder and are required in some form for a diagnosis. First, evidence of re-experiencing the trauma is required (known as the “B criteria”).