Selected talks from the forum on the health of women in the military: Posttraumatic stress disorder in women veterans

Abstract

The prime victims of most interpersonal violence by people known to them are women. The common myth is that with increasing violence in this country, women are very subject to rape by strangers. In fact, Department of Justice reports show that only 15% of rapes actually are stranger rapes. The remaining 85% are committed by people known to the victim. These background facts are important in analyzing and understanding data on posttraumatic stress disorder (PTSD) in women, The problem is a societal one, and the solution should be oriented to prevention and addressed on a public health level. This is in contradistinction to the level at which we are sometimes reduced to dealing with it, as a psychiatric or mental health problem for women. Very recently, Kessler published a national co-morbidity study in the Auchives ef GeneraI Psychiatry. It contains the most current update on rates of posttraumatic stress disorder in men and women in the United States and is based on general community samples that include military populations. In a cohort of 5,800 people, age range 15-54, the study revealed that posttraumatic stress reactions are far more prevalent in U.S. society than previously thought. The estimated lifetime rates are about 7.8%, whereas previous estimates had suggested they were as low as l-2%. To put that in some perspective, the rate of schizophrenia in this country is estimated to be l%, so this is a fairly common problem. Kessler also found that in a total lifetime prevalence rate of 7.8%, men only had roughly half the rate of women. They have 5%, whereas 10.4% of women had PTSD at some point in their life. There is some debate in this study as to why that might be the case. Women are exposed frequently to different types of events than are men, and this is probably one underlying reason why women get higher levels of posttraumatic stress symptomatology. Although this study preliminarily suggests that women have some kind of greater vulnerability to getting PTSD, this vulnerability is not necessarily biological. It could be social, if women are at greater risk for certain interpersonal events. In support of this are other studies that show comparable rates of posttraumatic stress between men and women when they are exposed to the same trauma: for example, a natural disaster. The most prevalent traumatic stressor encountered by women in this country and possibly the world, although I don’t think there are empirical data on it, is sexual assault. During 1992 in this country alone, 680,000 women were raped, and an additional 1.7 million women were nonsexually assaulted. ExThe views, opinions, and/or findings reported in this article are those of the author(s) and should not be construed as official Department of Defense or other U.S government agency positions, policies, or decisions. Published by Elsevier Science Inc. 1049-3867/96/$15.00 PII 51049.3867(96)00055