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There is a pervasive and comprehensive history of sexism in the pursuit of scientific truth, extending back beyond the days of 'hysteria' and continuing still. Herein, we discuss a disparity in scientific research on a disorder thought to affect less than 8% of the adult population in the USA with the number of women diagnosed with the disorder estimated to be two to three times higher than that of men. While post-traumatic stress disorder (PTSD) is more likely to be experienced by women, we find that the overwhelming majority of published scientific literature on PTSD involves male combat veterans. For example, since March 2019, according to a widely used medical research search engine, specifically the electronic database PubMed (https://www.ncbi.nlm.nih.gov/pubmed/), over 1,100 articles can be found with the keywords, 'veteran and PTSD' while using the keywords, 'sexual assault and PTSD' yields a little over 100 total articles. While not all victims of sexual assault are female and not all combat veterans are male, the majority sex in each category is such that much of the research on 'veteran' was specifically carried out with male veterans and much of the work on 'sexual abuse' was carried out exclusively with females. This creates a perception that both overinflates the incidence of PTSD experienced by male combat veterans and underemphasizes the experience of PTSD in female victims of sexual assault. Differences in symptoms of PTSD do vary by war and what little research exists on PTSD after sexual assault suggests that it is likely that symptoms as well as associated comorbidities will vary depending on the cause, type, number, and age at first trauma, among other factors. This study focuses on the specific comorbidities of pain, addiction, and immune function in those who experience PTSD following war-based or sexually-based traumas. It is our hope that in reviewing the currently available research, we spotlight the need for research focused on PTSD experienced after sexual assault. Doing so has the potential to lead to better and more tailored treatments for PTSD, thus enriching outcomes for all sufferers of PTSD. Keywords: Sex-differences, PTSD, Bias in research, Introduction Culture, politics, the legal and judicial systems as well as institutionalized 'truths' suffuse our fundamental understanding of biology in a way that usually promotes the status quo to foster [...]

Individuals living with HIV report disproportionately high levels of trauma exposure and PTSD symptoms, both which have been associated with suboptimal ART adherence. Often conflated, the question arises as to which construct is driving subsequent HIV self-care behavior. Given the HIV disparities among Black and Hispanic/Latinx individuals, and that Miami is a geographic region with a high racial/ethnic minority make up and a unique socioeconomic environment, it is important to explore factors related to HIV outcomes in Miami to mitigate its uncontrolled epidemic. This study aimed to examine the association of trauma exposure, PTSD symptoms, and relevant additional key factors with adherence to ART among a sample of majority Black and Hispanic/Latinx individuals who are economically marginalized receiving public HIV care in Miami, FL (N = 1237) via a cross-sectional survey. Sequential linear regression was used to examine the study aim in four blocks: (1) trauma, (2) PTSD symptoms, and key covariates of ART adherence including (3) depression and substance use (potential psychological covariates), and (4) indicators of socioeconomic status (potential structural covariates). In the first block, trauma exposure was associated with worse adherence. However, in the second block, the association with trauma dropped and PTSD was significantly associated with worse adherence. Of note, for those experiencing high levels of trauma exposure, adherence was negatively impacted regardless of PTSD. When other key factors associated with adherence were entered in the third and fourth blocks, neither trauma exposure nor PTSD were uniquely significant. In this final model, depression, substance use, and unstable housing were uniquely associated with worse adherence. Trauma-informed models of HIV care that holistically address co-occurring factors are warranted to cater to communities with HIV health disparities and keep them from falling off the HIV care continuum., Author(s): Tiffany R. Glynn [sup.1] , Noelle A. Mendez [sup.1] , Deborah L. Jones [sup.3] , Sannisha K. Dale [sup.1] , Adam W. Carrico [sup.2] , Daniel J. Feaster [sup.2] [...]

Objectives. We examined gender differences in sociodemographic, military service, and mental health characteristics among Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) veterans. We evaluated associations between these sociodemographic and service characteristics and depression and posttraumatic stress disorder (PTSD) diagnoses. Methods. In a retrospective, cross-sectional study, we used univariate descriptive statistics and log binominal regression analyses of Department of Veterans Affairs (VA) administrative data on 329049 OEF and OIF veterans seeking VA health care from April 1, 2002, through March 31, 2008. Results. Female veterans were younger and more likely to be Black and to receive depression diagnoses than were male veterans, who were more frequently diagnosed with PTSD and alcohol use disorders. Older age was associated with a higher prevalence of PTSD and depression diagnoses among women but not among men. Conclusions. Consideration of gender differences among OEF and OIF veterans seeking health care at the VA will facilitate more targeted prevention and treatment services for these newly returning veterans. (Am J Public Health. 2010;100:2450-2456. doi: 10.2105/AJPH.2009.166165)

Little is known about the impact of traumatic experiences and stressful life conditions on people in low-income countries who live in conditions of ongoing political violence. In order to determine the prevalence and predictors of post-traumatic stress disorder (PTSD) and major depression (MD) among Palestinians subjected to chronic political violence and upheaval, we used a stratified multi-stage cluster random sampling strategy to interview a representative sample of 1,200 Palestinian adults living in Gaza, the West Bank, and East Jerusalem. Prevalence of PTSD/MD for men living in the West Bank, Gaza, and East Jerusalem was 25.4%/29.9%, 22.6%/27.6%, and 16.1%/16.1%, respectively. For women, the prevalence of PTSD/MD was 23.8%/29.0%, 23.9%/28.9%, and 19.7%/27.6%. Among men, PTSD was significantly positively associated with age group, two or more incidences of political violence (compared to none), greater intrapersonal resource loss, and loss of faith in government. MD was positively associated with experiencing exposure to one, or two of more, incidences of political violence (compared to none), and greater interpersonal and intrapersonal resource loss. Among women, PTSD was positively associated with greater interpersonal and intrapersonal resource loss, and MD was positively associated with death of a loved one, two of more socio-political stressors (compared to none) previous to the past year, one of more socio-political stressors (compared to none) in the past year, and greater interpersonal and intrapersonal resource loss. Interpersonal and intrapersonal resource losses were consistently associated with PTSD and MD, suggesting potential targets for intervention and prevention efforts and thus provide important keys to treatment in areas of ongoing conflict.

American Indians and Alaska Natives are vulnerable populations with significant levels of trauma exposure. The Indian Country Child Trauma Center developed an American Indian and Alaska Native (AI/AN) adaptation of the evidence-based child trauma treatment, trauma-focused cognitive-behavioral therapy. Honoring Children, Mending the Circle (HC-MC) guides the therapeutic process through a blending of AI/AN traditional teachings with cognitive-behavioral methods. The authors introduced the HC-MC treatment and illustrated its therapeutic tools by way of a case illustration. Keywords: American Indian; Alaska Native; child trauma; PTSD; psychotherapy; cultural sensitive; evidence-based practices DOI: 10.1002/jclp.20707

Objective: The present study investigated the influence of race on posttraumatic stress disorder (PTSD) treatment among 94 African American and 214 Caucasian female victims of interpersonal violence participating in 2 studies of cognitive--behavioral treatment for PTSD that were conducted sequentially and continuously. Method: In each study, participants were randomized into 1 of 3 conditions. The first study compared cognitive processing therapy with prolonged exposure and a delayed treatment condition. In the second study, cognitive processing therapy was compared with its constituent components: cognitive therapy only and written accounts. Participants were assessed with the Clinician Administered PTSD Scale and the Structured Clinical Interview for DSM--IV, as well as through self-report measures of PTSD. Results: Analyses revealed that African Americans were significantly less likely to complete treatment compared with Caucasians (45% vs. 73%, respectively, p < .001) and that the differences held even after controlling for education and income. Despite racial differences in treatment completion status, analyses with the intent-to-treat sample indicated no racial differences in outcomes on PTSD measures. Conclusions: The lack of difference in treatment outcomes despite racial differences in dropout may be explained by greater symptom improvement of African Americans who dropped out compared with Caucasians who dropped out. Implications of these findings and practical approaches to addressing sociocultural barriers to care are explored. Keywords: African Americans, posttraumatic stress disorder, cognitive processing therapy, prolonged exposure, dropout Supplemental materials: http://dx.doi.org/10.1037/a0019551.supp DOI: 10.1037/a0019551

Utilizing the concept of race-based traumatic stress, this study tested whether posttraumatic stress symptoms explain the process by which perceived discrimination is related to health risk behaviors among Mexican American adolescents. One hundred ten participants were recruited from a large health maintenance organization in Northern California. Mediational analyses indicated that adolescents who perceived more discrimination reported worse posttraumatic stress symptoms, controlling for covariates. In turn, adolescents who experienced heightened posttraumatic stress symptoms reported more alcohol use, more other drug use, involvement in more fights, and more sexual partners. Perceived discrimination was also directly related to involvement in more fights. Results provide support for the notion of race-based traumatic stress, specifically, that perceived discrimination may be traumatizing for Mexican American adolescents. Counseling psychologists and counselors in schools and community settings should assess Mexican American adolescents for the effects of discrimination and provide appropriate interventions to reduce its negative emotional impact. Keywords: perceived discrimination, posttraumatic stress symptoms, health risk behaviors, Mexican American adolescents DOI: 10.1037/a0020026

This study investigated the degree to which parental symptomatology and characteristics of the family environment related to posttraumatic growth (PTG) among children and adolescents who had been directly exposed to the 2004 tsunami in Thailand. One hundred five 6- to 17-year-olds (M = 11.9 years, SD = 3.3) and their parents (N = 67) were interviewed approximately 10 months and 2 years 5 months after the tsunami. The parents' self-reported PTG was a significant predictor of PTG in their children, suggesting that social processes play a role in the development of PTG in youth. Parental self-reported posttraumatic stress symptoms did not predict PTG in their children nor did youth's ratings of family cohesion, but parental tsunami-related sick leave related to lower levels of PTG reported by their children. Overall, these findings imply that elements of parents' functioning can affect children's positive adaptation after a disaster and highlight the need to assess potential parental influences and those of other sources of support in the child's environment after trauma. Attending to such lectors holds salience for efforts to promote adaptation and facilitate PTG. DOI: 10.1111/j.1939-0025.2010.01028.x

Tobacco smoking has been found to increase after the experience of a traumatic event and has been associated with posttraumatic stress disorder (PTSD). Initiation and persistence of cigarette smoking is moderately heritable; two recent investigations have implicated the COMT Val158Met (also known as rs4680) polymorphism in smoking age of initiation, dependence, as well as in quantity and frequency of smoking. To examine a possible association of COMT Val158Met and posttrauma increases in cigarette smoking, we studied 614 adults from the 2004 Florida Hurricane Study who returned saliva DNA samples via mail. PTSD was strongly associated with increased smoking. Moreover, each COMT Val158Met 'Met' allele predicted a 2.10-fold risk of smoking post-hurricane, in-dependent of PTSD; follow-up analyses revealed that this finding was primarily driven by European-American males. This study represents the first genetic association study (to our knowledge) of smoking behavior following an acute stressor.

The population impact of a preventive intervention depends on two factors: what proportion of the full population at risk receives the intervention and how large a reduction in risk occurs among those who receive it. We sought to illustrate how information from a cognitive behavioral psychotherapy (CBT) trial and stepped collaborative care (CC) trial could be used to estimate the population impact of two contrasting approaches to PTSD prevention. We first specified trauma center target populations represented by participants in each trial. Patient characteristics were compared, as were effect size and reach indices and population-level reductions in PTSD incidence. The CBT trial demonstrated a larger effect size (50% PTSD prevention), but minimal reach (27/10,000), while the CC trial demonstrated a smaller effect size (7% PTSD prevention) but greater reach (1762/10,000). Modeling of the population impact suggested that a 9.5-fold greater cumulative reduction in the incidence of PTSD would result from the dissemination of the CC broad reach prevention strategy. A reciprocal relationship between effect size and reach was evident in these two trials. By specifying a target population, effect size and reach could be combined to project the overall population impact of each PTSD prevention approach.

This study examines the association between trauma exposure and posttraumatic stress disorder (PTSD) among 157 help-seeking children (aged 8-17). Structured clinical interviews are carried out, and linear and logistic regression analyses are conducted to examine the relationship between PTSD and type of trauma exposure controlling for age, gender, and ethnicity. Confrontation with traumatic news, witnessing domestic violence, physical abuse, and sexual abuse are each significantly associated with PTSD. Witnessing a crime, being the victim of a crime, and exposure to accidents, fire, or disaster are not associated with PTSD. These findings underscore the association between interpersonal violence and childhood PTSD. Keywords: interpersonal violence; trauma exposure; PTSD 10.1177/0886260508325494

The primary aim for this research was to explore the overlap and differences between the concepts related to secondary traumatization: posttraumatic stress disorder (PTSD), secondary traumatic stress (STS), compassion fatigue (CF), and burnout (BRN). A secondary aim for this research was to examine the impact of secondary traumatization and some of the personal and professional elements that affect how pediatric healthcare providers experience PTSD, STS, CF, and BRN. An online survey was sent via e-mail to numerous list serves for healthcare providers who had worked on PICU, NICU, or PEDS units within the last year. The analyses revealed that a significant overlap existed between the terms of STS, PTSD, BRN, CS, and CF for PICU, NICU, and PEDS providers. However, a hierarchical linear regression revealed a significant amount of unique contributions to the variance in CF based on each of the measured concepts. Despite previous literature that indicates that the terms STS and CF can be used interchangeably, the two most prominent measures utilized in the assessment of CF and STS are actually capturing at least some unique elements. Given these results, future researchers should examine and conceptualize the difference in etiology, prevalence, symptoms, and treatment efficacy for CF and STS as separate but related entities and then return their focus to understanding secondary traumatization in healthcare providers. doi: 10.2190/OM.60.2.a

Although Latinos have been a rapidly growing population in the US, little is known about how mental health symptoms may present in Latino children especially in the context of those living in poverty and exposed to violence. We explored the level of violence exposure and trauma symptoms in Latino youth and the relationship of these factors with English language fluency. During 20002002, 1,601, Latino students from seven middle schools participated in a school-based screening to identify students with exposure to community violence and symptoms of Posttraumatic Stress Disorder (PTSD). The students completed a self-report instrument, in either Spanish or English, that combined a modified version of the Life Events Scale and the Child PTSD Symptom Scale (CPSS). Bivariate analyses and multivariate regression models showed that youth with higher English language fluency reported greater violence exposure and PTSD symptoms than those with lower fluency. No difference was found in functioning by English language fluency. English language fluency appears to be related to violence exposure and PTSD symptoms in these Latino youth. We discuss the importance of school-based programs especially designed to serve Latino students of varying English language fluency. Keywords Trauma * Violence exposure * Latino youth * Language fluency

We examine the historical development and use of the diagnosis of post-traumatic stress disorder that has been primarily applied to war veterans. We explore how study of this population and refinement of this diagnosis were influenced by changing paradigms and the emergence of new theory. From this context, we then explore similarities and differences between the symptoms, stressors, and social supports of war veterans with those of youth living in violent, impoverished communities. Based upon this analysis, we conclude with implications for researchers, education, mental health, and social service policy-makers and service providers. Keywords Post-traumatic stress disorder * Diagnosis * Urban youth * Violence * War veterans

Differences between boys' and girls' exposure to terror and posttraumatic symptoms were examined in a sample of 2,999 Israeli adolescents. Gender differences were also assessed regarding perceived social support, religious beliefs, and ideological commitment. Results indicate that girls reported more posttraumatic symptoms than boys, although boys reported twice the rate of very severe symptoms. Differences were also found between boys and girls in levels of fear, religiosity, ideological commitment, and social support, but not regarding exposure. Path analysis revealed that gender is not a direct predictor of posttraumatic stress disorder (PTSD); however, it does have an indirect effect, especially through fear, which was the best predictor of PTSD. Social extrinsic religiosity and ideological intolerance were positive predictors of PTSD. The study concludes that gender differences in PTSD are largely the result of differences in levels of fear and are not due to differences in political ideology, religiosity, or social support. Keywords: gende; post trauma; adolescence; terror

The present study uses a feminist theoretical framework to explore risk factors for the development of posttraumatic stress symptoms following intimate partner violence, with a community sample of 120 low-income European American and African American women. Hierarchical regression analyses were used to examine demographic, violence, and mental health variables that predict posttraumatic stress symptoms. The data reveal that African American women report lower levels of posttraumatic stress symptoms than do their European American peers. This difference was observed despite the presence of more empirically identified risk factors for African American women. Regression analyses show that symptoms of depression increase risk for posttraumatic stress for both groups. However, a difference was observed such that past victimization increase risk for only European American women, whereas amount of psychological violence in the previous year increases risk for only African American women. Potential explanations for observed ethnic differences are offered. Keywords: intimate partner violence; ethnicity; posttraumatic stress disorder

Using the Posttraumatic Growth Inventory, we examined posttraumatic growth in a sample of 50 adolescents and young adults who had experienced parental death in childhood or adolescence. Longitudinal relations were examined between baseline measures of contextual and intraindividual factors and scores on the posttraumatic growth subscales (i.e., New Possibilities, Relating to Others, Personal Strengths, Spiritual Changes, and Appreciation of Life) six years later. Controlling for time since death, threat appraisals, active coping, avoidant coping, seeking support from parents or guardians, seeking support from other adults, internalizing problems, and externalizing problems were significant predictors of posttraumatic growth. The implications of these findings for research and clinical practice are discussed.

This study evaluated the construct of childhood traumatic grief (CTG) and its correlates through a multi-site assessment of 132 bereaved children and adolescents. Youth completed a new measure of the characteristics, attributions, and reactions to exposure to death (CARED), as well as measures of CTG, posttraumatic stress disorder (PTSD), depression, and anger. CTG was distinct from but highly correlated with PTSD, depression, and, to a lesser degree, anger. In contrast to a recent study of complicated grief CTG severity was significantly associated with the degree to which the death was viewed as traumatic. CTG was also associated with caregivers' emotional reaction at the time of the death and caregivers' current sadness. Clinical implications and recommendations for future research are discussed.

The study investigated the effects of World War II (WWII) on psychological and social functioning of Jewish and non-Jewish survivors 60 years after the war. The authors hypothesized that the level of posttraumatic symptoms, depression, and social isolation of survivors who were at least 5 years old (but younger than 18) in the last year of WWII would be predicted by the extent of traumatic loss, (i.e., death of parent[s]) and age at the end of WWII. Data were collected from 211 individuals living in Poland, ages 66-80; 30% were Jewish Holocaust survivors. Current posttraumatic stress disorder was almost 2 times higher for Jewish (55.6%) than for non-Jewish survivors (30.9%), whereas no differences were found for depression and social isolation. Parental loss during the war predicted a global decrement of well-being (across measured outcome indices). For certain subgroups (e.g., Jewish survivors who had not lost their parents during WWII), war trauma may have less profound effects if most of the trauma exposure occurred during an earlier age (i.e., Keywords: child war survivor, posttraumatic stress disorder (PTSD), Holocaust, parental loss, social isolation

Using a nationally representative sample of 4,008 adolescents, this study examines gender differences in violence exposure, major depressive episode (MDE) and posttraumatic stress disorder (PTSD), and characteristics of violence incidents. It was hypothesized that there would be gender differences in the types of violence exposure reported and in the prevalence of MDE and PTSD and that gender would moderate the relationship between violence exposure and mental health outcomes. Results indicated significant gender differences in rates of violence exposure, PTSD, and MDE. Additionally, gender was a moderating variable in the relation between sexual assault and PTSD, but not in the other violence exposure--mental health relations examined. It thus appears that the pathways for developing PTSD may be different for male and female victims of sexual abuse. Implications for interventions and future research are discussed. Keywords: gender, trauma, PTSD, sexual abuse, National Survey of Adolescents

The primary purpose of this study was to examine relations between trauma exposure, post-resettlement stressors, perceived discrimination, and mental health symptoms in Somali adolescent refugees resettled in the U.S. Participants were English-speaking Somali adolescent refugees between the ages of 11 and 20 (N = 135) who had resettled in the U.S. Participants were administered an interview battery comprising self-report instruments that included the UCLA Posttraumatic Stress Disorder (PTSD) Index, the War Trauma Screening Scale, the Every Day Discrimination scale, the Adolescent Post-War Adversities Scale, and the Acculturative Hassles Inventory. Results indicated that cumulative trauma was related to PTSD and depression symptoms. Further, post-resettlement stressors, acculturative stressors, and perceived discrimination were also associated with greater PTSD symptoms after accounting for trauma, demographic, and immigration variables. Number of years since resettlement in the US and perceived discrimination were significantly related to depressive symptoms, after accounting for trauma, demographic, and immigration variables. Further research elucidating the relations between postresettlement stressors, discrimination, and mental health of refugee adolescents may inform intervention development. Keywords: refugees, adolescents, discrimination, trauma exposure

This article presents lifetime and 12-month prevalence rates and comorbidity for posttraumatic stress disorder (PTSD) among a sample of 428 homeless and runaway adolescents. Data are from baseline interviews of a longitudinal diagnostic study of 428 (187 males; 241 females) homeless and runaway adolescents aged 16-19 years (mean age = 17.4 years, SD = 1.05). The data were collected by full-time street interviewers on the streets and in shelters in eight Midwesteru cities of various populations. About one-third (35.5%) of the runaways met lifetime criteria for PTSD and 16.1% met 12-month criteria for the disorder. More than 90% of the adolescents who met criteria for PTSD met criteria for at least one of the other four diagnoses. Multivariate analyses indicated that correlates of PTSD were age of adolescent, being female, having experienced serious physical abuse and/or sexual abuse from an adult caretaker, and having been assaulted or injured by weapon when on the street. The multiplicative interaction between sexual abuse by caretaker and sexual assault when the adolescents were on their own was statistically significant, indicating that rape victims were highly likely to meet criteria for PTSD regardless of early sexual abuse. At very high levels of early sexual abuse, the probability of meeting criteria for PTSD converges with that for sexual assault victims. Keywords: homeless adolescents; runaways; victimization; posttraumatic stress

This study examined differences in male-perpetrated adult sexual assault experiences among women of various sexual orientations using a large urban convenience sample (N = 1,022). Results showed many similarities in disclosure to others, perceived helpfulness, and attributions of blame, but there were also differences by sexual orientation. Heterosexual women were more likely to experience completed sexual assault than lesbian or bisexual women. Lesbians were more likely to be assaulted by relatives than bisexual or heterosexual women. Finally, bisexual women disclosed the assault to the greatest number of formal support sources, were most likely to tell a romantic partner about the assault, received the fewest positive social reactions overall, and had higher posttraumatic stress disorder (PTSD) symptomatology. Keywords: violence against women; lesbian; bisexual women

The authors examine the relationship between 2 separate but interrelated findings in the epidemiology of posttraumatic stress disorder (PTSD): women's greater PTSD risk following traumatic events and the sensitizing effects of a prior trauma on the PTSD response to a subsequent trauma. Data come from a representative sample of 1,698 young adults from a large U.S. city. Analysis was conducted on the subset exposed to traumatic events. Women's risk for PTSD following assaultive violence was higher than men's. When assaultive violence preceded a later nonassaultive trauma in women, there was an increased risk (relative risk = 4.9) for PTSD, which was not observed in men. The relative risk estimate in women was significantly higher than in men. These findings suggest that assaultive violence elicits women's PTSD response directly and by sensitizing them to the effects of subsequent traumatic events of lesser magnitude. Keywords: PTSD, gender differences, prior trauma, assaultive violence

There is a great deal of speculation about why women are at greater risk than men for being diagnosed with PTSD. Among the plausible arguments are (1) differences in the types of trauma experienced, (2) inflated rates due to methodological gender bias, (3) socially defined social roles and confounding stressors, (4) biological differences, and (5) differences in cognitive perceptions of traumatic events. The following conceptual study outlines and disputes these arguments using relevant research findings and logical reasoning, while paying particular attention to how the arguments interplay in feminist therapy, doi:10.1300/J015v30n01_05 KEYWORDS. Post-traumatic stress disorder, gender differences, women

This study examines the impact of exposure to ongoing terrorism on 695 Israeli high school students. Exposure was measured using a questionnaire developed for the security situation in Israel. Posttraumatic symptoms were measured using the UCLA PTSD Index for DSM-IV--Adolescent Version (N. Rodriguez, A. Steinberg, & R. S. Pynoos, 1999), functional impairment and somatic complaints were assessed using items derived from the Diagnostic Interview Schedule for Children (C. P. Lucas et al., 2001), and depression was measured with the Brief Beck Depression Inventory (A. T. Beck & R. W. Beck, 1972). According to the criteria of the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994), the prevalence of probable posttraumatic stress disorder was 7.6%. Girls reported greater severity of posttraumatic symptoms, whereas boys exhibited greater functional impairment in social and family domains. School-based screening appears to be an effective means of identifying adolescents who have been exposed to terror and are experiencing posttraumatic stress symptomatology and psychosocial impairment. Keywords: posttraumatic stress disorder, functional impairment, terrorism, screening, adolescents

This study examined gender differences in levels of violence exposure, and in levels of posttraumatic stress (PTS) and related symptomatology in a sample of inner-city predominantly African American youth. Because such youth are at risk for exposure to chronic community violence, they are likely to experience considerable distress and clinical or subclinical levels of posttraumatic stress and related symptoms. Previous research has found that although boys are exposed to violence more frequently than are girls, girls are more likely to express posttraumatic stress and related symptoms as a result of violence exposure. Thus, we examined gender as a moderator of the relation between violence exposure and symptoms. A stronger positive association of anxiety and depression symptoms with extent of community violence exposure for girls than boys was found. It was also found that while girls do not appear to differ in their responses to witnessing violence versus being a victim of violence, boys appear to be more distressed by being a victim of violence than by witnessing violence. KEY WORDS: community violence; gender differences; posttraumatic stress.

Context: Treating high-risk substance abusers who are members of minority groups may require varied protocols depending on differences among minority groups. Objectives: To explore cocaine abuse (CA)/ dependence with physiological dependence (CDPD) and posttraumatic stress disorder (PTSD) diagnosis differences between out-of-treatment Hispanic and African American adults, in order to identify cultural differences in how experiences and attitudes affect cocaine use behaviors. Design, Setting, and Participants: This study uses data collected between February and November 2000, as part of a three-year longitudinal study. A cohort of 347 out-of-treatment, Hispanic and African American cocaine-using adults from the Houston metropolitan area were interviewed to measure differences between cocaine users who are dually diagnosed and those that are not. Main Outcome Measures: Meeting the Diagnostic and Statistical Manual of Mental Disorders, 4th ed. criteria for dual diagnoses of CA/PTSD or CDPD/ PTSD. Results: For the dual diagnoses categories, 102 (29%) participants met the requirements for CA/PTSD or CDPD/PTSD. Logistic regression models were used, with CA/PTSD and CDPD/PTSD as the dependent variables. Age, race, gender, and income were used as the independent variables. Results indicate that individuals with higher income have a greater probability of developing CA/PTSD ([beta] = 0.919, p < 0.05). For both dual diagnoses categories of CA/PTSD and CDPD/ PTSD, results indicate that being female increases the likelihood of developing both of these dual diagnoses, ([beta] = 2.106, p < 0.05) or ([beta] = 2.510, p Key Words: African-American; Drug user; Hispanic; Post traumatic stress disorder; PTSD., INTRODUCTION Numerous research studies reflect a strong relationship between substance use and posttraumatic stress disorder (PTSD) (1-11), especially among those individuals who use cocaine in its various forms. The bulk [...]

Immigrants to the US from Mexico, Central and South America may have mental health problems caused by exposure to violence in their native country, according to a survey of 638 Latino immigrants in Los Angeles, California. About half had been exposed to political violence in their native country. Thirty-six percent had symptoms of depression and 18% had symptoms of post-traumatic stress disorder.

Male violence is an enduring feature of women's lives from childhood through old age. The review covers child sexual abuse, rape, and partner violence with emphasis on the prevalence of violence, its mental health consequences, the course of recovery, and mediators and moderators of traumatic impact. The primary focus is depression and post-traumatic stress disorder, the two major diagnostic entities through which postassault emotions and behaviors have been conceptualized and measured. The effects of psychiatric conceptualizations of victimization and patterns of individual recovery are critically reviewed. The PTSD paradigm as the sole foundation for most victimization research is also debated. Following the review, mental health services for victimized women are examined. The article concludes with public policy recommendations to improve the availability and accessibility of mental health services with emphasis on reaching those survivors who are less likely to consult the formal system.

The harm of prostitution is socially invisible, and it is also invisible in the law, in public health, and in psychology. This article addresses origins of this invisibility, how words in current usage promote the invisibility of prostitution's harm, and how public health perspectives and psychological theory tend to ignore the harm done by men to women in prostitution. Literature which documents the overwhelming physical and psychological harm to those in prostitution is summarized here. The interconnectedness of racism, colonialism, and child sexual assault with prostitution is discussed. [Article copies available for a fee from The Haworth Document Delivery Service: 1-800-HAWORTH. E-mail address: Website: [c] 2003 by The Haworth Press, Inc. All rights reserved.] KEYWORDS. Prostitution, domestic violence, rape, PTSD, torture

This study examined posttraumatic stress disorder (PTSD) symptom severity in Hispanic immigrants exposed to September 11th attacks through television, ascertained the relationship between previous traumatic exposure and September 11th-related symptoms, and investigated the effect of television exposure of the attacks on symptoms. A total of 110 Hispanic immigrant adults (22 males, 88 females) living more than 1,000 miles from the attacks completed measures of natural disaster exposure, war violence exposure, and September 11th-related PTSD symptoms. Of the sample, 14% self-reported September 11th-related PTSD symptoms consistent with a Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) diagnosis. Previous exposure to natural disasters and war violence was significantly related to September 11th--related PTSD symptomatology. Individuals with symptoms consistent with a DSM-IV PTSD diagnosis reported twice as much war violence exposure and one-and-a-half times as much natural disaster exposure as those not meeting criteria. Results are discussed regarding potential public health implications. Keywords: PTSD; September 11th; terrorism; Hispanic immigrants; previous traumatic exposure

26 sailors who survived a Kamikaze attack during the battle for Okinawa in World War II were given two adapted forms of the Posttraumatic Stress Disorder Checklist-Civilian to assess the psychological reactions they had to the sinking of their ship. Depending on the assessment criteria used, their responses indicated significant stress reactions ranging from 8.3% to 44% of the sample. The findings provide evidence that a single combat experience can have lifelong, averse psychological effects.

This article examines psychiatric problems of opiate and cocaine dependent pregnant women with and without post-traumatic stress disorder (PTSD). The authors maintain drug dependent pregnant women with PTSD were more likely to have attempted suicide, more likely to have been sexually abused, and more likely to have had more previous drug treatments than drug dependent pregnant women without PTSD.

We examined data from a community survey of trauma exposure and DSM-IV PTSD in Winnipeg, Canada to explore factors associated with the higher rate of PTSD in women than men. Women were found to be at significantly increased risk for PTSD following exposure to serious trauma (odds ratio approximately 5), even when sexual trauma - which predominates in women - was excluded (odds ratio approximately 3). Adjusting for gender differences in the number of lifetime traumata, or in the likelihood of the trauma being associated with particular reactions to or consequences of the event (i.e. thinking that one would be killed or seriously injured; sustaining a serious physical injury; seeing someone else seriously injured or killed) did not result in a lessening of the PTSD risk in women. Women were found to be at increased risk for PTSD following nonsexual assaultive violence (e.g. mugging or other physical attack) but not following nonassaultive trauma (e.g. fire, witnessing injury to others). Understanding the basis of (and parameters for) this increased susceptibility to PTSD in women compared to men following trauma exposure should be a priority for future traumatic stress research.