Dataset Information

Accounting for sex differences in PTSD: A multi-variable mediation model.

ABSTRACT:

Background

Approximately twice as many females as males are diagnosed with posttraumatic stress disorder (PTSD). However, little is known about why females report more PTSD symptoms than males. Prior studies have generally focused on few potential mediators at a time and have often used methods that were not ideally suited to test for mediation effects. Prior research has identified a number of individual risk factors that may contribute to sex differences in PTSD severity, although these cannot fully account for the increased symptom levels in females when examined individually.

Objective

The present study is the first to systematically test the hypothesis that a combination of pre-, peri-, and posttraumatic risk factors more prevalent in females can account for sex differences in PTSD severity.

Method

The study was a quasi-prospective questionnaire survey assessing PTSD and related variables in 73.3% of all Danish bank employees exposed to bank robbery during the period from April 2010 to April 2011. Participants filled out questionnaires 1 week (T1, N=450) and 6 months after the robbery (T2, N=368; 61.1% females). Mediation was examined using an analysis designed specifically to test a multiple mediator model.

Results

Females reported more PTSD symptoms than males and higher levels of neuroticism, depression, physical anxiety sensitivity, peritraumatic fear, horror, and helplessness (the A2 criterion), tonic immobility, panic, dissociation, negative posttraumatic cognitions about self and the world, and feeling let down. These variables were included in the model as potential mediators. The combination of risk factors significantly mediated the association between sex and PTSD severity, accounting for 83% of the association.

Conclusion

The findings suggest that females report more PTSD symptoms because they experience higher levels of associated risk factors. The results are relevant to other trauma populations and to other trauma-related psychiatric disorders more prevalent in females, such as depression and anxiety.

SUBMITTER: Christiansen DM

PROVIDER: S-EPMC4300366 | biostudies-literature | 2015

REPOSITORIES: biostudies-literature

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Publications

Accounting for sex differences in PTSD: A multi-variable mediation model.

Christiansen Dorte M DM Hansen Maj M

European journal of psychotraumatology 20150119

<h4>Background</h4>Approximately twice as many females as males are diagnosed with posttraumatic stress disorder (PTSD). However, little is known about why females report more PTSD symptoms than males. Prior studies have generally focused on few potential mediators at a time and have often used methods that were not ideally suited to test for mediation effects. Prior research has identified a number of individual risk factors that may contribute to sex differences in PTSD severity, although thes ...[more]

PMID: 25604705

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Project description:BackgroundPost-traumatic stress disorder (PTSD) affects men and women differently. Not only are women twice as likely as men to develop PTSD, they experience different symptoms and comorbidities associated with PTSD. Yet the dearth of preclinical research on females leaves a notable gap in understanding the underlying neuropathology of this sex difference.MethodsUsing two standard measures of PTSD-like responses in rats, the acoustic startle response (ASR) and dexamethasone suppression test (DST), we tested the effects of traumatic stress in adult male and female rats using two rodent models of PTSD, single prolonged stress and predator exposure. We then examined the neural correlates underlying these responses with cFos and glucocorticoid receptor immunohistochemistry in brain regions implicated in the traumatic stress response.ResultsWe now report that adult male and female rats across two models of PTSD show consistent sex-specific responses that recapitulate fundamental differences of PTSD in men and women. Trauma-exposed males showed the well-established hyper-responsive phenotype of enhanced ASR and exaggerated negative feedback control of the hypothalamic-pituitary-adrenal axis, while the same traumatic event had little effect on these same measures in females. Dramatic sex differences in how trauma affected cFos and glucocorticoid receptor expression in the brain lend further support to the idea that the trauma response of male and female rats is fundamentally different.ConclusionsTwo standard measures, ASR and DST, might suggest that females are resilient to the effects of traumatic stress, but other measures make it clear that females are not resilient, but simply respond differently to trauma. The next important question to answer is why. We conclude that males and females show fundamentally different responses to trauma that do not simply reflect differences in resilience. The divergent effects of trauma in the brains of males and females begin to shed light on the neurobiological underpinnings of these sex differences, paving the way for improved diagnostics and therapeutics that effectively treat both men and women.

Project description:This article describes the data, data flows, and spreadsheet implementations for linking multi-level contribution margin accounting as a subsystem in cost accounting with several versions of a multi-level fixed-charge problem (MLFCP), the latter based on the optimization approach in operations research. This linkage can reveal previously hidden optimization potentials within the framework of multi-level contribution margin accounting, thus providing better information for decision making in companies and other organizations. For the data, plausible fictitious values have been assumed taking into consideration the calculation principles in cost accounting where applicable. They include resource-related data, market-related data, and data from cost accounting needed to analyze the profitability of a company´s products and organizational entities in the presence of hierarchically structured fixed costs. The data are processed and analyzed by means of mathematical optimization techniques and sensitivity analysis. The linkage between multi-level contribution margin accounting and MLFCP is implemented in three spreadsheet files, including versions for deterministic optimization, stochastic optimization, and robust optimization. This paper provides specifications for compatible solver add-ins and for executing sensitivity analysis. The data and spreadsheet implementations described in this article were used in a research article entitled "Making better decisions by applying mathematical optimization to cost accounting: An advanced approach to multi-level contribution margin accounting" [1]. The data sets and the spreadsheet implementations may be reused a) by researchers in management and cost accounting as well as in operations research and quantitative methods for verification and for further development of the linkage concept and of the underlying optimization models; b) by practitioners for gaining insight into the data requirements, methods, and benefits of the proposed linkage, thus supporting continuing education; and c) by instructors in academia who may find the data and spreadsheets valuable for classroom use in advanced courses. The complete spreadsheet implementations in the form of three ready-to-use Excel files (deterministic, stochastic, and robust version) are available for download at Mendeley Data. They may serve as customizable templates for various use cases in research, practice, and education.

Dataset Information

Accounting for sex differences in PTSD: A multi-variable mediation model.

Background

Objective

Method

Results

Conclusion

Publications

Accounting for sex differences in PTSD: A multi-variable mediation model.

Similar Datasets

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