title: Gender differences of postdeployment post-traumatic stress disorder among service members and veterans of the Iraq and Afghanistan conflicts.
abstract: Despite the marked expansion of roles for women in the US military over the last decade, whether differences by gender exist in regard to the development of mental health conditions postdeployment is unclear. This comprehensive review of the literature (2001-2012) examined whether US servicewomen were more likely than men to experience post-traumatic stress disorder (PTSD) after returning from deployments to the Iraq and Afghanistan conflicts. Findings from 18 studies from 8 unique study populations were reviewed. Seven studies found that women had a higher risk for screening positive for PTSD compared with men, including prospectively designed studies that evaluated new-onset PTSD among members from all service branches. Although results from studies with Veterans Affairs samples found women at decreased risk in 4 analyses, these studies used the same source databases, were conducted in treatment-seeking populations, and were mostly unable to account for combat experience. Seven studies detected no differences by gender. In summary, women appeared to have a moderately higher risk for postdeployment PTSD, although there was a lack of consensus among the studies, and even those with the most rigorous methods were not designed specifically to evaluate potential gender differences. Given the limitations of the published literature, further research should use longitudinal study designs and comprehensive evaluations of deployment experiences while adjusting for predeployment factors to confirm that gender differences exist with regard to postdeployment PTSD.
authors.affiliation: Abbreviations: AOR, adjusted odds ratio; CI, confidence interval; MST, military-related sexual trauma; OEF, Operation Enduring Freedom; OIF, Operation Iraqi Freedom; PCL-C, PTSD Checklist Civilian Version; PTSD, post-traumatic stress disorder; VA, Veterans Administration.
authors.forename: Nancy F
authors.initials: NF
authors.lastname: Crum-Cianflone
authors.forename: Isabel
authors.initials: I
authors.lastname: Jacobson
mesh_terms: D000346:Afghanistan; D003130:Combat Disorders / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006801:Humans; D007493:Iraq; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000523:psychology; D008889:Military Personnel / Q000523:psychology / Q000706:statistics & numerical data*; D016017:Odds Ratio; D015995:Prevalence; D017678:Sex Distribution; D012737:Sex Factors; D012742:Sex Offenses / Q000706:statistics & numerical data; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology* / Q000523:psychology; D014728:Veterans / Q000523:psychology / Q000706:statistics & numerical data*; D014931:Women, Working / Q000523:psychology / Q000706:statistics & numerical data*
keywords: Operation Enduring Freedom; Operation Iraqi Freedom; post-traumatic stress disorder; deployment; gender; health outcomes; military; women