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Biological Research For Nursing, Vol. 7, No. 1, 44-54 (2005)
DOI: 10.1177/1099800405276709

Biological Underpinnings of Health Alterations in Women With PTSD: A Sex Disparity

Jessica M. Gill, RN, MSN, CRNP

Johns Hopkins University School of Nursing, Baltimore, MD, jgill{at}son.jhmi.edu

Sarah L. Szanton, RN, MSN, CRNP

Johns Hopkins University School of Nursing, Baltimore, MD

Gayle G. Page, RN, DNSc, FAAN

Johns Hopkins University School of Nursing, Baltimore, MD

Women develop posttraumatic stress disorder (PTSD) at twice the rate of men, even though fewer women than men experience traumatic events over their lifetimes. Current studies of individuals with PTSD provide evidence of alterations in the neuroendocrine system that involve levels and activity of cortisol and DHEA and changes in immune function that predispose these individuals toward an innate (Th1) immune response. Yet few studies have addressed the possible role of these biologic alterations in women’s increased vulnerability to developing PTSD. In addition, current studies are limited in their ability to link biologic alterations to the observed fourfold increase in medical conditions in women with PTSD as compared to women without PTSD. And finally, few studies have addressed the biologic impact of co-occurring major depressive disorder (MDD) in individuals with PTSD. This critical review provides an update on neuroendocrine and immune perturbations associated with PTSD with and without cooccurring MDD to suggest links to health and possible mechanisms underlying the observed sex disparity in the development of PTSD.

Key Words: PTSD • depression • neuroendocrine • immune • health disparities • women’s health


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