PTSD in the Female Soldier

Psych Central

February 20, 2009 – According to military records, as of September 30, 2008 over 200,000 women were serving on active duty. While women are technically barred from serving in combat, they are serving in support positions in combat areas in greater numbers.

This new role for women in the military brings with it new physical and mental health concerns, namely post-traumatic stress disorder (PTSD) for those exposed to combat-related trauma.

According to the National Institute of Mental Health, PTSD is a condition that develops after a distressing ordeal that involved physical harm or the threat of physical harm. This harm may have happened to the person who develops PTSD or to a friend or loved one, or may have simply been witnessed by the person who develops PTSD.

People with PTSD may suffer flashbacks to the traumatic event, become aggressive or withdrawn, have nightmares, or become emotionally numb or even violent. Symptoms of PTSD usually appear about three months after the traumatic event.

PTSD affects approximately 2.6 percent of the U.S. population. Among military personnel serving in Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF), that percentage climbs as high as 17 percent. In the general population, women suffer from PTSD at almost twice the rate as do men.

Why are women more susceptible to PTSD? Animal models have shown that male and female rats react to stress differently. For example, male rats are more prone to develop memory impairments in response to stressors.

In addition, women have been shown to ruminate over nontraumatic negative events more than men, who tend to use more distraction-based coping techniques. While these behaviors may pose evolutionary advantages for each sex, they also may contribute to the increased incidence of PTSD in women. Surprisingly, female soldiers suffer from PTSD at about the same rate as do male soldiers.

More study is needed to determine whether the degree of trauma experienced by female soldiers is less severe, due to the differences in job assignments.

Because the female combat-exposed soldier is a relatively new phenomenon, little is known about the unique needs and issues facing the female soldier with combat-related PTSD. Studies have shown that the PTSD symptoms of female and male soldiers are different. Female patients report more depressive symptoms than do male patients, and men report more irritability and anger, nightmares, and flashbacks.

The good news for female soldiers suffering from PTSD is that effective treatments are available.

Cognitive processing therapy (CPT) and exposure therapy have shown promise in treating both combat and noncombat-related PTSD. However, not everyone who experiences a trauma seeks treatment.

Women are more likely than men to seek help after a traumatic event and least one study found that women respond to treatment as well as or better than men. This may be because women are generally more comfortable sharing feelings and talking about personal things with others than men.

While the Veterans Administration is developing treatment programs specifically tailored to the unique needs of the female soldier, more and more female soldiers are returning from combat and transitioning into the private health care system.

According to Dr. Dan McCarthy, chief clinical officer of Magellan Health Services, “Behavioral health providers in the private sector have a couple of basic hurdles to overcome in preparing to better serve our nation’s female veterans who may have PTSD.

“The first has to do with regularly obtaining information from women, as they routinely do with men, about their military service and veteran status in order to facilitate follow-up questioning regarding possible military-related traumatic experiences.

“The second has to do with acquiring a greater familiarity with military culture so that private sector treatment can be delivered in a culturally sensitive manner and coordination with Department of Defense and VA resources can be maximized.”

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