To the Editor:—Posttraumatic stress disorder (PTSD) among women who have experienced assaultive violence is being studied and better understood. Women veterans who have PTSD commonly have fair or poor health, depression, anxiety and disability. This problem is also associated with higher rates of reproductive and substance use disorders.1

A recent publication by Washington, et al. discusses the incidence of PTSD among women Veterans and that a significant segment of this group does not receive mental health care. The majority of women Veterans receive care outside of the US Department of Veterans Affairs (VA) and their healthcare providers may be unaware of the increased risk of PTSD among this patient population. The authors feel that the patients and their providers should be made more aware so that appropriate treatment may be offered.1

Other informative recent articles have explored PTSD in women. Betts, et al. have described a female-specific risk to partial and full PTSD following physical assault. These author postulate that traumatic events affect males and females differently, with females at increased risk for PTSD when controlling for trauma type.2 Inslicht et al. have written about enhanced acquisition of conditioned fear in women with PTSD. They state that stress hormones and neuromodulators may enhance fear conditioning during traumatic stress exposure. Inslicht et al. suggest a sex specific vulnerability to increased fear conditioning from heightened levels of pituitary adenylate cyclase-activating polypeptide, which is modulated by estrogen.3

Physiological changes have been demonstrated by Liberzon et al. They state that PTSD patients have altered regional cerebral blood flow in multiple areas that regulate the hypothalmis-pituitary-adrenal axis, have exaggerated emotional responses and changes in sensitivity to glucocorticoids.4

These important publications focus on the increased incidence of PTSD following assaultive violence, the specific risk to women as well as physiological changes that occur in the patients affected. If physicians are made aware of these facts, they will provide improved care for the patients suffering from this serious problem.1–4