Advertisement

Trauma and Stressor-Related Disorders in Women

  • Andrea Feijó de Mello
  • Mariana Rangel Maciel
  • Sara Motta Borges Bottino
  • José Paulo Fiks
  • Marcelo Feijó de Mello
Chapter
  • 6 Downloads

Abstract

Posttraumatic stress disorder (PTSD) and acute stress disorder (ASD) are the most frequent diagnosis in the Trauma and Stressor-Related Disorders chapter of the Diagnostic and Statistical Manual of Mental Disorders-5th Edition (DSM-5). The present chapter focuses on ASD and PTSD including background, psycho- and physiopathology, diagnosis, and treatment. Women are more likely to develop PTSD than men and the most frequent events reported in surveys to be related to the start of symptomatology are sexual abuse (before the age of 18), and intimate partner violence. Rape is strongly related to the development of PTSD; studies show rates around 40–50% of women developing PTSD after sexual assault. Besides, there are traumatic events specifically related to women, like breast cancer and traumatic delivery that can trigger PTSD symptoms. Given the fact that women usually look for treatment in general practitioner’s services and/or gynecological-related services, it is extremely important that the professionals working at these settings learn to recognize PTSD symptomatology and refer these women to proper treatment.

Keywords

Posttraumatic stress disorder PTSD Acute stress syndrome ASD Sexual assault Interpartner violence Traumatic delivery Breast cancer Violence against women 

References

  1. 1.
    APA. Diagnostic and statistical manual of mental disorders-DSMIII. 3rd ed. Washington, D.C.: American Psychiatric Association; 1980.Google Scholar
  2. 2.
    Herrera-Ferrá K, Giordano J. Re-classifying recurrent violent behavior? Considerations, caveats and neuroethical concerns for psychiatry and social engagement. Acta Psychopathologica. 2016;2:6.CrossRefGoogle Scholar
  3. 3.
    Braga LL, Fiks JP, Mari JJ, Mello MF. The importance of the concepts of disaster, catastrophe, violence, trauma and barbarism in defining posttraumatic stress disorder in clinical practice. BMC Psychiatry. 2008;8:68.PubMedPubMedCentralCrossRefGoogle Scholar
  4. 4.
    Selye H. Stress in health and disease. 1st ed. Boston: Butterworth; 1976.Google Scholar
  5. 5.
    Riboni FVB, Stress C. Psychiatric disorders: from categorical to dimensional approaches. Curr Opin Behav Sci. 2017;14:72–7.CrossRefGoogle Scholar
  6. 6.
    Dorahy MJ, van der Hart O. DSM-5’s posttraumatic stress disorder with dissociative symptoms: challenges and future directions. J Trauma Dissociation. 2015;16(1):7–28.PubMedCrossRefGoogle Scholar
  7. 7.
    Kandel ER, Dudai Y, Mayford MR. The molecular and systems biology of memory. Cell. 2014;157(1):163–86.PubMedCrossRefPubMedCentralGoogle Scholar
  8. 8.
    Luz MP, Coutinho ESF, Berger W, Mendlowicz MV, Vilete LMP, Mello MF, et al. Conditional risk for posttraumatic stress disorder in an epidemiological study of a Brazilian urban population. J Psychiatr Res. 2016;72:51–7.PubMedCrossRefGoogle Scholar
  9. 9.
    American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Arlington: American Psychiatric Publishing; 2013.CrossRefGoogle Scholar
  10. 10.
    Neto JBB, Tiba PA, Faturi CB, de Castro-Neto EF, Naffah-Mazacoratti MD, Maria JD, et al. Stress during development alters anxiety-like behavior and hippocampal neurotransmission in male and female rats. Neuropharmacology. 2012;62(1):518–26.CrossRefGoogle Scholar
  11. 11.
    Gradus JL. Prevalence and prognosis of stress disorders: a review of the epidemiologic literature. Clin Epidemiol. 2017;9:251–60.PubMedPubMedCentralCrossRefGoogle Scholar
  12. 12.
    APA. Diagnostic and statistical manual of mental disorders-DSM-5. Washington, D.C.: American Psychiatric Association; 2013.Google Scholar
  13. 13.
    Mello AF, Yeh MSL. Trauma and stressor related disorders. 1st ed. Oxford: Oxford University Press; 2017.CrossRefGoogle Scholar
  14. 14.
    Krystal JH, Neumeister A. Noradrenergic and serotonergic mechanisms in the neurobiology of posttraumatic stress disorder and resilience. Brain Res. 2009;1293:13–23.PubMedPubMedCentralCrossRefGoogle Scholar
  15. 15.
    Miller GE, Chen E, Zhou ES. If it goes up, must it come down? Chronic stress and the hypothalamic-pituitary-adrenocortical axis in humans. Psychol Bull. 2007;133(1):25–45.PubMedCrossRefPubMedCentralGoogle Scholar
  16. 16.
    Hoge EA, Worthington JJ, Nagurney JT, Chang Y, Kay EB, Feterowski CM, et al. Effect of acute posttrauma propranolol on PTSD outcome and physiological responses during script-driven imagery. CNS Neurosci Ther. 2012;18(1):21–7.PubMedCrossRefPubMedCentralGoogle Scholar
  17. 17.
    Rauch SL, Shin LM, Phelps EA. Neurocircuitry models of posttraumatic stress disorder and extinction: human neuroimaging research--past, present, and future. Biol Psychiatry. 2006;60(4):376–82.PubMedCrossRefPubMedCentralGoogle Scholar
  18. 18.
    Bremner JD, Vermetten E, Schmahl C, Vaccarino V, Vythilingam M, Afzal N, et al. Positron emission tomographic imaging of neural correlates of a fear acquisition and extinction paradigm in women with childhood sexual-abuse-related post-traumatic stress disorder. Psychol Med. 2005;35(6):791–806.PubMedPubMedCentralCrossRefGoogle Scholar
  19. 19.
    Lindauer RJ, Booij J, Habraken JB, Uylings HB, Olff M, Carlier IV, et al. Cerebral blood flow changes during script-driven imagery in police officers with posttraumatic stress disorder. Biol Psychiatry. 2004;56(11):853–61.PubMedCrossRefPubMedCentralGoogle Scholar
  20. 20.
    Shin LM, Orr SP, Carson MA, Rauch SL, Macklin ML, Lasko NB, et al. Regional cerebral blood flow in the amygdala and medial prefrontal cortex during traumatic imagery in male and female Vietnam veterans with PTSD. Arch Gen Psychiatry. 2004;61(2):168–76.PubMedCrossRefPubMedCentralGoogle Scholar
  21. 21.
    Shin LM, Shin PS, Heckers S, Krangel TS, Macklin ML, Orr SP, et al. Hippocampal function in posttraumatic stress disorder. Hippocampus. 2004;14(3):292–300.PubMedCrossRefPubMedCentralGoogle Scholar
  22. 22.
    Lindauer RJ, Olff M, van Meijel EP, Carlier IV, Gersons BP. Cortisol, learning, memory, and attention in relation to smaller hippocampal volume in police officers with posttraumatic stress disorder. Biol Psychiatry. 2006;59(2):171–7.PubMedCrossRefPubMedCentralGoogle Scholar
  23. 23.
    Yehuda R, Golier JA, Tischler L, Harvey PD, Newmark R, Yang RK, et al. Hippocampal volume in aging combat veterans with and without post-traumatic stress disorder: relation to risk and resilience factors. J Psychiatr Res. 2007;41(5):435–45.PubMedCrossRefPubMedCentralGoogle Scholar
  24. 24.
    Schwabe L, Joels M, Roozendaal B, Wolf OT, Oitzl MS. Stress effects on memory: an update and integration. Neurosci Biobehav Rev. 2012;36(7):1740–9.PubMedCrossRefPubMedCentralGoogle Scholar
  25. 25.
    McCormick CM, Thomas CM, Sheridan CS, Nixon F, Flynn JA, Mathews IZ. Social instability stress in adolescent male rats alters hippocampal neurogenesis and produces deficits in spatial location memory in adulthood. Hippocampus. 2012;22(6):1300–12.PubMedCrossRefPubMedCentralGoogle Scholar
  26. 26.
    McEwen BS. The ever-changing brain: cellular and molecular mechanisms for the effects of stressful experiences. Dev Neurobiol. 2012;72(6):878–90.PubMedPubMedCentralCrossRefGoogle Scholar
  27. 27.
    Long VA, Fanselow MS. Stress-enhanced fear learning in rats is resistant to the effects of immediate massed extinction. Stress. 2012;15(6):627–36.PubMedPubMedCentralCrossRefGoogle Scholar
  28. 28.
    Felmingham KL, Tran TP, Fong WC, Bryant RA. Sex differences in emotional memory consolidation: the effect of stress-induced salivary alpha-amylase and cortisol. Biol Psychol. 2012;89(3):539–44.PubMedCrossRefPubMedCentralGoogle Scholar
  29. 29.
    Caetano R, Ramisetty-Mikler S, Field CA. Unidirectional and bidirectional intimate partner violence among White, Black, and Hispanic couples in the United States. Violence Vict. 2005;20(4):393–406.PubMedCrossRefGoogle Scholar
  30. 30.
    Goldstein RB, Smith SM, Chou SP, Saha TD, Jung J, Zhang H, et al. The epidemiology of DSM-5 posttraumatic stress disorder in the United States: results from the National Epidemiologic Survey on Alcohol and Related Conditions-III. Soc Psychiatry Psychiatr Epidemiol. 2016;51(8):1137–48.PubMedPubMedCentralCrossRefGoogle Scholar
  31. 31.
    Mello MF, Faria AA, Mello AF, Carpenter LL, Tyrka AR, Price LH. Childhood maltreatment and adult psychopathology: pathways to hypothalamic-pituitary-adrenal axis dysfunction. Rev Bras Psiquiatr. 2009;31(Suppl 2):S41–8.PubMedPubMedCentralCrossRefGoogle Scholar
  32. 32.
    Ullman SE, Peter-Hagene LC, Relyea M. Coping, emotion regulation, and self-blame as mediators of sexual abuse and psychological symptoms in adult sexual assault. J Child Sex Abus. 2014;23(1):74–93.PubMedCrossRefPubMedCentralGoogle Scholar
  33. 33.
    Elklit A, Christiansen DM. Risk factors for posttraumatic stress disorder in female help-seeking victims of sexual assault. Violence Vict. 2013;28(3):552–68.PubMedCrossRefPubMedCentralGoogle Scholar
  34. 34.
    Luz MP, Coutinho ES, Berger W, Mendlowicz MV, Vilete LM, Mello MF, et al. Conditional risk for posttraumatic stress disorder in an epidemiological study of a Brazilian urban population. J Psychiatr Res. 2016;72:51–7.PubMedCrossRefGoogle Scholar
  35. 35.
    Ferrari G, Agnew-Davies R, Bailey J, Howard L, Howarth E, Peters TJ, et al. Domestic violence and mental health: a cross-sectional survey of women seeking help from domestic violence support services. Glob Health Action. 2016;9(1):29890.PubMedCrossRefPubMedCentralGoogle Scholar
  36. 36.
    Machisa MT, Christofides N, Jewkes R. Mental ill health in structural pathways to women’s experiences of intimate partner violence. PLoS One. 2017;12(4):e0175240.PubMedPubMedCentralCrossRefGoogle Scholar
  37. 37.
    Wang LL, Chang XN, Yang SB, Du YK, Shen M. Relationship between domestic violence and posttraumatic stress disorder among women living in the communities of Wuhan city. Zhonghua Liu Xing Bing Xue Za Zhi. 2016;37(12):1574–7.PubMedPubMedCentralGoogle Scholar
  38. 38.
    O’Connor M, Christensen S, Jensen AB, Moller S, Zachariae R. How traumatic is breast cancer? Post-traumatic stress symptoms (PTSS) and risk factors for severe PTSS at 3 and 15 months after surgery in a nationwide cohort of Danish women treated for primary breast cancer. Br J Cancer. 2011;104(3):419–26.PubMedPubMedCentralCrossRefGoogle Scholar
  39. 39.
    Voigt V, Neufeld F, Kaste J, Buhner M, Sckopke P, Wuerstlein R, et al. Clinically assessed posttraumatic stress in patients with breast cancer during the first year after diagnosis in the prospective, longitudinal, controlled COGNICARES study. Psychooncology. 2017;26(1):74–80.PubMedCrossRefPubMedCentralGoogle Scholar
  40. 40.
    Bottino SMB. Prevalência e impacto do transtorno do estresse pós traumático na qualidade de vida de mulheres recem diagnosticadas com cancer de mama: Universidade de Sao Paulo; 2009.Google Scholar
  41. 41.
    Zambaldi CF, Cantilino A, Sougey B. Parto traumático e transtorno de estresse pós traumático: revisão de literatura. J Bras Psiquiatr. 2009;58(4):252–7.CrossRefGoogle Scholar
  42. 42.
    Ayers S. Delivery as a traumatic event: prevalence, risk factors, and treatment for postnatal posttraumatic stress disorder. Clin Obstet Gynecol. 2004;47(3):552–67.PubMedCrossRefPubMedCentralGoogle Scholar
  43. 43.
    Hoskins M, Pearce J, Bethell A, Dankova L, Barbui C, Tol WA, et al. Pharmacotherapy for post-traumatic stress disorder: systematic review and meta-analysis. Br J Psychiatry. 2015;206(2):93–100.PubMedCrossRefPubMedCentralGoogle Scholar
  44. 44.
    Va/DoD clinical practice guidelines: management of posttraumatic stress disorder and acute stress reaction (2017) [Internet]. 2017 [cited 09092017]. Available from: healthquality.va.gov.
  45. 45.
    Hendriksen H, Olivier B, Oosting RS. From non-pharmacological treatments for post-traumatic stress disorder to novel therapeutic targets. Eur J Pharmacol. 2014;732:139–58.PubMedCrossRefPubMedCentralGoogle Scholar
  46. 46.
    Markowitz JC, Petkova E, Neria Y, Van Meter PE, Zhao Y, Hembree E, et al. Is exposure necessary? A randomized clinical trial of interpersonal psychotherapy for PTSD. Am J Psychiatry. 2015;172(5):430–40.PubMedPubMedCentralCrossRefGoogle Scholar
  47. 47.
    Foa EB, Keane TM, Friedman MJ, Cohen JA. Effective treatments for PTSD, practice guidelines form the International Society of Traumatic Stress Studies. New York: Guilford Press; 2010. p. 658.Google Scholar
  48. 48.
    Gu W, Wang C, Li Z, Wang Z, Zhang X. Pharmacotherapies for posttraumatic stress disorder: a meta-analysis. J Nerv Ment Dis. 2016;204(5):331–8.PubMedCrossRefPubMedCentralGoogle Scholar
  49. 49.
    Ipser JC, Stein DJ. Evidence-based pharmacotherapy of post-traumatic stress disorder (PTSD). Int J Neuropsychopharmacol. 2012;15(6):825–40.PubMedCrossRefPubMedCentralGoogle Scholar
  50. 50.
    Taylor FB, Martin P, Thompson C, Williams J, Mellman TA, Gross C, et al. Prazosin effects on objective sleep measures and clinical symptoms in civilian trauma posttraumatic stress disorder: a placebo-controlled study. Biol Psychiatry. 2008;63(6):629–32.PubMedCrossRefPubMedCentralGoogle Scholar
  51. 51.
    Amos T, Stein DJ, Ipser JC. Pharmacological interventions for preventing post-traumatic stress disorder (PTSD). Cochrane Database Syst Rev. 2014;7:CD006239. https://doi.org/10.1002/14651858.CD006239.pub2.
  52. 52.
    Rose SC, Bisson J, Churchill R, Wessely S. Psychological debriefing for preventing posttraumatic stress disorder (PTSD). Cochrane Database Syst Rev. 2002;2:CD000560. https://doi.org/10.1002/14651858.CD000560.
  53. 53.
    Gelpin E, Bonne O, Peri T, Brandes D, Shalev AY. Treatment of recent trauma survivors with benzodiazepines: a prospective study. J Clin Psychiatry. 1996;57(9):390–4.PubMedPubMedCentralGoogle Scholar
  54. 54.
    Seedat S, Stein DJ, Carey PD. Post-traumatic stress disorder in women: epidemiological and treatment issues. CNS Drugs. 2005;19(5):411–27.PubMedCrossRefPubMedCentralGoogle Scholar
  55. 55.
    Felmingham KL, Bryant RA. Gender differences in the maintenance of response to cognitive behavior therapy for posttraumatic stress disorder. J Consult Clin Psychol. 2012;80(2):196–200.PubMedCrossRefPubMedCentralGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Andrea Feijó de Mello
    • 1
  • Mariana Rangel Maciel
    • 1
  • Sara Motta Borges Bottino
    • 1
  • José Paulo Fiks
    • 1
  • Marcelo Feijó de Mello
    • 1
  1. 1.Department of Psychiatry of the Federal University of São PauloSão PauloBrazil

Personalised recommendations