What Does Sex Have to Do with It? The Role of Sex as a Biological Variable in the Development of Posttraumatic Stress Disorder

Sara L. Kornfield, Liisa Hantsoo, C. Neill Epperson

Research output: Contribution to journalReview articlepeer-review

Abstract

Purpose of Review: This review highlights the neurobiological aspects of sex differences in posttraumatic stress disorder (PTSD), specifically focusing on the physiological responses to trauma and presents evidence supporting hormone and neurosteroid/peptide differences from both preclinical and clinical research. Recent Findings: While others have suggested that trauma type or acute emotional reaction are responsible for women’s disproportionate risk to PTSD, neither of these explanations fully accounts for the sex differences in PTSD. Sex differences in brain neurocircuitry, anatomy, and neurobiological processes, such as those involved in learning and memory, are discussed as they have been implicated in risk and resilience for the development of PTSD. Gonadal and stress hormones have been found to modulate sex differences in the neurocircuitry and neurochemistry underlying fear learning and extinction. Summary: Preclinical research has not consistently controlled for hormonal and reproductive status of rodents nor have clinical studies consistently examined these factors as potential moderators of risk for PTSD. Sex as a biological variable (SABV) should be considered, in addition to the endocrine and reproductive status of participants, in all stress physiology and PTSD research.

Original languageEnglish (US)
Article number39
JournalCurrent psychiatry reports
Volume20
Issue number6
DOIs
StatePublished - Jun 1 2018
Externally publishedYes

Keywords

  • Gonadal hormones
  • Neurobiology
  • Neurocircuitry
  • Posttraumatic stress disorder (PTSD)
  • Sex as a biological variable (SABV)
  • Stress physiology

ASJC Scopus subject areas

  • Psychiatry and Mental health

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