New research published in the Journal of International Women’s Studies provides evidence that there are significant differences in the manifestation of post-traumatic stress disorder among combat veterans and sexual assault victims. The authors of the new paper argue that more research is needed to specifically examine PTSD among sexual assault victims.
Common symptoms of PTSD include recurring memories or dreams of the traumatic event and dissociative reactions also known as “flashbacks.” Researchers Jessica Anzalone and her colleagues were interested in investigating differences in chronic pain, addiction, and changes in immune function among combat war veterans and victims of sexual abuse or assault, all of whom have PTSD.
“Because there is little data on women who experience PTSD as a result of sexual assault, researchers and clinicians must rely on what is known from the more abundant research of PTSD in combat war veterans, but the problem, as we have outlined here, is that these findings are not universally transferable,” the researchers wrote.
Examining the total number of studies published prior to March 2019, they found more than 1,100 research articles related to PTSD among veterans but only a little more than 100 articles related to PTSD among sexual assault victims. Studies on PTSD among veterans mostly included male subjects, while studies on PTSD among sexual assault mostly included female subjects.
Results from their analysis show that chronic pain was associated more with combat veterans than with victims of sexual assault. About 50% of the combat veterans who experienced chronic pain were male.
The researchers argue that victims of sexual assault experience different pain than sexual assault victims, writing that the sexual assault victims likely experience pelvic, abdominal, chest, and genital pain. Combat veterans of both sexes are more likely to experience arthritis and lower back pain, as indicated in some of the reviewed articles.
Individuals with PTSD who also struggle with addiction tend to have disrupted dopamine function. Anzalone and colleagues found that veterans who struggle with addiction and PTSD most often abuse opioid substances, which tend to be prescribed to them to treat chronic pain. PTSD is associated with impairment of the prefrontal cortex, which can put veterans at high risk for substance abuse due to poor impulse control.
Anzalone and colleagues also found victims of sexual assault as children who now struggle with PTSD tended to develop sexual compulsions. The authors argue that these sexual compulsions may be a result of the victim’s desire to understand and have control a situation in which they previously did not have control (sexual assault during childhood). Sexual compulsions were more frequently reported by sexual assault victims with PTSD than by combat veterans with PTSD.
Finally, the researchers found that veterans from the Iraq and Afghanistan wars had twice the number of autoimmune diseases compared to the general population and a 51% increase in cases of autoimmune diseases compared to veterans without a psychiatric diagnosis. Veterans with PTSD and a history of sexual trauma had an increased risk for comorbid diagnosis with an autoimmune disease.
Anzalone and colleagues posit that we need a better understanding of disorders that involve stress and inflammation to understand how specific types of trauma are associated with PTSD and the onset of autoimmune diseases. The researchers say there is a need for more research on PTSD resulting from sexual assault.
“The research conducted on veterans contributes to a rich and nuanced understanding of the disease in this population and for those veterans who do experience PTSD, supporting this continued research is essential. However, even the limited research on PTSD in survivors of sexual assault shows us that there are significant differences in the manifestation of the disorder between these two populations,” Anzalone and colleague wrote.
The study, “Differences in Research on Post-Traumatic Stress Disorder: How Trauma-Type and Sex Contribute to the Published Research“, was authored by Jessica Anzalone, Sharon Ramos-Goyette, Marissa Morganelli, and Merideth Krevosky.
