Not only do females experience a greater symptom burden than males but they have a longer course of illness; the median time to remission was 35 months for females, which contrasted to nine months for males. When only traumas experienced directly are examined, the median duration increases to 60 months in females and 24 months in males.
In summary, estimates of the lifetime prevalence of PTSD are approximately twice as high for females as for males. At present, we recognize that the burden of PTSD in females is associated with the unique role of assaultive violence. While males experience somewhat more assaultive violence, females are at far greater risk for PTSD when exposed to such traumatic events. Sex differences with respect to other categories of traumatic events are small. Although females' higher vulnerability to PTSD effects of assaultive violence is, in part, attributable to the higher prevalence of rape, the sex difference persists when this particular event is taken into account. The duration of PTSD symptoms is nearly four times longer in females than males. These differences in duration are largely due to the higher proportion of female PTSD cases attributable to assaultive violence.
Are women at greater risk for PTSD than men? Yes. How can we understand this finding? First of all, it is important to understand that other risk factors known to predispose individuals to PTSD do not demonstrate a sex difference. For example, prior depression predisposes individuals to the later development of PTSD but there is no interaction effect with sex. While we have confirmed and elaborated on a sex difference in the risk for PTSD, new questions have emerged: Why are females more likely to develop PTSD from assaultive violence, and why do females who develop PTSD have a greater burden of symptoms and a longer duration of illness than males who develop PTSD from assaultive violence? Further research is necessary and we can only speculate about the causes. Women are more frequently unwilling victims of violence while men may be active participants (barroom fights, and so forth).
Finally, there is greater physical inequality and injury risk for women than men. Women may experience more helplessness and, thus, have greater difficulty extinguishing the arousal (for example, enhanced startle reflex) and depressive symptoms (restricted affect).