ABSTRACT
Lifetime prevalence rates of depression are higher in women than men. Because this gender disparity appears after the onset of puberty and declines after menopause, gonadal hormones may play a role in women's increased vulnerability to dysphoric states. Estrogens have powerful effects beyond their role in reproduction. Fluctuations in estrogen occur naturally throughout the reproductive years and can be associated with disruptions in mood. Treatment for depression with exogenous estrogen has produced equivocal results. To shed light on the complex interactions among estrogens, serotonin, and mood, we briefly examine (a) central serotonin systems and their relationship to mood and mood disorders, (b) nonreproductive effects of estrogens on those systems, (c) potential points of intersection between serotonin systems and estrogens, and (d) research into the use of exogenous estrogen in depression in women. In conclusion, we reiterate the call for carefully controlled research into the etiology and treatment of depression in women.
Subject(s)
Estradiol/physiology , Mood Disorders/physiopathology , Serotonin/physiology , Affect/drug effects , Affect/physiology , Estrogen Replacement Therapy/psychology , Female , Humans , Mood Disorders/drug therapy , Receptors, Serotonin/physiologyABSTRACT
TOPIC: The aim of this three-part series is to examine the sufficiency of the posttraumatic stress (PTSD) diagnostic construct to capture the full spectrum of human responses to psychological trauma. Part I (Lasiuk & Hegadoren, 2006a) reviewed the conceptual history of PTSD from the nineteenth century to its inclusion in the third edition of the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 1980), while Part II (Lasiuk & Hegadoren, 2006b) described subsequent refinements to the original PTSD diagnostic criteria and highlighted subsequent controversies. PURPOSE: This paper focuses on interpersonal violence (sexual, physical, and emotional abuse/assault) and its sequelae in women. We argue in support of Judith Herman's (1992) conceptualization of the human trauma response as a spectrum, anchored at one end by an acute stress reaction that resolves on its own without treatment, and on the other by "complex" PTSD, with "classic" or "simple" PTSD somewhere between the two. SOURCES OF INFORMATION: he existing theoretical, clinical and research literatures related to humans responses to trauma. CONCLUSION: The paper concludes with a call for the need to increase a gendered perspective in all aspects of trauma research and clinical service delivery.
Subject(s)
Health Status , Interpersonal Relations , Stress Disorders, Post-Traumatic/psychology , Violence/psychology , Women's Health , Women/psychology , Diagnostic and Statistical Manual of Mental Disorders , Escape Reaction/physiology , Female , Global Health , Health Services Needs and Demand , Humans , Hypothalamo-Hypophyseal System/physiopathology , Life Change Events , Mental Health , Mental Health Services/organization & administration , Pituitary-Adrenal System/physiopathology , Self Concept , Stress Disorders, Post-Traumatic/diagnosis , Stress Disorders, Post-Traumatic/epidemiology , Stress Disorders, Post-Traumatic/physiopathology , Stress Disorders, Post-Traumatic/therapy , Violence/statistics & numerical data , Women's Health Services/organization & administration , World Health OrganizationABSTRACT
TOPIC: The impairment associated with posttraumatic stress disorder (PTSD) carries with it staggering costs to the individual, to the family, and to society as a whole. Although there is strong evidence that gender plays a significant role in responses to stress and trauma, gender specificity is still not well incorporated into clinical or research work in the area of PTSD. PURPOSE: This is the second of three articles examining the sufficiency of the current PTSD construct to articulate the full spectrum of human responses to trauma. This article chronicles ongoing refinements to the original PTSD criteria and the subsequent controversies. SOURCE OF INFORMATION: Existing bodies of theoretical and research literature related to the effects of trauma. CONCLUSION: In a third article we will review evidence supporting the existence of a more complex posttraumatic stress reaction associated with interpersonal trauma (physical/sexual abuse/assault).
Subject(s)
Psychiatric Status Rating Scales , Stress Disorders, Post-Traumatic/classification , Stress Disorders, Post-Traumatic/diagnosis , Humans , United StatesABSTRACT
TOPIC: Posttraumatic Stress Disorder (PTSD) is a significant health problem, characterized by high rates of chronicity and comorbidity. PURPOSE: This is the first of three articles examining the sufficiency of the current PTSD construct to articulate the spectrum of human responses to trauma, in particular as it relates to women and interpersonal trauma. This paper reviews the conceptual history of PTSD from the nineteenth century up to its inclusion in the DSM-III (American Psychiatric Association, 1980). SOURCES OF INFORMATION: Existing bodies of theoretical and research literature related to the effects of trauma. CONCLUSION: Although there is strong evidence that gender plays a role in responses to stress and trauma, gender specificity is not well-incorporated into clinical services or research in the area of PTSD.
