Females Who Have Experienced Assaultive Violence are Three Times More Likely than Males to Suffer from Post-Traumatic Stress Disorder

NEW YORK CITY, Dec. 15 ??? Males are nearly twice as likely as females to experience assaultive violence between first grade and the age of 21, but females who???ve endured such trauma are three times likelier to suffer from post-traumatic stress disorder (PTSD), according to a new study in the December issue of the Journal of Urban Health: Bulletin of The New York Academy of Medicine, a quarterly peer-reviewed journal.

Researchers led by Naomi Breslau, Ph.D., a Professor in the Department of Epidemiology at the Michigan State University College of Human Medicine, recruited 2,311 high-risk youths in the mid-1980s as they entered first grade in 19 public schools in a large mid-Atlantic city. Nearly 75 percent of the youths were re-recruited upon reaching a mean age of 21 and agreed to be interviewed about their lifetime history of trauma and PTSD.

Sixty-two percent of males said they had experienced assaultive violence??? including being shot, stabbed, badly beaten, mugged, threatened with a weapon, raped, sexually assaulted, or kidnapped. While 33.7 percent of females had these experiences, their PTSD risk was more than three times higher than in males (23.5 percent and 7.1 percent, respectively) following assaultive violence. Females??? PTSD risk remained significantly higher (12.7 percent) than males??? (4.7 percent) even after excluding rape and other sexual assault. ???What???s important for future research is to look at it in more detail and figure out why PTSD risk is higher for females,??? Breslau said.

Other intriguing findings in the Journal include:

-Surprisingly few parents know basic facts about child pedestrian safety and nearly half wrongly believe that children younger than 10 could safely cross streets alone, two factors that may be placing their children at unnecessary risk of traffic accidents.

A research team led by Andrea C. Gielen, Sc.D., Sc.M., of the Johns Hopkins Bloomberg School of Public Health Center for Injury Research and Policy surveyed 732 parents from four urban elementary school neighborhoods. The neighborhoods had both low and high levels of income and child injury risk. Only 16 percent of the parents knew basic child pedestrian safety facts, such as that kids are most likely to be hit by a car in the middle of a block. Another 46 percent erroneously believed that children younger than 10 could safely cross streets alone. Parents in lower income, high-risk neighborhoods were least likely to let their children walk to school either alone or with an adult, citing unpleasant walking environments and concerns about drug dealers, crime, violence and trash.

As childhood obesity in America spirals out of control, walkable neighborhoods need to be promoted, the authors write. But children must be protected from injury risk, such as by having safe walking routes and play areas, and by ensuring that parents have the proper knowledge about safety practices and risk. ???Promoting physical activity in urban neighborhoods, especially lower income ones, must address concerns about the physical and social environment,??? Gielen said. Among children ages 0-9 in the United States, pedestrian crashes caused 10,000 injuries and 270 deaths in 2001. The rate of these traffic-related pedestrian deaths has declined in the last two decades, but that is partly because children are more sedentary and fewer are walking to school.

-People who attempted to buy sterile syringes from pharmacies in four states were refused one-third of the time, even though purchase of syringes without a prescription is legal in those and most other states. This does not bode well for HIV prevention, since injection drug users who purchase sterile syringes are less likely to share needles and spread blood-borne diseases.

Of 1,600 overall syringe purchase attempts by research assistants whom all had a prior history of drug use, 35 percent were refused, researchers found. In Colorado, 25 percent of purchases were refused; in Connecticut, 28 percent; in Kentucky, 41 percent; and in Missouri, 47 percent. Urban settings had higher rates of refusal than rural settings (40 and 31 percent, respectively).

While no specific laws prohibit pharmacies from selling syringes in the four states, each state has a different level of permissiveness. Connecticut allows prescription-free sale of syringes (one of the few states that does so), for example, while Missouri gives individual pharmacies the power to set their own policies. That makes it easy for pharmacists to refuse to sell syringes to suspected drug users or to demand a prescription.

"As a way to reduce the spread of HIV, pharmacy syringe purchase without prescription is a promising alternative to needle exchange, but pharmacies and pharmacists often erect barriers to such purchase," said lead author Wilson M. Compton, M.D., of the Washington University in St. Louis School of Medicine. "We need to study educational strategies to enhance the willingness of pharmacies and pharmacists to engage more fully in these and other HIV prevention activities." Since Jan. 2001, New York State has been testing a policy of allowing syringe sales at pharmacies without a prescription.

The Journal of Urban Health is published quarterly for The New York Academy of Medicine. The Academy, one of the country???s premier urban health policy and intervention centers, focuses on enhancing the health of people living in cities through research, education, advocacy, and prevention. Visit us online.

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Posted on December 15, 2004

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