Accounting for sex differences in PTSD: A multi-variable mediation model

Figures & data

Table 1 Descriptive statistics and sex differences in mediators and PTSD severity

	Females		Males
	M	SD	M	SD	T	Cohen's d
PTSD severity	26.77	8.30	22.54	6.60	5.41***	0.564
Neuroticism	14.02	7.98	9.30	6.98	5.80***	0.630
Depression	20.39	5.89	18.10	4.54	4.18***	0.435
Physical anxiety sensitivity	5.30	5.40	3.97	5.01	2.38*	0.319
Psychological anxiety sensitivity	2.37	2.72	1.90	2.52	1.68	0.179
Social anxiety sensitivity	3.11	2.37	3.28	2.34	−0.69	−0.072
Fear, horror, helplessness	1.08	1.00	0.52	0.81	5.83***	0.615
Tonic immobility	8.76	7.25	5.53	5.66	4.77***	0.497
Peritraumatic panic	12.58	12.80	5.41	6.67	7.04***	0.703
Peritraumatic dissociation	18.74	8.07	14.71	4.81	6.00***	0.607
Negative thoughts about self	1.64	0.74	1.35	0.41	4.85***	0.485
Negative thoughts about the world	2.45	1.16	2.07	0.99	3.18**	0.352
Self-blame	1.80	0.95	1.93	1.06	−1.23	−0.129
Feeling let down	2.16	1.83	1.76	1.48	2.26*	0.240

*p<0.05; **p<0.005; ***p<0.001.

Table 2 Correlations between pre-, peri- and posttraumatic risk factors and PTSD severity (Pearson's r)

		1	2	3	4	5	6	7	8	9	10	11	12	13
1.	PTSD severity
2.	Neuroticism	0.45***
3.	Depression	0.39***	0.71***
4.	Physical AS	0.33***	0.29***	0.23***
5.	Psychological AS	0.38***	0.38***	0.39***	0.68***
6.	Social AS	0.27***	0.18***	0.25***	0.48***	0.43***
7.	A2	0.46***	0.30***	0.26***	0.31***	0.33***	0.16**
8.	Tonic immobility	0.38***	0.31***	0.30***	0.27***	0.40***	0.23***	0.54***
9.	Peritraumatic panic	0.51***	0.37***	0.41***	0.43***	0.47***	0.26***	0.63***	0.51***
10.	Peritraumatic dissociation	0.42***	0.32***	0.32***	0.29***	0.39***	0.28***	0.49***	0.50***	0.64***
11.	Neg. cog. about self	0.61***	0.58***	0.55***	0.31***	0.48***	0.29***	0.37***	0.38***	0.49***	0.44***
12.	Neg. cog. about others	0.49***	0.41***	0.37***	0.31***	0.37***	0.28***	0.33***	0.30***	0.42***	0.37***	0.62***
13.	Self-blame	0.21***	0.11*	0.13*	0.17**	0.17**	0.16**	0.03	0.00	0.16**	0.12*	0.37***	0.35***
14.	Feeling let down	0.21***	0.20***	0.27***	0.15**	0.21***	0.10	0.18**	0.15**	0.29***	0.17**	0.27***	0.21***	0.06

*p<0.05; **p<0.01; ***p<0.001.

AS: anxiety sensitivity; A₂: peritraumatic fear, horror, and helplessness; neg. cog.: negative cognitions.

Fig. 1 Illustration of a multiple mediation model of sex differences in PTSD. Path c represents the total effect. Path c′ represents the direct effect. Paths a + b represent the indirect effect of sex on PTSD through the mediators. The strength of the mediation is the difference between c and c′. Mediation occurs when path c is statistically significant but becomes non-significant after adjusting for the mediators, resulting in a non-significant path c′.

Table 3 Mediation analysis of sex differences in PTSD severity: Indirect effects of sex on PTSD severity through the 10 mediators

				Bootstrapping
		Product of coefficients		Percentile 95% CI		BC 95% CI		BCa 95% CI
	Point estimate	SE	Z	Lower	Upper	Lower	Upper	Lower	Upper
Neuroticism	−0.4290	0.2847	−1.5065	−1.0716	0.1499	−1.0964	0.1268	−1.0878	0.1289
Depression	0.1083	0.1890	0.5732	−0.3204	0.5707	−0.2737	0.6191	−0.2747	0.6164
Physical anxiety sensitivity	−0.1081	0.0986	−1.0967	−0.4016	0.0683	−0.4554	0.0440	−0.4556	0.0436
Fear, horror, helplessness	−0.6846	0.2689	−2.5459	−1.3740	−0.0568	−1.4697	−0.1243	−1.5440	−0.1568
Tonic immobility	−0.0866	0.1843	−0.4698	−0.5440	0.3258	−0.5393	0.3296	−0.5196	0.3507
Peritraumatic panic	−0.6429	0.3291	−1.9532	−1.4372	0.1152	−1.4989	0.0694	−1.5470	0.0419
Peritraumatic dissociation	−0.0501	0.2372	−0.2113	−0.6064	0.4945	−0.6139	0.4861	−0.6187	0.4846
Negative thoughts about self	−1.2226	0.3534	−3.4594	−2.1018	−0.4991	−2.1672	−0.5482	−2.2518	−0.5867
Negative thoughts about the world	−0.2931	0.1614	−1.8160	−0.6766	−0.0225	−0.7309	−0.0455	−0.7338	−0.0463
Feeling let down	−0.0151	0.0734	−0.2059	−0.1907	0.1600	−0.2160	0.1377	−0.2173	0.1353
Total	−3.4238	0.6042	−5.6671	−4.5262	−2.3321	−4.6078	−2.3949	−4.6264	−2.4040