Lecture – PTSD and Women’s Health – Life Course Burden With and Across Generations

Presented by Karestan C. Koenen, PhD, Harvard T.H. Chan School of Public Health – Visiting Scholar Series

“Sadly, many women’s lives are marked by exposure to violence and trauma from early childhood through adolescence and into adulthood,” Koenen says. “My work has been trying to understand this trajectory of trauma in women’s lives and how it relates to their functioning and in the life course from birth until death.”

In this lecture, Koenen reports that more than 50% of the U.S. population has experienced two or more traumatic events, and that some 60% of all people will have been exposed to interpersonal violence and accidents by age 18.

Although men are more likely to experience a traumatic event, women are more likely to experience a “high-impact” event. For example, Koenen states that physical abuse, neglect, sexual abuse, and rape impact women at higher levels than men. Also, far more women are diagnosed with post-traumatic stress disorder (PTSD).

Watch this lecture to learn more about:

• The epidemiology of trauma exposure
• The mechanisms through which trauma/PTSD impacts women’s health over the life span
• Skill training in affective regulation and prolonged exposure (STAIR/PE) to address trauma/PTSD

Drawing on her own work and other research, Koenen reveals the enduring impact of trauma throughout a woman’s lifetime. She cites that women with PTSD often have issues with decreased physical activity, inflammation, and rapid weight gain. Many develop diabetes or show signs of accelerated aging.

The lecture also includes a discussion of the adverse effects of PTSD across generations. Koenen discusses studies showing that children of mothers with PTSD are exposed to more traumatic events and are more likely to have PTSD.

She also reports on research indicating that children of mothers with PTSD are at risk for serious health issues. One study, for example, showed that children of mothers who were abused are more likely to start smoking early and continue at a high volume. Another report found that children of mothers who were abused have higher body mass indexes (BMIs) and higher risk weight trajectories.

To address these issues, Koenen reviews the epidemiology of trauma exposure and empirically supported treatments for PTSD. These treatments involve a combination of skill training in affective regulation and prolonged exposure (STAIR/PE). Prolonged exposure is a cognitive behavioral approach in which trauma patients gradually narrate and reimagine the traumatic experience.