There’s a perception that posttraumatic stress disorder is something suffered by men who go to war. While that is sometimes the case, the disorder is more often experienced by civilians, often women, who have been on the receiving end of sexual and physical violence.
Karestan Chase Koenen, Ph.D. has studied that population for years. A professor of psychiatric epidemiology at the Harvard T.H. Chan School of Public Health, her research focuses on identifying the link between trauma and physical conditions including diabetes, cardiovascular disease (heart disease and stroke), obesity and rheumatoid arthritis.
Back in 2008, Koenen and colleagues began working with data from the Nurses’ Health Study developed by Frank Speizer that involved 121,000 middle-age nurses filling out health questionnaires about lifestyle, nutrition and health habits.
By adding questions about experiences of trauma including rape, the researchers were able to discover that almost every woman had symptoms following rape such as depression, sleeplessness and nightmares but more than half recovered.
They also saw that trauma victims early in life are more likely to experience PTSD after a later trauma.
Koenen’s work also found that PTSD sufferers are 50 percent more likely to have a stroke or heart attack; 36 percent more likely to become overweight or obese and twice as prone to suffer diabetes than the general population.
Other research showed women at greater risk of developing a fatal blood clot disorder called venous thromboembolism if they have been exposed to trauma and PTSD symptoms.
“We’re trying to get at the question: if we treat those with PTSD, will that reduce the risk of chronic disease?” she explained.
“When we treat mental health problems effectively, can we not only see mental health benefits in our patients but in their long term physical health as well?”
Koenen said that question supports the argument to put more resources into mental health research.
In addition to her work in that area, Koenen co-leads the PTSD group of the Psychiatric Genomics Consortium, which is compiling data on thousands of trauma victims to determine whether there is a genetic influence on PTSD.
“People think PTSD is caused by a bad experience. The fact is you have to have a bad experience – a traumatic event – but even when you look at severe experiences such as rape or being a prisoner of war, not everyone develops PTSD,” Koenen said. “There are differences in risk and resilience and genetics is part of understanding those individual differences.”
Long-term, Koenen hopes the data could help professionals who treat the disorder to respond more effectively.
“For psychologists, a couple of the benefits are that a lot participate in the consortium and it is supporting broader research in the field and that if we have better information on the underlying neurobiology, that may help us inform treatment development. But that’s a very long term goal,” she said.
Koenen, also an associate member of the Broad Institute at MIT and Harvard, started her career intending to become a development economist.
But during a stint in the Peace Corps in West Africa, she was raped and developed PTSD.
“When I came home to my parents’ house in New Jersey, I sort of tried to figure out what to do next. In the process of recovering from my own PTSD, I got interested in studying it.”
Twenty years after the rape, in 2011, she saw a 20/20 report on television about Peace Corps volunteers talking about their sexual assaults and the organization’s inadequate response to them.
It spurred her to become an advocate for victims of sexual violence, appearing on national television, writing for several news publications and speaking before the House Foreign Affairs Committee at a hearing about sexual violence and victim blaming.
By Susan Gonsalves