Objective: Posttraumatic stress disorder (PTSD) and substance use disorders are a significant comorbid concern among sexual assault survivors. Thus, underlying risk and protective factors are critical to investigate in understanding how to prevent this comorbidity. Method: The current study assessed potential moderating effects of coping self-efficacy (CSE) and emotion dysregulation on the association between sexual assault-related PTSD symptom severity and drug use severity in a sample of college women. In this study, 518 female undergraduate students completed self-report measures of nonconsensual sexual experiences, PTSD symptoms, CSE, emotion dysregulation, and drug use severity. Results: Of these participants, 287 women reported at least 1 incident of attempted or completed rape. We found evidence of a significant moderation effect, suggesting that high levels of CSE and low levels of emotion dysregulation reduce the likelihood of drug use issues for female sexual assault survivors. Conclusions: These findings suggest that assessment tools, interventions, and trauma-related policies should target CSE and emotion dysregulation in attenuating the risk of drug use for women with assault-related PTSD symptoms. Clinical Impact StatementCollege women are at high risk for sexual violence, a public health crisis which is strongly associated with numerous adverse health outcomes. This study is the first evaluation of the conditional effect of PTSD symptom severity on drug use severity contingent upon the influence of both coping self-efficacy and emotion regulation among a sample of women with a history of rape experiences. These findings provide clear clinical implications for informed assessment and intervention practices for mental health providers, including more comprehensive and tailored interventions to reduce the likelihood of drug use issues for women.

Objective: The COVID-19 pandemic has been conceptualized as a potentially traumatic event, although heterogeneity in experience (e.g., isolation) and in type and severity of traumatic stress response (e.g., hygiene hypervigilance) query the applicability of the posttraumatic stress disorder (PTSD) diagnostic construct. Parallels may be drawn to chronic illness and continuous traumatic situations (CTS) literature, which suggests unique symptom presentations that may occur during cumulative, ongoing traumas. Method: Eighty-four adults completed the PTSD Checklist with appended questions evaluating pandemic index events, temporality of intrusive symptoms, self-appraised abnormality, and context dependence of symptoms. Using exploratory latent profile analysis, we modeled the latent structure of traumatic stress response to COVID-19 in order to evaluate possible nuanced patterns of symptoms differentiating PTSD from a transient ongoing trauma response. Results: Two profiles broadly delineated by severity across all variables emerged, suggesting the framework of PTSD is apt when applied to COVID-19. However, secondary analyses revealed subtle signals supporting chronic illness and CTS frameworks. Specifically, some participants who met criteria for PTSD did not endorse index events meeting Criterion A, most endorsed intrusive symptoms related to a present or future threat (versus a past trauma), and 30% reported their symptoms to be context dependent. Conclusion: Results highlight a need for improved assessment and opportunities for treatment modification. Clinical Impact StatementFindings from this study shed light onto those who may be especially at risk for development of traumatic stress during the pandemic by identifying particular events (e.g., death of a loved one) as predictors of increased PTSD. Based on results, this article also provides recommendations on specific ways in which PTSD treatments may need to adapt to help clients make sense of a stress response to the ongoing threat of the pandemic, which is distinct from a posttraumatic response to a past threat.

Editor's Note. This is an introduction to the special section "Women's Health and Trauma." Please see the Table of Contents here: