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Complex posttraumatic stress disorder (CPTSD) follows persistent and repeated trauma and is a serious mental health problem among women. One of the strongest predictors of CPTSD symptoms is childhood trauma, especially child abuse and neglect, both of which are traumas that tend to be persistent and repeated. CPTSD is also associated with intimate partner violence (IPV; physical, emotional, and/or sexual violence in an intimate relationship), a trauma that, similar to child abuse and neglect, is also persistent and repeated. However, it is unclear how child abuse/neglect and IPV may jointly influence CPTSD symptoms vis-à-vis other traumatic events. In this study, we examined the relative effects of child abuse/ neglect and IPV on CPTSD symptoms over and above other traumatic events in a sample of women (N = 553) using a partial least squares approach to multiple regression and structural equation modeling. Results indicated that in general childhood trauma was the strongest predictor of CPTSD symptoms. However, when we analyzed specific aspects of child abuse, child neglect, and IPV, we found that childhood emotional abuse was the primary predictor of CPTSD symptoms over and above the effects of other traumatic life events, with sexual and emotional IPV also having small effects. These results highlight the salient effects of childhood emotional trauma on CPTSD symptoms among women, underscoring the importance of assessing for this in women presenting for treatment of CPTSD.

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Lehinger et al.’s (2022) study on the associations between posttraumatic stress symptoms, posttraumatic cognitions, and alcohol use in sexual assault survivors extends previous research on posttraumatic response to sexual trauma. The study is useful for these purposes but it also raises other interesting questions about the nature of posttraumatic response and the structure of psychopathology more generally. In this commentary, we describe Lehinger et al.’s (2022) study and its findings and discuss their potential relevance for emerging transdiagnostic, hierarchical models of psychopathology.

Sexual assault is a common traumatic stressor associated with a number of psychosocial problems for adult men and women. The problems associated with sexual assault are thought to be attributable to its complexity as an interpersonal behavior. However, the interpersonal ramifications of sexual assault are unclear. One way of understanding the nature of interpersonal behavior is by using a tool that has deep roots in psychoanalytic thought, the interpersonal circumplex (IPC). The IPC is a graphical tool used to map the interpersonal salience of behavior across two dimensions, warmth (vs. coldness) and dominance (vs. submissiveness). In this study, we examined the interpersonal sensitivities related to sexual assault in a sample of adult men and women (N = 390) using a bootstrapped structural summary approach to mapping constructs across the IPC. Results indicated that sexual assault is associated with a sensitivity to submissiveness. Results further suggested some differences in how sexual assault is differentially associated with interpersonal sensitivity for men and women. Men who experienced sexual assault are especially sensitive to submissiveness, while women who experienced sexual assault are sensitive to submissiveness as well as many other kinds of interpersonal behaviors. These findings suggest directions for future research and have implications for working clinically with adult survivors of sexual assault.