Associations between PTSD symptoms and other psychiatric symptoms among college students exposed to childhood sexual abuse: a network analysis

Abstract

Background: Childhood sexual abuse (CSA) is one of the prevalent forms of trauma experienced during childhood and adolescence. Previous research underscores its associations with depression, anxiety, post-traumatic stress disorder (PTSD), and psychosis. Objective: This study examined symptom connections between depression, anxiety, PTSD, and psychosis while simultaneously investigating whether these connections differed by gender among CSA survivors. Methods: A large-scale, cross-sectional study among 96,218 college students was conducted in China. Participants’ CSA was measured by the Childhood Trauma Questionnaire-Short Form (CTQ-SF). Participants’ PTSD, psychosis, depression, and anxiety were measured by the Trauma Screening Questionnaire (TSQ), the Psychosis Screener (PS), the nine-item Patient Health Questionnaire (PHQ-9), and the 7-item Generalized Anxiety Disorder Scale (GAD-7), respectively. Network analysis was used to explore the potential associations between these symptoms and to compare the sex differences in the symptoms model. Results: Among participants who suffered from CSA, females were more likely from left-behind households, while males were more likely from households with a high annual income ( P < .001, Cohen’s W = 0.07). In addition, compared to male victims, female victims were more likely to report depression, anxiety, and PTSD ( P < .001, Cohen’s d ≈0.2), while male victims were more likely to report psychosis ( P < .001, Cohen’s d = 0.36). Results from network estimation showed that psychosis, depression, anxiety, and PTSD symptoms were positively correlated. Moreover, psychosis had a stronger connection with PTSD symptoms, including hypervigilance, intrusive thoughts, and physiological and emotional reactivity. Conclusions: The current study explores the associations between PTSD symptoms and psychiatric symptoms among college students exposed to CSA using a network analysis approach. These crucial symptoms of PTSD may have potential connections to psychosis. Target intervention and strategy should be developed to improve mental health and quality of life among these CSA victims. Furthermore, longitudinal studies are warranted to advance our understanding of PTSD and psychosis.

Symptom association between social anxiety disorder, appearance anxiety, and eating disorders among Chinese University students: A network analysis to conceptualize comorbidity

“…Therefore, as a visualized method, network analysis can identify strong links between symptoms of different psychological disorders and provide evidence for pathogenesis research ( 34 , 35 ). For example, among young people with childhood sexual abuse experience, associations between psychosis and post-traumatic stress disorder (PTSD) symptoms include hypervigilance, intrusive thoughts, and physiological and emotional reactivity ( 36 ). Other studies also found connections between depression and anxiety ( 37 ), anxiety and insomnia ( 38 ), and other mental health disorder symptoms ( 39 , 40 ).…”

Sexual Abuse in Childhood: Relationship With Post-Traumatic Stress Disorder

“…The other two studies by Rameckers et al, (2021) and Wang et al, (2022) were conducted years after the abuse when the children were adults and found that emotional abuse is also very likely to be associated with PTSD especially when it occurs along with sexual.…”

“…First of all, the gender of the child. In this regard, the research of Yinzhe Wang et al, (2022), among others, reveals that boys are much more likely to be sexually abused but have a harder time developing a disorder than girls, who are more likely to develop post-traumatic stress disorder.…”

“…During the 1970s, under the state of classical epidemiological sociological research in the USA, the phenomenon was attributed to social structural factors, such as poverty and unemployment. The role of the child himself through his characteristics led to the theory of the "special victim" that was quickly abandoned in 1980 when Blesky developed the ecological model, which is a holistic approach to the phenomenon (Agathonos-Georgopoulou, 1999;Belsky, 1993). According to this, parents who have been abused in the past by their own parents have an increased likelihood of abusing their own children.…”

Introduction to Population-Based Nursing

“…A study conducted in Saudi Arabia, where beating and insults are often an acceptable parenting style, identified a correlation between beating and insults (once or more per month) and an increased risk for cancer, cardiac disease, and asthma (Hyland et al, 2012). A large-scale, cross-sectional study of college students in China revealed a relationship between childhood sexual abuse, post-traumatic stress disorder (PTSD), and other psychiatric symptoms (Jin et al, 2022). A descriptive cross-sectional study conducted in Nepal revealed that emotional neglect during childhood and depression were independent predictors of poor quality of life (Dhungana et al, 2022).…”