Posttraumatic cognitions and sexual assault: Understanding the role of cognition type in posttraumatic stress symptoms and problematic alcohol use

Abstract

Identifying potential mechanisms underlying the association between posttraumatic stress symptoms (PTSS) and problematic alcohol use is an important target among college women who have experienced sexual assault. This study examined the role of posttraumatic cognitions in this association among college women (N = 530) who experienced either an alcohol‐involved assault or non–alcohol‐involved assault, using baseline assessment data from a larger study examining cognitive and emotional risk factors for problem drinking. Conditional path analysis was used to examine the indirect effects of posttraumatic cognitions on the association between PTSS and alcohol use consequences, with assault type as a moderator. The findings revealed a significant indirect path from PTSS to alcohol use consequences through posttraumatic cognitions, B = 0.21, SE = 0.04, p < .001, 95% CI [0.13, 0.29], β = .16, R2 = .32. Exploratory analyses revealed a significant conditional indirect effect through self‐blame cognitions, R2 = .31, whereby the indirect effect of self‐blame on the association between posttraumatic stress and alcohol consequences was present among participants who experienced alcohol‐involved assault, B = 0.10, SE = 0.03, p < .001, 95% CI [0.06, 0.16], β = .07, but not among those who experienced a non–alcohol‐involved assault, B = 0.03, SE = 0.03, p = 0.32, 95% CI [−0.02, 0.08], β = .02. Posttraumatic cognitions are a potential mechanism underlying the link between posttraumatic stress and alcohol consequences. Addressing posttraumatic cognitions, particularly those related to self‐blame, may be an important target for interventions promoting healthy recovery following alcohol‐involved assault.

A Web-Based Sexual Violence, Alcohol Misuse, and Bystander Intervention Program for College Women (RealConsent): Randomized Controlled Trial

“…An estimated 1 in 5 women report having experienced attempted or completed rape in their lifetime, and 43.9% have experienced other forms of SV in their lifetime [ 5 , 6 ]. Consequences of SV include posttraumatic stress disorder, suicidality, problematic alcohol use, and increased risk for re-exposure to SV [ 7 , 8 ]. College campuses, in general, are high-risk environments for SV.…”

Thinking hierarchically about posttraumatic response: Commentary on Lehinger et al. (2022)

“…There are some benefits to conceptualizing posttraumatic response hierarchically. First, thinking about these different aspects of posttraumatic response as structurally related attenuates problems of causality inherent in crosssectional research designs, which Lehinger et al (2022) acknowledged and is a common limitation of many studies. Taking a hierarchical approach is also useful for clinical assessment and intervention, and there is emerging literature on how to use this approach to identify a patient's most impairing domain of problems and intervene at a level of specificity that matches their idiosyncratic presentation (Hopwood et al, 2020).…”

“…Lehinger et al.’s ( 2022 ) study on the direct and indirect associations between posttraumatic stress symptoms (PTSS), posttraumatic cognitions, and alcohol use among sexual assault survivors is useful in many ways. It confirms previous work showing a link between PTSS and posttraumatic cognitions of sexual trauma (e.g., Kline et al., 2021 ).…”