Posttraumatic Cognitions Differ Between Men and Women after Military Sexual Assault Revictimization in Their Contribution to PTSD Symptoms

Abstract

Sexual revictimization is heightened among military service members and veterans and is associated with greater posttraumatic stress symptoms (PTSS) and severity. The heightened distress following revictimization may be due to posttraumatic cognitions (PTC), which include negative beliefs about the self and world, and self-blame. Moreover, it is unclear whether men and women experience different levels of PTC. The current study tested PTC (overall and subdomains) as a possible mediator between sexual revictimization and PTSS severity, and gender as a possible moderator of these associations. Revictimization was defined across time periods (military sexual assault [MSA] only vs. premilitary sexual trauma + MSA) and in military rape frequency (0, 1, 2+). Participants were 400 ( n = 200 [50%] male) service members/veterans with a history of MSA and completed online, anonymous, self-report questionnaires. PTC mediated the association between revictimization and PTSS severity. A significant interaction of gender suggested that men reported high overall PTC and PTC about the self regardless of revictimization; by contrast, overall PTC and PTC about the self were lower for women in response to MSA only and increased with revictimization. Results also showed men were more sensitive to PTC about self-blame as it pertains to more severe PTSS compared to women. There were no unique gender interactions when assessing revictimization by rape frequency, although PTC (overall, all subdomains) significantly mediated the association between rape frequency and PTSS severity. PTC may be a beneficial target when treating PTSS in men, and may be especially heightened in women who have experienced revictimization.

Negative posttraumatic cognitions about self potentially mediate the relation between sexual revictimization and suicide risk in a sample of military sexual assault survivors.

“…Male sex (0.49, SE = 0.15, p = .01) and veteran status (−0.52, SE = 0.15, p < .001) were associated with self-blame, whereas veteran status (0.28, SE = 0.13, p = .04) was associated with negative cognition about the world. Given the split nature of our dataset regarding male and female sex, as well as established sex differences in suicide risk and PTCs (e.g., Aslan et al, 2020; Tannahill et al, 2023), we explored whether sex moderated the association between revictimization and PTC subscales and between PTC subscales and suicide risk. Interaction terms were specified on both the “a” and “b” paths.…”

“…The current study utilized data from a parent study that examined individual and interpersonal outcomes among service members and veterans who have experienced MST that involved assault (Tannahill et al, 2023). Participants were recruited during 2021 via Qualtrics, Inc. (Qualtrics Panels, 2017).…”

“…Answering “yes” to either of the questions indicated a history of MST that involved assault. To limit fraudulent responses and validate current or previous service in the U.S. military in the post-9/11 era, prospective participants subsequently answered four military validation questions (Tannahill et al, 2023). An incorrect response to any of the validation questions resulted in automatic discontinuation, and the likelihood of answering all four questions accurately by chance is 0.16%.…”

“…The average score for each subscale is calculated by taking the total subscale score and dividing it by the number of items in that subscale, with a range of 1–7. A confirmatory factor analysis using the parent dataset confirmed the presence of the three subscales, χ 2 (492) = 943.49, p < .01, comparative fit index (CFI) = .99, Tucker–Lewis index (TLI) = .99, root-mean-square error of approximation (RMSEA) = .05; factor loadings self-blame: 0.54–0.79, negative cognitions about self: 0.64–0.79, negative cognitions about world: 0.61–0.82; Tannahill et al, 2023. In this sample, the PTCI subscales show good to excellent internal consistency for negative cognitions about self (Cronbach’s α = .95), negative cognitions about the world (Cronbach’s α = .89), and self-blame (Cronbach’s α = .81) subscales.…”

Sexual assault characteristics and posttraumatic stress symptoms among collegiate women: The role of posttraumatic cognitions

“…Overall, the authors found that social cognitions were the strongest mediators of this association. Furthermore, in a sample of male and female military service members and veterans who experienced sexual assault while in the military, there was a significant indirect effect of the number of rapes experienced during military service on posttraumatic stress symptoms (PTSS) via posttraumatic cognitions (Tannahill et al., 2023). Thus, it is possible that sexual assault characteristics are associated with increased negative posttraumatic cognitions, particularly related to social relationships, which, in turn, are associated with more severe symptoms of PTSD.…”