A Theoretical Model Test of Emotional and Cognitive Reactions to Sexual Trauma

Abstract

Peri- and post-trauma emotional and cognitive reactions play a pivotal role in PTSD. Illuminating the complex relationship among them necessitates a sound theoretical and statistical approach that ensures valid measurement and theory testing. Taking such an approach this study examined the relationships among peri-trauma sense of control and emotional reactions, post-trauma fear, helplessness, shame and guilt responses, and PTSD in 601 women with a history of perceived sexual trauma exposure. Participants completed an online survey involving reliable and valid measures of perceived severity of sexual trauma, post-trauma fear due to a sense of ongoing threat to safety, and sense of helplessness in life, trauma-related shame, and guilt cognitions. A theoretical model was tested using Structural Equation Modeling. The measurement and structural models provided a good fit to the data. Levels of sense of control during trauma predicted peri-trauma distress levels. Peri-trauma emotions had direct effects on post-trauma fear, helplessness, and shame, but not on guilt cognitions. Fear, sense of helplessness, and shame had direct effects on PTSD and mediated the association between peri-trauma emotions and PTSD. Although guilt cognitions had direct effects on PTSD, they were not mediators. These findings suggested that peri-trauma emotions play a role in PTSD as long as they induce chronic fear for safety, a sense of helplessness in life, and shame. Trauma-focused psychological interventions designed to overcome fear and shame, reduce helplessness, and restore a sense of control over one's life would be effective in improving PTSD in survivors of sexual violence.