title: Early PTSD symptom sub-clusters predicting chronic posttraumatic stress following sexual assault.
abstract: Contemporary models of PTSD disaggregate this disorder into sub-clusters that differentially impact functioning. Severity of different types of PTSD symptoms in the acute posttrauma period may be predictive of the course of PTSD over time. Few research studies, however, have examined the predictive utility of PTSD sub-clusters. This study sought to determine the relative predictive validity of 4 sub-clusters, namely reexperiencing, strategic avoidance, emotional numbing, and hyperarousal, assessed within 1 month of a sexual assault. Women (N=120) who had been sexually assaulted completed self-report measures at 1 and 4 months postassault. Linear regression analyses revealed that early reexperiencing and emotional numbing sub-clusters uniquely contributed to the prediction of PTSD symptoms at month 4 (strategic avoidance and hyperarousal did not). To help explain and contextualize these findings, we explored the extent to which posttraumatic cognitions mediated the relationship between acute reexperiencing and emotional numbing and later PTSD symptoms. Simultaneous multiple mediation analyses revealed that general negative cognitions about the self significantly mediated the relationship between both reexperiencing and emotional numbing and month 4 PTSD symptoms. These findings have significant clinical implications, pointing to the importance of targeting posttraumatic cognitions in the acute posttrauma phase.
authors.affiliation: Orlando VA Medical Center.
authors.forename: Teresa L
authors.initials: TL
authors.lastname: Carper
authors.affiliation: VA Boston Healthcare System.
authors.forename: Mary Alice
authors.initials: MA
authors.lastname: Mills
authors.affiliation: Department of Psychiatry, New York University.
authors.forename: Maria M
authors.initials: MM
authors.lastname: Steenkamp
authors.affiliation: School of Psychology, University of New South Wales.
authors.forename: Angela
authors.initials: A
authors.lastname: Nickerson
authors.affiliation: Department of Psychology, Eastern Connecticut State University.
authors.forename: Kristalyn
authors.initials: K
authors.lastname: Salters-Pedneault
authors.affiliation: VA Boston Healthcare System.
authors.forename: Brett T
authors.initials: BT
authors.lastname: Litz
mesh_terms: D000293:Adolescent; D000328:Adult; D002908:Chronic Disease; D005260:Female; D006801:Humans; D016014:Linear Models; D008875:Middle Aged; D008960:Models, Psychological; D011379:Prognosis; D057566:Self Report; D012742:Sex Offenses / Q000523:psychology*; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000209:etiology* / Q000523:psychology; D013997:Time Factors; D055815:Young Adult