4 - (IOP 6) Do Changes in Trauma Appraisals Drive Changes in PTSD Symptoms over Time? A Deeper Dive into the Role of Cognitions in Women Sexual Trauma Survivors’ Early Recovery

Sexual trauma is highly prevalent, particularly in women, and is often associated with elevated posttraumatic stress disorder (PTSD) symptoms. Many survivors experience a natural reduction in PTSD symptoms over time, but the mechanisms underlying these changes remain unclear. Changes in cognitions may be one mechanism of trauma recovery, though the longitudinal examination of changes in trauma appraisals and their impact on PTSD symptoms has been largely overlooked. This study aims to document the natural course of change in trauma appraisals (i.e., threat, challenge, centrality, self-blame, and self and life impact) over time and resulting impact on change in PTSD symptoms as well as to examine potential directionality of relationships between trauma appraisals and PTSD symptoms early in sexual trauma recovery. Women (N = 203) who experienced a sexual trauma in the past month were recruited via Prolific and completed questionnaires at three timepoints (baseline, 1-month, and 2-month follow-ups). Latent growth curve analyses revealed significant declines in appraisals (except challenge) as well as PTSD symptoms, with the steepest changes occurring earlier in recovery. Cross-lagged panel models revealed bidirectional relationships between appraisals (threat, self-blame, centrality) and PTSD symptoms at least at some timepoints, while self and life impact exerted solely-unidirectional influence. In contrast, challenge appraisals remained stable over time and showed no significant longitudinal relationship with PTSD symptoms, suggesting more positive appraisals may operate differently from negative appraisals in the early aftermath of sexual trauma. Findings underscore the critical role of timing – threat and self and life impact appraisals most strongly influence symptoms early on, while self-blame and centrality become more impactful two to three months later. These results highlight the need for stage-specific interventions, targeting threat and self and life impact appraisals in the immediate aftermath of trauma and addressing self-blame and centrality as recovery progresses to mitigate long-term distress. Given the bidirectional nature of these relationships, interventions directly targeted at PTSD symptoms in the first month of experiencing sexual trauma is also warranted.