(PS10-42) Trait Shame and PTSD Symptom Severity Among Sexual Assault Survivors: A Mediation Analysis

Introduction: Sexual assault (SA) is a pervasive public health issue, with 50% of women and 33% of men experiencing it. Compared to other forms of trauma, SA is associated with heightened risk for posttraumatic stress disorder (PTSD). In particular, traumas experienced during childhood may be linked to increased risk for PTSD compared to traumas experienced in adolescence or adulthood. Shame, an emotion stemming from the belief an individual is flawed and undeserving of acceptance, has been conceptualized as a mechanism that may underlie PTSD risk. However, little research has examined how shame may underlie the association between timing of SA (i.e., in childhood vs. adolescence and adulthood) and PTSD symptoms.

Method: Undergraduates (N = 250, M_age = 20.14 yrs, SD = 3.77; 83% female; 45% White; 36% Latine) reporting SA completed an online battery of self-report measures. Timing of SA was assessed by the Life Events Checklist for DSM-5, and participants were dichotomized as experiencing their first SA in childhood (0-12 years; n = 102) vs. adolescence/adulthood (13+ years; n = 148). Trait shame was measured by an item of the Positive and Negative Affect Schedule, and PTSD symptom severity was assessed using the PTSD Checklist for DSM-5. A mediation analysis was used to test hypotheses in PROCESS macro for SPSS. Age and gender were included in the analysis as covariates.

Results: The full model accounted for a significant 21.0% of the variance in PTSD symptom severity (F (4 , 245) = 16.56, p < .001). Childhood SA was significantly associated with increased shame (B = -.48, SE = .16, 95% CI [-.79, -.17]), which was then significantly positively associated with greater PTSD symptom severity (B = 6.42, SE = .89, 95% CI [4.66, 8.18]). Lastly, the indirect effect of childhood SA on PTSD symptom severity through shame was significant (B = -3.08, SE = 1.15, 95% CI [-5.48, -.99]).

Conclusion: Results demonstrate childhood SA is associated with increased PTSD symptoms vs. adolescent or adult SA, and trait shame may explain this heightened risk. Limitations of the current study include the adult SA group being relatively small, potentially impacting power, and use of self-report for all constructs of interest. Shame may be a potential malleable treatment target for childhood SA survivors.