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Psychol Med DOI:10.1017/S0033291717001593

Post-traumatic stress disorder associated with sexual assault among women in the WHO World Mental Health Surveys.

Publication TypeJournal Article
Year of Publication2018
AuthorsScott, KM, Koenen, KC, King, A, Petukhova, MV, Alonso, J, Bromet, EJ, Bruffaerts, R, Bunting, B, de Jonge, P, Haro, JM, Karam, EG, Lee, S, Medina-Mora, ME, Navarro-Mateu, F, Sampson, NA, Shahly, V, Stein, DJ, Torres, Y, Zaslavsky, AM, Kessler, RC
JournalPsychol Med
Date Published2018 Jan
KeywordsCrime Victims, Diagnostic and Statistical Manual of Mental Disorders, Female, Humans, Internationality, Life Change Events, Logistic Models, Mental Health, Retrospective Studies, ROC Curve, Sex Offenses, Stress Disorders, Post-Traumatic, Surveys and Questionnaires, World Health Organization

BACKGROUND: Sexual assault is a global concern with post-traumatic stress disorder (PTSD), one of the common sequelae. Early intervention can help prevent PTSD, making identification of those at high risk for the disorder a priority. Lack of representative sampling of both sexual assault survivors and sexual assaults in prior studies might have reduced the ability to develop accurate prediction models for early identification of high-risk sexual assault survivors.

METHODS: Data come from 12 face-to-face, cross-sectional surveys of community-dwelling adults conducted in 11 countries. Analysis was based on the data from the 411 women from these surveys for whom sexual assault was the randomly selected lifetime traumatic event (TE). Seven classes of predictors were assessed: socio-demographics, characteristics of the assault, the respondent's retrospective perception that she could have prevented the assault, other prior lifetime TEs, exposure to childhood family adversities and prior mental disorders.

RESULTS: Prevalence of Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV) PTSD associated with randomly selected sexual assaults was 20.2%. PTSD was more common for repeated than single-occurrence victimization and positively associated with prior TEs and childhood adversities. Respondent's perception that she could have prevented the assault interacted with history of mental disorder such that it reduced odds of PTSD, but only among women without prior disorders (odds ratio 0.2, 95% confidence interval 0.1-0.9). The final model estimated that 40.3% of women with PTSD would be found among the 10% with the highest predicted risk.

CONCLUSIONS: Whether counterfactual preventability cognitions are adaptive may depend on mental health history. Predictive modelling may be useful in targeting high-risk women for preventive interventions.


Alternate JournalPsychol Med
PubMed ID28625214
PubMed Central IDPMC5896282
Grant ListR01 DA016558 / DA / NIDA NIH HHS / United States
R01 MH093612 / MH / NIMH NIH HHS / United States
R03 TW006481 / TW / FIC NIH HHS / United States
R01 MH069864 / MH / NIMH NIH HHS / United States
R01 MH061905 / MH / NIMH NIH HHS / United States
K05 DA015799 / DA / NIDA NIH HHS / United States
U01 MH060220 / MH / NIMH NIH HHS / United States
R01 MH070884 / MH / NIMH NIH HHS / United States
R01 MH059575 / MH / NIMH NIH HHS / United States
R13 MH066849 / MH / NIMH NIH HHS / United States