Background & Aims
Sexual trauma is highly prevalent particularly in women,1 and associated with heightened risk of physical health symptoms.2 In particular, a number of studies have demonstrated that sexual trauma increases risk for developing or worsening pain symptoms3,4 as well as sleep difficulties.3 Individuals vary greatly in how they understand, or appraise, the traumatic event and its sequelae, which in turn may influence long-term health outcomes including pain and sleep disturbance. Trauma appraisals include threat (i.e., potential for harm and loss due to trauma), self and life impact (i.e., perceived implications of the trauma on an individual and their life), and controllability by self (i.e., perceived personal control in managing the impact of the trauma). However, little research has examined how different trauma appraisals within the acute phase following sexual trauma can impact longer term pain interference and sleep disturbance and thus is the present aim of this study.
Methods
Women (N = 203; ages 19-86, 61.6% White) who experienced sexual trauma within the past month were recruited from an online platform and completed questionnaires at T1 (within 30 days of trauma) and T2 (4 weeks later) that assessed trauma appraisals, pain interference, and sleep disturbances. Trauma appraisals included threat (e.g., “is this stressful experience threatening?”), controllable by self (e.g., “do I have the ability to do well in response to this stressful experience?”) and self and life impact (e.g., “this stressful experience has destroyed my life”). Structural equation modeling was used to develop a path model of the three trauma appraisals at T1 predicting T2 pain interference and sleep disturbance. Given that pain and sleep influence one another, we examined them simultaneously to parse out effects of each trauma appraisal while accounting for covariances. Covariates of age and income were included. Missing data was addressed using full information maximum likelihood.
Results
Self and life impact trauma appraisals significantly predicted subsequent pain interference (B = .10, SE = .04, p = .007), though control and threat were not significant predictors (ps > .30). Threat appraisals significantly predicted subsequent sleep disturbance (B = .39, SE = .14, p = .006), while control and self and life impact were not significant predictors (ps > .10). The three trauma appraisals and covariates accounted for 18.0% of the variance in pain interference and 15.5% of the variance in sleep disturbance. Model fit was excellent (RMSEA = 0.000, CFI = 1.000).
Conclusions
These findings suggest that different trauma appraisals may differentially relate to pain interference and sleep difficulties in the acute aftermath of sexual trauma. Perhaps the perception that the trauma has negatively impacted one’s self and life can be related to helplessness and worthlessness, which also contribute to worse pain outcomes. Moreover, it is possible that individuals who appraise the trauma as a threat may have more ruminative and anxiety symptoms which can negatively impact sleep. Experiences of pain interference and sleep disturbance may be partially dependent on the individual’s understanding and perceptions of their sexual trauma, which points to specific treatment targets. Future research should continue to assess the differential roles of trauma appraisals in longitudinal physical health outcomes as well as the reverse relationship to examine the impact that pain and sleep can have on one’s trauma appraisals.
References
1.Bonny-Noach H, Roth-Cohen O, Ne’eman-Haviv V. Gender differences in the experience of sexual harassment and assault, and attitudes toward the #metoo campaign. Smith Coll Stud Soc Work. 2022;92(3):185-199. doi:10.1080/00377317.2022.2111398
2.Golding JM. Sexual-assault history and long-term physical health problems: Evidence from clinical and population epidemiology. Curr Dir Psychol Sci. 1999;8(6):191-194. doi:10.1111/1467-8721.00045
3.Ulirsch J c., Ballina L e., Soward A c., et al. Pain and somatic symptoms are sequelae of sexual
assault: Results of a prospective longitudinal study. Eur J Pain. 2014;18(4):559-566. doi:10.1002/j.1532-2149.2013.00395.x
4.Short NA, Tungate AS, Bollen KA, et al. Pain is common after sexual assault and posttraumatic arousal/reactivity symptoms mediate the development of new or worsening persistent pain. Pain. 2022;163(1):e121-e128. doi:10.1097/j.pain.0000000000002329
Presenting Author
Mariel Emrich
Poster Authors
Topics
- Lifestyle Issues: Sleep/Diet/Exercise/Social Interactions