История сексуального насилия усугубляет симптомы ПТСР после новых травматических событий

A history of sexual violence (SV) increases post-traumatic stress disorder (PTSD) symptoms and prolongs symptom duration after subsequent nonsexual trauma events. These study findings were published in JAMA Psychiatry. Multiple studies have reported that SV creates the greatest conditional risk for PTSD. However, few studies have assessed how a history of SV affects PTSD symptom trajectories. Researchers conducted a case-controlled study to evaluate how PTSD symptoms in those with vs without an earlier history of SV were affected after a new incident of trauma exposure. Using the Advancing Understanding of Recovery After Trauma (AURORA) study, a longitudinal cohort study, researchers selected eligible participants. Study participants were adults aged 18 to 75 years who presented at a participating emergency department (ED) in the US within 72 hours of a traumatic event. Study participants had a history of sexual abuse during childhood or adulthood. The patients underwent Childhood Trauma Questionnaire–Short Form (CTQ) and the Life Events Checklist for the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5; LEC-5) assessments at 2 weeks and repeated PTSD Checklist for DSM-5 (PCL-5) assessments at 2 weeks, 8 weeks, 3 months, 6 months, and 12 months. Probable PTSD was defined as a PCL-5 score of at least 31. Exposure to [sexual violence] may be an important risk factor for [post-traumatic stress disorder] not only immediately after the [sexual violence] but also after a subsequent nonsexual trauma. A total of 2423 study participants (mean age, 36 years; 64.6% women) were selected for final analysis. Study participants were separated into those with (n=1270; mean age, 35.9 years; 76.0% women; 47.8% Black) and without (n=1153; mean age, 37.2 years; 52.1% women; 51.3% Black) a SV history, and each group had a mean Injury Severity Score of 2.5 and 2.4, respectively. Most patients were admitted to the ED after a motor vehicle collision (75%). Individuals with vs without a history of SV had higher CTQ scores (mean, 10.9 vs 4.4, respectively; P <.001), tended to have higher LEC-5 scores, which reflected the number of nonsexual traumas (mean, 9.1 vs 8.5, respectively; P =.07) at 2 weeks, had higher PCL-5 scores (mean range, 26.7-35.4 vs 17.1-25.9, respectively; all P <.001), and fit the criteria for probable PTSD (range, 39.5%-57.3% vs 20.1%-35.8%, respectively; all P <.001) at all follow-up assessments. Symptoms of PTSD were significantly higher among patients with vs without a history of SV (β, 4.62), and there was a time-by-SV interaction between weeks 2 and 8 (β, 0.92) and months 6 and 12 (β, 0.88; all P <.001), indicating that those with SV had a slower recovery. Among patients with SV, hypervigilance symptoms were greater than symptoms of negative cognition and mood (β, -0.29), intrusion (β, -0.13), and avoidance (β, -0.11; all P <.001). Study limitations include relying on the PCL-5 instead of the diagnostic scale Clinician Administered PTSD Scale for DSM-5 (CAPS-5), potential confounding variables related to higher CTQ scores in the group with SV, which may reflect a broadly more adverse developmental environment in the group without SV, and a short follow-up time of 1 year, which limits fully understanding PTSD trajectories. The study authors concluded, “Exposure to [sexual violence] may be an important risk factor for [post-traumatic stress disorder] not only immediately after the [sexual violence] but also after a subsequent nonsexual trauma.” Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures. References: Mellen EJ, Poplin T, Jovanovic T, et al. Prior sexual violence, PTSD symptoms, and recovery trajectories after new trauma. JAMA Psychiatry. 2026:e262219. doi:10.1001/jamapsychiatry.2026.2219