Posttraumatic cognitions and sexual assault: Understanding the role of cognition type in posttraumatic stress symptoms and problematic alcohol use.

Identifying potential mechanisms underlying the association between posttraumatic stress symptoms (PTSS) and problematic alcohol use is an important target among college women who have experienced sexual assault. This study examined the role of posttraumatic cognitions in this association among college women (N = 530) who experienced either an alcohol-involved assault or non-alcohol-involved assault, using baseline assessment data from a larger study examining cognitive and emotional risk factors for problem drinking. Conditional path analysis was used to examine the indirect effects of posttraumatic cognitions on the association between PTSS and alcohol use consequences, with assault type as a moderator. The findings revealed a significant indirect path from PTSS to alcohol use consequences through posttraumatic cognitions, B = 0.21, SE = 0.04, p < .001, 95% CI [0.13, 0.29], β = .16, R = .32. Exploratory analyses revealed a significant conditional indirect effect through self-blame cognitions, R = .31, whereby the indirect effect of self-blame on the association between posttraumatic stress and alcohol consequences was present among participants who experienced alcohol-involved assault, B = 0.10, SE = 0.03, p < .001, 95% CI [0.06, 0.16], β = .07, but not among those who experienced a non-alcohol-involved assault, B = 0.03, SE = 0.03, p = 0.32, 95% CI [-0.02, 0.08], β = .02. Posttraumatic cognitions are a potential mechanism underlying the link between posttraumatic stress and alcohol consequences. Addressing posttraumatic cognitions, particularly those related to self-blame, may be an important target for interventions promoting healthy recovery following alcohol-involved assault.