Worry Differentially Mediates Posttraumatic Cognition and Posttraumatic Stress Symptom Relationships Among Veterans Seeking Treatment Associated With Military Sexual Trauma

Research has established negative posttraumatic cognitions (NPC) affect the development and course of posttraumatic stress symptoms (PTSS) following trauma exposure (L. A. Brown et al., 2019). Previous studies in civilian and combat veteran populations also suggest positive associations among worry, NPC (Beck et al., 2004; Bennett et al., 2009), and PTSS (Fergus & Bardeen, 2017). However, little research has investigated the prevalence of worry in veterans who have experienced military sexual trauma (MST), and no research has examined the role of worry in the relation between NPC and PTSS among veterans seeking treatment associated with MST. This project examined the prevalence of worry in a MST sample and whether worry mediated NPC-PTSS associations. Veterans (N = 91) seeking MST-related treatment presented to a Veterans Affairs Posttraumatic Stress Disorder specialty clinic for assessment and treatment recommendations. Veterans completed questionnaires assessing NPC, worry, and PTSS. Bootstrapped mediation analyses examined NPC-PTSS associations. Veterans reported similar levels of worry as nonveterans seeking treatment associated with generalized anxiety disorder. Mediation analyses showed worry significantly mediated NPC-PTSS relationships for beliefs about the world, self-blame, and coping competence but not for beliefs about the self or global NPC severity. Further, the degree of mediation differed by NPC type. Though a limitation of this study is the use of cross-sectional data, these results inform the use of clinical intervention strategies targeting worry in trauma-focused interventions and necessitate further research on whether trauma-focused interventions ameliorate co-occurring worry among veterans exposed to MST. Impact Statement<br /> Veterans exposed to military sexual trauma exhibit high levels of worry. Worry mediates the relation between negative posttraumatic cognitions and posttraumatic stress symptoms. Worry's mediating effect differs by the type of negative cognition (e.g., about the self, the world, self-blame, and coping). This study suggests that the relation between negative posttraumatic cognitions and posttraumatic stress symptoms may be due to both thought process (e.g., worry) and thought content.