Category: Trauma and Stressor Related Disorders and Disasters

Symposium

Does Childhood Abuse Influence the Role of Shame in Co-Occurring PTSD and SAD After Adult Trauma Exposure?

Sunday, November 19
10:15 AM - 11:45 AM
Location: Cobalt 500, Level 5, Cobalt Level

Keywords: Stress | Social Anxiety | Trauma
Presentation Type: Symposium

Reports of co-occurring Posttraumatic Stress Disorder (PTSD) and Social Anxiety Disorder (SAD) range from 4.2-72% in clinical samples, suggesting that exploration of moderating factors of this co-morbidity may be useful. Available reports suggest that those with both PTSD/SAD report greater instances of childhood abuse (CA), higher levels of shame, and more severe PTSD symptoms compared to individuals with either condition alone. The aim of the present study was to examine whether shame moderated the association between symptoms of PTSD/SAD, and whether the effect of shame in PTSD/SAD was moderated by CA exposure. We predicted that high levels of shame would increase the association between PTSD/SAD symptoms, and that the moderating effects of shame would be strengthened by CA exposure.


This study utilized a diverse sample of 259 adult women seeking mental health services after exposure to Intimate Partner Violence (IPV).  Symptoms of PTSD and SAD were assessed using clinical interviews. Physical and sexual CA exposure and shame were assessed using self-report questionnaires. A moderated moderation analysis was used to assess shame and CA as moderators predicting the association between symptoms of SAD and PTSD. Results indicated the overall model accounted for 16% of the variance in PTSD symptoms, F (8, 250) = 6.79, p < .001, R2=.16. A significant three-way interaction was noted between SAD symptoms, shame, and CA predicting PTSD symptoms, b= -.02, t (250) = -3.33, p = .001 (CI [-.04, -.01]). Follow-up analyses indicated a significant relationship between SAD and PTSD symptoms at high levels of shame and CA-. Shame did not moderate the relationship between SAD and PTSD symptoms for CA- and low levels of shame. Further, shame did not moderate the association between SAD and PTSD symptoms when there was a positive history of CA, contrary to prediction. These findings suggest a nuanced interplay between CA exposure and shame in the association of PTSD/SAD, wherein high levels of shame may be of particular relevance to the SAD/PTSD comorbidity among IPV survivors without history of CA, whereas among CA+ IPV survivors, other factors such as emotion dysregulation may be more relevant.

Alexandra J. Lipinski

Graduate Student
University of Memphis

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Does Childhood Abuse Influence the Role of Shame in Co-Occurring PTSD and SAD After Adult Trauma Exposure?



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