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      Effects of sexual assault vs. other traumatic experiences on emotional and cannabis use outcomes in regular cannabis users with trauma histories: moderation by gender?

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          Abstract

          Introduction

          While sexual assault may have particularly adverse emotional effects compared with other forms of trauma, it remains unclear which emotional outcome dimensions are impacted, whether cannabis outcomes are similarly impacted, and whether gender differences exist in sexual assault’s links with these outcomes.

          Methods

          N = 100 cannabis users with trauma histories ( M age = 33.1) completed standardized measures of demographics, trauma exposure, posttraumatic stress (PTS) and depressive symptoms, hopelessness, and cannabis outcomes (frequency, medicinal prescription, motives, and craving).

          Results

          Sexual assault was experienced more often by women (83.9%) than men (31.8%). A series of 2 × 2 analyses of variance [gender: women ( n = 56) vs. men ( n = 44) × trauma type: sexual assault ( n = 61) vs. other ( n = 39)] and logistic regression revealed that sexual assault survivors scored higher than other trauma survivors on re-experiencing and hyperarousal PTS symptoms (DSM-5 Clusters B and E), cognitive depressive symptoms, hopelessness, cannabis use frequency, medicinal cannabis prescription, cannabis use to cope with psychological symptoms, and compulsivity craving; and lower on social and enhancement cannabis use motives. In terms of gender main effects, women scored higher than men on cannabis use to cope with negative emotions. In terms of interactions for PTS Cluster D symptoms (negative alterations in mood/cognitions), among men only, sexual assault survivors scored higher than other trauma survivors; and for cannabis enhancement motives and purposefulness cannabis craving, among sexual assault survivors only, women scored higher than men.

          Discussion

          Across many different trauma, women survivors’ use of cannabis to cope with negative affect should be a specific therapeutic focus. Moreover, we identified specific emotional and cannabis use outcomes that should be of specific clinical concern among sexual assault survivors regardless of gender. Finally, in terms of gender differences of clinical interest among sexual assault survivors, while PTS Cluster D symptoms should be specific treatment targets in men, cannabis enhancement motives and purposefulness craving should be treatment targets in women.

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          Most cited references61

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          Controlling the False Discovery Rate: A Practical and Powerful Approach to Multiple Testing

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            The Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5): Development and Initial Psychometric Evaluation.

            The Posttraumatic Stress Disorder Checklist (PCL) is a widely used DSM-correspondent self-report measure of PTSD symptoms. The PCL was recently revised to reflect DSM-5 changes to the PTSD criteria. In this article, the authors describe the development and initial psychometric evaluation of the PCL for DSM-5 (PCL-5). Psychometric properties of the PCL-5 were examined in 2 studies involving trauma-exposed college students. In Study 1 (N = 278), PCL-5 scores exhibited strong internal consistency (α = .94), test-retest reliability (r = .82), and convergent (rs = .74 to .85) and discriminant (rs = .31 to .60) validity. In addition, confirmatory factor analyses indicated adequate fit with the DSM-5 4-factor model, χ2 (164) = 455.83, p < .001, standardized root mean square residual (SRMR) = .07, root mean squared error of approximation (RMSEA) = .08, comparative fit index (CFI) = .86, and Tucker-Lewis index (TLI) = .84, and superior fit with recently proposed 6-factor, χ2 (164) = 318.37, p < .001, SRMR = .05, RMSEA = .06, CFI = .92, and TLI = .90, and 7-factor, χ2 (164) = 291.32, p < .001, SRMR = .05, RMSEA = .06, CFI = .93, and TLI = .91, models. In Study 2 (N = 558), PCL-5 scores demonstrated similarly strong reliability and validity. Overall, results indicate that the PCL-5 is a psychometrically sound measure of PTSD symptoms. Implications for use of the PCL-5 in a variety of assessment contexts are discussed.
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              Posttraumatic stress disorder in the National Comorbidity Survey.

              Data were obtained on the general population epidemiology of DSM-III-R posttraumatic stress disorder (PTSD), including information on estimated life-time prevalence, the kinds of traumas most often associated with PTSD, sociodemographic correlates, the comorbidity of PTSD with other lifetime psychiatric disorders, and the duration of an index episode. Modified versions of the DSM-III-R PTSD module from the Diagnostic Interview Schedule and of the Composite International Diagnostic Interview were administered to a representative national sample of 5877 persons aged 15 to 54 years in the part II subsample of the National Comorbidity Survey. The estimated lifetime prevalence of PTSD is 7.8%. Prevalence is elevated among women and the previously married. The traumas most commonly associated with PTSD are combat exposure and witnessing among men and rape and sexual molestation among women. Posttraumatic stress disorder is strongly comorbid with other lifetime DSM-III-R disorders. Survival analysis shows that more than one third of people with an index episode of PTSD fail to recover even after many years. Posttraumatic stress disorder is more prevalent than previously believed, and is often persistent. Progress in estimating age-at-onset distributions, cohort effects, and the conditional probabilities of PTSD from different types of trauma will require future epidemiologic studies to assess PTSD for all lifetime traumas rather than for only a small number of retrospectively reported "most serious" traumas.
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                Author and article information

                Contributors
                URI : https://loop.frontiersin.org/people/14233/overviewRole: Role: Role: Role: Role: Role: Role: Role:
                URI : https://loop.frontiersin.org/people/1975028/overviewRole:
                Role: Role: Role:
                URI : https://loop.frontiersin.org/people/508221/overviewRole: Role: Role: Role: Role:
                Role: Role: Role: Role: Role: Role:
                URI : https://loop.frontiersin.org/people/195306/overviewRole: Role: Role: Role: Role:
                Journal
                Front Psychol
                Front Psychol
                Front. Psychol.
                Frontiers in Psychology
                Frontiers Media S.A.
                1664-1078
                31 May 2024
                2024
                : 15
                : 1386264
                Affiliations
                [1] 1Mood, Anxiety, and Addiction Comorbidity Lab, Department of Psychiatry, Dalhousie University , Halifax, NS, Canada
                [2] 2Department of Psychology and Neuroscience, Dalhousie University , Halifax, NS, Canada
                [3] 3Department of Psychology, University of Regina , Regina, SK, Canada
                [4] 4Department of Psychology, Saint Francis Xavier University , Antigonish, NS, Canada
                [5] 5School of Psychology, University of Sussex , Brighton, United Kingdom
                Author notes

                Edited by: Alessandro Musetti, University of Parma, Italy

                Reviewed by: Steven D. Shirk, United States Department of Veterans Affairs, United States

                Ana Fresan, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñíz, Mexico

                *Correspondence: Sherry H. Stewart, sstewart@ 123456dal.ca
                Article
                10.3389/fpsyg.2024.1386264
                11178137
                38882518
                be5e2e3e-0c1d-4435-9d1a-d45bcce87b6d
                Copyright © 2024 Stewart, Khoury, Watt, Collins, DeGrace and Romero-Sanchiz.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 14 February 2024
                : 06 May 2024
                Page count
                Figures: 3, Tables: 3, Equations: 0, References: 67, Pages: 14, Words: 12925
                Funding
                Funded by: Mental Health Commission of Canada
                Funded by: Nova Scotia Health Research
                Funded by: Dalhousie Department of Psychiatry Research Fund
                Funded by: Social Sciences and Humanities Research Council of Canada, doi 10.13039/501100000155;
                Funded by: Dalhousie Medical Research Foundation, doi 10.13039/100007670;
                Categories
                Psychology
                Original Research
                Custom metadata
                Psychopathology

                Clinical Psychology & Psychiatry
                sexual assault,gender,ptsd,depression,hopelessness,cannabis use motives,cannabis craving,women

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