Does the Link Between Posttraumatic Cognitions and Eating Pathology Depend on Trauma Type? The Role of Sexual Violence

Objective: Exposure to potentially traumatic events is well-known to disrupt cognitions about the self. Among trauma-exposed college students, negative cognitions about the self can include low self-worth and heightened perception of behavioral control over outcomes (i.e., self-controllability), including overevaluation of self-control over weight, shape, and eating behaviors. Thus, posttraumatic cognitions may increase risk for eating pathology. These associations may be particularly heightened among those whose trauma was of a sexual nature, given the stigma and inaccurate rape myths that often place the blame on sexual violence survivors rather than perpetrators. Consistent with these possibilities, the present study tested whether sexual violence history moderated expected associations between lower self-worth and greater eating pathology and between greater self-controllability and eating pathology. Method: Participants were 1,303 trauma-exposed college students (71.6% cisgender women) who completed self-report measures. Two linear regression models were examined, controlling for gender identity and posttraumatic stress symptom severity. Results: As expected, more negative views toward the self were associated with greater eating pathology, and this association was stronger among college students who had experienced sexual violence compared with those who only experienced other trauma types. In contrast, beliefs about behavioral control over outcomes were unrelated to eating pathology regardless of trauma type. Conclusions: Findings point to low self-worth as a cognitive target for future research and clinical efforts aimed at addressing trauma-related distress and eating pathology concurrently, especially among individuals with a history of sexual violence.