The Cognitive, Emotional, and Behavioral Sequelae of Trauma Exposure: An Integrative Approach to Examining Trauma's Effect

Objective: In this study, we tested direct pathways from trauma exposure to trauma symptomatology and risky and self-destructive behavior and indirect pathways through two cognitive and affective mechanisms: (a) world assumptions and (b) emotion dysregulation. Method: A sample of 270 undergraduate students with an average age of 20.02 years participated in the study (204 women, 65 men, and one participant choosing not to disclose). Participants completed self-report measures assessing trauma exposure, trauma symptoms, emotion dysregulation, world assumptions, and lifetime and past-month engagement in any of 38 risky and self-destructive behaviors. Results: The direct path from trauma exposure to trauma symptoms was significant, and so was the indirect effect of self-worth assumptions on this association. The indirect pathway between trauma symptoms and risky and self-destructive behavior in the past month was significant through difficulties with impulse control when distressed. Trauma symptoms had an indirect effect on the association between trauma exposure and lifetime and past-month engagement in risky and self-destructive behavior, while the direct pathway from trauma exposure to lifetime engagement remained significant. Conclusion: We offer theoretically and empirically supported integrative pathways that explicate some aspects of trauma exposure's negative sequelae with potential areas for intervention. Clinical Impact Statement Trauma exposure is widespread and is associated with negative views about oneself and the world and with difficulties in managing one's emotions, which in part is associated with individuals' risk for developing psychopathology and engaging in risky and self-destructive behaviors. The findings inform optimal time for intervention and prevention efforts targeting trauma exposure.