Negative Posttraumatic Cognitions about Self Mediate the Relation Between Sexual Revictimization and Suicide Risk in a Sample of Military Sexual Assault Survivors

Military sexual trauma (MST) is a risk factor for suicide among service members/veterans. Research reported that 41.79% of male and 63.58% female MST survivors were exposed to pre-military sexual trauma, making MST a revictimization experience. Unfortunately, little is known about mechanisms of the association between revictimization and suicide risk among MST survivors. One possible mechanism is posttraumatic cognitions (PTCs), which include the survivor’s (1) negative thoughts and beliefs about themselves, (2) negative thoughts and beliefs about the world, and (3) self-blame. The current study examined each of the PTC subscales as mediators of the association between sexual revictimization and suicide risk. Participants were 383 service members/veterans reporting a history of MST that involved assault (50.65% female), recruited via Qualtrics., Inc. in 2021. Participants completed self-report questionnaires assessing demographics, suicide risk, history of sexual victimization (MST only, MST and pre-military sexual victimization), and PTCs. Of these, 340 (88.8%) reported a history of MST and pre-military victimization and comprised the revictimization group. Parallel mediation analysis with suicide risk regressed on each of the PTCs subscales and covariates accounted for 43.48% of the variance, and revealed that negative cognitions about the self had a significant indirect effect on the association between revictimization and higher suicide risk, above and beyond negative cognitions about world and self-blame. Targeting negative cognitions about the self among sexual revictimization survivors may be an effective therapeutic strategy to most effectively reduce suicide risk. Cognitive Processing Therapy may be particularly useful among revictimization survivors given the focus on altering posttraumatic cognitions.