(PS13-27) Sex, Negative Posttraumatic Cognitions, and Suicide Behaviors Following the Experience of Military Sexual Assault

A principal criterion of PTSD is the presence of negative posttraumatic cognitions (NPCs), which describe maladaptive beliefs (cognitions) concerning one’s sense of self, others, and the world. Prior research asserts the development and maintenance of NPCs is unique to the type of trauma an individual experiences and may relate to patterns of suicide ideation (SI), and possible history of suicide attempt. In military populations, the experience of assaultive Military Sexual Trauma (MST) appears to be particularly deleterious, prompting specific trends in the type and severity of NPCs survivors develop. These NPCs and their relationship to suicide behaviors, including suicide ideation (SI) and history of suicide attempt (SA), may also vary as a function of biological sex. Notably, much extant research associated with MST and suicide behavior is limited to non-clinical samples, female survivors, and/or those with a range of MST experiences that cover the spectrum of assault, harassment, and coercion. The present study examined the relationships between SI, lifetime SA, and specific types of NPCs in 289 veterans (83 male, 206 female) seeking treatment related to assault-type MST within a Midwestern PTSD specialty clinic. Descriptive analyses revealed that male Veterans reporting MST in the sample were significantly older (Mage (male)=50.21; Mage (female)=40.46, p< .001), more likely to have served during the Vietnam era (38.6% male, 5.80% female, p< .001), and more likely to have been in the Navy or Marines (Navy/Marines=21.70/28.9% male, 1.50/8.3% female, p’s< .01). Veterans did not otherwise differ by sex with respect to demographic presentation (Male/Female= 15.70/11.2% LGBTQIA, 74.70/66.5% White). Both sexes reported severe symptoms of PTSD (MPCL5=58.14 male, 55.29 female), high rates for NPCs (MPTCITotal=164.47 male, 159.75 female), and alarmingly high rates of suicide behavior (SI/SA=37.30/41.0% male, 38.3/33.5% female). Logistic regressions were performed within each sex-group to assess the relationships between NPCs and presence of SI and SA respectively, controlling for overall PTSD symptom severity. Among female Veterans, higher NPCs regarding the inability to cope following MST were significantly related to SA (OR=1.94, p = 0.003) as was PTSD symptom severity (OR=.96, p = 0.04), though nothing was significantly predictive of SI. By contrast, for males, nothing in the model was significantly related to SA, while only higher NPCs about the self were related to SI (OR=3.80, p = 0.02). This and prior data suggest the experience of assaultive-MST reliably results in the presentation of severe symptoms of PTSD characterized by high rates of NPCs. Our findings further suggest that the content of those NPCs (self vs. coping focus) may differentially affect risk for specific suicide behaviors (SI vs. SA) as a function of sex. Regarding the treatment of MST-related PTSD, focused exploration of the connections between specific NPCs, development of suicide behaviors, and sex is warranted to facilitate optimal treatment and a greater understanding of the functional relationship between trauma, NPCs, and suicide risk in Veterans.