Posttraumatic Stress Disorder and Body Image Distress in Victims of Physical and Sexual Assault Terri L. Weaver 1, Ph.D., Michael G. Griffin 2, Ph.D. and.

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Posttraumatic Stress Disorder and Body Image Distress in Victims of Physical and Sexual Assault Terri L. Weaver 1, Ph.D., Michael G. Griffin 2, Ph.D. and Elisha R. Mitchell 1 1 Saint Louis University, and 2 The University of Missouri -Saint Louis INTRODUCTION METHODS DISCUSSION  84% of women reported sustaining at least one acute or residual injury as a result of their assault (See Figure 1). BODY IMAGE DISTRESS  No significant differences in severity of body image distress were observed between women who suffered from a physical versus sexual assault.  With regard to MDD, there was no difference in severity of body image distress (t = -1.56, p =.12) for women positive versus those negative for diagnosis of MDD.  A small-moderate, significant correlation was observed between body image distress and severity of PTSD (See Table 1).  In terms of assault-related factors, more trust (compared with less) in perpetrator was significantly associated with increased severity of body image distress. 27.2% of female victims indicated that they had some trust in their perpetrator. Assault-related factors including presence of a weapon and degree of restraint were NS associated with body image distress.  Body image distress was a unique significant predictor of PTSD symptom severity, and explained an additional 13% of the variance above and beyond that explained by age and type of assault (See Table 2). REFERENCES ABSTRACT Weaver, T.L., Resnick, H.S., Kokoska, M.S., & Etzel, J.C. (2007). Appearance-related residual injury, posttraumatic stress, and body image: Associations within a sample of female victims of intimate partner violence. Journal of Traumatic Stress, 20(6), Weaver, T.L., Turner, P.K., Schwarze, N., Thayer, C.A., & Carter-Sand, S. (2007). An exploratory examination of the meanings of residual injuries from intimate partner violence. Women & Health, 45(3),  Participants were eighty-one women ranging in age from 18 to 66 who had been recent victims of physical and sexual assault.  Women were recruited from local victim assistance agencies and police agencies, and postcards were mailed to recent crime victims describing the study. Informational flyers were also posted in local community agencies.  On average, individuals participated in the study one month post- assault. Violence-related injury has consistently conferred increased risk for developing posttraumatic stress disorder (PTSD) though most studies have conceptualized injury as an acute phenomenon. However acute injuries may lead to lasting physical changes including alterations in appearance with marks or scars. Previous research with a small sample of victims of intimate partner violence (IPV) (N = 31) found that IPV- related residual injuries were significantly associated with body image distress and body focused distress was significantly (and uniquely) associated with symptoms of PTSD. The current study expands these previous findings by exploring related associations within a sample of victims of physical or sexual assault utilizing diagnostic assessments. Eighty-one predominantly African-American victims of physical or sexual assault were assessed for violence-related injury, body image distress, PTSD and major depression. Within the entire sample, severity of body image distress was significantly associated with severity of PTSD and with PTSD diagnostic status. Associations with the severity of symptoms of Major Depression were non-significant. Additional analyses exploring the relationships between body image distress, assault characteristics and PTSD were examined.  Many experiences of IPV are associated with acute injuries which can play an important role in the development of PTSD. However, an individual’s appearance may be permanently altered as a result of these acute injuries in the form of marks, scars, or other physical changes.  Focus group studies have demonstrated that IPV-related residual injuries may be associated with IPV-related self-blame, and may play a role in victims’ self-identity and their perceived potential for future relationships (Weaver et al, 2007b).  These lasting residual injuries may play an important role in the maintenance of psychological distress in victims of IPV.  Preliminary findings support an association between body image distress and self-reported symptoms of PTSD among women who experienced moderate to severe IPV, with body image distress emerging as a unique predictor of PTSD (Weaver et al, 2007a).  At this time, further research is needed using diagnostic assessments of PSTD and an expanded sample of female victims of interpersonal violence in order to further document the relationship between PTSD and body image distress. MeanSD Body Image PTSD Sev Age Body Image *.22* PTSD Sev Age * p <.01 Table 1. Means and Correlations Among Measures Group Differences VariableSexual Assault M(SD)Physical Assault M (SD)tp Body Image Distress (26.37)65.91(37.59) PTSD + PTSD - Body Image Distress73.63 (33.38)55.46 (39.31)-2.21 *.04 MDD + MDD - Body Image Distress76.59 (30.81)63.97 (39.17) Trust in Perp M(SD)No Trust in Perp M(SD) Body Image Distress89.63 (30.03)61.02 (35.31)-3.36**.001 PTSD Severity68.77 (24.39)59.81 (26.58) Regression Analysis: Body Image Distress Predicts PTSD Symptom Severity Variable BSEBβt Type of Assault Age Body Image Distress ** Figure 1. Percentages of Type of Injury Sustained Table 2. Group Differences and Regression Analysis * p <.05, **p <.01 FUTURE DIRECTIONS RESULTS Note. PTSD was measured by the CAPS and total severity score is shown.  Current findings provide additional support for the association between body image distress and PTSD (both at the diagnostic and severity level) within a sample of injured female crime victims using standardized diagnostic assessments.  The lack of an association between severity of body image distress and MDD suggest that body image distress adds to a trauma-specific conceptualization, particularly when the distress is anchored to a residual injury resulting from a violent crime.  The body image distress measure may not include all the potential concerns experienced by sexual assault victims. Future work may benefit from tailoring body image distress assessment to areas of concern unique to women who have experienced sexual assault.  Meaning continues to appear important for associations with body image distress. The way that betrayal of trust may negatively affect body image concerns post-crime requires further study. Other assault- related factors such as pain may also be important correlates of body image distress. This research was funded in part by NIMH R29-MH-55688, Griffin (PI) Note. MDD was assessed with the SCID.