Doctoral Dissertation
University of Oregon

INTERNAL BODY AWARENESS AMONG SEXUAL TRAUMA SURVIVORS:
A MULTI-METHOD STUDY

By

KRISTEN M. REINHARDT

Defended & Completed June 2017
PhD to be granted 2018 after clinical internship

Advisor Freyd, Jennifer J.

Dissertation Abstract

Sexual trauma, in addition to being a human rights violation, harms people in numerous ways, including negative psychological and physical outcomes.  Body-based interventions reduce sexual trauma symptoms, but limited information exists about how these interventions work.  Researchers propose changes in internal body sensation awareness (i.e., interoceptive awareness; IA) as a potential mechanistic explanation.  We are not aware of any studies testing that claim.  Further, there is scant extant information on IA – sexual trauma relationships.  Before evaluating mechanistic therapeutic hypotheses, studies need to test sexual trauma – IA associations.  We focus on this understudied area here.

Through a multi-method study (behavioral, self-report and qualitative data), we tested the associations between IA and sexual trauma among females.  Aim 1: Characterize IA among sexual trauma survivors.  We hypothesized that survivors would have significantly lower self-reported IA than existing literature.  Aim 2: Quantify the amount of variance IA explains in posttraumatic stress disorder (PTSD) symptoms.  We hypothesized that IA would predict significant variance in PTSD, such that increases in IA would predict increases in PTSD.  We expected that an IA – dissociation symptom interaction would qualify that main effect via weakening it for survivors with higher dissociation.  Aim 3: Through a moderated mediation model, test if IA mediates the sexual trauma – PTSD association.  We hypothesized that IA would mediate that association.  Further, we predicted that the IA – PTSD relationship would be moderated by dissociation: higher dissociation would attenuate the IA – PTSD association.  

In this manuscript, we report results from two samples: 1) University (n = 153), and 2) community (n = 21) participants.  Given ongoing community participant recruitment, the following are university participant results.  Aim 1: Self-reported IA is significantly lower among survivors than comparator samples.  Aim 2: Behavioral IA explained significant variance in PTSD, though opposite to the direction we predicted: we observed that as IA increased, PTSD decreased.  We observed a significant interaction between self-reported IA and dissociation in predicting declines in PTSD.  PTSD symptoms were lowest among survivors with high dissociation and high IA.  Aim 3: IA did not mediate the sexual trauma – PTSD association.  We discuss clinical implications, limitations and future directions.  

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