Does coping style add to the effects of sex and trauma type on PTSD and mental health outcomes?

While a large percentage of the population experiences trauma, only 8-10% of those individuals develop posttraumatic stress disorder (PTSD) and other trauma-related mental health problems. Previous research has shown that female sex is associated with higher rates of negative mental health outcomes. Survivors of interpersonal violence (physical and sexual abuse or assault) report higher rates of PTSD than survivors of most other forms of trauma, such as death of a loved one or natural disasters. Among the possible explanations for these differences (including biological, social, cognitive, and behavioral factors), coping style has been suggested as an additional reason for increased mental health problems after trauma. Research has shown that avoidant coping is associated with increases in PTSD symptoms and other mental health outcomes. Yet there is a paucity of research examining the interplay among participant sex, trauma type, and coping style on PTSD symptoms and other trauma-related outcomes. A large sample of college student participants completed a survey study examining demographic information (including participant sex), trauma history, coping style, PTSD outcomes, and other mental health issues. We conducted a series of hierarchical linear regressions; the results indicated that female sex, interpersonal violence exposure, and avoidant coping styles were associated increases in PTSD symptoms and other negative mental health outcomes. Male sex and problem-focused coping seemed to buffer the effects of trauma on PTSD and negative mental health outcomes. The results confirm that being female and interpersonal violence exposure are both independently and in concert strongly related to PTSD while the influence of experiencing the death of a loved one seems to be important but mild. These findings support the assertion that problem-focused coping leads to desirable outcomes and avoidant coping leads to poor outcomes. Clinicians and first responders working with survivors of trauma should carefully assess for this constellation of risk factors (female sex, interpersonal violence, and avoidant coping), as individuals with these risk factors seem to be at a significantly high risk for negative outcomes. In addition, interventions that decrease avoidance coping and improve problem-focused coping will likely be useful for survivors of trauma.