Evolution of psychopathological manifestations and cognitive functioning in rape survivors in eastern Democratic Republic of the Congo.

Abstract

This longitudinal observational study examined (a) whether changes in posttraumatic stress disorder (PTSD) symptoms predicted a concomitant improvement in working memory (WM) among women living in eastern Democratic Republic of Congo and (b) whether these patterns differed by rape history or psychosocial care. The longitudinal analytic sample included participants assessed at baseline (Time [T] T1) and 6 months later (T2; N = 142, n = 55 rape survivors, n = 87 women with no reported rape history). PTSD symptoms were assessed using the PTSD Symptom Scale Interview for DSM-5 (PSSI-5), and WM was assessed primarily using a forward digit span task. In a baseline-adjusted regression predicting T2 forward span, T1 span predicted T2 span, B = 0.30, 95% CI [0.13, 0.47], p < .001, whereas T2 PTSD symptoms were not independently associated with T2 span after adjusting for T1 span and T1 PTSD symptoms, B = -0.01, 95% CI [-0.04, 0.02], p = .435. Rape history was associated with a lower T2 forward span in the primary model, B = -0.96, p = .049, but this association was slightly attenuated in a sensitivity model that adjusted for other directly experienced potentially traumatic events. The PTSD × Rape History interaction was not significant, p = .922. Among rape survivors, psychosocial care showed a positive but statistically uncertain association with T2 span and did not reach conventional significance in the baseline-adjusted moderation model. The findings should be interpreted cautiously given attrition, complete-case analyses, the small psychosocial care subgroup, and the nonrandomized design.