Stress and Health最新文献

{"title":"Invisible Scars: A Population-Based Study Examining Mental and Physical Health, Suicide Risk, and Family Well-Being Among Women Survivors of Intimate Partner Violence.","authors":"Margherita Cameranesi, Caroline C Piotrowski","doi":"10.1002/smi.70171","DOIUrl":"10.1002/smi.70171","url":null,"abstract":"<p><p>This research study used linked population-based administrative data to identify and analyze similarities and differences in several indicators of mental and physical health, suicide risk, and family well-being between two cohorts of women living in Central Canada, one including intimate partner violence (IPV) survivors (IPV cohort) and one including women who had never experienced IPV (non-IPV cohort). A population-based retrospective cohort study design was used to create the two study cohorts using linked administrative data on all residents of the Canadian Province of Manitoba over a 12-year period. Mental health, including suicide risk, physical health, and family well-being were compared in the two cohorts using Chi-square test, T-test, and Wilcoxon Mann-Whiney U-test analyses. The women survivors of IPV showed significantly higher rates of depression, anxiety, and post-traumatic stress disorder (PTSD) diagnoses. Suicide risk was significantly elevated in women IPV survivors, with 3% of the IPV cohort having attempted suicide 1-7 times and 0.7% having died by suicide during the study period. All poor physical health indicators were significantly prominent in the IPV cohort, except for asthma diagnosis. Additionally, the IPV cohort showed poorer family well-being, as indicated by a significantly larger proportion of single-parent families (vs. dual-parent families) and contacts with the child welfare system. This investigation highlights the profound and lasting effects that IPV has on the mental and physical health of women in Manitoba, with significant implications for suicide risk and family well-being. There is a critical need for integrated, trauma-informed, and contextually sensitive support services tailored to the needs of IPV survivors, particularly in more socioeconomic disadvantaged communities.</p>","PeriodicalId":51175,"journal":{"name":"Stress and Health","volume":"42 2","pages":"e70171"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13062720/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147640102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychological Distress and Associated Factors Among Adult Tuberculosis Patients in Ethiopia: Systematic Review and Meta-Analysis.","authors":"Yihenew Sewale Bizu, Kassahun Dires Ayenew","doi":"10.1002/smi.70159","DOIUrl":"10.1002/smi.70159","url":null,"abstract":"<p><p>Tuberculosis (TB) remains a leading global infectious cause of illness and death, despite being preventable and curable, with the highest burden in low- and middle-income countries, particularly in Southeast Asia and Africa. TB is closely linked with mental health, as psychological distress manifested by anxiety, depression, and somatic symptoms is a common and significant comorbidity. However, nationally representative data on the prevalence of psychological distress among TB patients are limited. This systematic review and meta-analysis aimed to estimate the pooled prevalence of psychological distress and identify associated factors in TB patients in Ethiopia. A systematic review and meta-analysis of five studies involving 2117 participants was conducted, showing very high heterogeneity (I² = 99.8%). A comprehensive search of PubMed, Scopus, Web of Science, Google Scholar, PsycINFO, and AJOL identified studies published from June 2000 to August 1, 2025. The review followed PRISMA 2020 guidelines, and study quality was assessed using the Joanna Briggs Institute Checklist for Analytical Cross-Sectional Studies. Data were analysed in STATA version 16 using a random-effects model with 95% confidence intervals. Heterogeneity was evaluated using the I² statistic (p < 0.05 indicating significance). Publication bias was assessed using a funnel plot with asymmetry distribution and Egger's test revealed a statistically significant result (p = 0.007) and meta-regression was conducted to explore potential sources of heterogeneity. The pooled prevalence of psychological distress among 2117 adult tuberculosis patients was 47.47% (95% CI; 11.95, 82.98). In this review, stigma (AOR = 2.21, 95 CI: 1.49, 3.26), and co-infection (AOR = 2.89, 95% CI: 1.57, 5.35) were statistical significant associated with psychological distress. Psychological distress affecting nearly half adult tuberculosis patients in Ethiopia. Stigma and co-infection are statistically significant with psychological distress. Therefore, integrate mental health screening and psychosocial support into tuberculosis programs, strengthen community-based stigma reduction strategies, and provide tailored care for TB-HIV co-infected patients, especially in rural areas with limited resources is essential.</p>","PeriodicalId":51175,"journal":{"name":"Stress and Health","volume":"42 2","pages":"e70159"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147318739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Methods of Repeated Monitoring of Stress and Stress-Related Mental Health Outcomes in Military Personnel and Veterans: A Systematic Review.","authors":"Allison Metts, Emma Harris, Nevaeh M Martinez, Rahel Pearson, Suzannah K Creech","doi":"10.1002/smi.70175","DOIUrl":"10.1002/smi.70175","url":null,"abstract":"<p><p>Military personnel and veterans are exposed to high levels of stress throughout their military careers and following separation and are susceptible to stress-related psychopathology. The objective of this systematic review is to evaluate research on the repeated monitoring of stress and stress-related mental health outcomes in these populations (PROSPERO ID#CRD42024587783; Funding: US Department of Veterans Affairs). Systematic searches of three databases (APA PsycInfo, PubMed, PTSDPubs) were conducted from inception until September 30, 2025. Inclusion criteria were military or veteran samples, self-report or clinician-rated stress, depression, anxiety, trauma-related distress, or mood measures, repeated monitoring within a 4-week timeframe, and original peer reviewed research. Each study was assessed for risk of bias with an empirically supported critical appraisal checklist. Data were synthesised by three authors (A.M., E.H., and N.M.M.). Of the 61 included studies, most were in majority male (94.9%), White (82.6%), and veteran-only (67.2%) samples. Traditional self-report measures were the most used assessment type (32.7%), followed by ecological momentary assessment (26.2%). Most studies monitored posttraumatic stress disorder (PTSD) (52.5%) and depressive (44.3%) symptoms, with fewer studies measuring stress (31.1%) and anxiety (11.5%). Approximately a quarter (26.2%) measured stress and stress-related mental health outcomes concurrently. Most studies measuring mood were completed in samples with a primary focus on PTSD (63.2%). Although repeated assessment in military and veteran populations provides important insight into changes in stress and stress-related outcomes, studies together were limited by inconsistencies in methodology. We highlight potential contributions in methodology to capture risk and resilience and improve outcomes for these populations. TRIAL REGISTRATION: This systematic review was pre-registered: https://www.crd.york.ac.uk/PROSPERO/view/CRD42024587783.</p>","PeriodicalId":51175,"journal":{"name":"Stress and Health","volume":"42 2","pages":"e70175"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13191599/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147647533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Restorative Potential of Natural Soundscapes in Indoor Environments: EEG and Psychological Evidence.","authors":"Chao Liu, Nan Zhang, Zhen Peng, Run Wang, Huisen Wen, Weijun Gao","doi":"10.1002/smi.70173","DOIUrl":"10.1002/smi.70173","url":null,"abstract":"<p><p>Given the considerable time individuals spend indoors, the acoustic characteristics of indoor environments play a crucial role in shaping psychophysiological health. To investigate how various sound types influence subjective perception and neural responses, this study examined five auditory conditions: no sound, traffic noise (TN), environmental noise, birdsong (BS), and water sound (WS). Thirty-eight university students participated in the experiment, during which subjective evaluations-including sound comfort (SCV), sound pleasure (SPV), and sound satisfaction (SSV)-were collected alongside electroencephalogram (EEG) data. EEG analysis included time-frequency and nonlinear dynamic features. Compared with TN, both BS and WS improved subjective perception, with BS increasing SCV, SPV, and SSV by 1.68-2.42 points (p < 0.001) and WS increasing them by 1.95-2.37 points (p < 0.01). Exposure to BS and WS elicited enhanced α and β activity, with power increases of 3.42%-11.05% and 9.61%-13.22% (both p < 0.05), predominantly in the frontal and parietal regions. Furthermore, natural sounds induced neural avalanche dynamics with shorter durations, smaller avalanche sizes, and reduced branching parameters and avalanche critical indices (decreases of 4.94%-8.24% and 15.53%-16.43%, both p < 0.05), indicating closer proximity to the brain's critical state. Compared to traffic noise, the ratio of brain self-stabilisation to synchronisation under natural sound increased by 1.34-1.35 times. Canonical correlation analysis revealed a strong association (r = 0.643) between subjective sound perception and brain activity, highlighting the psychophysiological coupling induced by sound exposure. These findings support incorporating restorative natural sounds into architectural acoustic design. Based on a neuroarchitectural framework, this study proposes an integrated evaluation approach for indoor sound environments, offering insights for enhancing occupant well-being in built spaces.</p>","PeriodicalId":51175,"journal":{"name":"Stress and Health","volume":"42 2","pages":"e70173"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147634727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incident-Specific Measurement of Divine Forgiveness: Psychometric Properties of the Christian-Sensitive Reconciliation With God Scale.","authors":"Richard G Cowden, Carmen Callizo, Ni Made Taganing Kurniati, Patrick Nyamaruze, Zuhal Agilkaya Sahin, Maria Calatrava, Martiño Rodríguez-González, Katelyn N G Long, Tyler J VanderWeele, Kaye V Cook","doi":"10.1002/smi.70165","DOIUrl":"10.1002/smi.70165","url":null,"abstract":"<p><p>When people perceive themselves as having violated religious/spiritual principles, they may experience distress that prompts efforts to restore alignment with what they hold as sacred. While divine forgiveness is increasingly recognized as an important part of this process, much of the empirical literature tends to overlook tradition-specific considerations that may be essential to conceptualising and measuring divine forgiveness. Building on an interdisciplinary Christian-sensitive dual-process model for conceptualising and measuring incident-specific psychological experiences of reconciliation with God for personal wrongdoing, we use cross-sectional and longitudinal data to examine the psychometric properties of the Reconciliation with God Scale in seven independent adult Christian samples representing a diverse range of countries, linguistic backgrounds, and denominational affiliations (N = 1391). We present evidence for the two proposed factors-engaging in repentance with God and experiencing absolution from God-based on analyses of internal structure and internal consistency. Evidence of convergent validity was observed from associations with theoretically relevant proximal (e.g., trait divine forgiveness) and distal (e.g., personal flourishing) variables. Group comparisons based on theory-driven classifications provided support for discriminative validity, with somewhat consistent evidence that those who scored higher on both proposed factors tended to score more favourably on a number of the auxiliary variables. These findings provide initial psychometric evidence supporting the utility of the incident-anchored Reconciliation with God Scale among Christians, making processes of engaging in repentance with God and experiencing absolution from God empirically tractable as stress-regulatory mechanisms following spiritually salient moral transgressions.</p>","PeriodicalId":51175,"journal":{"name":"Stress and Health","volume":"42 2","pages":"e70165"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147464105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Childhood Maltreatment and Its Pathways to Irritable Bowel Syndrome in Adulthood: Insights From Sequential Mediation Analysis.","authors":"Shuyi Peng, Qianyu Liu, Yanyan Ni, Jin Tao, Lan Guo","doi":"10.1002/smi.70178","DOIUrl":"10.1002/smi.70178","url":null,"abstract":"<p><p>Childhood maltreatment has been associated with an increased risk of irritable bowel syndrome (IBS) in adulthood, but the longitudinal relationship and underlying mechanisms remain underexplored. Using data from the UK Biobank, this cohort study investigated the association between childhood maltreatment and the onset of IBS in adulthood and explored potential mediating pathways. A total of 108,365 participants (mean age: 34.57 [SD: 4.81] years; 57.2% were female) were followed up from age 30 onwards (or January 1, 1985, whichever was later) until the first IBS diagnosis, death, or the end of follow-up, whichever occurred first. Childhood maltreatment was assessed through self-reported data, and incident IBS cases were identified using ICD-10 codes, with subtypes classified by Rome III criteria. Cox proportional hazards, sequential mediation analyses, and multinomial logistic regression were performed. Over a mean follow-up of 35.6 years, 5806 incident IBS cases were recorded. A positive association was observed between cumulative childhood maltreatment and incident IBS (HR: 1.10; 95% CI: 1.07-1.12). Among individual maltreatment types, emotional neglect showed the strongest association with IBS (HR: 1.27; 95% CI: 1.20-1.35). Sequential mediation analyses indicated that psychological adversity accounted for the largest proportion of the indirect effect (15.3%-17.0%), followed by socioeconomic status, lifestyle behaviours, and biological alterations. These findings emphasise the need for prevention strategies to reduce childhood maltreatment and mitigate its long-term health impacts. Tailored interventions focussing on psychosocial support, addressing socioeconomic disparities, and promoting healthy lifestyle changes may further reduce IBS risk in affected individuals.</p>","PeriodicalId":51175,"journal":{"name":"Stress and Health","volume":"42 2","pages":"e70178"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147788493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Heterogeneous and Joint Developmental Trajectories of Non-Suicidal Self-Injury and Depression in Emerging Adulthood: The Role of Interpersonal Dynamics.","authors":"Shuqian Liang, Jiajing Li, Shuyu Shan, Yang Yang, Xiuya Lei","doi":"10.1002/smi.70170","DOIUrl":"10.1002/smi.70170","url":null,"abstract":"<p><p>Non-suicidal self-injury (NSSI) and depression frequently co-occur among emerging adulthood, yet how they co-develop over time in response to interpersonal stress and which social factors shape this process remain unclear. Understanding these joint trajectories and their interpersonal predictors is critical for early identification and effective intervention. This longitudinal study examined how NSSI and depression co-develop in Chinese college students and tested four interpersonal predictors (parent-child, peer, teacher-student, and dormitory relationships) via latent class growth analysis (LCGA). Three-wave data over 12 months revealed two NSSI trajectories (Low-Stable and High-Decreasing) and three depression trajectories (Low-Stable, Moderate-Fluctuating, High-Stable). Joint trajectories of NSSI and depression formed two patterns: Low-Comorbidity-Stable and Moderate-Comorbidity -Decreasing. Parent-child, peer, and dormitory relationships each predicted lower-risk trajectories, with dormitory ties exerting the strongest influence and suggesting that dormitory environments serve as crucial intervention targets. In contrast, teacher-student relationships had no significant effect, a finding that warrants further investigation. Findings indicate that interpersonal stressors and the buffering effect of supportive relationships shape stress-related health outcomes in emerging adults, with implications for interpersonal-focused campus prevention strategies.</p>","PeriodicalId":51175,"journal":{"name":"Stress and Health","volume":"42 2","pages":"e70170"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147516309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Heterogeneity of Academic Stress Profiles and Depression-Anxiety Symptom Networks in Left-Behind Children: A Latent Profile and Simulated Intervention Network Analysis.","authors":"Kuiliang Li, Lei Ren, Rui Lang, Xuemei Li, Lin Wu, Tingwei Feng, Jingxuan Zhang, Chang Liu, Zhengzhi Feng, Ming Ji","doi":"10.1002/smi.70172","DOIUrl":"10.1002/smi.70172","url":null,"abstract":"<p><p>Compared with non-left-behind children (NLBC), left-behind children (LBC) face a higher risk of academic stress, depression, and anxiety symptoms due to separation from their parents; however, the heterogeneity of academic stress profiles and their relationships with the symptom network remain insufficiently explored. To address this gap, a cross-sectional survey of 10,524 Chinese children compared LBC (n = 2487) and NLBC. Latent profile analysis (LPA) was first conducted to identify academic stress subgroups among LBC. Subsequently, depression-anxiety symptom networks were estimated using Ising and Gaussian graphical models (GGM), with edge weights derived from regularised logistic regression (Ising) and partial correlation (GGM). Simulated interventions were further evaluated via the NodeIdentifyR algorithm (NIRA). Overall, compared to NLBC, LBC exhibited higher levels of academic stress, depression, and anxiety (ps < 0.001, Cliff's δ = 0.076; Cohen's d = 0.067). LPA revealed three academic stress subgroups: moderate (31.44%), high (9.17%), and low (59.39%). The severity of depression and anxiety symptoms increased with the level of academic stress. The high stress subgroup displayed a sparse network with stronger edges (e.g., A1 'Sudden Fear'-A4 'Physical Symptoms', edge weight = 2.10) compared to moderate- and low-academic stress subgroups. Core nodes with the strongest expected influence were A8 ('Decision Hesitation', moderate subgroup), A2 ('Worry', high subgroup), and D1/D6 ('Sadness' and 'Failure', low subgroup). Simulated interventions indicated that alleviating A8 'Decision Hesitation' or A2 'Worry' most effectively reduced symptom risk (16.66%-30.76%), whereas D8 'Motor' and A7 'Early Departure' were associated with maximal symptom aggravation. Taken together, by integrating LPA-derived academic stress profiles with symptom network analysis, this study reveals distinct symptom associations across subgroups. In the high stress subgroup, symptom A2 ('Worry') is a core intervention target; in the low stress subgroup, A7 ('Early Departure') holds preventive potential. These findings underscore subgroup-specific interventions tailored to individual stress profiles.</p>","PeriodicalId":51175,"journal":{"name":"Stress and Health","volume":"42 2","pages":"e70172"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147610247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health Insurance Premium and Psychological Distress: Evidence From the ARPA Enhanced Subsidies.","authors":"Sankar Mukhopadhyay","doi":"10.1002/smi.70176","DOIUrl":"10.1002/smi.70176","url":null,"abstract":"<p><p>Health insurance costs are a well-documented source of stress for Americans, yet little causal evidence links improved insurance affordability to better psychological health. We use a natural experiment from the American Rescue Plan Act (ARPA) of 2021 to assess whether enhanced premium subsidies reduced psychological distress. We utilize nationally representative individual-level panel data from the Panel Study of Income Dynamics (2015-2023) and a difference-in-differences design, comparing individuals with private health insurance (treatment group) to those with employer-sponsored insurance (control group) before and after the ARPA's implementation. Results indicate that ARPA's subsidy expansions led to a significant decline in out-of-pocket premium costs (approximately 22% or $532 annually for single-person households), which corresponded with a notable reduction in moderate-to-severe psychological distress. Among single adults with private insurance, distress prevalence dropped by about 33% (p-value 0.039) post-ARPA, with a smaller but still significant decline of about 26.2% (p-value 0.022) observed when including all household types. These findings suggest that making health insurance more affordable can alleviate psychological distress.</p>","PeriodicalId":51175,"journal":{"name":"Stress and Health","volume":"42 2","pages":"e70176"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147693350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pain, Sleep Disturbance, and PTSD Symptoms in Women Sexual Trauma Survivors: A Cross-Lagged Panel Analysis.","authors":"Katherine E Gnall, Mariel Emrich, Joshua A Wilt, Camille L Garnsey, Crystal L Park","doi":"10.1002/smi.70177","DOIUrl":"10.1002/smi.70177","url":null,"abstract":"<p><p>Posttraumatic stress disorder (PTSD) and pain are common following trauma exposure, highly comorbid, known to exacerbate one another, and together contribute to reduced quality of life. Sleep disturbance is likewise associated with both PTSD and pain and may partially explain the PTSD-pain link over time. Despite their well-documented co-occurrence, studies have yet to examine the bidirectional influences of PTSD symptoms, sleep disturbance, and pain (i.e., severity and interference) together over time among women in the acute post-trauma period. This is the aim of the present secondary analysis. Women (N = 203) recruited within 1 month of experiencing a sexual trauma completed online surveys at baseline (T1) and two follow-up periods each spaced 1 month apart (T2 and T3). Cross-lagged panel models (CLPMs) were used to test the directionality of associations between PTSD symptoms and pain over time as well as the mediating role of sleep disturbance on cross-lagged paths (between-person level). A sensitivity analysis using random-intercept cross-lagged panel models (RI-CLPMs) was conducted to isolate within-person effects. Findings from CLPMs demonstrated that PTSD symptoms at T1 predicted both sleep disturbance and pain interference (but not pain severity) at T2 (between-person level). Sleep disturbance did not mediate associations between PTSD symptoms and pain. No cross-lagged effects were observed from T2 to T3. No within-person cross-lagged effects were observed among PTSD symptoms, pain, and sleep in RI-CLPMs. Findings suggest that individuals with more severe PTSD symptoms in the month following sexual trauma experience worse physical health symptoms early-on in the post-trauma phase, including pain interference and sleep disturbance. Understanding the directionality and strength of co-occurring concerns can inform first-line treatment targets to prevent downstream negative physical and mental health sequelae following sexual trauma.</p>","PeriodicalId":51175,"journal":{"name":"Stress and Health","volume":"42 2","pages":"e70177"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147718776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}