Posttraumatic Stress Disorder in Students Exposed to Sexual Violence: A Network Analysis

Background

Gender-based and sexual violence (GBSV) is a major public health concern among university students, yet the specific symptom architecture and central drivers of PTSD in this population remain under-researched. This study assessed PTSD severity and identified central symptoms among student victims of GBSV using network analysis.

Methods

Participants (n = 563; 76.9% female; 18–30 years) were drawn from a prospective cohort launched in October 2024 at a French university. GBSV exposure (five types) and PTSD severity (PCL-5) were assessed at baseline (M0) and three-month follow-up (M3). Network analysis was conducted to identify central symptoms (closeness/strength centrality) and edge weights (links between symptoms) across different violence types.

Results

At baseline, 51.7% of participants reported at least one GBSV incident since starting university. PCL-5 scores were significantly higher following sexual assault (36±21) and attempted rape /rape (44±19; p < 0.001). Network analysis identified “intense negative feelings” as the most central symptom for sexual assault, and “loss of interest” for attempted rape /rape. The strongest edge linked hypervigilance to exaggerated startle response in sexual assault victims, while internal and external avoidance were most strongly linked in rape victims. At M3, 30% of initial victims reported revictimization, showing significantly higher PTSD scores than first-time victims (26.4±18.3 vs. 17.8±16.9; p = 0.022).

Conclusions

Students exposed to GBSV carry a significant psychotraumatic burden, worsened by severity and repetition. Network analysis identifies specific symptom clusters that could guide targeted, symptom-specific psychotherapeutic interventions within university health services.

Key messages

• PTSD severity among student victims of GBSV varies by violence type, with attempted rape or rape associated with the highest PCL-5 scores (44±19).

• Network analysis reveals distinct central symptoms (e.g., loss of interest) by violence type, offering a roadmap for targeted, symptom-specific psychological support on university campuses.