Assault-related self-blame and its association with PTSD in sexually assaulted women: an MRI inquiry

Sexual assault is a frequent interpersonal trauma, which often leads to post-traumatic stress disorder (PTSD). Among other postassault characteristics, self-blame attributions were suggested to play an important role in sexually assaulted individuals' coping and were consistently associated with PTSD in this population. The present study aimed to elucidate the neural underpinnings that may associate self-blame and PTSD in women who experienced sexual assault at adulthood, using structural and resting-state functional MRI. Thirty-eight sexually assaulted women and 24 non-exposed matched controls were studied (mean age: 25 years). Among the sexually assaulted participants, assault-related self-blame was negatively correlated with gray matter volume (GMV) bilaterally in the lingual gyrus and adjacent intracalcarine cortex. GMV in this cluster was also predicted by intrusion symptoms and negative social reactions. Resting-state functional connectivity (rs-FC) of this cluster with the left anterior temporal fusiform cortex significantly differed between PTSD and non-PTSD sexually assaulted participants, and was inversely correlated with intrusion symptoms and with peritraumatic dissociation. Finally, lingual cluster's GMV and rs-FC with the anterior fusiform mediated the association between self-blame and intrusion symptoms across sexually assaulted participants. These findings link assault-related self-blame, disrupted postassault recovery and the neural circuitry involved in the processing of traumatic memories.