The moderational impact of disclosure following trauma

Contemporary theories of trauma identify the creation of a coherent trauma narrative and therapeutic exposure to trauma memories as potential recovery mechanisms. These factors are often inherent to the disclosure process, resulting in a parallel theoretical framework for experimental research that conceptualizes disclosure as a therapeutic intervention. The present investigation examined the moderational impact of disclosure following trauma on the link between trauma severity and symptoms of Posttraumatic Stress Disorder (PTSD). Disclosure status (discloser or nondiscloser), highest extent of disclosure, and length of delay to first disclosure were tested in a series of moderated regression models among a sample of female physical and sexual assault victims (N = 1087). Findings indicate that engaging in more detailed disclosure is associated with a modest beneficial impact on PTSD, but that the majority of nondisclosers have lower symptom levels than disclosers. There is also evidence for a small subset of nondisclosers that remain at heightened distress. A unique effect was found for disclosure delay, such that for physical assault, delaying disclosure is associated with a progressively weakening negative relation between time since the trauma and PTSD. At extreme delays, the association may become positive. Findings have implications for theories of trauma recovery and therapeutic interventions, including concerns about early interventions that emphasize disclosure. Future research may benefit from focusing on nondisclosing trauma victims to gain greater insight into recovery processes.