Behavioral Inhibition and Posttrauma Symptomatology: Moderating Effects of Safety Behaviors and Biological Sex

Behavioral inhibition – a temperamental tendency characterized by general sensitivity to negative outcomes – is a trait-level factor thought to contribute to maintenance of posttraumatic stress disorder (PTSD). Anxiety-related safety behaviors – actions performed to prevent or mitigate feared outcomes and associated distress – may impact the nature of the relation between behavioral inhibition and trauma-focused symptoms by interfering with natural habituation of anxiety. The current research examined the unique and interactive effects of behavioral inhibition, safety behaviors, and biological sex on PTSD symptom clusters in undergraduates (N = 133; 74% female; 77% White/Non-Hispanic) reporting exposure to Criterion-A trauma. Regression models indicated direct effects of safety behaviors for cognition-mood (p = .001, pr = .323) and intrusion (p < .001, pr = .354) clusters. A main effect of behavioral inhibition was also noted for cognition-mood (p = .046, pr = .178). Participant sex moderated the relation between safety behaviors and arousal-reactivity symptoms (p = .035, pr = .187) with men demonstrating a stronger association as compared to women. Sex also moderated the relation between safety behaviors and avoidance-reactivity (p = .033, pr = -.190) with only women evidencing an association between safety behaviors and symptoms. Safety behaviors moderated the relation between behavioral inhibition and arousal-reactivity (p = .002, pr = .272) such that inhibition only predicted symptoms at high utilization of safety behaviors. Results suggest trauma-related safety behaviors are associated with more severe posttrauma symptoms though effects vary across sex and symptom cluster.