Pathways Towards Posttraumatic Stress Symptomatology: A Moderated Mediation Model Including Perceived Stress, Worry, and Defense Mechanisms

Objective: The general aim of this study was to examine the psychological variables associated with post-traumatic stress disorder (PTSD) symptomatology, focusing on perceived stress, worry, as well as mature, neurotic, and immature defenses. Therefore, the differences in the study variables based on the levels of posttraumatic stress were explored, and a moderated mediation model was tested, controlling for gender and SARS-CoV-2 infection as covariates. Method: A sample of 1,864 Italian participants completed the Impact of event scale-revised (IES-R), the 10-Item Perceived Stress Scale (PSS-10), the Penn State Worry Questionnaire (PSWQ), and the 40-Item Defense Style Questionnaire (DSQ-40). Results: 41% (n = 764) of participants showed scores indicative of a probable presence of PTSD. They reported significantly higher levels of perceived stress, worry, neurotic and immature defenses than participants with lower PTSD symptomatology. Perceived stress was significantly associated with PTSD symptomatology, both directly and indirectly through the mediation of worry. Furthermore, neurotic and immature defenses were significant moderators in some relationships of this model. Conclusions: Such data can provide useful indications to elaborate tailored interventions and specific prevention activities for PTSD.