Posttraumatic belief in a dangerous world: Demographic and clinical correlates in a large-scale epidemiological study

Cognitive distortions are thought to play a significant role in the etiology and maintenance of psychopathology. The belief in a dangerous world (BDW) is an important cognitive distortion that, along with other distortions, was recently included in formal diagnostic criteria for posttraumatic stress disorder (PTSD). Due to its grouping with other distortions, posttraumatic BDW has not been examined in large-scale epidemiological studies, though one recent survey assessed it in isolation. This methodological change provided a novel opportunity to empirically evaluate this cognitive distortion in a large representative sample. We used data from the National Epidemiological Survey on Alcohol and Related Disorders-III (NESARC-III), which assessed BDW as part of the PTSD diagnostic module. Sociodemographic factors, psychiatric diagnoses, and trauma type histories were examined in a subsample of the NESARC-III that endorsed at least one traumatic event (N = 23,936; M_age = 46.2, SD = 17.2). When covarying for trauma history, endorsement of trauma-related BDW was more likely among Black and Hispanic respondents, and was also associated with being single, identifying as bisexual, having lower income and education, and greater importance of religious beliefs. Additionally, panic disorder, agoraphobia, borderline personality disorder, and suicide attempt history were uniquely associated with endorsement of posttraumatic BDW when covarying for PTSD severity. These findings highlight the transdiagnostic nature of BDW and its relevance in different populations.