A Comparison of Psychological Symptoms in Survivors of Sex and Labor Trafficking

Behav Med. 2018 Jul-Sep;44(3):177-188. doi: 10.1080/08964289.2018.1432551.


Human trafficking is a form of interpersonal trauma that has significant mental health impacts on survivors. This study examined psychological symptoms in 131 survivors of sex and labor trafficking, including people trafficked into or within the United States. High rates of depression (71%) and posttraumatic stress disorder (PTSD) (61%) were identified. Two thirds of survivors also met criteria for multiple categories of Complex PTSD (C-PTSD), including affect dysregulation and impulsivity; alterations in attention and consciousness; changes in interpersonal relationships; revictimization; somatic dysregulation; and alterations in self-perception. Although there were not significant differences in the prevalence rates of diagnoses of PTSD or depression between survivors of sex and labor trafficking, important group differences were identified. Compared to survivors of labor trafficking, sex trafficking survivors had higher prevalence rates of pre-trafficking childhood abuse and a higher incidence of physical and sexual violence during trafficking. They reported more severe post-trauma reactions than labor trafficking survivors, including more PTSD and C-PTSD symptoms. They were also more likely to meet criteria for comorbid PTSD and depression, while labor trafficking survivors were more likely than sex trafficking survivors to meet criteria for depression alone. An analysis of gender differences found that trafficking survivors who identified as transgender endorsed more PTSD and C-PTSD symptoms, than male or female survivors. Childhood abuse exposure was linked to PTSD and C-PTSD in trafficking survivors, and trafficking type was predictive of the number of trauma-related symptoms beyond the role of pre-trafficking child abuse. Implications for assessment and intervention with trafficking survivors are discussed.

Keywords: PTSD; depression; symptoms; trafficking; trauma.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Child Abuse / statistics & numerical data
  • Depression / epidemiology*
  • Female
  • Human Trafficking / psychology*
  • Humans
  • Male
  • Middle Aged
  • Prevalence
  • Risk Factors
  • Sex Work / psychology*
  • Stress Disorders, Post-Traumatic / epidemiology*
  • Survivors / psychology*
  • Transgender Persons / psychology
  • United States / epidemiology
  • Violence / statistics & numerical data
  • Work / psychology*
  • Young Adult