A model exploring the relationship between betrayal trauma and health: The roles of mental health, attachment, trust in healthcare systems, and nonadherence to treatment.

Abstract

Prior research suggests that there is a relationship between traumatic experiences and poor health. When considered through the lens of betrayal trauma (i.e., the perpetrator and the victim have a close interpersonal relationship), traumatic experiences predict greater posttraumatic difficulty and higher levels of depression. Betrayal trauma has been associated with poorer interpersonal relationships and less trust in individuals and systems that may be important for a person's wellbeing, such as health care systems. In turn, trauma survivors are less likely to adhere to medical treatment, which may ultimately affect their overall health. The current study examined the complex relationship between experiences of betrayal trauma and poor health, while accounting for demographics, mental health symptoms, trust in physicians and the medical system, attachment style, and nonadherence to medical treatment. A demographically representative sample of 312 Canadian participants was surveyed online. Participants completed measures that assessed symptoms of mental health (PTSD, depression), trauma, attachment style, trust, and nonadherence to medical treatment. Hierarchical regression models were used to examine the relationship between betrayal trauma and health. Betrayal trauma significantly predicted nonadherence to treatment, while trust in physicians was explained by trauma, attachment style, and mental health symptoms. All of these factors significantly explained poor health status. Results suggest the importance of implementing trauma-informed care in health care systems. (PsycINFO Database Record (c) 2019 APA, all rights reserved).