Abstract
ABSTRACTInstitutional betrayal (IB), an institutional failure to either prevent or to respond supportively to a traumatic event, tends to cause trauma survivors further psychological distress. The medical system may exhibit significant levels of IB given the frequency of medical interactions and vulnerability of patients. The current study aimed to assess the reliability and validity of a new measure of IB in the medical system in a sample of 352 Canadian adults with chronic medical conditions. An exploratory factor analysis found 3 stable and reliable factors of IB: negative healthcare experiences, cognitive-affective reactions, and systemic responses to these experiences. Subsequent analyses found evidence supporting the validity of the IB questionnaire. As expected, IB predicted poorer mental health even after controlling for demographics, and traumatic experiences. Future studies should confirm that these factors hold in different populations, and should employ different experimental designs to better understand the causal factors of IB.
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