Betrayal Trauma Research Articles

Acquiring Psychopathy and Callousness Traits: Examining the Influence of Childhood Betrayal Trauma and Adult Dissociative Experiences in a Community Sample

ABSTRACT The study of psychopathy has largely centered on samples of incarcerated offenders with a focus on primary psychopathy traits. Less is known, however, about how experiences of childhood betrayal trauma and dissociation influence the development of these traits in non-institutionalized individuals. In the present study, we utilized structural equation modeling to investigate the relationships among childhood betrayal trauma, adult dissociation, and adult psychopathy traits and callous affect traits in a community sample (N = 746). Childhood betrayal trauma was associated with psychopathy and callous affect traits, and mediated by dissociative experiences. These results are consistent with theory and prior empirical findings associating childhood betrayal trauma with dissociation, psychopathy, and callous affect traits. The results will help influence the design of future studies that can further inform the developmental course of psychopathy.

Racial/Ethnic Differences in Associations Between Traumatic Childhood Experiences and Both Metabolic Syndrome Prevalence and Type 2 Diabetes Risk Among a Cohort of U.S. Women.

Childhood adversity has been associated with metabolic syndrome (MetS) and type 2 diabetes risk in adulthood. However, studies have yet to investigate traumatic childhood experiences (TCEs) beyond abuse and neglect (e.g., natural disaster) while considering potential racial/ethnic differences. To investigate race/ethnicity as a potential modifier of the association between TCEs, MetS, and type 2 diabetes, we used prospectively collected data from 42,173 eligible non-Hispanic White (NHW; 88%), Black/African American (BAA; 7%), and Hispanic/Latina (4%) Sister Study participants (aged 35-74 years) enrolled from 2003 to 2009. A modified Brief Betrayal Trauma Survey captured TCEs. At least three prevalent metabolic abnormalities defined MetS, and self-report of a new diagnosis during the study period defined type 2 diabetes. We used adjusted Cox proportional hazards regression to estimate hazard ratios (HRs) and 95% CIs for type 2 diabetes over a mean ± SD follow-up of 11.1 ± 2.7 years, overall and by race/ethnicity. We also tested for modification and mediation by MetS. Incident cases of type 2 diabetes were reported (n = 2,479 among NHW, 461 among BAA, and 281 among Latina participants). Reporting any TCEs (50% among NHW, 53% among BAA, and 51% among Latina participants) was associated with a 13% higher risk of type 2 diabetes (HR 1.13; 95% CI 1.04-1.22). Associations were strongest among Latina participants (HR 1.64 [95% CI 1.21-2.22] vs. 1.09 for BAA and NHW). MetS was not a modifier but mediated (indirect effect, HR 1.01 [95% CI 1.00-1.01]; P = 0.02) the overall association. TCE and type 2 diabetes associations varied by race/ethnicity and were partially explained by MetS.

Prevalence and sociocultural correlates of post-traumatic stress disorder and complex PTSD among Chinese community health service users in Hong Kong.

Complex post-traumatic stress disorder (CPTSD) is a newly recognized trauma disorder in ICD-11. Little is known about the prevalence and correlates of CPTSD in primary care settings. Its cultural aspects also remained minimally explored. This study investigated the prevalence and sociocultural correlates of PTSD and complex PTSD among Chinese community health service users in Hong Kong. This study investigated ICD-11 PTSD and CPTSD in a sample of adults (N = 376) who had recently received services from Registered Chinese Medicine Practitioners in Hong Kong. Traditional Chinese medicine service is part of primary care services in Chinese societies. Participants completed self-report measures of CPTSD, trauma exposure, perceived family support, perceived caregiver's Chinese traditionality/modernity, participation (social activities and occupational productivity), depression and pain. The past-month prevalence of ICD-11 PTSD and CPTSD was 5.6% and 18.4%, respectively, in our sample. Chi-square tests and one-way ANOVAs revealed that participants with CPTSD were younger and reported more trauma, lower family support, lower levels of social participation and productivity, more depressive symptoms and pain, and more social welfare and mental health service usages than those without PTSD. We found that perceived caregiver's Chinese modernity (e.g. egalitarianism) was negatively correlated with CPTSD symptoms. Apart from age, non-betrayal trauma had the strongest association with classical PTSD symptoms, while betrayal trauma and perceived family support had the strongest association with disturbances in self-organization symptoms. This study provides the first data regarding the prevalence and correlates of ICD-11 PTSD and CPTSD among community health service users in Hong Kong. PTSD and CPTSD are common but often unrecognized mental health problems which are associated with more impairments and more service needs.

Interpersonal stress mediates the relationship between childhood trauma and depressive symptoms: Findings from two culturally different samples.

Childhood trauma is associated with adulthood depressive symptoms, but very few studies explored potential social and interpersonal mediators behind this association. This study made the first attempt to test the potential mediating effects of interpersonal stress in the associations between childhood betrayal and non-betrayal trauma and depressive symptoms. We analyzed data in a sample of English-speaking adults from diverse backgrounds (from 19 different countries, mainly from Western countries) (N = 468). We then replicated and compared the results with those in another convenience sample of Chinese-speaking younger adults with different cultural backgrounds and mental health status (N = 205). The results in both samples indicated that (1) childhood betrayal trauma had a stronger relationship with depressive symptoms than childhood non-betrayal trauma and that (2) interpersonal stress was a significant mediator in the relationship between childhood betrayal trauma and depressive symptoms, even when childhood non-betrayal trauma was included as a covariate. The indirect effect of childhood non-betrayal trauma on depressive symptoms through interpersonal stress was not consistent in two samples. Our findings point to the importance of taking social and interpersonal contexts into account when investigating, preventing and managing depression in trauma-exposed populations. Early social interventions such as family interventions, interpersonal skills training and building social resources may have the potential to change the trajectory of the development of mental health problems in trauma survivors.

Interpersonal Emotion Regulation in Betrayal Trauma Survivors: A Preliminary Qualitative Exploration

ABSTRACT Interpersonal trauma, or trauma involving maltreatment by someone that a survivor has a close, personal relationship with (i.e., betrayal trauma), may be particularly predictive of alterations in interpersonal and emotion regulation processes. Social support may facilitate interpersonal emotion regulation (IER) and posttraumatic functioning, though this process may be particularly difficult for survivors of betrayal trauma. The current study includes a sample of female-identifying betrayal trauma survivors with clinically significant PTSD symptomology (N = 70). Thematic analysis was utilized to investigate how these survivors describe their affective experience and the factors that impact their willingness and comfort to engage with others during times of distress. Most participants were able to describe their emotional experiences, but provided brief, simplistic descriptions. Generally, participants reported feeling wary of sharing negative emotions with others due to fear of judgment or being seen as a burden. Findings allow us to better understand how survivors make sense of and differentiate their emotions, and their experienced benefits of or barriers to IER.

PRELIMINARY PSYCHOMETRIC PROPERTIES OF RELATIONAL BETRAYAL TRAUMA SCALE

The present study aimed to construct and validate an indigenous scale of relational betrayal trauma for young adults. Initially, 60 items were generated through deductive and inductive methods. A pilot study was conducted on university students and retained 39 items. Factorial validity of the scale was determined on a sample of (N=359) 115 male & 244 female young adults, age ranged between 19 to 35 years from different universities of Punjab. Exploratory factor analysis was run on 28 items that were retained after pilot study. Subsequently, confirmatory factor analysis was run on a sample of (N=600) 300 male &300 female young adults and 20 items were retained for the final scale. Furthermore, convergent and divergent validity of the scale was determined by using Berlin Social support Scale and Betrayal Response Scale respectively. The results show that relational betrayal trauma is a psychometrically valid measure to evaluate painful experiences of young adults in their nonromantic relationships in the context of Pakistani culture. Keywords: Relational betrayal trauma, Young adults, Factorial validity, Painful experiences, Non-romantic relationship.

Influence of Betrayal Trauma on Schizotypal Personality Pathology

ABSTRACT Schizotypal personality pathology (SZP) is a persistent and debilitating problem for a substantial number of people. Research on SZP has typically emphasized its biological and more specifically genetic origins. However, recent research has highlighted the potential influence of trauma on SZP. This research is promising, although it has thus far focused primarily on type of trauma (e.g., different types of abuse vs. neglect in childhood) rather than who perpetrated the trauma. Previous studies on both personality pathology in general and psychotic-spectrum experiences characteristic of SZP in particular have highlighted the influence of trauma perpetrated by someone with whom the trauma survivor was close (i.e., betrayal trauma), although this has not yet been examined with respect to SZP specifically. In this study we examined this, evaluating the influence of trauma with varying degrees of betrayal on SZP in a sample of adults (N = 364) using structural equation modeling. Results suggest that interpersonal trauma in general was associated with higher levels of SZP. Findings further indicate that for women but not men, trauma with a high degree of betrayal was uniquely associated with SZP. These results underscore the potential role of trauma in SZP and have implications for future research on and intervention with people with high levels of SZP.

Initial development of perpetrator confrontation using deepfake technology in victims with sexual violence-related PTSD and moral injury.

Interventions aimed at easing negative moral (social) emotions and restoring social bonds - such as amend-making and forgiving-have a prominent role in the treatment of moral injury. As real-life contact between persons involved in prior morally injurious situations is not always possible or desirable, virtual reality may offer opportunities for such interventions in a safe and focused way. To explore the effects of the use of deepfake technology in the treatment of patients suffering from PTSD and moral injury as a result of being forced by persons in authority to undergo and commit sexual violence (so-called betrayal trauma). Two women who had experienced sexual violence underwent one session of confrontation with the perpetrator using deepfake technology. The women could talk via ZOOM with the perpetrator, whose picture was converted in moving images using deepfake technology. A therapist answered the questions of the women in the role of the perpetrator. Outcome measures were positive and negative emotions, dominance in relation to perpetrator, self-blame, self-forgiveness, and PTSD-symptom severity. Both participants were positive about the intervention. Although they knew it was fake, the deepfaked perpetrator seemed very real to them. They both reported more positive and less negative emotions, dominance in relation to the perpetrator and self-forgiveness, and less self-blame and PTSD-symptoms after the intervention. Victim-perpetrator confrontation using deepfake technology is a promising intervention to influence moral injury-related symptoms in victims of sexual violence. Deepfake technology may also show promise in simulating other interactions between persons involved in morally injurious events.

Childhood betrayal trauma, dissociation, and shame impact health-related quality of life among individuals with chronic pelvic pain

BackgroundHigh betrayal trauma (HBT), or interpersonal trauma perpetrated by someone close, is linked to dissociation and shame, while trauma perpetrated by someone less close, low betrayal trauma (LBT) is associated with post-traumatic stress disorder (PTSD). ObjectiveChild interpersonal trauma is common among women with chronic pelvic pain (CPP) and can negatively impact physical and mental health-related quality of life (HRQOL). Our study investigates unexplored connections between these variables. Participants & settingSurvey data were analyzed from 96 English-speaking female patients with CPP at a women's health clinic (mean age = 33, 59 % White non-Hispanic, 62 % married or cohabitating, 61.5 % completed post-high school degree); prevalence of HBT and LBT were 65.2 % and 45.6 %, respectively. MethodsMultiple regression analyzed relationships between mental and physical HRQOL and dissociation, shame, and PTSD. Parallel mediation analyses examined indirect relationships between mental and physical HRQOL and exposure to childhood HBT and LBT. ResultsDissociation was related to worse physical HRQOL, while shame was related to worse physical and mental HRQOL. Dissociation and shame mediated relationships between childhood HBT and current mental (R2 = 0.08, p = .01) and physical (R2 = 0.11, p = .002) HRQOL. Shame, but not PTSD, mediated relationships between childhood LBT and current mental (R2 = 0.14, p < .001) and physical (R2 = 0.16, p < .001) HRQOL. ConclusionsOur study provides preliminary evidence that dissociation and shame negatively impact HRQOL among individuals with CPP in the context of exposure to different types of childhood betrayal trauma. Replication studies to validate our results with larger samples and longitudinal designs are encouraged.

Peritraumatic assault characteristics predict worsened obsessive-compulsive contamination symptoms in survivors of sexual trauma

Extant research suggests there may be a relationship between sexual trauma and obsessive-compulsive (OC) contamination symptoms. Peritraumatic assault characteristics, such as physical force and peritraumatic fear, are related to more severe posttraumatic stress symptoms (PTSS), however assault characteristics may also predict OC symptoms. Limited research suggests that assault type and peritraumatic emotions may relate to increased OC contamination symptoms, yet little is known about how victim and perpetrator demographics and other peritraumatic assault characteristics may predict OC contamination over and above PTSS. To address this gap, participants included 164 undergraduate sexual assault survivors (74.4% female, 16.5% LGBTQ, 35% non-white) who completed a cross-sectional study involving self-report measures of OC contamination symptoms, PTSS, and peritraumatic assault characteristics. Correlations were run to determine independent variables in the ordinary least squares regression predicting OC contamination symptoms. Controlling for PTSS, greater contamination severity was predicted by nonwhite victim race, greater peritraumatic closeness to perpetrator, and injury severity. Assault severity, perpetrator force, and peritraumatic fear were not significant predictors of contamination symptoms. Findings support betrayal trauma theory and highlight peritraumatic characteristics that are important to consider as potential risk factors related to the development or exacerbation of contamination symptoms.

Youth Suicidality and the Role of Maternal Betrayal Trauma, Child Maltreatment, and Dissociative Symptoms

Youth Suicidality and the Role of Maternal Betrayal Trauma, Child Maltreatment, and Dissociative Symptoms

Mediation effect of psychological factors on betrayal trauma and physical health symptoms among young adults

Background: Betrayal trauma theory postulates abuse perpetrated by a caregiver or someone close to the victim results in worse mental health and physical health problems than abuse perpetrated by a non caregiver. Hence the present study was designed to study the mediation effect of psychological factors on high betrayal trauma and physical health symptoms among young adults.Methods: young adults with history of trauma based on purposive were taken from Delhi. Out of 200 young adults, 100 were high betrayal traumas and 100 were low betrayal traumas with age group ranged from 20-30 years. In order to identify high betrayal trauma and low betrayal trauma the brief betrayal trauma survey, followed by Toronto alexithymia scale, trauma symptom checklist-40, Pennebaker inventory of limbic languidness and socio-demographic data sheet.Results: The present study studied the mediation analyses and found that sexual abuse and sexual problem were mediates the association between high betrayal trauma and physical health problem.Conclusions: The mediation effect by sexual abuse trauma and sexual problem was reported on high betrayal trauma and physical health symptoms It highlights to inform the health professionals about the diverse range of symptoms associated with betrayal trauma and highlights the urgency of immediate intervention of betrayal trauma and helps the health professionals in awareness of connection among betrayal trauma, psychological difficulties, and physical health complaints and make appropriate assessments and referrals.

A Cross-Cultural Investigation of the Association between Betrayal Trauma and Dissociative Features.

Betrayal trauma theory proposes that betrayal and non-betrayal traumas are different in terms of their nature and impacts. The theory predicts that dissociation is more strongly related to betrayal than to non-betrayal trauma, however there is a lack of cross-cultural evaluation of the theory. One competing theory is the socio-cognitive model, which proposes that dissociative amnesia (DA) and identity dissociation (ID) are the results of social influence and are not trauma-related conditions. This study aimed to test the hypotheses based on betrayal trauma theory and investigated the relationship between trauma, dissociation and other mental health problems in two culturally different convenience samples of people seeking web-based educational interventions for dissociation (N = 83 English speakers and N = 82 Chinese speakers). Compared with childhood non-betrayal trauma, childhood betrayal trauma had a statistically stronger relationship with dissociation and borderline personality disorder (BPD) symptoms in both samples. DA and ID symptoms were cross-culturally associated with childhood betrayal trauma after controlling for other variables (including sample membership, age, depression levels, medication treatment and non-betrayal trauma). Participants with DA/ID symptoms reported significantly more trauma-related symptoms in both samples. The findings supported the cross-cultural application of the betrayal trauma theory for dissociative features and BPD symptoms. Implications for research and practice (e.g., child protection, assessment for survivors of childhood betrayal trauma) are highlighted.

Violence victimization in Latina/o/x young adults: The multiplicative effects of cultural and high betrayal trauma

Latinas/os/xs experience pervasive rates of interpersonal violence victimization while also experiencing frequent discrimination and societal trauma (e.g., hate crimes). Betrayal trauma theory and cultural betrayal trauma theory provide frameworks for examining the distinct harm of violence perpetrated by a close other and by a member of the same marginalized group(s), respectively. However, no known research has examined the concurrent impacts of both forms of betrayal among Latina/o/x young adults. The current study examined the unique and multiplicative effects of high betrayal trauma (i.e., violence perpetrated by a close other) and cultural betrayal trauma (i.e., violence perpetrated by someone of the same marginalized group(s)) on psychological and physical health symptoms in Latina/o/x young adults. Latina/o/x undergraduate students (N = 208) participated in a 60-minute online survey assessing violence victimization, psychological symptoms, and physical health. Rates of victimization (91.35%, n = 190) were high across differing forms of violence. Interactions of high betrayal trauma and cultural betrayal trauma were significant for psychological, physical, and anxiety symptoms. Although there were no significant simple effects, the pattern of results suggested that being assaulted by someone who shares one’s Latina/o/x identity was more strongly associated with psychological and physical symptoms when participants had not been assaulted by someone with whom they were close. The current study highlights the importance of culturally competent therapy for Latina/o/x survivors that incorporates the interpersonal and cultural contexts of victimization.

An investigation of whether emotion regulation mediates the relationship between attachment insecurity and suicidal ideation and behaviour.

The aim of this research was to examine relationships between attachment insecurity and suicidal ideation and behaviour. Secondary aims were to explore the mediating role of emotion dysregulation and the moderating role of betrayal trauma in explaining hypothesised relationships. Sixty-five participants with experience of suicidal ideation completed questionnaire measures assessing attachment security, suicide ideation, emotion regulation, betrayal trauma, depressive symptoms and hopelessness. A direct relationship was found between avoidant attachment and suicide ideation after controlling for age and gender. Multiple suicide attempters had higher anxious attachment. Anxious and avoidant attachment, suicide ideation and betrayal trauma were associated with emotion dysregulation. The relationship between attachment insecurity and suicide ideation was not mediated by emotion dysregulation. In the mediation model, only anxious attachment remained a significant predictor of emotion regulation and there was no significant effect of emotion regulation nor betrayal trauma, on suicide ideation. Suicidal individuals may benefit from therapeutic intervention that explores attachment-related difficulties and therapies such as dialectical behavioural therapy, which support skills in emotional regulation. Future longitudinal research should identify other important mediators of the association between attachment and suicidality to develop more targeted psychological interventions for suicidality.

The moderation of maternal parenting on the association of trauma, dissociation, and psychosis in depressive inpatients

ABSTRACT Background The effect of dissociation and parenting style on the relationship between psychological trauma and psychotic symptoms has not previously been investigated. Objective The aim of this study was to develop a moderated mediation model to assess whether the association between psychological trauma and psychotic symptoms is mediated by dissociation and moderated by parental maltreatment. Methods Inpatients with major depressive disorder (MDD) and bipolar depression (BP) were recruited. Self-reported and clinical rating scales were used to measure the level of dissociation, psychotic symptoms, history of psychological trauma and parental maltreatment. The PROCESS macro in SPSS was used to estimate path coefficients and adequacy of the moderated mediation model. High betrayal trauma (HBT), low betrayal trauma (LBT), paternal maltreatment, and maternal maltreatment were alternatively entered into the conceptual model to test the adequacy. Results A total of 91 patients (59 with MDD and 32 with BP) were recruited, with a mean age of 40.59 ± 7.5 years. After testing with different variables, the moderated mediation model showed that the association between LBT and psychotic symptoms was mediated by dissociation and moderated by maternal maltreatment. A higher level of maternal maltreatment enhanced the effect of LBT on dissociation. Conclusions Healthcare workers should be aware of the risk of developing psychotic symptoms among depressive patients with a history of LBT and maternal maltreatment.

The role of the victim-offender relationship on psychological distress among Latinx women: A betrayal trauma perspective.

The current study expands the knowledge within the betrayal trauma literature by applying this conceptualization to the victimization of Latinx women, a generally understudied minority group in the United States. Under the betrayal trauma framework, this study focuses on the victim and perpetrator relationship of Latinx women to examine trauma-related psychological distress outcomes, including depression, anger, dissociation, and anxiety. Using data from the Sexual Assault Among Latinas Study on 2,000 adult Latinx women in the United States, findings examine the victim-perpetrator relationship of the Latinx women who experienced victimization (n = 870). Ordinary least squares regressions were conducted with the Trauma Symptom Inventory scales of depression, anger, dissociation, and anxiety as the dependent variables, resulting in four regression models. A sequential regression including the interaction terms was then completed for each of the TSI scale outcomes to account for possible moderation between cultural variables and victim-perpetrator relationships. Linear models show that childhood betrayal trauma and total victimization significantly associate with greater psychological distress, including depression, anger, dissociation, and anxiety. Interactions effects were significant for anxiety, showing a stronger relationship between childhood family-perpetrated victimization for highly enculturated women while the opposite was found for family-perpetrated victimization in adulthood where low-enculturated women had a stronger relationship to anxiety. The study findings support the betrayal trauma theory among Latinx women by showing that the closeness in relationship between the victim and the perpetrator for childhood victimization was associated with greater psychological distress above and beyond the impact of other perpetrator-victim relationships. This effect remained significant even when accounting for the total lifetime victimization. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Betrayal trauma, dissociative experiences, and posttrauma cognitions among women in a state shelter home

Context: There is a long history of interpersonal trauma in women, and the risk factors and mental health consequences have been well studied. Betrayal trauma (BT) theory by Freyd talks about the specific kind of trauma perpetrated by someone close to the victim, which may lead to increased dissociative responses. Recent research extends the theory to explain the role of posttrauma appraisals playing a mediating role in the development of psychopathological responses.Aim: The aim of this study was to explore trauma history, BT, and dissociative experiences among women in a Government Reception Centre.Setting: The sample included 30 women from the Reception Centre, Bangalore.Subjects and Methods: Data were obtained using a Sociodemographic Data Sheet, Brief BT Survey (revised), the Dissociative Experiences Scale, Posttrauma Cognitions Inventory and a visual analog scale for assessing psychological distress.Statistical Analysis Used: Descriptive statistics and nonparametric inferential statistics were used for quantitative analysis.Results: All the women in the sample had experienced BT directly or as witnesses. There was no significant difference in dissociation between high- and low-BT groups. The presence of negative cognitions toward oneself was associated with increased dissociative experiences. Negative cognitions toward self and depersonalization experiences were higher in the group with severe physical trauma than the group without.Conclusion: The article highlights the high prevalence of betrayal trauma, and risk for trauma-related psychopathology and revictimization that go unassessed in government shelter homes, while reiterating the need for a trauma-informed care approach to intervention.

Mental health implications of the acting white accusation: The role of cultural betrayal and ethnic-racial identity among Black and Latina/o emerging adults.

The "acting white" accusation (AWA) is a cultural invalidation commonly experienced by people of color that challenges their ethnic-racial authenticity for demonstrating behaviors that are not traditionally associated with their ethnic-racial group. Prior research shows that the AWA has negative implications for mental health and ethnic-racial identity (ERI). Cultural betrayal trauma theory also suggests that harmful events perpetrated by ingroup members have unique harm due to the violation of (intra)cultural trust. Prior research has yet to examine the distinct mental health implications of the AWA from ethnic-racial ingroup versus outgroup perpetrators. The present study examines this gap in the literature using longitudinal data and investigates whether ERI centrality moderates the relationship between AWA perpetrators and mental health outcomes. Emerging adults (N = 401; 43% Black, 57% Latina/o; 65% female) were recruited upon enrollment at five predominantly White universities in the Midwest U.S. and surveyed multiple times over their first year of college. Results indicated that AWA insults from ethnic-racial ingroup members were associated with more severe mental health outcomes (greater anxiety and depressive symptoms). Further, ERI centrality provided a protective buffering effect that reduced depressive symptoms, but this effect only occurred for students who received the AWA from White perpetrators and ERI centrality was not protective against AWA insults from ingroup perpetrators. Study findings highlight that specific AWA perpetrators and a person's level of ERI centrality should be taken into consideration when determining the best strategies for helping Black and Latina/o college students cope with cultural invalidations. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Editors’ Note: Sound and Affect in Times of Crisis ★ ★ ★

Editors’ Note: Sound and Affect in Times of Crisis ★ ★ ★