PloS one · 2026
Betrayal trauma and adult mental health: The role of mentalizing and dissociation.
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Jańczak Monika Olga, Gagliardini Giulia, Kamza Anna, Colli Antonello, Fonagy Peter, Nolte Tobias
Аннотация
BACKGROUND: Trauma experienced across the lifespan has been linked to a wide range of adverse mental health outcomes. However, the psychological mechanisms connecting betrayal trauma to later psychopathology remain insufficiently understood.
OBJECTIVE: This cross-sectional study investigated associations between betrayal trauma during childhood and adulthood and adult psychopathology-specifically depressive symptoms and level of personality functioning within a dimensional model of personality disorders. We tested a path model examining direct and indirect associations between betrayal trauma at different developmental periods and adult psychopathology via dissociation and hypomentalizing.
PARTICIPANTS: A sample of 209 adults (61% female; aged 18-45 years; M = 29.7, SD = 7.88) were recruited from community and clinical settings in Poland.
METHODS: Participants completed validated self-report measures assessing betrayal trauma, depressive symptoms, personality functioning (ICD-11 model), dissociation, and mentalizing. Path analyses with parallel mediation were conducted using Satorra-Bentler estimation and 5,000 bootstrap resamples to examine both direct and indirect associations.
RESULTS: Both childhood and adulthood betrayal trauma were significantly associated with depressive symptoms and PD severity through dissociation and hypomentalizing [χ²(6) = 13.68, p = .033; CFI = 0.989; TLI = 0.931; RMSEA = 0.078; SRMR = 0.038]. No significant direct effects were observed once psychological processes were included. Mentalizing consistently demonstrated a stronger indirect association than dissociation across models. Adulthood betrayal trauma showed a greater total effect on depressive symptoms (β = .30; p < .001) than childhood trauma (β = .17; p = .043), whereas their effects on personality pathology were comparable (respectively, β = .21; p = .006 for adult trauma and β = .22; p = .008 for childhood trauma). For adulthood trauma and PD severity, the direct association was small and non-significant (β = -.06), whereas indirect effects via dissociation (β = .11) and mentalizing (β = .16) were positive, resulting in a positive total effect.
CONCLUSIONS: These findings indicate that the link between betrayal trauma and adult psychopathology may be best conceptualised in terms of co-occurring psychological processes rather than direct exposure effects. Hypomentalizing, in particular, appears to represent a key transdiagnostic mechanism connecting relational trauma across developmental stages with both mood and personality pathology.
OBJECTIVE: This cross-sectional study investigated associations between betrayal trauma during childhood and adulthood and adult psychopathology-specifically depressive symptoms and level of personality functioning within a dimensional model of personality disorders. We tested a path model examining direct and indirect associations between betrayal trauma at different developmental periods and adult psychopathology via dissociation and hypomentalizing.
PARTICIPANTS: A sample of 209 adults (61% female; aged 18-45 years; M = 29.7, SD = 7.88) were recruited from community and clinical settings in Poland.
METHODS: Participants completed validated self-report measures assessing betrayal trauma, depressive symptoms, personality functioning (ICD-11 model), dissociation, and mentalizing. Path analyses with parallel mediation were conducted using Satorra-Bentler estimation and 5,000 bootstrap resamples to examine both direct and indirect associations.
RESULTS: Both childhood and adulthood betrayal trauma were significantly associated with depressive symptoms and PD severity through dissociation and hypomentalizing [χ²(6) = 13.68, p = .033; CFI = 0.989; TLI = 0.931; RMSEA = 0.078; SRMR = 0.038]. No significant direct effects were observed once psychological processes were included. Mentalizing consistently demonstrated a stronger indirect association than dissociation across models. Adulthood betrayal trauma showed a greater total effect on depressive symptoms (β = .30; p < .001) than childhood trauma (β = .17; p = .043), whereas their effects on personality pathology were comparable (respectively, β = .21; p = .006 for adult trauma and β = .22; p = .008 for childhood trauma). For adulthood trauma and PD severity, the direct association was small and non-significant (β = -.06), whereas indirect effects via dissociation (β = .11) and mentalizing (β = .16) were positive, resulting in a positive total effect.
CONCLUSIONS: These findings indicate that the link between betrayal trauma and adult psychopathology may be best conceptualised in terms of co-occurring psychological processes rather than direct exposure effects. Hypomentalizing, in particular, appears to represent a key transdiagnostic mechanism connecting relational trauma across developmental stages with both mood and personality pathology.