Moving towards a subjective conceptualization of betrayal: Examining associations between perceived betrayal, emotion dysregulation, and PTSD symptoms in sexual trauma survivors.

BACKGROUND: Sexual trauma survivors commonly experience feelings of betrayal. Betrayal has largely been studied as a static trauma characteristic that is determined by a survivor's closeness to the perpetrator. This approach overlooks survivors' subjective feelings and experiences. This study examines whether: 1) degree of perceived betrayal differs by type of survivor-perpetrator relationship, 2) perceived betrayal in the early aftermath of trauma predicts subsequent PTSD symptoms, and 3) emotion dysregulation mediates the relationship between perceived betrayal and PTSD symptoms.

METHODS: Women (N = 203; ages 19-86) who experienced sexual trauma within a month of recruitment completed questionnaires on Prolific at T1 (within 30 days of trauma), T2 (4 weeks post-T1), and T3 (8 weeks post-T1). Descriptive statistics and an independent samples t-test examined differences in perceived betrayal across survivor-perpetrator relationship characteristics. Structural equation models assessed perceived betrayal at T1 predicting PTSD symptoms at T3 and the potential mediating effect of T2 emotion dysregulation.

RESULTS: Although betrayal was highest among survivors who knew the perpetrator prior to the trauma (M = 76.8, range 0-100), average perceived betrayal was high across the sample (M = 70.5), and the quarter of survivors who identified the perpetrator as a stranger also reported elevated betrayal (M = 51.6). T1 perceived betrayal significantly predicted T3 PTSD symptoms with increases in emotion dysregulation partially mediating this effect (p = .01).

CONCLUSIONS: Findings support moving towards a subjective conceptualization of betrayal that incorporates survivors' perceptions. Moreover, emotion dysregulation may be an important intervention target in the early aftermath of sexual trauma and warrants further empirical research.