Physical Health, Psychological Distress, and Betrayal Trauma

Numerous studies have revealed an association between trauma and adverse physical and mental health status. While the relation is well established, the mechanisms underlying this link are less well understood. In the current study we sought to distinguish impact on health arising from types of trauma as indicated by betrayal trauma theory (Freyd 1996, 2001), with an eye toward eventually uncovering mechanisms and developing interventions. Betrayal trauma theory distinguishes two dimensions as primary for events that cause long lasting harm to people: life-threat (e.g. major car accident; urban violence) and social betrayal (e.g. abuse by a close other). We recruited 99 community adults who reported at least 12 months of chronic medical or pain problems for a longitudinal intervention study. Participants were assessed for trauma history and physical and mental symptoms. Trauma assessment included measuring exposure to both traumas high in betrayal and traumas low in betrayal (but high in life-threat). Associations between overall trauma exposure and negative health and mental status were found. High betrayal was particularly potent. For instance, exposure to traumas with high betrayal is significantly correlated with number of physical illness symptoms (r=.37), anxiety symptoms (r = .49), and depression symptoms (r=.45). Multiple regression analyses predicting these symptoms from betrayal trauma exposure reveal that adding exposure to trauma with less betrayal into the model changes R-square statistics very little, and these changes are not significant. This pattern of results has been replicated with data recently collected in our laboratory using a different population. In addition, interesting gender effects are emerging. With the large amount of variance in symptoms predicted by exposure to high betrayal trauma, we are focusing on uncovering mechanisms and evaluating the health consequences of an intervention that involves writing about reactions to these events.This research was supported by the Northwest Health Foundation Grant Number 2001-255 Child Abuse and Health: An Intervention (Freyd, PI). The manuscript preparation was also supported in part by the Trauma and Oppression Research Fund at the University of Oregon Foundation