Institutional Betrayal Related to Sexual Trauma in Military Service Members and Veterans: An Examination of Posttraumatic Sequelae

Military sexual harassment and/or assault (MSH/A) is pervasive and destructive. MSH/A survivors who believe the institution played a role in the traumatic experience by failing to respond in a supportive manner or for failing to keep them safe may feel betrayed by the military itself, a concept referred to as institutional betrayal. Previous research suggests it is more harmful to be abused by trusted others or institutions due to the violation of trust. This two-study dissertation explored experiences of MSH/A-related institutional betrayal to identify survivors at-risk for worse posttraumatic outcomes. Study #1 evaluated whether PTSD explained the relationship between MSH/A type and somatic symptom severity, and whether this relationship depended on experiences of institutional betrayal. Study #2 examined whether exposure to killing and/or death during combat strengthened the link between institutional betrayal and risk for suicidal behaviors. Findings revealed MSH/A perpetrators were typically male, a fellow servicemember, unit member, battle buddy, or first-line leader. The most common experiences of MSH/A-related institutional betrayal included responding inadequately once MSH/A was reported, creating an environment in which MSH/A seemed normal or common, making it difficult to report MSH/A, not taking proactive steps to prevent MSH/A, and mishandling the case once reported. PTSD explained the link between MSH and somatic symptom severity, but contrary to hypotheses in Study #1 and #2, institutional betrayal was unrelated to somatic symptom severity and suicide risk. Alternatively, MSH was an independent risk factor for severe posttraumatic distress, including suicide risk, somatic symptom severity, PTSD, depression, and alcohol abuse when compared to MSA. MSH is often the precursor to MSA, but the experience goes unreported or is not taken seriously by leadership, which likely contributes to the cycle of violence and maintains the abuse. This dissertation illustrates that any type of sexual violence is demeaning and has the potential to cause harm. Prevention strategies are needed to thwart MSH, thereby decreasing risk for MSA, suicidal behavior, somatic symptom severity, PTSD, depression, and alcohol abuse. It is imperative that the Department of Defense increases accountability for perpetrators and ensures leadership does not tolerate sexual violence or retaliate upon disclosure