Doctoral Dissertation
University of Oregon

PHYSICAL AND EMOTIONAL HEALTH EFFECTS OF BETRAYAL TRAUMA: A LONGITUDINAL STUDY OF YOUNG ADULTS

Rachel Evelyn Goldsmith
PhD
2004
Advisor Freyd, Jennifer J.

This study investigates young adults' interpersonal traumatic experiences, their perceptions of those experiences, and their current physical and psychological health. Current theoretical and empirical literature reveals connections between trauma perpetrated by close others (betrayal trauma) and traumatic sequelae such as dissociation, depression, anxiety, and alexithymia, a deficit in individuals' ability to identify and describe emotional experiences. Childhood abuse is a type of betrayal trauma with particularly deleterious effects because of its concurrent timing with developing systems such as affect regulation. Impaired awareness is often adaptive during abuse; for past abuse, awareness appears to have mixed effects.

The present study assesses trauma and health experiences in 185 college students, who completed surveys that included questions asking whether they had been physically, sexually, or emotionally abused or maltreated (using the words "abused" and "maltreated"), the Toronto Alexithymia Scale-20 (TAS-20), the Brief Betrayal Trauma Survey (BBTS), which measures trauma with higher and lower levels of betrayal, the Child Abuse Trauma Scale (CAT scale), the Trauma Symptom Checklist-40 (TSC-40), and the Pennebaker Inventory of Limbic Languidness (PILL), a physical health inventory. Ninety-six participants returned, 18-28 months later, for a follow-up session that included the same questionnaires. Test-retest reliability values were high for psychological and physical health measures and for the CAT and BBTS scales. At both timepoints, trauma with more betrayal predicted anxiety, depression, and dissociation, while trauma with less betrayal did not. Using the words "abused" or "maltreated" for oneself was related to the amount of childhood trauma reported on the CAT scale at both timepoints, and at follow-up abuse perceptions were related to health complaints and visits, anxiety, and depression. At baseline, depression and abuse were significant independent predictors of the difficulty identifying feelings subscale of the TAS-20. Negative home environments and difficulty identifying feelings each independently predicted the quantity of individuals' physical health complaints at both timepoints.

The results indicate that processes for coping with betrayal trauma are complex phenomena with numerous mental and physical health consequences. Understanding relations between childhood abuse, self-labeling of abuse, psychological symptoms, and physical health will improve the treatment of abused individuals.

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