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

M. Emrich, Camille L. Garnsey, Erika K Osherow, Crystal Park

Journal of anxiety disorders · April 1, 2025

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.

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