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Post-Infidelity Stress and Ambiguous Loss: An Integrative Literature Review of Betrayed Partners' Psychological Experience and Decision-Making Processes
Infidelity is among the most disruptive events a romantic relationship can undergo, and a growing empirical literature indicates that the betrayed partner’s psychological reaction frequently meets or approaches the threshold for clinically significant post-traumatic stress. This paper presents an integrative review of published research on the informally termed Post-Infidelity Stress Disorder (PISD) and its relationship to two complementary theoretical frameworks: betrayal trauma theory (Freyd, 1996) and ambiguous loss theory (Boss, 2016). Thirty-plus peer-reviewed and dissertation-level sources spanning quantitative, qualitative, and grounded-theory designs were reviewed and synthesized. Across studies, probable infidelity-related post-traumatic stress symptoms have been documented in between roughly one-third and two-thirds of betrayed partners, depending on sample and measurement (Dean & Bergner, 2018; Roos et al., 2019; Steffens & Rennie, 2006). Qualitative and grounded-theory studies converge on a set of recurring psychological processes: intrusive re-experiencing and hypervigilance; a distinctive, socially unrecognized grief for a partner who remains physically present but psychologically altered; and a prolonged, non-linear process of decisional ambivalence shaped by investment, attachment history, and available support (Fife et al., 2022; Mitchell et al., 2025; Perez, 2023; Yaghoobi Tourki et al., 2022). The review identifies a persistent gap: although betrayal trauma and ambiguous loss are each well established in adjacent literatures, few studies have applied them jointly to explain why the decision to stay or leave after infidelity is experienced as psychologically prolonged rather than as a single rational choice. The paper concludes with an integrated conceptual model and recommendations for clinical practice and future empirical research, including the development of a validated, infidelity-specific trauma measure and longitudinal designs that follow betrayed partners through the active decision-making window rather than only after a decision has been reached.
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