Betray my trust, shame on me

Platt, M. G., & Freyd, J. J. (2015). Betray my trust, shame on me: Shame, dissociation, fear, and betrayal trauma. Psychological trauma: theory, research, practice, and policy, 7(4), 398.

DOI: http://dx.doi.org/10.1037/tra0000022

Study type: Quantitative analysis of an online survey

Sample size: 124 females

Demographics:
Needed to have at least one traumatic experience and be female. Ninety-eight identified as white/Caucasian (79%), nine identified as Hispanic (7.3%),two identified as African American/black (1.6%), 20 identified as Asian or Asian
American (16.1%), and five identified as “other” (4.0%) Average age was 20.40 years.

Key findings & quotes
  • High-betrayal trauma has been strongly associated with the female gender and low-betrayal trauma has been strongly associated with male gender. 
  • Study focused on women and the associations between trauma, shame, fear, and dissociation responses to perceived threat 
  • “Baseline shame was significantly higher for Asians/Asian American (M= 3.45, SD= 3.64) compared with all other participants (M= 1.24, SD=1.89)” (p. 399).
  • “In the current study, we differentiate between the word trauma and the word threat. When referring to trauma, we mean a particular type of threat that involves major physical, sexual, or emotional harm and violation. We use the term threat more broadly to encompass traumatic experiences as well as more minor experiences that may elicit strong emotions, such as viewing the images in the current study” (p. 399).
  • Participants were randomly assigned to an interpersonal-threat condition or a non-interpersonal-threat condition. 
    • “For the interpersonal-threat condition, participants viewed 10 images from the International Affective Picture System (IAPS). Participants viewed each image for 6 s with a 2-s pause between images. We matched the images with images in the non-interpersonal-threat condition based on arousal and valence norms and treat ratings” (p. 400).
      • Images included items like people/children crying, sexual harassment, and a nude bruised woman lying on a bed.
    • “The non-interpersonal threat condition was identical to the interpersonal-threat condition, apart from the specific images viewed by participants. In the non-interpersonal-threat condition, we included IAPS images without an interpersonal component” (p. 401).
      • Images included items like tornadoes, plane crashes, and fires. 
  • 56% (69 individuals) indicated at least one lifetime high-betrayal trauma, and 48% (59 individuals) indicated at least one lifetime low-betrayal trauma. “High-betrayal trauma consisted of physical, sexual, or emotional abuse by someone close and low-betrayal trauma consisted of physical and sexual abuse by someone not close or major automobile accidents” (p. 401).  
  • “Participants endorsing more exposure to high-betrayal trauma were more prone to shame and dissociation, but not fear, in response to viewing images involving interpersonal threat…Participants endorsing more exposure to low-betrayal trauma were more prone to fear, but not shame or dissociation, in response to viewing images involving non-interpersonal threat” (p. 402). 
  • Between-group differences in fear, dissociation, and shame were not compelling, adding validity to the claim that threat type only matters when individual history of high-betrayal trauma and low-betrayal trauma is considered. 
  • Betrayal plays a unique and significant role in posttraumatic distress. 
  • “The findings that shame and dissociation-proneness are increased for high-betrayal trauma survivors, in response to interpersonal threat, and fear proneness is increased for low-betrayal trauma survivors in response to no interpersonal threat, have implications for future research and clinical practice.”
  • Evidence suggests that exposure-based treatments may be effective, but research also indicates that exposure therapy is less effective for survivors of childhood trauma, people with emotion regulation difficulties, and people with high-trauma-related shame. 
  • Continued attention to betrayal in the clinical science and treatment of trauma will enhance care for a broad range of survivors.
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