3 - (SYM 26) Change in Emotion Regulation Mediates the Relationship Between Betrayal in the Recent Aftermath of Sexual Trauma and Subsequent Posttraumatic Stress Disorder Symptoms

Sexual trauma survivors commonly report feelings of betrayal (i.e., perceiving those expected to protect them as responsible in some way for the event). Although betrayal has been closely linked to adverse mental health outcomes (e.g., PTSD), the underlying mechanism of these relationships, particularly in the early aftermath of sexual trauma, is less clear. Increases in emotion dysregulation is a potential pathway. Thus, the current study aims to assess the potential mediating role of changes in emotion regulation on the relationship between betrayal and PTSD symptoms in the first few months post-sexual trauma, offering insight for potential early assessment and intervention targets.

Women (N = 203; ages 19-86; 61.6% White) who experienced sexual trauma in the past month were recruited from an online platform and completed questionnaires of betrayal (Life Threat and Betrayal Questionnaire), emotion regulation (DERS-18), and PTSD symptoms (PCL-5) at T1 (within 30 days of trauma), T2 (4 weeks later), and T3 (8 weeks later). Structural equation modeling with 1,000 bootstrapped samples was used to assess betrayal at T1 predicting PTSD symptoms at T3 and the indirect effects of emotion regulation at T2 (controlling for emotion regulation at T1 to assess residual change). Lifetime trauma exposure and additional trauma exposure throughout the study (THQ) were included as covariates. Missing data was handled using FIML.

Betrayal significantly predicted subsequent PTSD symptoms (B = .10, p = .003). Change in emotion regulation was a significant partial mediator of betrayal predicting PTSD (p  = .01). Specifically, greater betrayal was associated with an increase in emotion dysregulation (B = .05, p = .01), which in turn was associated with greater PTSD symptoms (B = .46, p < .001). Model fit was good (CFI = .96). 

Increase in emotion dysregulation was a significant underlying mechanism linking betrayal in the first month of experiencing a sexual trauma to subsequent PTSD symptoms, even when controlling for prior and ongoing trauma exposure. Betrayal can disrupt an individual’s trust, sense of safety, and self-esteem, and in turn may decrease an individual’s ability to regulate emotional experiences which can be associated with PTSD symptoms. Findings point to emotion regulation skills as an important intervention in the early aftermath of sexual trauma to mitigate downstream effects on PTSD symptomatology in individuals experiencing betrayal. Examining the replicability of these research results in other genders and populations is a critical next step.