Influence of betrayal trauma on borderline personality disorder traits

Is Internet Gaming Disorder Associated with Trauma and Stress? Testing the Trauma Model of Addiction Among Young Adults

Internet gaming disorder (IGD) is a growing public health concern, with longitudinal studies linking it to a range of negative outcomes, including psychological distress and poor academic achievements. While the trauma model has been applied to other addictive behaviors, little is known about the relationship between childhood trauma, trauma-related symptoms, and IGD symptoms. This preliminary study investigated whether childhood betrayal trauma would have a stronger relationship with IGD symptoms than non-betrayal trauma and whether IGD symptoms would be associated with interpersonal stress and trauma-related symptoms. A regionally diverse, predominantly female sample of English-speaking young adults aged 18 to 24 (N = 283) completed validated standardized measures. We found that IGD symptoms were associated with childhood non-betrayal trauma (β = .225, p < .001) and interpersonal stress (β = .214, p < .001) but not with childhood betrayal trauma and post-traumatic and dissociative symptoms. While the results should be interpreted with caution because of the limitations of this study, it extends the application of the trauma model of addiction to the context of IGD. Our study underscores the universal importance of child protection and early interventions for childhood trauma survivors in the prevention of addictive behaviors.

Betrayal Trauma and Personality Pathology: An Integrated Review

Personality pathology is a common and debilitating problem for many, and among the factors associated with personality pathology is trauma. Recent research on the association between personality pathology and trauma has highlighted the role of trauma perpetrated by a person whom the victim trusts and/or relies upon for support (i.e., betrayal trauma). There is an increasing number of studies on the association between betrayal trauma and a range of different forms of personality pathology, although neither these studies nor the more general bodies of the literature on which they draw (i.e., in both trauma and personality pathology) have been meaningfully integrated. The goals of this paper are threefold. We first review relevant theories and research on trauma (definition, diagnosis, and different typologies, including betrayal trauma) and personality pathology (conceptualization, risk factors). Second, we review and integrate research on the association between betrayal trauma and different forms of personality pathology (e.g. antisocial/psychopathic, borderline, histrionic, narcissistic, obsessive-compulsive, schizoid, and schizotypal). Finally, we use this integration to suggest directions for future research on and clinical application with respect to the intersection of betrayal trauma and personality pathology.

Influence of Betrayal Trauma on Schizoid Personality Pathology

Schizoid personality pathology is among the most debilitating and enigmatic forms of personality pathology. Some have suggested that a potential etiological influence on schizoid pathology is trauma. Thus far, research on the association between trauma and schizoid pathology has focused primarily on type of trauma (e.g., abuse vs. neglect during childhood) rather than who perpetrated the trauma. This contrasts with recent research on trauma perpetrated by someone upon whom the survivor relies and/or trusts (i.e. betrayal trauma), which many studies show has a uniquely pernicious association with several forms of personality pathology. However, this has not yet been examined with respect to schizoid pathology specifically. In this study, we examined the relative associations between trauma varying degrees of betrayal and schizoid personality pathology in a sample recruited from Amazon's Mechanical Turk (N = 300) using a Bayesian approach to structural equation modeling. Results suggest that interpersonal trauma in general was associated with higher levels of schizoid pathology. Findings further indicate that for men but not women, trauma with a high degree of betrayal was uniquely associated with schizoid pathology. These findings contribute to the growing body of research suggesting the influence of interpersonal trauma in general and betrayal trauma in particular on personality pathology and have implications for future research on and intervention with people with high levels of schizoid pathology.

Influence of Betrayal Trauma on Schizotypal Personality Pathology

Schizotypal personality pathology (SZP) is a persistent and debilitating problem for a substantial number of people. Research on SZP has typically emphasized its biological and more specifically genetic origins. However, recent research has highlighted the potential influence of trauma on SZP. This research is promising, although it has thus far focused primarily on type of trauma (e.g., different types of abuse vs. neglect in childhood) rather than who perpetrated the trauma. Previous studies on both personality pathology in general and psychotic-spectrum experiences characteristic of SZP in particular have highlighted the influence of trauma perpetrated by someone with whom the trauma survivor was close (i.e., betrayal trauma), although this has not yet been examined with respect to SZP specifically. In this study we examined this, evaluating the influence of trauma with varying degrees of betrayal on SZP in a sample of adults (N = 364) using structural equation modeling. Results suggest that interpersonal trauma in general was associated with higher levels of SZP. Findings further indicate that for women but not men, trauma with a high degree of betrayal was uniquely associated with SZP. These results underscore the potential role of trauma in SZP and have implications for future research on and intervention with people with high levels of SZP.

The elephant in the room: Is betrayal trauma associated with borderline personality disorder?

Background

Borderline personality disorder (BPD) has been found to be closely linked to childhood trauma, particularly betrayal trauma.

Aim

In our study, we aimed to investigate the association between betrayal trauma and anxiety among young adults.

Methods

We assessed a total of 305 young adults using a Google form utilizing three assessment tools: the 10-item McLean Screening Instrument for Borderline Personality Disorder (MSI-BPD), the 12-item Brief Betrayal Trauma Survey (BBTS), and the 7-item Generalized Anxiety Disorder (GAD-7) to evaluate borderline personality traits, betrayal trauma experiences, and anxiety level.

Results

Our findings revealed that 22% [95% confidence interval (CI) 17.7 to 26.9] of the participants screened positive for BPD on MSI-BPD assessment; self-reported anxiety as reported by GAD-7 was observed in 27.9% (95% CI 23.1 to 33.2), while 82% (95% CI 77.3 to 85.9) reported experiencing betrayal trauma. A significantly higher proportion of individuals with BPD (97%) reported experiencing betrayal trauma compared to those without the disorder. High betrayal trauma [odds ratio (OR) 8.14, 95% CI 3.06 to 21.67] and medium betrayal trauma (OR 7.06, 95% CI 2.64 to 18.92) were significantly associated with the diagnosis of BPD. The associations held true across genders, although they were stronger in females.

Conclusions

Our study highlights the strong relationship between betrayal trauma and BPD, with significant implications for the development of anxiety in young adults. These findings underscore the importance of recognizing and addressing childhood trauma, particularly betrayal trauma, in individuals at risk for BPD.

Dissociation in mothers with borderline personality disorder: a possible mechanism for transmission of intergenerational trauma? A scoping review

BACKGROUND

Dissociation is a feature of Borderline Personality Disorder (BPD), but rarely a focus for research, particularly in the perinatal literature. BPD partly has its aetiology in childhood and is characterised by emotional changes and difficulty with self-coherence that impacts on the processes of caregiving.

METHODS

A scoping review was conducted to synthesise current perspectives on the effect of dissociation in caregivers with BPD, particularly regarding the impact of caregiver dissociation on the interactional quality of relationship within parent-child dyads. Studies were included if they explicitly mentioned dissociation in the target population, or if dissociation was implied. A thematic analysis was conducted.

RESULTS

20 studies were included; 10 experimental or quasi-experimental; 2 presenting case material; and 8 non-systematic review articles. 4 studies used the Dissociative Experiences Scale (DES) to measure dissociation, while 2 studies included a 'dissociative behaviour' subscale as part of an observational measure. The remaining studies did not measure dissociation but referenced directly or indirectly a concept of dissociation.

CONCLUSIONS

Findings suggested there was some evidence that dissociation plays a unique role in BPD caregivers' interactions with their offspring, however any findings should be interpreted with caution as the concept has been poorly operationalised and defined.

A Cross-Cultural Investigation of the Association between Betrayal Trauma and Dissociative Features

Betrayal trauma theory proposes that betrayal and non-betrayal traumas are different in terms of their nature and impacts. The theory predicts that dissociation is more strongly related to betrayal than to non-betrayal trauma, however there is a lack of cross-cultural evaluation of the theory. One competing theory is the socio-cognitive model, which proposes that dissociative amnesia (DA) and identity dissociation (ID) are the results of social influence and are not trauma-related conditions. This study aimed to test the hypotheses based on betrayal trauma theory and investigated the relationship between trauma, dissociation and other mental health problems in two culturally different convenience samples of people seeking web-based educational interventions for dissociation (N = 83 English speakers and N = 82 Chinese speakers). Compared with childhood non-betrayal trauma, childhood betrayal trauma had a statistically stronger relationship with dissociation and borderline personality disorder (BPD) symptoms in both samples. DA and ID symptoms were cross-culturally associated with childhood betrayal trauma after controlling for other variables (including sample membership, age, depression levels, medication treatment and non-betrayal trauma). Participants with DA/ID symptoms reported significantly more trauma-related symptoms in both samples. The findings supported the cross-cultural application of the betrayal trauma theory for dissociative features and BPD symptoms. Implications for research and practice (e.g., child protection, assessment for survivors of childhood betrayal trauma) are highlighted.

Influence of Betrayal Trauma on Psychopathy

Psychopathy is a virulent form of personality pathology that exerts a costly burden on society. Although there is a strong hereditary component to psychopathy, the environment also has an impact. One of the most salient environmental influences is trauma, although not all forms of trauma may be equally predictive of psychopathy. Many studies suggest that trauma perpetrated by someone whom the victim trusts and relies upon (i.e., betrayal trauma) has an especially robust influence on personality pathology. However, there has not yet been research examining this with respect to psychopathy specifically. In this study we examined the influence of traumas with varying degrees of betrayal on psychopathy in a sample of men and women working for Amazon's Mechanical Turk (N = 444) using partial least square structural equation modeling. Results suggest that interpersonal trauma in general was associated with psychopathy for both men and women, and that trauma high in betrayal was uniquely associated with psychopathy among men. These results clarify previous research on the association between betrayal trauma and personality pathology and on the traumatic antecedents of psychopathy in particular.

Influence of Betrayal Trauma on Antisocial Personality Disorder Traits

Antisocial personality disorder (ASPD) is linked to a number of social problems and accordingly is the focus of intensive empirical study. There is reason to believe that ASPD is influenced at least in part by exposure to trauma, but there has been minimal research on the association between trauma and ASPD traits. Specifically, research has not examined how traumatic experiences with different degrees of interpersonal betrayal differentially influence ASPD traits. This is notable in light of recent studies indicating that exposure to traumatic experiences high in betrayal (i.e., high betrayal trauma) is the primary predictor of borderline and narcissistic personality pathology. In this study, we examined the relative associations between high, medium, and low betrayal trauma and ASPD traits in a sample recruited from Amazon's Mechanical Turk (N = 363) using structural equation modeling. Results confirmed a strong association between trauma and ASPD traits in general, although the influence of specific forms of trauma differed depending on both sex and how trauma was calculated (i.e., in terms of severity vs. exposure). In general, high betrayal trauma was the most consistent predictor of ASPD traits for men, whereas medium and low betrayal traumas were more consistently associated with ASPD traits for women. Study findings extend research on betrayal trauma to more malevolent forms of personality pathology. Sex differences in the influence of trauma across ASPD traits suggest the possibility of sex-specific personality responses to trauma high in betrayal, a topic that can be addressed in the future research.

Gendered Sexual Violence: Betrayal Trauma, Dissociation, and PTSD in Diverse College Students

Young adults' transition into college includes risk for onset of mental health problems and sexual violence, particularly for women. Compared to men and boys, women and girls across the lifespan are more likely to be sexually abused, with the perpetrators often being someone close to them. High betrayal trauma is linked to varied mental health outcomes. Despite literature depth, many samples are not ethnically diverse, which results in uncertainty about the generalizability of these findings outside of majority White American populations. The purpose of the current study is to assess gender and high betrayal in sexual violence and mental health outcomes among ethnically diverse college students in the U.S. Participants (N = 368) were ethnically diverse college students attending a public university in the Pacific Northwest, who completed online measures assessing sexual violence and mental health outcomes. When controlling for medium betrayal sexual trauma (perpetrator: unclose other), the associations between high betrayal sexual trauma and dissociation and anxiety, respectively, were moderated by the female gender. The findings point to the utility of relational cultural therapy as a feminist framework that can identify sexism as a contributing factor to young women's increased risk for sexual violence and associated mental health problems.