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Yalch MM, Robbins AL. Betrayal Trauma and Personality Pathology: An Integrated Review. J Trauma Dissociation 2025; 26:159-177. [PMID: 39569462 DOI: 10.1080/15299732.2024.2429465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 09/18/2024] [Indexed: 11/22/2024]
Abstract
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.
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Affiliation(s)
- Matthew M Yalch
- Department of Psychology, Palo Alto University, Palo Alto, California, USA
| | - Abbey L Robbins
- Department of Psychology, Palo Alto University, Palo Alto, California, USA
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Jarcuskova D, Pallayova M, Carnakovic S, Frajka M, Fidmik J, Bednarova A. Clinical characteristics of adults with alcohol dependence syndrome comorbid with antisocial personality disorder: a cross-sectional study. Front Psychiatry 2024; 15:1397009. [PMID: 39351332 PMCID: PMC11440125 DOI: 10.3389/fpsyt.2024.1397009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 08/21/2024] [Indexed: 10/04/2024] Open
Abstract
Introduction Antisocial Personality Disorder (ASPD) is characterized by a pervasive pattern of disregard for and violation of the rights of others, typically emerging by age 15 years and involving behaviors such as deceitfulness, impulsivity, and aggressiveness. The present study sought to examine the prevalence of the comorbid ASPD in adult people with Alcohol Dependence Syndrome (ADS) and identify clinical characteristics associated with ASPD. Methods A cross-sectional study of 100 consecutive subjects diagnosed with ADS was conducted. Subjects were examined between August 2023 and September 2023. Various assessments and questionnaires were employed, including the Montreal Cognitive Assessment (MoCA), Alcohol Use Disorders Identification Test (AUDIT), and Structured Clinical Interview for DSM-IV (SCID-II). A computed tomography (CT) scan of the brain was performed on 47.5% participants. Results Out of the 100 individuals screened for the study, 20 were excluded. The study found that 35% of the examined study participants had a comorbid ASPD. Individuals with both ADS and ASPD were more likely to be younger, started drinking at an earlier age, had higher hospitalization rates, and scored higher on the AUDIT test (all P < 0.05%). Also, they had lower education levels, higher rates of unemployment, and lower marriage rates (all P < 0.05%). In addition, they reported more family members with ADS, incarceration, or mental illness and a higher frequency of traumatic experiences (all P < 0.05%). Depression, anxiety, stress (all P < 0.05%), and sleep problems (P = 0.058) were correlated with ASPD. Participants with the comorbid ASPD had lower MoCA scores (P = 0.046) and struggled with attention and linguistic subtests compared to subjects with ADS only. Conclusion The study highlights the high prevalence of comorbid ASPD in participants with ADS, shedding light on their demographic and psychometric characteristics. Individuals with the comorbid ASPD are more likely to face cognitive deficits, especially in linguistic and attention-related tasks. The findings underline the importance of considering the comorbidity of ASPD in ADS subjects. The study implies that the understanding of the associated risk factors can aid in developing more targeted treatment interventions.
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Affiliation(s)
- Dominika Jarcuskova
- 1st Department of Psychiatry, University Hospital of Louis Pasteur and Pavol Jozef Safarik University Faculty of Medicine, Kosice, Slovakia
| | - Maria Pallayova
- 1st Department of Psychiatry, University Hospital of Louis Pasteur and Pavol Jozef Safarik University Faculty of Medicine, Kosice, Slovakia
- Department of Human Physiology, Pavol Jozef Safarik University Faculty of Medicine, Kosice, Slovakia
| | - Simona Carnakovic
- 1st Department of Psychiatry, University Hospital of Louis Pasteur and Pavol Jozef Safarik University Faculty of Medicine, Kosice, Slovakia
| | - Maria Frajka
- 1st Department of Psychiatry, University Hospital of Louis Pasteur and Pavol Jozef Safarik University Faculty of Medicine, Kosice, Slovakia
| | - Jan Fidmik
- 1st Department of Psychiatry, University Hospital of Louis Pasteur and Pavol Jozef Safarik University Faculty of Medicine, Kosice, Slovakia
| | - Aneta Bednarova
- 2nd Department of Psychiatry, University Hospital of Louis Pasteur and Pavol Jozef Safarik University Faculty of Medicine, Kosice, Slovakia
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Newcomb KM, Froehlich M, Yalch MM. Influence of Betrayal Trauma on Schizoid Personality Pathology. J Trauma Dissociation 2024; 25:456-466. [PMID: 38433450 DOI: 10.1080/15299732.2024.2323972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Accepted: 12/13/2023] [Indexed: 03/05/2024]
Abstract
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.
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Affiliation(s)
| | | | - Matthew M Yalch
- Department of Psychology, Palo Alto University, Palo Alto, CA, USA
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Hujing CL, Yalch MM, Levendosky AA. Association Between Betrayal Trauma and the PAI Traumatic Stress Scale. J Trauma Dissociation 2024; 25:408-418. [PMID: 38385573 DOI: 10.1080/15299732.2024.2320873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 11/30/2023] [Indexed: 02/23/2024]
Abstract
The Personality Assessment Inventory (PAI) is among the most commonly used broadband inventories of psychological functioning. For the purposes of assessing trauma specifically, the most relevant aspect of the PAI is the Traumatic Stress subscale of the Anxiety-Related Disorders scale (ARD-T), which measures the degree to which a person feels wounded by something in their past. Research suggests that ARD-T is associated with exposure to a variety of different traumatic stressors. However, there is little research on the degree to which traumatic stressors that entail a component of interpersonal betrayal (i.e. betrayal trauma) are associated with higher scores on ARD-T relative to other stressors. In this study, we evaluated the relative associations between traumas with varying degrees of betrayal and scores on ARD-T in a secondary analysis of two non-clinical samples (college sample N = 494; crowdsourced sample N = 364) using a Bayesian approach to multiple regression. In both samples, traumas with both high and medium (but not low) degrees of betrayal were associated with elevated ARD-T scores. Findings suggest that ARD-T scores are associated with interpersonal trauma regardless of betrayal, which has implications for interpretation of the ARD-T scale in practice.
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Affiliation(s)
| | - Matthew M Yalch
- Department of Psychology, Palo Alto University, Palo Alto, CA, USA
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Yalch MM, Snyder K, Hujing CL, Torres AN. Influence of Betrayal Trauma on Schizotypal Personality Pathology. J Trauma Dissociation 2024; 25:366-378. [PMID: 36050931 DOI: 10.1080/15299732.2022.2120153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Accepted: 08/12/2022] [Indexed: 10/14/2022]
Abstract
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.
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Affiliation(s)
- Matthew M Yalch
- Department of Psychology, Palo Alto University, Palo Alto, California, USA
| | - Kaitlin Snyder
- Department of Psychology, Palo Alto University, Palo Alto, California, USA
| | - Christine L Hujing
- Department of Psychology, Palo Alto University, Palo Alto, California, USA
| | - Alicia N Torres
- Department of Psychology, Palo Alto University, Palo Alto, California, USA
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Spytska L. Symptoms and Main Differences Between a Psychopath and a Sociopath. J Nerv Ment Dis 2024; 212:52-56. [PMID: 38166182 DOI: 10.1097/nmd.0000000000001728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2024]
Abstract
ABSTRACT The research relevance is predefined by the fact that, in modern psychology and psychiatry, the concepts of psychopathy and sociopathy are combined and interchanged. These are two concepts that describe different etiologies of the same mental health condition. The research aims to describe in detail the main manifestations and characteristics of personality disorders (psychopathy and sociopathy) in psychiatry and psychology. The research analyzes the main features and manifestations of sociopathy and psychopathy. It examines the work of psychologists, psychiatrists, neurologists, and neurosurgeons in helping sociopaths and psychopaths. The study also explores the challenges of treating antisocial personality disorders and identifies internal and external factors that influence the development of these conditions. In addition, the article emphasizes the behavioral differences between sociopaths and psychopaths, proposes various methods for integrated therapy, diagnoses the main aspects of these disorders, and highlights the importance of psychiatric care and psychotherapeutic interventions. The research is of theoretical and practical value for psychologists, psychoanalysts, and physicians who can help people with these pathologies of personal development.
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Affiliation(s)
- Liana Spytska
- Department of Practical Psychology and Social Work, Volodymyr Dahl East Ukrainian National University, Kyiv, Ukraine
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Affiliation(s)
- Sarah J Harsey
- Center for Institutional Courage, USA.,Department of Psychology, University of Oregon, Eugene, Oregon, USA
| | - Jennifer J Freyd
- Center for Institutional Courage, USA.,Department of Psychology, University of Oregon, Eugene, Oregon, USA.,Stanford School of Medicine, Palo Alto, California, USA
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Abstract
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.
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Affiliation(s)
- Matthew M Yalch
- Department of Psychology, Palo Alto University, Palo Alto, California, USA
| | - Ryanne M Dehart
- Department of Psychology, Palo Alto University, Palo Alto, California, USA
| | - Dominic B Ceroni
- Department of Psychology, Palo Alto University, Palo Alto, California, USA
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