The Role of Cumulative Trauma, Betrayal, and Appraisals in Understanding Trauma Symptomatology

Poor psychological outcomes are common among trauma survivors, yet not all survivors experience adverse sequelae. The present study examined links between cumulative trauma exposure as a function of the level of betrayal (measured by the relational closeness of the survivor and the perpetrator), trauma appraisals, gender, and trauma symptoms. Participants were 273 college students who reported experiencing at least one traumatic event on a trauma checklist. Three cumulative indices were constructed to assess the number of different types of traumas experienced that were low, moderate, or high in betrayal (HBT). Greater trauma exposure was related to more symptoms of depression, dissociation, and posttraumatic stress disorder, with exposure to HBTs contributing the most. Women were more likely to experience HBTs than men, but there were no gender differences in trauma-related symptoms. Appraisals of trauma were predictive of trauma-related symptoms beyond the effects explained by cumulative trauma at each level of betrayal. The survivor's relationship with the perpetrator, the effect of cumulative trauma, and their combined effect on trauma symptomatology are discussed.