Institutional betrayal following military sexual trauma is associated with more severe depression and specific posttraumatic stress disorder symptom clusters

J Clin Psychol. 2019 Jul;75(7):1305-1319. doi: 10.1002/jclp.22773. Epub 2019 Apr 4.

Abstract

Objective: Preliminary research suggests that perceptions of institutional betrayal are associated with more severe symptoms of posttraumatic stress disorder (PTSD) and depression, as well as suicide attempts in military sexual trauma (MST) survivors. However, results have not been replicated. Additionally, associations of institutional betrayal with specific PTSD symptom clusters or sexual function are understudied.

Method: Female service members/veterans who reported experiencing MST (N = 679) completed self-report measures of PTSD and depression symptom severity, suicidal ideation, and sexual function. Institutional betrayal was assessed from free-text descriptions of self-reported index traumas.

Results: Institutional betrayal was significantly associated with more severe depression and PTSD symptoms, including avoidance, negative alterations in cognitions and mood, re-experiencing, and dysphoric arousal.

Conclusions: Targeting specific PTSD and depressive symptoms through evidence-based treatment may be important for managing institutional betrayal sequelae. Future research should identify specific strategies to help support survivors in their recovery following institutional betrayal.

Keywords: depression; military psychology; posttraumatic stress disorder; sexual assault; trauma.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Depressive Disorder, Major / etiology*
  • Depressive Disorder, Major / physiopathology*
  • Ethics, Institutional*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Military Personnel / psychology*
  • Organizational Culture
  • Self Report
  • Sex Offenses / psychology*
  • Stress Disorders, Post-Traumatic / etiology*
  • Stress Disorders, Post-Traumatic / physiopathology*
  • Survivors / psychology*
  • United States
  • Veterans / psychology
  • Young Adult