Betrayal Trauma Among Homeless Adults

Abstract

Betrayal trauma theory postulates that traumas perpetrated by a caregiver or close other are more detrimental to mental health functioning than are traumatic experiences in which the victim is not affiliated closely with the perpetrator. This study is the first to examine the concept of betrayal among a sample of individuals with a history of homelessness. A total of 95 homeless or formerly homeless adults completed the Brief Betrayal Trauma Survey, the Posttraumatic Stress Disorder Checklist-Civilian Version, the Center for Epidemiologic Studies Depression Scale the Perceived Stress Scale, and a demographics questionnaire assessing participants' histories of homelessness, health, and relationships with their families. Regression analyses were conducted to explore the associations between high betrayal (HB) and low betrayal (LB) trauma exposure, relationship with family, and physical and mental health symptoms. Exposure to HB traumas in childhood and poor family relationships predicted earlier age at first episode of homelessness, and participants who had been exposed to a greater number of traumas during childhood were more likely to be revictimized during adulthood. Trauma exposure as an adult and earlier age of first homeless episode predicted symptoms of posttraumatic stress disorder, while trauma exposure alone predicted symptoms of depression and perceived stress. Number of medical diagnoses was associated with trauma exposure and becoming homeless at an older age. These findings emphasize that even among the most marginalized and multiply victimized individuals in our society, traumas that are characterized by a higher degree of betrayal are associated with more adverse outcomes.

Illness and drug modifiable factors associated with violent behavior in homeless people with severe mental illness: results from the French Housing First (FHF) program

“…Subjects reporting history of violent victimization were found to be at increased risk of MDD in the present study. This result is consistent with previous findings (Mackelprang et al, 2014;Satyanarayana et al, 2015;Tong et al, 2019;Wong et al, 2016) and suggest that violent victimization should be prevented in this vulnerable population. Individuals with lived experience of homelessness face considerable marginalization, dehumanization and structural violence.…”

Cumulative Trauma Exposure and Chronic Homelessness Among Veterans: The Roles of Responses to Intrusions and Emotion Regulation

“…The lack of a sequential indirect effect for episode duration was not expected given previous findings that suggest coping skills and risky behaviors are related to the duration of homelessness (Caton et al, 2005;Harris et al, 2017). However, other research has not supported an association between trauma-related symptoms and homeless duration (Mackelprang et al, 2014). Trauma-related factors may be more relevant to episodic patterns of homelessness and the ability to retain housing as opposed to the duration of episodes and exiting homelessness.…”

Interpersonal Violence Exposure and Chronic Pain in Adult Sickle Cell Patients

“…Interpersonal violence exposure is a severe and potentially traumatic form of stressor exposure that can include witnessing or experiencing threatened or actual physical or sexual assault or emotional abuse. Exposure to traumatic interpersonal violence and persistent posttraumatic stress reactions have been linked to a plethora of physical and mental health problems including chronic pain (Bonomi et al, 2009; Campbell, 2002; Coker, Smith, Bethea, King, & McKeown, 2000; Nicolaidis, Curry, McFarland, & Gerrity, 2004), dysregulated stress response (Anda et al, 2006; Davies, Sturge-Apple, Cicchetti, & Cummings, 2008; Horan & Widom, 2015; Shenk, Noll, Putnam, & Trickett, 2010), as well as compromised immunological and metabolic functioning and physical health (Goldsmith, Freyd, & DePrince, 2012; Jun et al, 2012; Kendall-Tackett, 2013; Mackelprang et al, 2014; Schnurr & Green, 2004; Sumner et al, 2015). Posttraumatic stress symptoms and related psychosocial impairment have been shown to exacerbate pain and physical symptoms secondary to childhood abuse (Hart-Johnson & Green, 2012; Paras et al, 2009), severe injury (Beck, Gudmundsdottir, & Shipherd, 2003; Jenewein, Wittmann, Moergeli, Creutzig, & Schnyder, 2009), and illness (Smith, Egert, Winkel, & Jacobson, 2002), and to mediate the relationship between trauma exposure and pain (Powers et al, 2014).…”