Emotion Regulation Difficulties Mediate Associations Between Betrayal Trauma and Symptoms of Posttraumatic Stress, Depression, and Anxiety

Abstract

Emotion regulation difficulties following trauma exposure have received increasing attention among researchers and clinicians. Previous work highlights the role of emotion regulation difficulties in multiple forms of psychological distress and identifies emotion regulation capacities as especially compromised among survivors of betrayal trauma: physical, sexual, or emotional maltreatment perpetrated by someone to whom the victim is close, such as a parent or partner. It is unknown, however, whether links between emotion regulation difficulties and psychological symptoms differ following exposure to betrayal trauma as compared with other trauma types. In the present study, 593 male and female university undergraduates completed the Difficulties with Emotion Regulation Scale (Gratz & Roemer, 2004), the Brief Betrayal Trauma Scale (Goldberg & Freyd, 2006), the Impact of Event Scale (Horowitz, Wilner, & Alvarez, 1979), and the Trauma Symptom Checklist (Elliott & Briere, 1992). A path analytic model demonstrated that betrayal trauma indirectly impacted symptoms of intrusion (β = .11), avoidance (β = .13), depression (β = .17), and anxiety (β = .14) via emotion regulation difficulties, an effect consistent with mediation. Emotion regulation difficulties did not mediate the relationship between other trauma exposure and psychological symptoms. Results may inform treatment-matching efforts, and suggest that emotion regulation difficulties may constitute a key therapeutic target following betrayal trauma.

Does Emotion Dysregulation Mediate the Relationship between Early Maltreatment and Later Substance Dependence? Findings of the CANSAS Study

“…Simultaneously, higher emotion dysregulation increased the risk of developing an SUD. These findings are in line with past investigations of emotion dysregulation as a mediator of the relationship between maltreatment and different aspects of psychopathology [28,29,40] . The findings are further in line with studies on individuals without traumatization, where aspects of emotion regulation were identified as resilience factors [41] .…”

“…This has been supported by a study in an SUD sample so far, where childhood emotional and physical abuse were associated with emotion dysregulation [21] , while other studies found that different aspects of emotion dysregulation, like impulse control difficulties, mediate childhood maltreatment and psychopathology [28,29] . However, there are limitations to these studies, including the common use of college samples instead of clinical or exclusively traumatized samples or the examination of only single subscales of emotion dysregulation.…”

Cumulative childhood trauma, emotion regulation, dissociation, and behavior problems in school-aged sexual abuse victims

“…A study involving a sample of young adults found that emotional dysregulation mediated the association between high-betrayal trauma (i.e., abuse perpetrated by a close individual, as opposed to abuse perpetrated by a stranger or trauma that are not caused by another human being) and various mental health symptoms including anxiety, depression, intrusions, and avoidance (Goldsmith et al, 2013). Emotion regulation was also found to mediate the association between maltreatment and internalized and externalized behavior problems in school-age samples (Alink et al, 2009;Kim-Spoon et al, 2013).…”

Childhood Trauma and Active Mental Processes: Dissociation and Metacognition Influence Control of Negative Thoughts

“…Avoidant strategies are related to higher levels of PTSD and depressive symptoms, whereas emotional expression is associated with fewer symptoms (Hassija, Luterek, Naragon-Gainey, Moore, and Simpson 2012). In addition, ineffective emotion regulation strategies may contribute to the relationship between betrayal trauma exposure and subsequent symptoms (Goldsmith, Chesney, Heath, and Barlow 2013).…”