Health Outcomes by Closeness of Sexual Abuse Perpetrator: A Test of Betrayal Trauma Theory

Abstract

Betrayal trauma theory ( Freyd, 1996 Freyd, J. J. 1996. Betrayal trauma: The logic of forgetting childhood abuse, Cambridge, MA : Harvard University Press. [Google Scholar] ) postulates childhood abuse perpetrated by a caregiver or someone close to the victim results in worse mental health than abuse perpetrated by a noncaregiver. Using the Adverse Childhood Experiences (ACE) data, we tested whether adults with high betrayal (HB) abuse would report poorer functional and mental health than low betrayal (LB) abuse victims. Among those participants reporting childhood sexual abuse, 32% experienced HB abuse. HB victims had a higher average ACE score than LB victims (2.72 vs. 1.87, p < .001), had significantly lower functional health scores on 4 of the 7 SF–36 Health Survey scales (all p < .04), and reported higher depression, anxiety, suicidality, panic, and anger (all p < .05).