"It Will Always Feel Worse Because it Comes with That Added 'Betrayal'": Intersectionality Praxis and Black Young Women Survivors' Perspectives on Cultural Betrayal Trauma Theory.

Because of interlocking oppressions of racism and sexism (e.g. intersectionality), Black women's experiences of high rates of sexual violence are often ignored. A critical Black feminist framework, cultural betrayal trauma theory (CBTT) examines within-group violence in the Black community, which has compounding harm due to inequality. Though quantitative research has found support for CBTT, Black young women survivors' perspectives have not been examined. Therefore, the purpose of the current exploratory study was to engage in intersectionality praxis to qualitatively examine Black young women survivors' perspectives on CBTT through structured thematic analysis and coding based on theory. Respondents (N = 37; 18-30 years), provided their thoughts on CBTT following participating in a quantitative study. With most survivors in agreement that cultural betrayal in trauma is harmful, a key theme was community orientation in understanding both the harm and healing of cultural betrayal trauma. Black young women survivors' resonance with CBTT, as well as their recommendations for community-level solidarity and healing have important implications.

Violence victimization in Latina/o/x young adults: The multiplicative effects of cultural and high betrayal trauma.

Latinas/os/xs experience pervasive rates of interpersonal violence victimization while also experiencing frequent discrimination and societal trauma (e.g., hate crimes). Betrayal trauma theory and cultural betrayal trauma theory provide frameworks for examining the distinct harm of violence perpetrated by a close other and by a member of the same marginalized group(s), respectively. However, no known research has examined the concurrent impacts of both forms of betrayal among Latina/o/x young adults. The current study examined the unique and multiplicative effects of high betrayal trauma (i.e., violence perpetrated by a close other) and cultural betrayal trauma (i.e., violence perpetrated by someone of the same marginalized group(s)) on psychological and physical health symptoms in Latina/o/x young adults. Latina/o/x undergraduate students (N = 208) participated in a 60-minute online survey assessing violence victimization, psychological symptoms, and physical health. Rates of victimization (91.35%, n = 190) were high across differing forms of violence. Interactions of high betrayal trauma and cultural betrayal trauma were significant for psychological, physical, and anxiety symptoms. Although there were no significant simple effects, the pattern of results suggested that being assaulted by someone who shares one's Latina/o/x identity was more strongly associated with psychological and physical symptoms when participants had not been assaulted by someone with whom they were close. The current study highlights the importance of culturally competent therapy for Latina/o/x survivors that incorporates the interpersonal and cultural contexts of victimization.

Campus Sexual Harassment, Other Violence, and Racism, Oh my! Evidence From Black Women Undergraduates for a Culturally Competent University Approach to Title IX.

Relevant for Title IX federal legislation, the purpose of the current study is to examine cultural betrayal (within-group perpetrator) and sexual harassment (SH) with other violence and racial discrimination on Black women undergraduates' mental health. In a 60-minute online study (N = 162), over 50% experienced campus SH and other violence and/or racial discrimination, with multi-victimization being related to anxiety and other mental health outcomes. Cultural betrayal SH did not predict mental health when controlling for between-group SH. Implications include the 2019 Critical-Interdisciplinary Sexual Violence Research Summit's comprehensive research agenda: Intersectional Approaches, Perpetration, Communications, Beyond Policy, and Sexual Violence and Equity.

When solidarity hurts: (Intra)cultural trust, cultural betrayal sexual trauma, and PTSD in culturally diverse minoritized youth transitioning to adulthood.

Sexual trauma is associated with PTSD, with perpetrators putting women and girls more at risk than men and boys. Young adulthood is a time where risk of victimization and susceptibility to mental health problems increase. Certain contributors of costly trauma outcomes may be affected by the larger context of societal inequality. Cultural betrayal trauma theory (CBTT) highlights cultural betrayal in within-group trauma in minoritized populations as a dimension of harm that affects outcomes. In CBTT, within-group trauma violates the (intra)cultural trust-solidarity, love, loyalty, connection, responsibility-that is developed between group members to buffer against societal inequality. This violation, termed a cultural betrayal, can contribute to poorer mental health. The purpose of the current study is to address a gap in the CBTT literature by examining the role of (intra)cultural trust on the association between cultural betrayal sexual trauma and symptoms of PTSD among diverse minoritized youth transitioning to adulthood. Participants (N = 173) were diverse minoritized college students, who completed a 30-min online questionnaire at a location of their own choosing. Participants received course credit and could decline to answer any question without penalty. The results reveal that the interaction between cultural betrayal sexual trauma and (intra)cultural trust predicted clinically significant symptoms of PTSD. These findings have implications for increased cultural and contextual specificity in trauma research in minoritized populations, which can aid in the development and implementation of culturally competent interventions for diverse minoritized youth survivors of sexual trauma.

Cultural Betrayal as a Dimension of Traumatic Harm: Violence and PTSS among Ethnic Minority Emerging Adults.

According to cultural betrayal trauma theory, within-group violence confers a cultural betrayal that contributes to outcomes, including symptoms of posttraumatic stress disorder (PTSS). Close relationship with the perpetrator, known as high betrayal, also impacts PTSS. The purpose of the current study is to examine cultural betrayal trauma, high betrayal trauma, and PTSS in a sample of diverse ethnic minority emerging adults. Participants (N = 296) completed the one-hour questionnaire online. Hierarchical linear regression analyses revealed that when controlling for gender, ethnicity, and interracial trauma, high betrayal trauma and cultural betrayal trauma were associated with PTSS. Clinical interventions can include assessments of the relationship with and in-group status of the perpetrator(s) in order to guide treatment planning with diverse survivors.

Gendered Sexual Violence: Betrayal Trauma, Dissociation, and PTSD in Diverse College Students.

Young adults' transition into college includes risk for onset of mental health problems and sexual violence, particularly for women. Compared to men and boys, women and girls across the lifespan are more likely to be sexually abused, with the perpetrators often being someone close to them. High betrayal trauma is linked to varied mental health outcomes. Despite literature depth, many samples are not ethnically diverse, which results in uncertainty about the generalizability of these findings outside of majority White American populations. The purpose of the current study is to assess gender and high betrayal in sexual violence and mental health outcomes among ethnically diverse college students in the U.S. Participants (N = 368) were ethnically diverse college students attending a public university in the Pacific Northwest, who completed online measures assessing sexual violence and mental health outcomes. When controlling for medium betrayal sexual trauma (perpetrator: unclose other), the associations between high betrayal sexual trauma and dissociation and anxiety, respectively, were moderated by the female gender. The findings point to the utility of relational cultural therapy as a feminist framework that can identify sexism as a contributing factor to young women's increased risk for sexual violence and associated mental health problems.

Who Is Okay? The Harm of One-Dimensional Appraisals of Women Scholars During COVID-19 & Beyond.

In this essay, I detail how homogenizing appraisals of diverse faculty women during COVID-19 are harmful to all, including myself. I highlight how academic demands to be "talking heads" and not full human beings, though not new, is especially harmful in the current era. As a Black woman faculty dealing with the double pandemic of COVID-19 and anti-Black racism, the one-dimensional appraisals of women faculty exclude me: I am not a mother dealing with sexist overburden in household responsibilities that interfere with my work. Instead, I am dealing with isolation and loneliness, which I sublimate through work productivity. Resulting in shame, I also realize that universities could operate differently, recognizing women scholars for their diversity in identities, backgrounds, responsibilities, work styles, and personalities during the pandemic and beyond. Given that work productivity is not synonymous with well-being, I hope my colleagues know that, in this moment, I am not okay.

It Hurts When You're Close: High Betrayal Sexual Trauma, Dissociation, and Suicidal Ideation in Young Adults.

Sexual trauma (e.g., rape), is associated with dissociation and suicidal ideation (SI). Sexual trauma is additionally harmful when perpetrated by a person(s) who is close or trusted (known as high betrayal). With young adulthood as a high-risk period for mental instability, the purpose of the current study is to examine the roles of high betrayal sexual trauma and dissociation in SI among young adults. Participants (N = 192) were college students who completed the 30-minute online survey. A multivariate analysis of variance (MANOVA) found that high betrayal sexual trauma was associated with dissociation and SI. Moreover, there was an indirect effect of high betrayal sexual trauma on SI through dissociation. Empirical implications include examining these associations longitudinally, with a focus on the impact of revictimization over time.

Trainee Perspectives on Relational Cultural Therapy and Cultural Competency in Supervision of Trauma Cases.

Supervision is a key part of training in clinical psychology. From my postdoctoral trainee perspective as a Black woman, I reflect on supervision in 1 of my predoctoral practicum at a community clinic where I worked with low-income women with trauma histories. With relational cultural therapy (e.g., Miller, 1976), my clinical supervision was in the feminist multicultural framework (Porter & Vasquez, 1997) and included the complexities of power in the supervisory relationship, openness, collaboration, and critical self-reflection (Arczynski & Morrow, 2017). Moreover, incorporating research perspectives (e.g., betrayal trauma theory, Freyd, 1996; cultural betrayal trauma theory, Gómez, 2018d; microaggressions, Sue, 2010) and cultural competency (Sue, 1978) created a rich learning environment. In this article, I detail 2 case studies to illustrate exchanges in supervision that positively impacted my professional development. In Case Study 1, my supervisor engendered identification of parallel processing through engaging in mutual empathy and relational reconnection regarding racial discrimination from a client. In Case Study 2, my supervisor used a collaborative approach in treatment planning for a Latina client who was in an abusive relationship. Based on these experiences, implications for supervisors include ongoing training in discrimination of diverse minorities and facilitating discussions in supervision about how trainees' and clients' respective societal statuses impact the therapeutic process (e.g., case conceptualizations, treatment planning). Implications for trainees include maintaining a processing journal, in which trainees reflect on their experiences including but not limited to cultural competency to be better prepared to discuss complex issues in supervision.

La supervisión es una parte clave de la formación en psicología clínica. Desde mi perspectiva de aprendiz postdoctoral como mujer negra, reflexiono sobre la supervisión en una de mis prácticas predoctorales en una clínica comunitaria donde trabajé con mujeres de bajos ingresos con antecedentes de trauma. Con la terapia cultural relacional (por ejemplo, Miller, 1976), mi supervisión clínica estaba en el marco multicultural feminista (Porter y Vásquez, 1997) e incluía las complejidades del poder en la relación de supervisión, apertura, colaboración y autorreflexión crítica (Arczynski & Morrow, 2017). Además, la incorporación de perspectivas de investigación (por ejemplo, la teoría del trauma de la traición, Freyd, 1996; la teoría del trauma de la traición cultural, Gómez, 2018c; las microagresiones, Sue, 2010) y la competencia cultural (Sue, 1978) crearon un rico ambiente de aprendizaje. En este manuscrito, detallo dos estudios de caso para ilustrar los intercambios en la supervisión que impactaron positivamente mi desarrollo profesional. En el Estudio de caso # 1, mi supervisor generó la identificación del procesamiento paralelo a través de la empatía mutua y la reconexión relacional con respecto a la discriminación racial de un cliente. En el Estudio de caso # 2, mi supervisor utilizó un enfoque colaborativo en la planificación del tratamiento para una cliente latina que estaba en una relación abusiva. En base a estas experiencias, las implicaciones para los supervisores incluyen capacitación continua en discriminación de minorías diversas y facilitar debates en supervisión sobre cómo los estados sociales respectivos de los alumnos y los clientes impactan el proceso terapéutico (por ejemplo, conceptualizaciones de casos; planificación del tratamiento). Las implicaciones para los alumnos incluyen mantener un diario de procesamiento, en el que los alumnos reflexionen sobre sus experiencias, incluidas, entre otras, la competencia cultural, para estar mejor preparados para debatir cuestiones complejas en la supervisión.

Isn't It All About Victimization? (Intra)cultural Pressure and Cutural Betrayal Trauma in Ethnic Minority College Women.

Cultural betrayal trauma theory proposes that intraracial trauma in ethnic minority populations includes a cultural betrayal that contributes to outcomes, such as symptoms of PTSD (posttraumatic stress disorder; posttraumatic stress symptoms [PTSS]), dissociation, and (intra)cultural pressure. Participants (n = 179) were ethnic minority female college students, who completed online questionnaires. The results revealed that when controlling for age, ethnicity, and interracial trauma, intraracial trauma and (intra)cultural pressure affected PTSS and dissociation. There were also indirect effects of cultural betrayal trauma on outcomes through (intra)cultural pressure. The current study can contribute to clinical interventions that address trauma-related mental health in ethnic minority college women.

High Betrayal Adolescent Sexual Abuse and Nonsuicidal Self-Injury: The Role of Depersonalization in Emerging Adults.

Adolescent sexual abuse can interfere with healthy development. Sexual abuse that is perpetrated by close other(s)-high betrayal-can be additionally harmful, with sexual abuse being linked with dissociation and nonsuicidal self-injury (NSSI). Depersonalization, a dissociative subtype characterized by disconnection between oneself and one's body and/or thoughts, may further explain the role of dissociation in NSSI. The purpose of the current study was to: 1) isolate the impact of adolescent sexual abuse on NSSI; and 2) examine depersonalization as a pathway between high betrayal adolescent sexual abuse and NSSI. Participants (N = 192) were college students who completed online measures assessing sexual abuse, dissociation, and NSSI. While controlling for child sexual abuse and adult sexual abuse, adolescent sexual abuse predicted NSSI. Moreover, there was an indirect effect of high betrayal adolescent sexual abuse on NSSI through depersonalization, while controlling for child sexual abuse, adult sexual abuse, and medium betrayal (perpetrator: unclose other) adolescent sexual abuse. Findings from the current study have implications for relational cultural therapy as an evidence-informed treatment that highlights the relational harm of interpersonal trauma, while incorporating contextual elements, such as development of maladaptive coping strategies, into therapy.

Psychological Outcomes of Within-Group Sexual Violence: Evidence of Cultural Betrayal.

Cultural betrayal trauma theory is a new framework for understanding trauma-related mental health outcomes in immigrant and minority populations. The purpose of the current study is to empirically test cultural betrayal trauma theory. We hypothesized that the association between within-group sexual violence and mental health outcomes would be stronger for minorities. Participants (N = 368) were minority and majority college students, who completed online measures of sexual violence victimization and mental health outcomes. A MANOVA revealed that the link between within-group sexual violence and total trauma symptoms, depression, sexual abuse sequelae, sleep disturbance, and sexual problems was stronger for minorities. This study provides evidence for cultural betrayal trauma theory, as the findings suggest that outcomes from the same experience-within-group sexual violence-is affected by minority status. This work has implications for how mental health is understood, investigated, and treated in immigrant and minority populations.

High Betrayal Child Sexual Abuse and Hallucinations: A Test of an Indirect Effect of Dissociation.

Though hallucinations traditionally have been conceptualized as a central feature of psychosis, some hallucinations may be dissociative, with dissociation potentially contributing to hallucinations. Childhood trauma has been linked with dissociation and hallucinations. Betrayal trauma theory distinguishes abusive experiences based on closeness to the perpetrator. In the current study, we examined the indirect effect of dissociation on the relationship between high betrayal child sexual abuse (perpetrated by a close other) and hallucinations. Participants (N = 192) from a northwestern university in the United States completed self-report measures online assessing history of high betrayal child sexual abuse and current dissociation and hallucinations. Bootstrapping analyses indicated a significant indirect effect of high betrayal child sexual abuse on hallucinations through dissociation, 95% Confidence Interval (.16, .66). Through betrayal trauma theory, this study provides a non-pathologizing framework for understanding how dissociation and hallucinations may develop as natural reactions to the harm inherent in child sexual abuse perpetrated by a close other. These findings have clinical implications for relational models of healing for trauma survivors who are distressed by dissociation and hallucinations.

Betrayal trauma among homeless adults: associations with revictimization, psychological well-being, and health.

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.