Betrayal as a Mediator of PTSD Symptoms Following Romantic Partner Sexual Assault in College Students

Sexual assault (SA) is a prevalent issue among college students and is often perpetrated by romantic partners. Victims of romantic partner sexual assault (RPSA) may experience a heightened sense of betrayal compared to those assaulted by strangers or acquaintances, and this betrayal may be associated with more severe posttraumatic stress disorder (PTSD) symptoms. While previous literature has primarily examined betrayal in the context of childhood sexual abuse, this study aims to extend the literature by examining betrayal related to RPSA. We tested whether victims of RPSA experienced more severe PTSD and greater feelings of betrayal than those who were assaulted by a non-romantic partner (non-RPSA). We also examined whether feelings of betrayal mediated an association between sexual assault type (RPSA vs. non-RPSA) and PTSD symptoms. A total of 1,104 undergraduates from a public liberal arts college completed an online survey about their SA history, with 231 (21%) indicating an experience of SA during their time at college. Among the SA victims who completed all survey measures (N = 150), 40 students indicated a history of RPSA and reported higher levels of betrayal than those who experienced non-RPSA. Betrayal, in turn, predicted more severe PTSD symptoms. However, the level of PTSD symptoms was comparable between the two groups. A significant indirect effect of RPSA (vs. non-RPSA) on PTSD symptoms through betrayal demonstrated that victims of RPSA who perceived the assault as a violation of trust experienced more severe symptoms than those who experienced non-RPSA and those who felt less betrayal related to their assault. Interventions that target cognitive distortions related to trust, such as cognitive processing therapy, offer a well-suited approach to addressing issues of betrayal among victims of RPSA.