Institutional Betrayal and Closeness Among Women Veteran Survivors of Military Sexual Trauma: Associations with Self-Directed Violence and Mental Health Symptoms.

Publisher: Routledge Country of Publication: England NLM ID: 100898209 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1529-9740 (Electronic) Linking ISSN: 15299732 NLM ISO Abbreviation: J Trauma Dissociation Subsets: MEDLINE

Publication: Philadelphia : Routledge
Original Publication: Binghamton, NY : Co-published by Haworth Medical Press, Haworth Maltreatment & Trauma Press, c2000-

Veterans*/psychology ; Military Personnel*/psychology ; Sex Offenses*/psychology ; Stress Disorders, Post-Traumatic*/psychology; Humans ; Female ; Mental Health ; Betrayal ; Military Sexual Trauma ; Violence ; Survivors/psychology

Institutional betrayal is defined as harm caused by an institution to an individual in the context of trust and dependence. High institutional betrayal is associated with poorer health outcomes, and high levels of trust, dependence, or identification with the institution (institutional closeness) may exacerbate the negative effects of institutional betrayal. While military sexual trauma is prevalent among women Veterans and associated with high rates of institutional betrayal, studies of the impact of military sexual trauma-related institutional betrayal have been limited in size and scope and have not examined the potential role of institutional closeness. We conducted a secondary analysis of national survey data collected from women Veterans who screened positive for military sexual trauma ( n = 229). Hierarchical logistic and linear regression were used to examine associations between predictor variables (institutional betrayal, institutional closeness, and their interaction) and outcomes of interest and adjusted for age, education, and military sexual assault history. Institutional betrayal was associated with increased odds of suicidal ideation and suicide attempt during or following military service, as well as more severe symptoms of depression and posttraumatic stress disorder (PTSD). Institutional betrayal was not associated with non-suicidal self-injury or lifetime substance misuse. Counter to hypotheses, institutional closeness did not moderate relationships between institutional betrayal and mental health symptoms or self-directed violence. Results underscore the necessity of preventing and addressing institutional betrayal among women Veterans who experience military sexual trauma.

Keywords: Institutional betrayal; military sexual trauma; suicide attempt; veteran; women

Date Created: 20220907 Date Completed: 20240315 Latest Revision: 20240315

20240315

10.1080/15299732.2022.2120152

36069509