Betrayal trauma and adult mental health : The role of mentalizing and dissociation

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dc.abstract.enBackground Trauma experienced across the lifespan has been linked to a wide range of adverse mental health outcomes. However, the psychological mechanisms connecting betrayal trauma to later psychopathology remain insufficiently understood. Objective This cross-sectional study investigated associations between betrayal trauma during childhood and adulthood and adult psychopathology—specifically depressive symptoms and level of personality functioning within a dimensional model of personality disorders. We tested a path model examining direct and indirect associations between betrayal trauma at different developmental periods and adult psychopathology via dissociation and hypomentalizing. Participants A sample of 209 adults (61% female; aged 18–45 years; M = 29.7, SD = 7.88) were recruited from community and clinical settings in Poland. Methods Participants completed validated self-report measures assessing betrayal trauma, depressive symptoms, personality functioning (ICD-11 model), dissociation, and mentalizing. Path analyses with parallel mediation were conducted using SatorraBentler estimation and 5,000 bootstrap resamples to examine both direct and indirect associations. Results Both childhood and adulthood betrayal trauma were significantly associated with depressive symptoms and PD severity through dissociation and hypomentalizing [χ²(6) = 13.68, p = .033; CFI = 0.989; TLI = 0.931; RMSEA = 0.078; SRMR = 0.038]. No significant direct effects were observed once psychological processes were included. Mentalizing consistently demonstrated a stronger indirect association than dissociation across models. Adulthood betrayal trauma showed a greater total effect on depressive symptoms (β = .30; p < .001) than childhood trauma (β =  .17; p = .043), whereas their effects on personality pathology were comparable (respectively, β =  .21; p = .006 for adult trauma and β = .22; p = .008 for childhood trauma). For adulthood trauma and PD severity, the direct association was small and non-significant (β = −.06), whereas indirect effects via dissociation (β = .11) and mentalizing (β = .16) were positive, resulting in a positive total effect. Conclusions These findings indicate that the link between betrayal trauma and adult psychopathology may be best conceptualised in terms of co-occurring psychological processes rather than direct exposure effects. Hypomentalizing, in particular, appears to represent a key transdiagnostic mechanism connecting relational trauma across developmental stages with both mood and personality pathology.
dc.affiliationWydział Psychologii i Prawa w Poznaniu
dc.affiliationInstytut Psychologii
dc.contributor.authorKamza, Anna
dc.contributor.authorGagliardini, Giulia
dc.contributor.authorJańczak, Monika Olga
dc.contributor.authorColli, Antonello
dc.contributor.authorFonagy, Peter
dc.contributor.authorNolte, Tobias
dc.contributor.editorHong Wang Fung
dc.date.access2026-07-15
dc.date.accessioned2026-07-15T07:21:44Z
dc.date.available2026-07-15T07:21:44Z
dc.date.issued2026-07-13
dc.description.abstract<jats:sec id="sec001"> <jats:title>Background</jats:title> <jats:p>Trauma experienced across the lifespan has been linked to a wide range of adverse mental health outcomes. However, the psychological mechanisms connecting betrayal trauma to later psychopathology remain insufficiently understood.</jats:p> </jats:sec> <jats:sec id="sec002"> <jats:title>Objective</jats:title> <jats:p>This cross-sectional study investigated associations between betrayal trauma during childhood and adulthood and adult psychopathology—specifically depressive symptoms and level of personality functioning within a dimensional model of personality disorders. We tested a path model examining direct and indirect associations between betrayal trauma at different developmental periods and adult psychopathology via dissociation and hypomentalizing.</jats:p> </jats:sec> <jats:sec id="sec003"> <jats:title>Participants</jats:title> <jats:p> A sample of 209 adults (61% female; aged 18–45 years; <jats:italic>M</jats:italic>  = 29.7, <jats:italic>SD</jats:italic>  = 7.88) were recruited from community and clinical settings in Poland. </jats:p> </jats:sec> <jats:sec id="sec004"> <jats:title>Methods</jats:title> <jats:p>Participants completed validated self-report measures assessing betrayal trauma, depressive symptoms, personality functioning (ICD-11 model), dissociation, and mentalizing. Path analyses with parallel mediation were conducted using Satorra–Bentler estimation and 5,000 bootstrap resamples to examine both direct and indirect associations.</jats:p> </jats:sec> <jats:sec id="sec005"> <jats:title>Results</jats:title> <jats:p>Both childhood and adulthood betrayal trauma were significantly associated with depressive symptoms and PD severity through dissociation and hypomentalizing [χ²(6) = 13.68, p = .033; CFI = 0.989; TLI = 0.931; RMSEA = 0.078; SRMR = 0.038]. No significant direct effects were observed once psychological processes were included. Mentalizing consistently demonstrated a stronger indirect association than dissociation across models. Adulthood betrayal trauma showed a greater total effect on depressive symptoms (β = .30; p &lt; .001) than childhood trauma (β =  .17; p = .043), whereas their effects on personality pathology were comparable (respectively, β =  .21; p = .006 for adult trauma and β = .22; p = .008 for childhood trauma). For adulthood trauma and PD severity, the direct association was small and non-significant (β = −.06), whereas indirect effects via dissociation (β = .11) and mentalizing (β = .16) were positive, resulting in a positive total effect.</jats:p> </jats:sec> <jats:sec id="sec006"> <jats:title>Conclusions</jats:title> <jats:p>These findings indicate that the link between betrayal trauma and adult psychopathology may be best conceptualised in terms of co-occurring psychological processes rather than direct exposure effects. Hypomentalizing, in particular, appears to represent a key transdiagnostic mechanism connecting relational trauma across developmental stages with both mood and personality pathology.</jats:p> </jats:sec>
dc.description.accesstimeafter_publication
dc.description.issue7
dc.description.physical1-21
dc.description.sdgGoodHealthAndWellBeing
dc.description.versionfinal_published
dc.description.volume21
dc.identifier.doi10.1371/journal.pone.0353662
dc.identifier.issn1932-6203
dc.identifier.urihttps://share.swps.edu.pl/handle/swps/2458
dc.languageen
dc.pbn.affiliationpsychologia
dc.rightsCC-BY
dc.rights.questionYes_rights
dc.share.articleOPEN_JOURNAL
dc.swps.sciencecloudsend
dc.titleBetrayal trauma and adult mental health : The role of mentalizing and dissociation
dc.title.journalPLOS One
dc.typeJournalArticle
dspace.entity.typeArticle