Betrayal Trauma, Mindfulness, and Emotional Dysregulation: Associations With Moral Injury and Posttraumatic Stress Disorder

This study tested a structural equation model of associations between betrayal and nonbetrayal trauma, mindfulness, emotional dysregulation, shame, moral injury, and posttraumatic stress disorder symptoms (PTSS) in a sample of college students (N = 680). We hypothesized significant associations between betrayal trauma and PTSS and moral injury, mediated by facets of emotional dysregulation and shame and moderated by mindfulness. Betrayal trauma was associated with PTSS directly and indirectly, via the following facets of emotional dysregulation: lack of emotional clarity, limited access to strategies, and difficulty in impulse control. Betrayal trauma was also associated with moral injury directly, and indirectly via limited access to strategies. Mindfulness was associated with PTSS directly, and indirectly via four facets of emotional dysregulation and moral injury. Mindfulness was also indirectly associated with PTSS via shame and moral injury, and limited access to strategies and moral injury. Mindfulness was also associated with moral injury directly and indirectly via shame and limited access to strategies. Mindfulness did not moderate the associations between betrayal trauma and facets of emotional dysregulation. The indirect effect of betrayal trauma on moral injury via shame was not significant over and above other variables. The findings extend the existing literature and support the hypotheses on the indirect effects of betrayal trauma and mindfulness on moral injury and PTSD via facets of emotional dysregulation and shame. However, it did not support the moderating effect of mindfulness on the associations between betrayal trauma and emotional dysregulation.