Differences in psychological outcomes associated with institutional betrayal

Abstract

Institutional betrayal occurs when institutions fail to effectively support or protect the individuals who rely on them (Smith & Freyd, 2013). Institutional betrayal often happens after an adverse or traumatic event such as a sexual assault (Smith & Freyd, 2013). Previous research has found that institutional betrayal can result in worse mental and physical health outcomes following adverse experiences, even when the adverse experience is controlled for (Smith & Freyd, 2013). The purpose of this study was to investigate if differences in psychological outcomes exist for institutional betrayal following different types of adverse experiences, including racism, adverse medical experiences, and student sexual assault. Several hypotheses were posited. A total sample of 147 participants was collected with a relatively even split between groups (racism n = 34; adverse medical experiences n = 42; sexual assault n = 49; control n = 22). Participants were presented with an online questionnaire that asked about their adverse experiences and measured common psychological outcomes including anxiety, depression, and PTSD symptoms. Participants were separated into groups based on their adverse experiences and asked to complete a measure of institutional betrayal. Significant differences between groups on all symptom measures were found using one-way ANOVAs, and post hoc multiple comparisons revealed that the sexual assault group scored highest on all symptom measures. Regression analyses showed that demographic factors significantly predicted symptoms, and the addition of adverse experiences significantly improved the prediction of psychological symptoms. Results regarding institutional betrayal were mixed, showing that by itself, institutional betrayal significantly predicted PTSD symptoms, but did not predict anxiety symptoms. The addition of institutional betrayal to demographic factors and adverse experiences did not significantly add to the predictive power of the model, suggesting that it may have less of an impact on psychological symptoms than demographics and experiences. No moderation effects were found between institutional betrayal and adverse experiences. Implications, limitations, and future directions are discussed.