Skip to main content

Advertisement

SpringerLink
Log in

Youth Suicidality and the Role of Maternal Betrayal Trauma, Child Maltreatment, and Dissociative Symptoms

  • Original Article
  • Published:
Journal of Family Violence Aims and scope Submit manuscript

Abstract

Betrayal trauma is associated with dissociative symptoms, which can increase the risk of suicidal thoughts and behaviors. Previous research demonstrates associations between a mother’s history of betrayal trauma and intergenerational patterns of maltreatment and dissociation among their children. However, maternal betrayal trauma history remains unexplored in the etiology of youth suicidality. This study was conducted to investigate pathways between maternal betrayal trauma and youth suicidality, while considering the influences of youth maltreatment exposure and symptoms of dissociation. We implemented conditional growth curve modeling in a structural equation modeling framework to analyze secondary data from the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN; N = 1,354; 51.48% female, 53.29% Black). Predictors included mothers’ betrayal trauma history, youth maltreatment exposure, and youth dissociative symptoms at ages 8, 12, and 16. The slope and intercept of dissociative symptoms at the age-8, age-12, and age-16 visit were modeled as latent factors. A robust weighted least squares estimator accounted for categorical outcomes. Indirect effects were assessed via the delta method. We found a significant indirect effect from maternal betrayal trauma to adolescent suicidal ideation through children’s maltreatment exposure and the growth in children’s dissociative symptoms from ages 8 through 16. Maternal betrayal trauma may play a unique role in perpetuating intergenerational patterns of trauma that contribute to subsequent trajectories of youth suicidality among their offspring. Practice implications for screening, prevention, and early intervention strategies are described, along with directions for further study.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  • Administration for Children and Families. (2020). Child abuse, neglect data released: 29th edition of the Child Maltreatment Report. https://www.acf.hhs.gov/media/press/2020/2020/child-abuse-neglect-data-released

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Author.

    Book  Google Scholar 

  • Babcock Fenerci, R. L., & Allen, B. (2018). From mother to child: Maternal betrayal trauma and risk for maltreatment and psychopathology in the next generation. Child Abuse & Neglect, 82, 1–11.

    Article  Google Scholar 

  • Babcock Fenerci, R. L., Chu, A. T., & DePrince, A. P. (2016). Intergenerational transmission of trauma-related distress: Maternal betrayal trauma, parenting attitudes, and behaviors. Journal of Aggression, Maltreatment & Trauma, 25(4), 382–399.

    Article  Google Scholar 

  • Barnett, D., Manly, J. T., & Cicchetti, D. (1993). Defining child maltreatment: The interface between policy and research. In D. Cicchetti & S. L. Toth (Eds.), Child abuse, child development, and social policy (pp. 7–73). Ablex.

    Google Scholar 

  • Briere, J. (1996). Trauma symptom checklist for children: Professional manual. Psychological Assessment Resources, Inc.

    Google Scholar 

  • Calati, R., Bensassi, I., & Courtet, P. (2017). The link between dissociation and both suicide attempts and non-suicidal self-injury: Meta-analyses. Psychiatry Research, 251, 103–114.

    Article  PubMed  Google Scholar 

  • Carballo, J. J., Llorente, C., Kehrmann, L., Flamarique, I., Zuddas, A., Purper-Ouakil, D., Hoekstra, P. J., Coghill, D., Schulze, U. M. E., Dittmann, R. W., Buitelaar, J. K., Castro-Fornieles, J., Lievesley, K., Santosh, P., & Arango, C. (2020). Psychosocial risk factors for suicidality in children and adolescents. European Child and Adolescent Psychiatry, 29(6), 759–776.

    Article  CAS  PubMed  Google Scholar 

  • Children’s Bureau. (2021). Child Maltreatment 2019. Retrieved from https://www.acf.hhs.gov/cb/research-data-technology/statistics-research/child-maltreatment

  • Choi, K. J., & Kangas, M. (2020). Impact of maternal betrayal trauma on parent and child well-being: Attachment style and emotion regulation as moderators. Psychological Trauma: Theory, Research, Practice, and Policy, 12(2), 121.

    Article  PubMed  Google Scholar 

  • Chu, A., & DePrince, A. P. (2006). Development of dissociation: Examining the relationship between parenting, maternal trauma and child dissociation. Journal of Trauma & Dissociation, 7(4), 75–89.

    Article  Google Scholar 

  • Curran, P. J., Obeidat, K., & Losardo, D. (2010). Twelve frequently asked questions about growth curve modeling. Journal of Cognition and Development, 11(2), 121–136.

    Article  PubMed  PubMed Central  Google Scholar 

  • Dettlaff, A. J., & Boyd, R. (2020). Racial disproportionality and disparities in the child welfare system: Why do they exist, and what can be done to address them? The ANNALS of the American Academy of Political and Social Science, 692(1), 253–274.

    Article  Google Scholar 

  • DeVille, D. C., Whalen, D., Breslin, F. J., Morris, A. S., Khalsa, S. S., Paulus, M. P., & Barch, D. M. (2020). Prevalence and family-related factors associated with suicidal ideation, suicide attempts, and self-injury in children aged 9 to 10 years. JAMA Network Open, 3(2), e1920956–e1920956.

    Article  PubMed  PubMed Central  Google Scholar 

  • Edmonds, G. W., Hampson, S. E., Côté, H. C., Hill, P. L., & Klest, B. (2016). Childhood personality, betrayal trauma, and leukocyte telomere length in adulthood: A lifespan perspective on conscientiousness and betrayal traumas as predictors of a biomarker of cellular ageing. European Journal of Personality, 30(5), 426–437.

    Article  PubMed  PubMed Central  Google Scholar 

  • Edwards, V. J., Freyd, J. J., Dube, S. R., Anda, R. F., & Felitti, V. J. (2012). Health outcomes by closeness of sexual abuse perpetrator: A test of betrayal trauma theory. Journal of Aggression, Maltreatment & Trauma, 21(2), 133–148.

    Article  Google Scholar 

  • Enders, C. K., & Bandalos, D. L. (2001). The relative performance of full information maximum likelihood estimation for missing data in structural equation models. Structural Equation Modeling, 8, 430–457.

    Article  Google Scholar 

  • English, D. J. & LONGSCAN Investigators (1997). Modified Maltreatment Classification System (MMCS). Retrieved from http://www.iprc.unc.edu/LONGSCAN/

  • Foote, B., Smolin, Y., Neft, D. I., & Lipschitz, D. (2008). Dissociative disorders and suicidality in psychiatric outpatients. The Journal of Nervous and Mental Disease, 196(1), 29–36.

    Article  PubMed  Google Scholar 

  • Ford, J. D., & Gómez, J. M. (2015). The relationship of psychological trauma and dissociative and posttraumatic stress disorders to nonsuicidal self-injury and suicidality: A review. Journal of Trauma & Dissociation, 16(3), 232–271.

    Article  Google Scholar 

  • Freyd, J. J. (1994). Betrayal trauma: Traumatic amnesia as an adaptive response to childhood abuse. Ethics & Behavior, 4(4), 307–329.

    Article  Google Scholar 

  • Freyd, J. J. (1996). Betrayal trauma: The logic of forgetting childhood abuse. Harvard University Press.

    Google Scholar 

  • Freyd, J. J. (2008). Betrayal trauma. In G. Reyes, J. D. Elhai, & J. D. Ford (Eds.), The encyclopedia of psychological trauma (p. 76). Wiley & Sons.

    Google Scholar 

  • Freyd, J. J., Klest, B., & Allard, C. B. (2005). Betrayal trauma: Relationship to physical health, psychological distress, and a written disclosure intervention. Journal of Trauma & Dissociation, 6(3), 83–104.

    Article  Google Scholar 

  • Gagnon, K. L., Lee, M. S., & DePrince, A. P. (2017). Victim–perpetrator dynamics through the lens of betrayal trauma theory. Journal of Trauma & Dissociation, 18(3), 373–382.

    Article  Google Scholar 

  • Goldberg, L. R., & Freyd, J. J. (2006). Self-reports of potentially traumatic experiences in an adult community sample: Gender differences and test-retest stabilities of the items in a brief betrayal-trauma survey. Journal of Trauma & Dissociation, 7(3), 39–63.

    Article  Google Scholar 

  • Goldsmith, R. E., Freyd, J. J., & DePrince, A. P. (2012). Betrayal trauma: Associations with psychological and physical symptoms in young adults. Journal of Interpersonal Violence, 27(3), 547–567.

    Article  PubMed  Google Scholar 

  • Gómez, J. M. (2020). It hurts when you’re close: High betrayal sexual trauma, dissociation, and suicidal ideation in young adults. Violence and Victims, 35(5), 712–723.

    Article  PubMed  Google Scholar 

  • Hu, L., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling: A Multidisciplinary Journal, 6(1), 1–55.

    Article  Google Scholar 

  • Hulette, A. C., Kaehler, L. A., & Freyd, J. J. (2011). Intergenerational associations between trauma and dissociation. Journal of Family Violence, 26(3), 217–225.

    Article  Google Scholar 

  • Hussey, J. M., Marshall, J. M., English, D. J., Knight, E. D., Lau, A. S., Dubowitz, H., & Kotch, J. B. (2005). Defining maltreatment according to substantiation: Distinction without a difference? Child Abuse & Neglect, 29(5), 479–492.

    Article  Google Scholar 

  • Ivey-Stephenson, A. Z., Demissie, Z., Crosby, A. E., Stone, D. M., Gaylor, E., Wilkins, N., Lowry, R., & Brown, M. (2020). Suicidal ideation and behaviors among high school students - Youth Risk Behavior Survey, United States, 2019. MMWR Supplements, 69(1), 47.

    Article  PubMed  PubMed Central  Google Scholar 

  • Joiner, T. E. (2005). Why people die by suicide. Harvard University Press.

    Google Scholar 

  • Keefe, K. M., Hetzel-Riggin, M. D., & Sunami, N. (2020). The mediating roles of hostility and dissociation in the relationship between sexual assault and suicidal thinking in college students. Journal of Interpersonal Violence, 35(7–8), 1635–1653.

    Article  PubMed  Google Scholar 

  • Klimes-Dougan, B., Free, K., Ronsaville, D., Stilwell, J., Welsh, C. J., & Radke-Yarrow, M. (1999). Suicidal ideation and attempts: A longitudinal investigation of children of depressed and well mothers. Journal of the American Academy of Child & Adolescent Psychiatry, 38(6), 651–659.

    Article  CAS  Google Scholar 

  • Kline, R. B. (2016). Principles and practice of structural equation modeling (4th ed.). Guilford.

    Google Scholar 

  • Klonsky, E. D., & May, A. M. (2015). The three-step theory (3ST): A new theory of suicide rooted in the “ideation-to-action” framework. International Journal of Cognitive Therapy, 8(2), 114–129.

    Article  Google Scholar 

  • Klonsky, E. D., May, A. M., & Saffer, B. Y. (2016). Suicide, suicide attempts, and suicidal ideation. Annual Review of Clinical Psychology, 12, 307–330.

    Article  PubMed  Google Scholar 

  • Knight, E. D., Smith, J. B., & Martin, L. M. (2009). Measures for Assessment of Functioning and Outcomes in Longitudinal Research on Child Abuse and Neglect Volume 4: Middle Adolescence (Age 16). http://www.iprc.unc.edu/longscan/

  • Lanius, R. A., Boyd, J. E., McKinnon, M. C., Nicholson, A. A., Frewen, P., Vermetten, E., Jetly, R., & Spiegel, D. (2018). A review of the neurobiological basis of trauma-related dissociation and its relation to cannabinoid-and opioid-mediated stress response: A transdiagnostic, translational approach. Current Psychiatry Reports, 20(12), 1–14.

    Article  Google Scholar 

  • Lanktree, C. B., Gilbert, A. M., Briere, J., Taylor, N., Chen, K., Maida, C. A., & Saltzman, W. R. (2008). Multi-informant assessment of maltreated children: Convergent and discriminant validity of the TSCC and TSCYC. Child Abuse & Neglect, 32(6), 621–625.

    Article  Google Scholar 

  • Levinger, S., Holden, R. R., & Ben-Dor, D. H. (2016). Examining the importance of mental pain and physical dissociation and the fluid nature of suicidality in young suicide attempters. OMEGA-Journal of Death and Dying, 73(2), 159–173.

    Article  Google Scholar 

  • Liu, J., Fang, Y., Gong, J., Cui, X., Meng, T., Xiao, B., He, Y., Shen, Y., & Luo, X. (2017). Associations between suicidal behavior and childhood abuse and neglect: A meta-analysis. Journal of Affective Disorders, 220, 147–155.

    Article  PubMed  Google Scholar 

  • Lyssenko, L., Schmahl, C., Bockhacker, L., Vonderlin, R., Bohus, M., & Kleindienst, N. (2018). Dissociation in psychiatric disorders: A meta-analysis of studies using the dissociative experiences scale. American Journal of Psychiatry, 175(1), 37–46.

    Article  PubMed  Google Scholar 

  • MacKinnon, D. P., Fairchild, A. J., & Fritz, M. S. (2007). Mediation analysis. Annual Review of Psychology, 58(1), 593–614.

    Article  PubMed  PubMed Central  Google Scholar 

  • Martin, C. G., Van Ryzin, M. J., & Dishion, T. J. (2016). Profiles of childhood trauma: Betrayal, frequency, and psychological distress in late adolescence. Psychological Trauma: Theory, Research, Practice, and Policy, 8(2), 206–213.

    Article  Google Scholar 

  • Martin, C. G., Kim, H. K., & Freyd, J. J. (2018). Overwhelmed by emotion: Pathways from revictimization to mothers’ negative emotional responsivity. Family Process, 57(4), 947–959.

    Article  PubMed  Google Scholar 

  • Miller, A. B., Esposito-Smythers, C., Weismoore, J. T., & Renshaw, K. D. (2013). The relation between child maltreatment and adolescent suicidal behavior: A systematic review and critical examination of the literature. Clinical Child and Family Psychology Review, 16(2), 146–172.

    Article  PubMed  PubMed Central  Google Scholar 

  • Nicholson, A. A., Friston, K. J., Zeidman, P., Harricharan, S., McKinnon, M. C., Densmore, M., Neufeld, R. W. J., Theberge, J., Corrigan, F., Jetly, R., Spiegel, D., & Lanius, R. A. (2017). Dynamic causal modeling in PTSD and its dissociative subtype: Bottom–up versus top–down processing within fear and emotion regulation circuitry. Human Brain Mapping, 38(11), 5551–5561.

    Article  PubMed  PubMed Central  Google Scholar 

  • Nijenhuis, E. R., Van Der Hart, O., Kruger, K., & Steele, K. (2004). Somatoform dissociation, reported abuse and animal defence-like reactions. Australian & New Zealand Journal of Psychiatry, 38(9), 678–686.

    Article  Google Scholar 

  • Ong, M. S., Lakoma, M., Gees Bhosrekar, S., Hickok, J., McLean, L., Murphy, M., Poland, R. E., Purtell, N., & Ross-Degnan, D. (2020). Risk factors for suicide attempt in children, adolescents, and young adults hospitalized for mental health disorders. Child and Adolescent Mental Health, 26(2), 134–142.

    Article  PubMed  Google Scholar 

  • Rivaux, S. L., James, J., Wittenstrom, K., Baumann, D., Sheets, J., Henry, J., & Jeffries, V. (2008). The intersection of race, poverty, and risk. Child Welfare, 87(2), 151–168.

    PubMed  Google Scholar 

  • Runyan, D. K., Curtis, P. A., Hunter, W. M., Black, M. M., Kotch, J. B., Bangdiwala, S., Dubowitz, H., English, D., Everson, M. D., & Landsverk, J. (1998). LONGSCAN: A consortium for longitudinal studies of maltreatment and the life course of children. Aggression and Violent Behavior, 3(3), 275–285.

    Article  Google Scholar 

  • Runyan, D., Dubowitz, H., English, D. J., Kotch, J. B., Litrownik, A., & Thompson, R. (2014). Longitudinal studies of child abuse and neglect (LONGSCAN) assessment 0–18. National Data Archive on Child Abuse and Neglect. https://doi.org/10.34681/cxpj-5m96

    Article  Google Scholar 

  • Sivers, H., Schooler, J., & Freyd, J. J. (2002). Recovered memories. In V. S. Ramachandran (Ed.), Encyclopedia of the human brain (Vol. 4, pp. 169–184). Academic Press.

    Chapter  Google Scholar 

  • Tang, S. S. S., & Freyd, J. J. (2012). Betrayal trauma and gender differences in posttraumatic stress. Psychological Trauma: Theory, Research, Practice, and Policy, 4(5), 469.

    Article  Google Scholar 

  • Tschoeke, S., Steinert, T., & Bichescu-Burian, D. (2019). Causal connection between dissociation and ongoing interpersonal violence: A systematic review. Neuroscience & Biobehavioral Reviews, 107, 424–437.

    Article  Google Scholar 

  • Vermetten, E., & Spiegel, D. (2014). Trauma and dissociation: Implications for borderline personality disorder. Current Psychiatry Reports, 16(2), 1–10.

    Article  Google Scholar 

  • Vonderlin, R., Kleindienst, N., Alpers, G. W., Bohus, M., Lyssenko, L., & Schmahl, C. (2018). Dissociation in victims of childhood abuse or neglect: A meta-analytic review. Psychological Medicine, 48(15), 2467–2476.

    Article  PubMed  Google Scholar 

  • Williams, K., Moehler, E., Kaess, M., Resch, F., & Fuchs, A. (2021). Dissociation links maternal history of childhood abuse to impaired parenting. Journal of Trauma & Dissociation, 1–15.

Download references

Author information

Authors and Affiliations

  1. School of Social Work, Wayne State University, 5447 Woodward Avenue, Detroit, MI, 48202, USA

    Lisa S. Panisch

  2. Center for the Study and Prevention of Suicide, Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA

    Erinn B. Duprey

  3. Mt. Hope Family Center, University of Rochester, Rochester, NY, USA

    Erinn B. Duprey

Authors
  1. Lisa S. Panisch
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Erinn B. Duprey
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Lisa S. Panisch.

Ethics declarations

Conflicts of Interest

We have no conflicts of interest to disclose.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Panisch, L.S., Duprey, E.B. Youth Suicidality and the Role of Maternal Betrayal Trauma, Child Maltreatment, and Dissociative Symptoms. J Fam Viol 38, 647–658 (2023). https://doi.org/10.1007/s10896-022-00415-4

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10896-022-00415-4

Keywords

Search

Navigation