Yalch, M. M., & Froehlich, M. (2025). Influence of betrayal trauma on obsessive-compulsive personality pathology. Psychological Trauma: Theory, Research, Practice, and Policy, 17(2), 274–278. https://doi.org/10.1037/tra0001595

Key Takeaways

Focus: The study investigated the relationship between different types of trauma (specifically those high in betrayal) and obsessive-compulsive personality pathology (OCPD).
Aims: The research aimed to examine how traumas with varying levels of betrayal were associated with OCPD traits in a sample of men and women.
Findings: The study found that interpersonal trauma, particularly when involving betrayal, was linked to higher levels of OCPD traits, especially in men.
Implications: The findings suggest that incorporating trauma-focused techniques into OCPD treatment may be beneficial and that treatment approaches should consider the specific needs of men and women.

Rationale

Obsessive-compulsive personality disorder (OCPD) is a prevalent mental health condition characterized by rigidity, perfectionism, and emotional constraint.

Trauma has been identified as a potential risk factor for OCPD, with previous studies suggesting a link between childhood trauma and OCPD pathology.

However, research on the specific types of trauma most relevant to OCPD development remains limited.

Betrayal trauma, which involves trauma perpetrated by a trusted person, has been associated with various forms of personality pathology. T

his study aimed to expand the understanding of the relationship between betrayal trauma and personality pathology by specifically examining its link to OCPD.

The study also sought to explore potential gender differences in this association, as previous research suggests that men may be more vulnerable to the effects of betrayal trauma.

By investigating these relationships, the study aimed to inform clinical interventions and improve treatment strategies for individuals with OCPD.

Method

The study employed a cross-sectional design in which participants completed a series of self-report questionnaires online.

Participants were recruited through Amazon’s Mechanical Turk platform and were compensated for their participation.

The survey included measures assessing OCPD traits and experiences of trauma with varying degrees of betrayal.

Sample

The final sample consisted of 300 participants (45% women) with an average age of 38 years (SD = 10, range = 20–69).

The majority of the sample identified as White (89%), with smaller numbers identifying as Asian (5%), Black (4%), or with another racial group (3%).

Additionally, 18% of the participants identified as Latiné.

Measures

OCPD Traits: The Personality Inventory for DSM-5 (PID-5) was used to assess four maladaptive personality traits associated with OCPD: intimacy avoidance, perseveration, restricted affectivity, and rigid perfectionism. Participants rated the extent to which statements reflecting these traits were true for them on a 4-point scale.
Trauma: The Brief Betrayal Trauma Survey (BBTS) was used to measure experiences of trauma with varying degrees of betrayal. Participants rated the frequency of specific traumatic experiences on a 3-point scale. The BBTS yielded three subscales: high betrayal trauma (trauma perpetrated by a close person), medium betrayal trauma (interpersonal trauma without betrayal), and low betrayal trauma (non-interpersonal trauma).

Statistical Measures

The study utilized a Bayesian approach to structural equation modeling (BSEM) to analyze the data. BSEM was chosen for its accuracy, robustness, and ability to handle non-normal data distributions.

The blavaan package in R was used to estimate three models: one for the entire sample, one for women only, and one for men only.

In each model, a latent measurement of OCPD was regressed on observed indicators of high, medium, and low betrayal trauma.

Model fit was evaluated using Bayesian variants of conventional model fit indices. The credibility of regression coefficients was determined based on the highest density interval (HDI).

Results

Hypothesis 1: Trauma high in betrayal would be uniquely associated with OCPD over and above traumas with lower levels of betrayal.

Results: Partially supported. For men, high betrayal trauma was uniquely associated with OCPD.

For women, medium and low betrayal traumas were associated with OCPD, but high betrayal trauma was not.

Hypothesis 2: There would be gender differences in the influence of trauma, with a wider range of traumas associated with OCPD in men than in women.

Results: Supported. The types of trauma associated with OCPD differed between men and women. High and medium betrayal traumas were associated with OCPD in men, while medium and low betrayal traumas were associated with OCPD in women.

Insight

This study provides valuable insights into the complex relationship between trauma and OCPD.

The findings highlight the importance of considering the role of interpersonal trauma, particularly when it involves betrayal, in the development and manifestation of OCPD.

The study also underscores the significance of gender differences in the experience and impact of trauma, suggesting that men and women may be differentially affected by various types of trauma.

The study’s findings extend previous research by specifically examining the link between betrayal trauma and OCPD, a relationship that has received limited attention in the literature.

The results suggest that betrayal trauma may be particularly salient for men, potentially due to societal expectations and gender roles.

This finding challenges the notion that men are less affected by trauma and highlights the need for gender-specific trauma-informed interventions.

Future research could further explore the mechanisms underlying the association between betrayal trauma and OCPD, such as emotional pain, cognitive appraisal, and other posttraumatic responses.

Additionally, longitudinal studies could examine the long-term effects of betrayal trauma on OCPD and investigate potential mediators and moderators of this relationship.

Clinical Implications

The study’s findings have important implications for practitioners and policymakers working with individuals who have experienced trauma and exhibit OCPD traits.

The results suggest that incorporating trauma-informed approaches into the assessment and treatment of OCPD may be beneficial.

This could involve utilizing trauma-focused therapies, such as cognitive processing therapy (CPT) or prolonged exposure (PE), in conjunction with traditional OCPD treatments like cognitive behavioral therapy (CBT) or dialectical behavior therapy (DBT).

Furthermore, the findings emphasize the need for gender-specific interventions that address the unique experiences and needs of men and women who have experienced betrayal trauma.

Practitioners should be aware of the potential for men to be particularly vulnerable to the effects of betrayal trauma and tailor their treatment approaches accordingly.

Policymakers could consider implementing trauma-informed training for mental health professionals and promoting the development of gender-sensitive trauma services.

Additionally, policies aimed at preventing and addressing childhood trauma could have a significant impact on reducing the prevalence of OCPD and other mental health conditions.

Implementing trauma-informed approaches may present challenges, such as limited resources and a lack of trained professionals.

However, the potential benefits of improving outcomes for individuals with OCPD and reducing the long-term consequences of trauma outweigh these challenges.

Strengths

Novel Focus: The study examined the relationship between betrayal trauma and OCPD, an area that has not been extensively researched.
Dimensional Approach: The study used a dimensional approach to measure OCPD, which is consistent with current trends in personality disorder research.
Gender-Specific Analysis: The study examined gender differences in the relationship between trauma and OCPD, providing valuable insights into the unique experiences of men and women.
Bayesian Statistics: The study utilized Bayesian statistics, which offers advantages over traditional statistical methods in handling non-normal data and providing more accurate estimates.

Limitations

Cross-Sectional Design: The study’s cross-sectional design limits the ability to draw causal conclusions about the relationship between trauma and OCPD.
Sample Characteristics: The sample was primarily composed of White participants and may not be representative of the broader population.
Self-Report Measures: The study relied on self-report measures, which may be subject to response bias and recall difficulties.

Reference