VA Rocky Mountain Mental Illness Research, Education and Clinical Center for Suicide Prevention, Rocky Mountain Regional VA Medical Center, Aurora, Colorado, USA.
Department of Psychiatry, University of Colorado Anschutz Medical Campus, School of Medicine, Aurora, Colorado, USA.
J Trauma Dissociation. 2024 May-Jun;25(3):315-333. doi: 10.1080/15299732.2022.2120152. Epub 2022 Sep 7.
Institutional betrayal is defined as harm caused by an institution to an individual in the context of trust and dependence. High institutional betrayal is associated with poorer health outcomes, and high levels of trust, dependence, or identification with the institution (institutional closeness) may exacerbate the negative effects of institutional betrayal. While military sexual trauma is prevalent among women Veterans and associated with high rates of institutional betrayal, studies of the impact of military sexual trauma-related institutional betrayal have been limited in size and scope and have not examined the potential role of institutional closeness. We conducted a secondary analysis of national survey data collected from women Veterans who screened positive for military sexual trauma ( = 229). Hierarchical logistic and linear regression were used to examine associations between predictor variables (institutional betrayal, institutional closeness, and their interaction) and outcomes of interest and adjusted for age, education, and military sexual assault history. Institutional betrayal was associated with increased odds of suicidal ideation and suicide attempt during or following military service, as well as more severe symptoms of depression and posttraumatic stress disorder (PTSD). Institutional betrayal was not associated with non-suicidal self-injury or lifetime substance misuse. Counter to hypotheses, institutional closeness did not moderate relationships between institutional betrayal and mental health symptoms or self-directed violence. Results underscore the necessity of preventing and addressing institutional betrayal among women Veterans who experience military sexual trauma.
制度背叛是指在信任和依赖的背景下，机构对个人造成的伤害。高度的制度背叛与较差的健康结果相关，而对机构的高度信任、依赖或认同（机构亲近度）可能会加剧制度背叛的负面影响。虽然军事性创伤在女性退伍军人中很普遍，并且与高度的制度背叛有关，但关于军事性创伤相关制度背叛影响的研究在规模和范围上都受到限制，并且没有研究机构亲近度的潜在作用。我们对从筛查出有军事性创伤的女性退伍军人中收集的全国调查数据进行了二次分析（n=229）。使用分层逻辑回归和线性回归来检验预测变量（制度背叛、制度亲近度及其交互作用）与感兴趣的结果之间的关联，并调整了年龄、教育程度和军事性攻击史的影响。制度背叛与军事服务期间或之后出现自杀意念和自杀企图的几率增加，以及抑郁和创伤后应激障碍（PTSD）症状更严重相关。制度背叛与非自杀性自我伤害或终身物质滥用无关。与假设相反，制度亲近度并没有调节制度背叛与心理健康症状或自我导向暴力之间的关系。研究结果强调了预防和解决经历过军事性创伤的女性退伍军人中的制度背叛的必要性。
