Beyond the Perpetrator: The Role of Family Betrayal In Trauma Outcomes Following Child Sexual Abuse

Background and Purpose:
Child sexual abuse is associated with long-term trauma, yet outcomes vary widely across survivors. One factor that may help explain these differences is caregiver response, including whether caregivers recognize abuse and respond in protective or harmful ways. This study examined how grooming strategies and experiences of betrayal, particularly family or caregiver betrayal, are associated with trauma symptoms in adulthood. Drawing on betrayal trauma theory (Freyd, 1996; 2008) and attachment theory (Bowlby, 1969), the study focused on family betrayal as a key mechanism linking abuse experiences to long-term harm, with implications for child welfare systems and caregiver intervention.

Methods:
An anonymous online retrospective survey was completed by 342 adult survivors of child sexual abuse in the United States. Participants reported on three categories of grooming, including non-violent, drug or alcohol-related, and threatening or violent strategies. Emotional betrayal was assessed in two forms, using the Emotional Betrayal from Child Sexual Abuse Measure (EBCSAM): perpetrator betrayal and family or caregiver betrayal. Trauma symptoms were measured using the Trauma Symptom Checklist-40 (TSC-40). Structural equation modeling was used to examine direct and indirect pathways between grooming, betrayal, and trauma symptoms. Indirect effects were tested using bias-corrected bootstrapping procedures.

Results:
Grooming that included violence or threats was significantly associated with higher levels of feeling betrayed by caregivers, which in turn predicted greater trauma symptom severity across domains including depression, dissociation, sexual problems, and sleep disturbance (all paths p < .05). Family betrayal emerged as a significant mediator between threatening or violent grooming and trauma outcomes, with significant indirect effects across depression, dissociation, sexual problems, and sleep disturbance (β = .12–.18; 95% CIs excluded zero). Interestingly, perpetrator betrayal did not significantly mediate these relationships. Non-violent and drug or alcohol-related grooming were not significantly associated with trauma symptoms in the final model.

Conclusions and Implications:
Our findings suggest that caregiver response and failure to protect play a central role in linking threatening or violent grooming to trauma outcomes in adulthood. Family betrayal helped explain these relationships across multiple symptom areas, while perpetrator betrayal did not. These results shift attention from the perpetrator as the main source of betrayal to the caregiving environment in which abuse occurs. Future research should examine caregiver response over time, including recognition of abuse, belief of the child, and protective action. It should also test interventions that improve caregiver and system responses. For child welfare practice, the findings highlight the need for caregiver education, early recognition of grooming, and support for protective responses. At a systems level, results point to the need for policies and training that help caregivers, professionals, and institutions respond effectively to suspected abuse.