What's the Harm? Internalized Prejudice and Cultural Betrayal Trauma in Ethnic Minorities

Abstract

The differential contexts that ethnic minorities face as a result of lower societal status impact outcomes of trauma. Cultural betrayal trauma theory (CBTT) is a contextualized framework that was created to examine trauma in minority populations. According to CBTT, due to societal inequality, within-group trauma in minority populations is a cultural betrayal that contributes to outcomes. In addition to looking at typically studied abuse outcomes (e.g., posttraumatic stress disorder), CBTT also predicts cultural outcomes, such as internalized prejudice, changes in ethnic identity, and (intra)cultural pressure (e.g., silencing victims of intraracial trauma to protect the minority ingroup from discriminatory individuals and systems of the dominant culture). No prior studies have examined cultural outcomes in CBTT. It was hypothesized that intraracial trauma (aka, cultural betrayal trauma) would be associated with cultural outcomes in a sample of ethnic minority college students. Participants (N = 296; 60.5% female; age: M = 20.12, SD = 2.81) were ethnic minority college students (35.0% Asian, 24.7% Hispanic−Latino American, 14.2% Other, 13.2% Black−African American, 5.7% Native Hawaiian or Other Pacific Islander, 3.4% American Indian−Alaska Native, and 3.4% Middle Eastern) attending a predominantly White university. Participants completed self-report questionnaires assessing trauma and outcomes online. Separate hierarchical linear regression analyses suggested that when controlling for age, gender, ethnicity, and interracial trauma, intraracial trauma predicted internalized prejudice, (intra)cultural pressure, and changes in identification with ethnic identity. These findings have implications for cultural competency in clinical interventions for minority victims of trauma.

Full text

American Journal of Orthopsychiatry
What’s the Harm? Internalized Prejudice and Cultural
Betrayal Trauma in Ethnic Minorities
Jennifer M. Gómez
Online First Publication, November 8, 2018. http://dx.doi.org/10.1037/ort0000367
CITATION
Gómez, J. M. (2018, November 8). What’s the Harm? Internalized Prejudice and Cultural Betrayal
Trauma in Ethnic Minorities. American Journal of Orthopsychiatry. Advance online publication.
http://dx.doi.org/10.1037/ort0000367

What’s the Harm? Internalized Prejudice and
Cultural Betrayal Trauma in Ethnic Minorities
Jennifer M. Gómez
Wayne State University
The differential contexts that ethnic minorities face as a result of lower societal status impact
outcomes of trauma. Cultural betrayal trauma theory (CBTT) is a contextualized framework that was
created to examine trauma in minority populations. According to CBTT, due to societal inequality,
within-group trauma in minority populations is a cultural betrayal that contributes to outcomes. In
addition to looking at typically studied abuse outcomes (e.g., posttraumatic stress disorder), CBTT
also predicts cultural outcomes, such as internalized prejudice, changes in ethnic identity, and
(intra)cultural pressure (e.g., silencing victims of intraracial trauma to protect the minority ingroup
from discriminatory individuals and systems of the dominant culture). No prior studies have
examined cultural outcomes in CBTT. It was hypothesized that intraracial trauma (aka, cultural
betrayal trauma) would be associated with cultural outcomes in a sample of ethnic minority college
students. Participants (N!296; 60.5% female; age: M!20.12, SD !2.81) were ethnic minority
college students (35.0% Asian, 24.7% Hispanic"Latino American, 14.2% Other, 13.2% Black"A-
frican American, 5.7% Native Hawaiian or Other Pacific Islander, 3.4% American Indian"Alaska
Native, and 3.4% Middle Eastern) attending a predominantly White university. Participants com-
pleted self-report questionnaires assessing trauma and outcomes online. Separate hierarchical linear
regression analyses suggested that when controlling for age, gender, ethnicity, and interracial trauma,
intraracial trauma predicted internalized prejudice, (intra)cultural pressure, and changes in identifi-
cation with ethnic identity. These findings have implications for cultural competency in clinical
interventions for minority victims of trauma.
Public Policy Relevance Statement
As mental health disparities persist, ethnic minority populations may have specific needs follow-
ing exposure to violence. With cultural betrayal trauma theory, the current study found that
exposure to violence perpetrated by people of the same ethnic group was associated with
internalized prejudice, changes to strength of ethnic identity, and (intra)cultural pressure (e.g.,
being told that the victim’s experience may negatively affect the reputation of the entire minority
group). This work suggests that attending to these cultural outcomes in mental health care may
make treatment more culturally relevant and efficacious for ethnic minority victims of violence.
The differential contexts that ethnic minorities face as a
result of lower societal status impact outcomes of trauma—
physical, sexual, psychological abuse (e.g., Brown, 2008;
Bryant-Davis, 2005), with some racial"ethnic minorities at in-
creased risk for some forms of trauma (Porter & McQuiller Wil-
liams, 2011). In an effort to advance the field, there have been
numerous calls for meaningfully incorporating minority popula-
tions, aspects of the sociocultural context, and cultural values and
norms in the study of trauma (Briere & Scott, 2006; Bryant-Davis,
2010; Christopher, 2004; Cohen, Deblinger, Mannarino, & de
Arellano, 2001; Ford & Gómez, 2015a, 2015b; Gómez, 2015a,
2015d; Gómez, Rosenthal, Smith, & Freyd, 2015; Harvey, 2007;
Harvey & Tummalanarra, 2007; Korbin, 2002; Long, Ullman,
Starzynski, Long, & Mason, 2007; Pole & Triffleman, 2010).
Though the majority of mainstream trauma research is conducted
on White Americans, there is important theoretical and empirical
work being done with minority populations that includes aspects of
the sociocultural context, cultural values, and/or culturally congru-
ent approaches (e.g., Ahrens, Rios-Mandel, Isas, & del Carmen
Lopez, 2010; Balsam, Huang, Fieland, Simoni, & Walters, 2004;
Bryant-Davis, Ullman, Tsong, & Gobin, 2011; Bryant-Davis, Ull-
Work on this project was funded by the Ford Foundation Dissertation
Fellowship, administered by the National Academies of Sciences, Engi-
neering, & Medicine.
Correspondence concerning this article should be addressed to Jennifer
M. Gómez, Merrill Palmer Skillman Institute, Wayne State University, 71
East Ferry Street, Detroit, MI 48202. Email: jennifer.gomez@wayne.edu
This document is copyrighted by the American Psychological Association or one of its allied publishers.
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
American Journal of Orthopsychiatry
© 2018 Global Alliance for Behavioral Health and Social Justice 2018, Vol. 1, No. 999, 000
http://dx.doi.org/10.1037/ort0000367
1

man, Tsong, Tillman, & Smith, 2010; Cuevas, Sabina, & Picard,
2010; Evans-Campbell, Lindhorst, Huang, & Walters, 2006; Ford,
2008; Ford & Gómez, 2015a; Foynes, Platt, Hall, & Freyd, 2014;
Hampton, Oliver, & Magarian, 2003; Iverson et al., 2013; Kalt-
man, Green, Mete, Shara, & Miranda, 2010; Kenny & McEachern,
2000; Klest, Freyd, & Foynes, 2013; Korbin, 2002; Lehavot,
Walters, & Simoni, 2009; Littleton & Ullman, 2013; Long &
Ullman, 2013; Porter & McQuiller Williams, 2011; Rennison &
Planty, 2003; Simoni, Sehgal, & Walters, 2004; Westphal et al.,
2013; Wright, Pérez, & Johnson, 2010). Given the ubiquity of
inequality and oppression for minority populations, aspects of the
sociocultural context should be included in trauma work (Brown,
2008; Bryant-Davis, 2005; Ford & Gómez, 2015a, 2015b; Gómez,
2015b; Gómez, Lewis, Noll, Smidt, & Birrell, 2016), because they
affect outcomes of trauma (Brown, 2008; Bryant-Davis, 2005;
Burstow, 2003, 2005).
Cultural Betrayal Trauma Theory
In multiple psychology domains, such as the study of personal-
ity, intervention, and clinical psychology, theory-driven empirical
research is valued as a means for independent researchers to
efficiently and systematically test hypotheses (Dunn, van der Meu-
len, O’Campo, & Muntaner, 2013; Magidson, Roberts, Collado-
Rodriguez, & Lejuez, 2014; Pearson, Deeprose, Wallace-Hadrill,
Heyes, & Holmes, 2013; Snowden & Yamada, 2005; Wagner,
Rizvi, & Harned, 2007). Such work can then compare findings
within and across populations to gain a clearer understanding of
behaviors and psychological processes. Within trauma psychol-
ogy, a unifying theory that is based on knowledge from main-
stream trauma research (e.g., betrayal trauma theory; Freyd, 1997)
and additionally incorporates aspects of the sociocultural context
that can be specified across minority groups can provide one way
for conducting culturally relevant trauma research in underserved
minority populations.
Gómez (2012, 2015a, 2015b, 2017a, 2017b, 2018, press
1
,
press
2
) proposed cultural betrayal trauma theory (CBTT) as a
contextualized framework for examining how within-group trauma
in minority populations (e.g., ethnic, sexual, gender, religious
minorities) may be harmful because of the societal context of
inequality (see Figure 1). Specifically, in CBTT, Gómez (2015a)
suggested that some minorities develop (intra)cultural trust with
one another. (Intra)cultural trust is similar to racial loyalty (e.g.,
Bent-Goodley, 2001; Tillman, Bryant-Davis, Smith, & Marks,
2010) and is defined as the conscious process of self-sacrificing for
the greater good of the minority group (Bent-Goodley, 2001).
Construed as an extension of racial loyalty, (intra)cultural trust
further conceptualizes the need for attachment with other in-group
members because of the toll of societal inequality. Thus, (intra)cul-
tural trust is a form of within-group connection and community
that can serve as a protective factor against societal trauma, such
as racialized police brutality (see Figure 2).
Within-group trauma (e.g., Black perpetrator, Black victim)
violates this (intra)cultural trust and as such is a cultural betrayal.
Therefore, within-group traumas in minority populations are cul-
tural betrayal traumas. In CBTT, Gómez (2015a) proposed that
cultural betrayal trauma would predict typically studied abuse
outcomes, such as posttraumatic stress disorder (PTSD). Because
the harm of within-group trauma is influenced by societal trauma,
Gómez (2015b) proposed that cultural betrayal traumas would also
be linked with cultural outcomes, such as internalized prejudice,
deidentification with minority identity, and (intra)cultural pressure
(see Figure 3).
Understanding cultural outcomes of trauma necessitates a con-
textualized appreciation of the differential meanings that may be
attached to within-group trauma in minority populations. For in-
stance, Gómez (2015a) provided a hypothetical scenario in which
a Black female college student is raped by a Black male at a party.
In the aftermath of this sexual assault, this woman wonders,
“Maybe Black people really are violent and criminal” (p. 41). An
appraisal such as this could contribute to internalized prejudice
because the cultural betrayal trauma has reignited negative
thoughts toward Black people, including herself. It could also
result in deidentifying with her ethnic identity if Blackness has
been construed as negative, for example. Societal trauma may
affect other ethnic minorities in analogous ways. For instance, a
Latino who is physically abused by another Latino may rationalize
the human rights violations of diverse Latinos attempting to enter
the United States seeking asylum (Cumming-Bruce, 2018). In this
example, the internalized prejudice was linked with cultural be-
trayal trauma victimization because of the societal trauma of
bigotry in immigration laws and enforcement in the United States.
Whereas internalized prejudice and deidentification with ethnic
identity are individualized cultural outcomes, (intra)cultural pres-
sure describes trauma-related minority-group dynamics. Specifi-
cally, (intra)cultural pressure includes pressure from other minor-
ities not to disclose cultural betrayal trauma for fear that it would
reflect negatively on the minority group and even lead to societal
trauma, such as unfair treatment in the judicial system. Therefore,
(intra)cultural pressure can be conceptualized as a mechanism of
protection against the harm of societal trauma. Unfortunately, it is
a strategy that privileges the perceived needs of the perpetrator(s)
and/or minority group over the needs of the victims of cultural
betrayal trauma. Intersecting forms of oppression (e.g., Crenshaw,
1991) may further affect who is protected versus who bears the
responsibility of the protecting (e.g., women vs. men; lesbian, gay,
bisexual vs. heterosexual; transgender vs. cisgender). An example
of (intra)cultural pressure would be this: some Arab Americans
having a code of understanding that any victimization should be
kept away from formal sources (e.g., school, police) to protect
each other from the increased discrimination of post-9/11 United
States (Padela & Heisler, 2010). Examining these and other cul-
tural outcomes with CBTT can add to previous work that has
documented cultural barriers to treatment-seeking (see Bent-
Goodley, 2001, and Tillman et al., 2010, for reviews).
The burgeoning research on CBTT suggests that within-
group trauma in minority populations may be a cultural betrayal
that contributes to outcomes. Gómez and Freyd (2017) com-
pared abuse outcomes of within-group sexual violence between
minorities and majority members. They found that there was a
moderation of minority status, with the link between within-
group sexual violence and trauma symptoms being stronger for
minorities. Work has also been done with specific ethnic mi-
nority communities of interest. One study found that ethnocul-
tural betrayal trauma predicted symptoms of PTSD in a sample
of Black college students (Gómez, in press
1
). Furthermore,
when controlling for interracial trauma, intraracial trauma has
been linked with hallucinations in a sample of Latino under-
This document is copyrighted by the American Psychological Association or one of its allied publishers.
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
2GÓMEZ

graduates (Gómez, 2017b). Finally, in a diverse sample of
Asian"Asian American"Pacific Islander university students,
intraracial trauma was associated with dissociation, hallucina-
tions, symptoms of PTSD, and hypervigilance after controlling
for interracial trauma (Gómez, 2017a).
Purpose of the Study
Given the importance of contextual factors in understanding
outcomes of trauma (e.g., Brown, 2008; Bryant-Davis, 2005),
CBTT (e.g., Gómez, 2017a) is a theory from a minority per-
spective that incorporates aspects of the sociocultural context
into understanding what makes interpersonal trauma traumatic.
The extant evidence for CBTT does suggest that cultural be-
trayal trauma—that is, the trauma perpetrated by a minority
ingroup member—may contribute specifically to typically stud-
ied abuse outcomes. Though previous work has suggested
culture-specific outcomes in ethnic minority populations (e.g.,
Bryant-Davis, Chung, Tillman, & Belcourt, 2009), to date, the
supposition for the existence of cultural outcomes of trauma as
described in CBTT is purely theoretical (e.g., Gómez, 2015a).
With ethnic minority college students at risk for trauma expo-
sure (e.g., Porter & McQuiller Williams, 2011), the purpose of
the current study was to examine the links between intraracial
trauma (aka, cultural betrayal trauma) and cultural outcomes in
a sample of ethnic minority college students at a predominantly
White university. It was hypothesized that when controlling
for age, gender, ethnicity, and interracial trauma, intraracial
trauma would be associated with internalized prejudice, (in-
tra)cultural pressure, and changes in identification with ethnic
identity.
Method
Participants
Participants (N!296) were ethnic minority undergraduate
students at a large northwestern public university. The majority of
Figure 1. Bronfenbrenner Ecological Systems Model, adapted for Cultural Betrayal Trauma Theory. Reprinted
with permission.
This document is copyrighted by the American Psychological Association or one of its allied publishers.
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
3
CULTURAL BETRAYAL TRAUMA & INTERNALIZED PREJUDICE

the sample identified as female (60.5%), with the remaining iden-
tifying as male (38.9%) or other (.3%; an additional .3% declined
to answer). Participants ranged in age from 17 to 40 years (M!
20.12, SD !2.81). The sample was ethnically diverse, with 35.0%
Asian, 24.7% Hispanic"Latino American, 14.2% Other, 13.2%
Black"African American, 5.7% Native Hawaiian or Other Pacific
Islander, 3.4% American Indian"Alaska Native, and 3.4% Middle
Eastern. Just over half (51.5%) of participants indicated their
nation of origin as America, with an additional 35 countries and
continents being identified as nationalities for the remainder of
participants. Given the relative lack of diversity at the site insti-
tution, countries and continents identified by participants are not
reported here to protect participants’ confidentiality. The majority
of participants identified as heterosexual (71.3%), with 10.5%
identifying as asexual, bisexual, homosexual, pansexual, or queer.
The remaining 17.5% of participants declined to answer or pro-
vided their biological sex. Socioeconomic status was not assessed
in the current study. Finally, regarding religious affiliation, partic-
ipants identified as Christian (43.9%); as agnostic, atheist, or
having no religion (38.9%); or as having one of eight other
religions (9.1%; again, due to low frequency, the specific religions
are not listed here to protect confidentiality), and 7.8% of partic-
ipants declined to answer.
Measures
This study is part of a larger data collection (Gómez, 2016);
therefore, only some of the measures are reported here.
Brief Betrayal Trauma Survey. The Brief Betrayal
Trauma Survey (BBTS; Goldberg & Freyd, 2006) is a 12-item
self-report questionnaire that assesses for physical, sexual, and
emotional abuse perpetrated by close and unclose others. The
BBTS was modified for the current study to include information
on the ethnicity of the perpetrator(s). Items are rated on a 6-point
Likert scale from 1 (never)to6(more than 100 times). A sample
item is “You were deliberately attacked so severely as to result in
marks, bruises, blood, broken bones, or broken teeth by someone
of your same ethnicity with whom you were very close.” In its
initial validation, the completed measure yielded good test–retest
reliability (Goldberg & Freyd, 2006).
Figure 2. Introducing Cultural Betrayal Trauma among various models in Trauma Psychology. Reprinted with
permission. See the online article for the color version of this figure.
This document is copyrighted by the American Psychological Association or one of its allied publishers.
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
4GÓMEZ

Though the modified measure has been used previously with a
minority sample (Gómez & Freyd, 2017), its reliability has not
been determined in minority populations. A test of internal con-
sistency is not appropriate for this measure, given that the BBTS
assesses for frequency of different events. This measure was
combined with the Sexual Experiences Survey in analyses (details
are in the next section).
Sexual Experiences Survey. The Sexual Experiences
Survey (SES; Koss & Oros, 1982) is a 28-item self-report ques-
tionnaire that assesses sexual victimization. The SES was modified
to assesses for relationship with the perpetrator(s; close other vs.
unclose other) and identity of the perpetrator(s; same ethnicity vs.
different ethnicity). Identical to the BBTS (Goldberg & Freyd,
2006), items are rated on a 6-point Likert scale, from 1 (never) to
6(more than 100 times). A sample item is “An unknown or
unfamiliar person of the same ethnicity used some degree of
physical force (twisting your arm, holding you down, etc.) to try to
make you engage in kissing or petting when you didn’t want to.”
The SES has yielded good test–retest reliability in majority White
samples (Koss, Gidycz, & Wisniewski, 1987; Koss & Gidycz,
1985). To the author’s knowledge, reliability has not been exam-
ined in ethnic minority populations specifically, though the mod-
ified measure has been used previously in a minority sample
(Gómez & Freyd, 2017). This measure assesses different types of
sexually abusive experiences; therefore, a measure of internal
consistency is not warranted.
Combining items from the modified BBTS (Goldberg &
Freyd, 2006) and SES (Koss & Oros, 1982), we calculated and
used several mean scores for different types of trauma in
descriptive and/or inferential analyses: any trauma, physical
abuse, sexual abuse, emotional abuse, interracial trauma, and
intraracial trauma.
Institutional Betrayal Trauma Questionnaire 2.
The Institutional Betrayal Questionnaire 2 (IBQ-2; items created
by Smith and Freyd, as cited in Smith, 2014) is an 11-item
questionnaire that assesses trauma-related actions and inactions at
the institutional level. The IBQ-2 was modified for the current
study to assess (intra)cultural pressure, with two additional items
assessing ethnic group membership. Only participants who en-
dorsed at least one type of trauma were shown the modified IBQ-2,
because (intra)cultural pressure is linked with a specific traumatic
experience; therefore, intentionally, the whole sample did not
complete this measure. The IBQ-2 uses a 4-point Likert scale,
rated from 1 (not at all)to4(very much). A sample item is “In
thinking about the events described in the previous section, did
your ethnic group play a role by...Suggesting your experience
Figure 3. Cultural Betrayal Trauma theory flowchart. PTSD !posttraumatic stress disorder. Reprinted with
permission.
This document is copyrighted by the American Psychological Association or one of its allied publishers.
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
5
CULTURAL BETRAYAL TRAUMA & INTERNALIZED PREJUDICE

might affect the reputation of your ethnic group.” The original IBQ
has been used in several studies (e.g., Smith & Freyd, 2013),
though it has not been validated. The 11-item IBQ-2 (excluding
ethnic group membership items) had excellent internal consistency
in the current sample (#!.92). A mean score of the modified
IBQ-2 (excluding ethnic group membership items) was used in
analyses.
Multidimensional Inventory for Black Identity.
The Multidimensional Inventory for Black Identity (MIBI; Sell-
ers, Smith, Shelton, Rowley, & Chavous, 1998) assesses dimen-
sions of Black identity, including the Private Regard Subscale
(six items). In the current study, the Private Regard Subscale
was modified for ethnic group identity generally, which is
warranted provided such modifications are culturally consistent
for the groups being assessed (personal communication, R.
Sellers, February 15, 2014). The current study utilized the
Private Regard Subscale as a proxy for internalized prejudice.
Responses are on a 5-point Likert scale ranging from 1
(strongly disagree)to5(strongly agree). Items 1, 2, 3, 5, and
6 of the Private Regard subscale were reverse-coded before
calculating a continuous mean variable for internalized preju-
dice. A sample item from the Private Regard Subscale is “I
often regret that I am this ethnicity.” The MIBI has demon-
strated good internal and external validity for African Ameri-
cans (Sellers, Rowley, Chavous, Shelton, & Smith, 1997),
though, to the author’s knowledge, it has not previously been
assessed with other ethnic minority populations. In the current
study, the Private Regard subscale had good internal consis-
tency (#!.89).
Trauma-related changes in identification with
ethnic identity. One exploratory item to assess changes in
identification with ethnic identity following trauma was created for
the current study. The same item appeared two times in the study
(once after the modified BBTS, Goldberg & Freyd, 2006, and once
after the modified SES, Koss & Oros, 1982). The response is on a
4-point Likert scale rated from 1 (Not changed at all)to4(Has
changed a lot). Given that all participants saw these items, partic-
ipants could mark Not applicable if they had not endorsed any
trauma item. The item is “If you experienced any of the above
from someone of your same ethnicity: Has your identification with
this ethnicity changed?” For the current study, the same items
regarding trauma-related ethnic identity change following the
modified BBTS (Goldberg & Freyd, 2006) and the modified SES
(Koss & Oros, 1982) were combined to create one continuous
mean variable, which could range from 1.5 (with an average
between Not applicable and Not changed at all)to5(Has changed
a lot). A measure of internal consistency would not be appropriate,
given these items are identical and related to different events.
Procedure
Participants were ethnic minority undergraduate students who
were recruited from the university human subjects pool (HSP). The
HSP comprises undergraduate students who have the opportunity
to receive class credit in introductory psychology courses for
participation in research. All students are provided the option to
complete alternative assignments in lieu of research participation
to avoid coercive practices. The prescreen item “I identify as an
ethnic minority” was used to identify eligible individuals. Only
eligible participants (ethnic minority students) could access the
study online. Without prior knowledge of the study content, par-
ticipants chose the online study based on the length of the study
and class credit they would receive for participation. After reading
the informed consent form online, students who agreed to partic-
ipate checked “Agree.” Participants completed the 1-hr online
survey at a location of their own choosing. At the conclusion of the
study, participants were shown the debriefing form online that
detailed the purpose of the study, the study’s importance, contact
information of the principle investigator and faculty advisor, and a
list of local mental health resources. The study was conducted in
compliance with the university institutional review board. To
obtain a large enough ethnic minority sample at the site institution,
data collection lasted for 15 months.
Results
The current study examined interracial and intraracial trauma
and cultural outcomes in a sample of ethnic minority college
students at a predominantly White university. Over half the sample
reported experiencing any trauma, with sizable minority propor-
tions experiencing interracial trauma or intraracial trauma (see
Table 1). In this sample, there were low to moderate rates reported
of (intra)cultural pressure (M!1.77, SD !.66), internalized
prejudice (M!2.10, SD !.92), and trauma-related changes in
identification with ethnic identity (M!2.09, SD !.76). Internal-
ized prejudice was correlated with (intra)cultural pressure (r!.18,
p$.05) but not trauma-related changes in identification with
ethnic identity (r!.07, ns). Conversely, (intra)cultural pressure
was correlated with trauma-related changes to identification with
ethnic identity (r!.28, p$.001). Furthermore, victims of trauma
reported a range of different types of (intra)cultural pressure (see
Figure 4).
Finally, separate hierarchical linear regression analyses were run
to assess the additional impact of intraracial trauma on cultural
outcomes. The results showed that when controlling for age,
gender, ethnicity, and interracial trauma, intraracial trauma pre-
dicted internalized prejudice (see Table 2), (intra)cultural pressure
(see Table 3), and trauma-related changes in identification with
ethnic identity (see Table 4). These findings suggest that intraracial
trauma may include cultural betrayal as a dimension of traumatic
harm that contributes to cultural outcomes of trauma.
Table 1. Rates of Physical, Sexual, Emotional Abuse, and
Intraracial/Interracial Trauma
Trauma type Percentage Range
a
M(SD)
Any trauma 55.4 1–4 1.16 (.37)
Physical abuse 19.3 1–4.75 1.16 (.45)
Sexual abuse 29.4 1–4.10 1.10 (.37)
Emotional abuse 42.7 1–6 1.53 (.91)
Categories of trauma
Intraracial 42.9 1–3.80 1.15 (.36)
Interracial 44.3 1–4.20 1.17 (.41)
a
Denotes participants’ range of scores on a 6-point Likert scale from 1
(never)to6(more than 100 times).
This document is copyrighted by the American Psychological Association or one of its allied publishers.
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
6GÓMEZ

Discussion
The current study is the first to use cultural betrayal trauma
theory (CBTT; Gómez, 2018) to examine cultural outcomes of
trauma. According to CBTT, intraracial trauma is conceptualized
as a cultural betrayal trauma because it occurs within the harmful
context of societal inequality (Gómez, 2015a). Specifically, the
(intra)cultural trust developed by some minorities in reaction to
societal trauma, such as mass incarceration and genocide, is bro-
ken through intraracial trauma. This cultural betrayal is theorized
to be a dimension of traumatic harm that impacts typically studied
abuse outcomes (e.g., PTSD) and cultural outcomes (e.g., inter-
nalized prejudice). Given that previous research has documented
the link between cultural betrayal trauma and abuse outcomes
(Gómez, 2017; Gómez & Freyd, 2017), the purpose of the current
study was to examine cultural outcomes of trauma utilizing a
CBTT framework. Results were as expected: Controlling for age,
gender, ethnicity, and interracial trauma, intraracial trauma pre-
dicted internalized prejudice, (intra)cultural pressure, and changes
to identification with ethnic identity. Furthermore, (intra)cultural
pressure—a group dynamic outcome that overrides the needs of
the victim in favor of the perceived betterment of the group—was
correlated with an individual outcome, internalized prejudice.
Such a finding suggests the existence of a complicated interplay
between trauma, individualized cultural outcomes, and minority
group influence. Taken together, these results provide evidence for
CBTT as a contextualized framework from a minority perspective
that has implications for how trauma is empirically understood and
clinically addressed.
In terms of framing these findings within the existing literature,
the high rates of trauma exposure in this sample (over 50%) are in
line with results of other work on ethnic minorities, including those
85
54 51 50 48 46 44 42 40 36 36 36
0
20
40
60
80
100
Figure 4. (Intra)Cultural Pressure: Percentages for victims of trauma.
Table 2. Internalized Prejudice: Hierarchical Linear Regression
Analyses of Impacts of Interracial Trauma vs. Intraracial Trauma
Step and trauma %R
2
F
Step 1 .01
Age ".08
Gender ".06
Ethnicity ".06
Step 2 .02 F(1, 261) !1.42
Age ".09
Gender ".07
Ethnicity ".05
Interracial trauma .07
Step 3 .04 F(1, 260) !5.96
!
Age ".11
Gender ".05
Ethnicity ".05
Interracial trauma ".16
Intraracial trauma .28
!
!
p$.05.
Table 3. (Intra)Cultural Pressure: Hierarchical Linear
Regression Analyses of Impacts of Interracial Trauma vs.
Intraracial Trauma
Step and trauma %R
2
F
Step 1 .02
Age .08
Gender ".02
Ethnicity ".11
Step 2 .14 F(1, 147) !19.44
!!!
Age .05
Gender ".02
Ethnicity ".09
Interracial trauma .34
!!!
Step 3 .20 F(1, 146) !12.33
!!
Age .03
Gender .02
Ethnicity ".08
Interracial trauma ".04
Intraracial trauma .47
!!
!!
p$.01.
!!!
p$.001.
Table 4. Trauma-Related Change to Identification With Ethnic
Minority Identity: Hierarchical Linear Regression Analyses of
Impacts of Interracial Trauma vs. Intraracial Trauma
Step and trauma %R
2
F
Step 1 .04
Age .19
!!
Gender .06
Ethnicity .02
Step 2 .26 F(1, 270) !80.73
!!!
Age .13
!
Gender .05
Ethnicity .05
Interracial trauma .48
!!!
Step 3 .30 F(1, 269) !15.29
!!!
Age .11
!
Gender .08
Ethnicity .06
Interracial trauma .17
Intraracial trauma .37
!!
!
p$.05.
!!
p$.01.
!!!
p$.001.
This document is copyrighted by the American Psychological Association or one of its allied publishers.
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
7
CULTURAL BETRAYAL TRAUMA & INTERNALIZED PREJUDICE

in college (e.g., Porter & McQuiller Williams, 2011). To the
author’s knowledge, there have been no published studies that
examine internalized prejudice or trauma-related changes to iden-
tification with ethnic identity in relation to trauma. Nevertheless,
the findings of the current study seem to point to the need for
future researchers to attempt to replicate the results with more
specified measures. For example, given that the measurement of
ethnic identity changes did not specify a direction (“has changed”
as opposed to “became weaker/stronger”), future research can use
the current study as a base for examining not only the direction but
also the meaning of such identity changes for victims of cultural
betrayal trauma.
(Intra)cultural pressure, though a new term, is not an entirely
new construct, because it bears many similarities with racial loy-
alty (e.g., Bent-Goodley, 2001). Prior research has implicated
racial loyalty in barriers to disclosure for Black women victimized
by Black men (Richie, 1996; Tillman et al., 2010; West, 1999;
White, 1995). (Intra)cultural pressure expands the concept of racial
loyalty as a group dynamic that can be present across minority
groups because of the need for attachment within a discriminatory
society. Those differences notwithstanding, the current study adds
to the literature by demonstrating the link between cultural be-
trayal trauma and (intra)cultural pressure among diverse ethnic
minority college students at a predominantly White university.
Theorized as a transformation of the protective nature of (intra)cul-
tural trust, (intra)cultural pressure may serve as a point of individ-
ual and collective intervention, because the overwhelming major-
ity of victims of trauma in this sample (85%) reported any
(intra)cultural pressure. Thus, the need to address societal trauma
as the cause is evident, because (intra)cultural pressure is a mis-
guided attempt to protect the self and other minorities from dis-
criminatory individuals and systems of the dominant culture.
The current study has implications for cultural competency in
clinical interventions for ethnic minority victims of cultural be-
trayal trauma. Evidence-based treatments for trauma victims often
focus on PTSD (see Gómez et al., 2016, for a review). Herman
(1997) proposed the disguised presentation of trauma clients in
which she detailed the multifaceted harm of complex trauma
histories, including depression, dissociation, self-injury, and rela-
tionship problems. Bryant-Davis (2005) further expanded on this
understanding by adding how additional outcomes related to
safety, self-care, trust, shame and self-blame, memories, mourn-
ing, anger, body image, sexuality, and coping strategies may all be
influenced by the broader sociocultural context. In line with CBTT
(e.g., Gómez, 2018), findings from the current study suggest that
internalized prejudice, (intra)cultural pressure, and changes in
identification with ethnic minority identity may also be linked to
cultural betrayal trauma among ethnic minority victims. Therefore,
the inclusion of these cultural outcomes in treatment may be
warranted. Such inclusion may help reduce mental health dispar-
ities by making interventions for applicable to diverse populations
(Gómez, 2015c).
Relational cultural therapy (Jordan, 2010; J. B. Miller & Stiver,
1997) is a feminist approach that contextualizes clients’ problems
(e.g., within the societal context of racism and sexism) while
privileging the therapeutic relationship as a key mechanism of
change (see Gómez et al., 2016, for a review). As such, relational
cultural therapy may be uniquely suited to addressing ethnic mi-
nority victims of cultural betrayal trauma (Gómez et al., 2016).
Additionally, these cultural outcomes may be further tackled ex-
tratherapeutically through Emotion Emancipation Circles (Grills,
2013), activism, arts, and spiritual healing (Bryant-Davis, 2005).
Limitations and Future Directions
Utilizing a diverse ethnic minority sample of college students at
a predominantly White university has both strengths and limita-
tions (see Table 5). On the positive side, the findings do control for
ethnicity and are generalizable in terms of their contribution to the
knowledge base of understanding trauma in ethnic minority pop-
Table 5. Limitations and Future Directions from the Current Study
Limitation Importance Future directions
One sample: Diverse ethnic minorities Ethnic gloss
a
: Potentially missing important
within- and between-groups differences
Attempt to replicate these findings with
ethnic minority communities of interest
Cultural outcomes examined alone Potential associations between abuse and
cultural outcomes
Empirically test cultural outcomes as
predictors, mediators, and/or moderators
of abuse outcomes
Quantitative methods Qualitative methods and mixed-methods
designs can provide more detailed
information
Conduct qualitative and mixed-methods
studies within minority communities of
interest
Imperfect measurement of internalized
prejudice
Internalized prejudice likely varies in
specifics within and between groups
Can use more comprehensive and culturally
congruent measures for internalized
prejudice within minority communities of
interest
Unvalidated measures of cultural betrayal
trauma and (intra)cultural pressure
Psychometric properties of adapted
measures are undetermined
Create and validate a cultural betrayal
trauma theory questionnaire within
communities of interest
Implicit cultural betrayal Implicit cultural betrayal of intraracial
trauma is distinct from explicit feelings
of betrayal
Measure explicit feelings of cultural
betrayal and assess its relation to
(intra)cultural pressure and cultural
outcomes
a
Pole and Triffleman (2010).
This document is copyrighted by the American Psychological Association or one of its allied publishers.
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
8GÓMEZ

ulations. However, with a broad-brush study like the current one,
the findings are limited in terms of their specific applications to
individual ethnic minority groups. Furthermore, it is unknown
whether and how these findings would generalize to other institu-
tions of higher learning (e.g., historically Black colleges and
universities [HBCUs], Hispanic-serving institutions, more ethni-
cally diverse predominantly White institutions), in community
samples, and across socioeconomic status groups. Given the com-
plexity of identity development in biracial individuals (R. L. Miller
& Buchanan, 2015), future work can examine definitions and
experiences of cultural betrayal trauma across diverse biracial
individuals (e.g., Black"White vs. Black"Mexican individuals’
appraisal of their racial ingroup[s] and outcomes of trauma).
Additionally, the current study utilized a cross-sectional design;
therefore, temporal precedence could not be established. More-
over, further examination of bidirectional relationships may pro-
vide increased understanding of trauma sequelae. For instance,
though internalized prejudice would not cause cultural betrayal
trauma, it is possible that internalized prejudice could elicit more
feelings of cultural betrayal when victimization occurs. That ex-
plicit appraisal of cultural betrayal may affect outcomes. Along
these lines, using qualitative or mixed-methods approaches can
elucidate psychological processes of internalized prejudice, trauma
types that engender increased self-stigmatization, and situations
and contexts where internalized prejudice is more likely to appear.
Finally, future studies can also examine high interpersonal betrayal
(close relationship with the perpetrator; Freyd, 1997) in conjunc-
tion with cultural betrayal to determine additional impacts on
outcomes.
Conclusion
Minority populations are underrepresented in trauma psychol-
ogy. Moreover, much of trauma research has originated within
dominant cultural perspectives, which can limit the variety of
research questions that are pursued (Gómez, 2014, 2015a). In line
with work detailing the importance of contextualized trauma re-
search (e.g., Bryant-Davis, 2010), CBTT (e.g., Gómez, 2012) is a
framework from a minority perspective that can add breadth to the
empirical questions that are systematically investigated. As the
first study to investigate cultural outcomes of intraracial trauma
(known as cultural betrayal trauma), the findings suggest that (a)
cultural betrayal implicit in intraracial trauma is a dimension of
traumatic harm that impacts outcomes and (b) outcomes of trauma
in minority populations may be more diverse than has been pre-
viously studied, because they can include cultural outcomes, such
as internalized prejudice, (intra)cultural pressure, and trauma-
related changes to identification with ethnic identity. Future work
within a CBTT framework can provide increased nuance and
specificity within minority communities of interest, thus having
implications for diverse victims of trauma in an increasingly
pluralistic society (Gómez, 2014, 2015a).
Keywords: cultural betrayal trauma theory; CBTT; (intra)
cultural pressure; internalized prejudice; ethnic minority
References
Ahrens, C. E., Rios-Mandel, L. C., Isas, L., & del Carmen Lopez, M.
(2010). Talking about interpersonal violence: Cultural influences on
Latinas’ identification and disclosure of sexual assault and intimate
partner violence. Psychological Trauma: Theory, Research, Practice,
and Policy, 2, 284–295. http://dx.doi.org/10.1037/a0018605
Balsam, K. F., Huang, B., Fieland, K. C., Simoni, J. M., & Walters, K. L.
(2004). Culture, trauma, and wellness: A comparison of heterosexual
and lesbian, gay, bisexual, and two-spirit Native Americans. Cultural
Diversity and Ethnic Minority Psychology, 10, 287–301. http://dx.doi
.org/10.1037/1099-9809.10.3.287
Bent-Goodley, T. B. (2001). Eradicating domestic violence in the African
American community: A literature review and action agenda. Trauma,
Violence, & Abuse, 2, 316–330. http://dx.doi.org/10.1177/1524838001
002004003
Briere, J., & Scott, C. (2006). Principles of trauma therapy: A guide to
symptoms, evaluation, and treatment. Thousand Oaks, CA: Sage.
Brown, L. (2008). Cultural competence in trauma therapy: Beyond the
flashback. http://dx.doi.org/10.1037/11752-000
Bryant-Davis, T. (2005). Thriving in the wake of trauma: A multicultural
guide. Westport, CT: Praeger.
Bryant-Davis, T. (2010). Cultural considerations of trauma: Physical, men-
tal and social correlates of intimate partner violence exposure. Psycho-
logical Trauma: Theory, Research, Practice, and Policy, 2, 263–265.
http://dx.doi.org/10.1037/a0022040
Bryant-Davis, T., Chung, H., Tillman, S., & Belcourt, A. (2009). From the
margins to the center: Ethnic minority women and the mental health
effects of sexual assault. Trauma, Violence, & Abuse, 10, 330–357.
http://dx.doi.org/10.1177/1524838009339755
Bryant-Davis, T., Ullman, S. E., Tsong, Y., & Gobin, R. (2011). Surviving
the storm: The role of social support and religious coping in sexual
assault recovery of African American women. Violence Against Women,
17, 1601–1618. http://dx.doi.org/10.1177/1077801211436138
Bryant-Davis, T., Ullman, S. E., Tsong, Y., Tillman, S., & Smith, K.
(2010). Struggling to survive: Sexual assault, poverty, and mental health
outcomes of African American women. American Journal of Orthopsy-
chiatry, 80, 61–70. http://dx.doi.org/10.1111/j.1939-0025.2010.01007.x
Burstow, B. (2003). Toward a radical understanding of trauma and trauma
work. Violence Against Women, 9, 1293–1317. http://dx.doi.org/10.1177/
1077801203255555
Burstow, B. (2005). A critique of posttraumatic stress disorder and the
DSM.Journal of Humanistic Psychology, 45, 429–445. http://dx.doi
.org/10.1177/0022167805280265
Christopher, M. (2004). A broader view of trauma: A biopsychosocial-
evolutionary view of the role of the traumatic stress response in the
emergence of pathology and/or growth. Clinical Psychology Review, 24,
75–98. http://dx.doi.org/10.1016/j.cpr.2003.12.003
Cohen, J. A., Deblinger, E., Mannarino, A. P., & de Arellano, M. A.
(2001). The importance of culture in treating abused and neglected
children: An empirical review. Child Maltreatment, 6, 148–157. http://
dx.doi.org/10.1177/1077559501006002007
Crenshaw, K. (1991). Mapping the margins: Intersectionality, identity
politics, and violence against women of color. Stanford Law Review, 43,
1241–1299. http://dx.doi.org/10.2307/1229039
Cuevas, C. A., Sabina, C., & Picard, E. H. (2010). Interpersonal victim-
ization patterns and psychopathology among Latino women: Results
from the SALAS study. Psychological Trauma: Theory, Research,
Practice, and Policy, 2, 296–306. http://dx.doi.org/10.1037/a0020099
Cumming-Bruce, N. (2018, June 5). Taking migrant children from parents
is illegal, U.N. tells U.S. New York Times. Retrieved from https://www
.nytimes.com/2018/06/05/world/americas/us-un-migrant-children-
families.html?rref!collection%2Fbyline%2Fnick-cumming-bruce&
action!click&contentCollection!undefined&region!stream&module!
stream_unit&version!latest&contentPlacement!4&pgtype!collection
Dunn, J. R., van der Meulen, E., O’Campo, P., & Muntaner, C. (2013).
Improving health equity through theory-informed evaluations: A look at
housing first strategies, cross-sectoral health programs, and prostitution
This document is copyrighted by the American Psychological Association or one of its allied publishers.
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
9
CULTURAL BETRAYAL TRAUMA & INTERNALIZED PREJUDICE

policy. Evaluation and Program Planning, 36, 184–190. http://dx.doi
.org/10.1016/j.evalprogplan.2012.03.006
Evans-Campbell, T., Lindhorst, T., Huang, B., & Walters, K. L. (2006).
Interpersonal violence in the lives of urban American Indian and Alaska
Native women: Implications for health, mental health, and help-seeking.
American Journal of Public Health, 96, 1416–1422. http://dx.doi.org/
10.2105/AJPH.2004.054213
Ford, J. D. (2008). Ethnoracial minority background, psychological
trauma, PTSD, and DESNOS among urban low-income women with
severe mental illness. Journal of Psychological Trauma, 7, 170–184.
http://dx.doi.org/10.1080/19322880802266805
Ford, J. D., & Gómez, J. M. (2015a). The relationship of psychological
trauma and dissociative and posttraumatic stress disorders to nonsuicidal
self-injury and suicidality: A review. Journal of Trauma & Dissociation,
16, 232–271. http://dx.doi.org/10.1080/15299732.2015.989563
Ford, J. D., & Gómez, J. M. (2015b). Self-injury and suicidality: The
impact of trauma and dissociation [Editorial]. Journal of Trauma &
Dissociation, 16, 225–231. http://dx.doi.org/10.1080/15299732.2015
.989648
Foynes, M. M., Platt, M., Hall, G. C., & Freyd, J. J. (2014). The impact of
Asian values and victim-perpetrator closeness on the disclosure of
emotional, physical, and sexual abuse. Psychological Trauma: Theory,
Research, Practice, and Policy, 6, 134–141. http://dx.doi.org/10.1037/
a0032098
Freyd, J. J. (1996). Betrayal trauma theory: The logic of forgetting abuse.
Cambridge, MA: Harvard.
Freyd, J. J. (1997). Violations of power, adaptive blindness and betrayal
trauma theory. Feminism & Psychology, 7, 22–32. http://dx.doi.org/10
.1177/0959353597071004
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, 39–63. http://dx.doi.org/10.1300/
J229v07n03_04
Gómez, J. M. (2012). Cultural betrayal trauma theory: The impact of
culture on the effects of trauma. In Blind to Betrayal. Retrieved from
https://sites.google.com/site/betrayalbook/betrayal-research-news/
cultural-betrayal
Gómez, J. M. (2014). Ebony in the ivory tower: Dismantling the stronghold
of racial inequality from the inside out. In K. J. Fasching-Varner, R.
Reynolds, K. Albert, & L. Martin (Eds.), Trayvon Martin, race, and
American justice: Writing wrong (pp. 113–117). http://dx.doi.org/10
.1007/978-94-6209-842-8_21
Gómez, J. M. (2015a). Conceptualizing trauma: In pursuit of culturally
relevant research. Trauma Psychology Newsletter, 10, 40–44.
Gómez, J. M. (2015b, October 21). Inequality plays a role in campus sexual
violence [Op-ed]. The Register-Guard. Retrieved from http://
registerguard.com/rg/opinion/33611918-78/inequality-plays-a-role-in-
campus-sexual-violence.html.csp
Gómez, J. M. (2015c). Microaggressions and the enduring mental health
disparity: Black Americans at risk for institutional betrayal. Journal of
Black Psychology, 41, 121–143. http://dx.doi.org/10.1177/009579841
3514608
Gómez, J. (2015d). Rape, Black men, and the degraded Black woman:
Feminist psychologists’ role in addressing within-group sexual violence.
The Feminist Psychologist: Newsletter for the Society of the Psychology
of Women, 42, 12–13.
Gómez, J. M. (2016, May 11). Cultural betrayal trauma theory [Disserta-
tion]. Retrieved from http://dynamic.uoregon.edu/jjf/theses/gomez16
.pdf
Gómez, J. M. (2017a). Does ethno-cultural betrayal in trauma affect Asian
American/Pacific Islander college students’ mental health outcomes? An
exploratory study. Journal of American College Health, 65, 432–436.
http://dx.doi.org/10.1080/07448481.2017.1341896
Gómez, J. M. (2017b). Does gender matter? An exploratory study of
cultural betrayal trauma and hallucinations in Latino undergraduates at
a predominantly White university. Journal of Interpersonal Violence.
Advanced online publication. http://dx.doi.org/10.1177/088626051
7746942
Gómez, J. M. (2018). What’s in a betrayal? Trauma, dissociation, and
hallucinations among high-functioning ethnic minority emerging adults.
Advanced online publication. Journal of Aggression, Maltreatment, &
Trauma. http://dx.doi.org/10.1080/10926771.2018.1494653
Gómez, J. M. (in press
1
). Group dynamics as a predictor of dissociation for
Black victims of violence: An exploratory study of cultural betrayal
trauma theory. Transcultural Psychiatry.
Gómez, J. M. (in press
2
). It isn’t all about victimization? (Intra)cultural
pressure and cultural betrayal trauma in ethnic minority women. Vio-
lence Against Women.
Gómez, J. M., & Freyd, J. J. (2017). Psychological outcomes of within-
group sexual violence: Evidence of cultural betrayal. Journal of Immi-
grant & Minority Health. Advanced online publication. http://dx.doi.org/
10.1007/s10903-017-0687-0
Gómez, J. M., Lewis, J. K., Noll, L. K., Smidt, A. M., & Birrell, P. J.
(2016). Shifting the focus: Nonpathologizing approaches to healing
from betrayal trauma through an emphasis on relational care. Journal of
Trauma & Dissociation, 17, 165–185. http://dx.doi.org/10.1080/1529
9732.2016.1103104
Gómez, J. M., Rosenthal, M. N., Smith, C. S., & Freyd, J. J. (2015).
Participant reactions to questions about gender-based sexual violence:
Implications for campus climate surveys. eJournal of Public Affairs, 4,
39–71.
Grills, C. (2013). The context, perspective, and mission of ABPsi: Past and
present. Journal of Black Psychology, 39, 276–283. http://dx.doi.org/10
.1177/0095798413480685
Hampton, R., Oliver, W., & Magarian, L. (2003). Domestic violence in the
African American community: An analysis of social and structural
factors. Violence Against Women, 9, 533–557. http://dx.doi.org/10.1177/
1077801202250450
Harvey, M. R. (2007). Towards an ecological understanding of resilience
in trauma survivors: Implications for theory, research, and practice.
Journal of Aggression, Maltreatment & Trauma, 14(1–2), 9–32. http://
dx.doi.org/10.1300/J146v14n01_02
Harvey, M. R., & Tummalanarra, P. (2007). Sources and expression of
resilience in trauma survivors: Ecological theory, multicultural perspec-
tives. Journal of Aggression, Maltreatment & Trauma, 14(1–2), 1–7.
http://dx.doi.org/10.1300/J146v14n01_01
Herman, J. L. (1997). Trauma and recovery. New York, NY: Basic Books.
Iverson, K. M., Bauer, M. R., Shipherd, J. C., Pineles, S. L., Harrington,
E. F., & Resick, P. A. (2013). Differential associations between partner
violence and physical health symptoms among Caucasian and African
American help-seeking women. Psychological Trauma: Theory, Re-
search, Practice, and Policy, 5, 158–166. http://dx.doi.org/10.1037/
a0025912
Jordan, J. V. (2010). Relational-cultural therapy. Washington, DC: Amer-
ican Psychological Association.
Kaltman, S., Green, B. L., Mete, M., Shara, N., & Miranda, J. (2010).
Trauma, depression, and comorbid PTSD/depression in a community
sample of Latina immigrants. Psychological Trauma: Theory, Research,
Practice, and Policy, 2, 31–39. http://dx.doi.org/10.1037/a0018952
Kenny, M. C., & McEachern, A. G. (2000). Racial, ethnic, and cultural
factors of childhood sexual abuse: A selected review of the literature.
Clinical Psychology Review, 20, 905–922. http://dx.doi.org/10.1016/
S0272-7358(99)00022-7
Klest, B., Freyd, J. J., & Foynes, M. M. (2013). Trauma exposure and
posttraumatic symptoms in Hawaii: Gender, ethnicity, and social con-
text. Psychological Trauma: Theory, Research, Practice, and Policy, 5,
409–416. http://dx.doi.org/10.1037/a0029336
This document is copyrighted by the American Psychological Association or one of its allied publishers.
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
10 GÓMEZ

Korbin, J. E. (2002). Culture and child maltreatment: Cultural competence
and beyond. Child Abuse & Neglect, 26, 637–644. http://dx.doi.org/10
.1016/S0145-2134(02)00338-1
Koss, M. P., & Gidycz, C. A. (1985). Sexual experiences survey: Reliabil-
ity and validity. Journal of Consulting and Clinical Psychology, 53,
422–423. http://dx.doi.org/10.1037/0022-006X.53.3.422
Koss, M. P., Gidycz, C. A., & Wisniewski, N. (1987). The scope of rape:
Incidence and prevalence of sexual aggression and victimization in a
national sample of higher education students. Journal of Consulting and
Clinical Psychology, 55, 162–170. http://dx.doi.org/10.1037/0022-006X
.55.2.162
Koss, M. P., & Oros, C. J. (1982). Sexual Experiences Survey: A research
instrument investigating sexual aggression and victimization. Journal of
Consulting and Clinical Psychology, 50, 455–457. http://dx.doi.org/10
.1037/0022-006X.50.3.455
Lehavot, K., Walters, K. L., & Simoni, J. M. (2009). Abuse, mastery, and
health among lesbian, bisexual, and two-spirit American Indian and
Alaska Native women. Cultural Diversity and Ethnic Minority Psychol-
ogy, 15, 275–284. http://dx.doi.org/10.1037/a0013458
Littleton, H., & Ullman, S. E. (2013). PTSD symptomatology and hazard-
ous drinking as risk factors for sexual assault revictimization: Exami-
nation in European American and African American women. Journal of
Traumatic Stress, 26, 345–353.
Long, L., & Ullman, S. E. (2013). The impact of multiple traumatic
victimization on disclosure and coping mechanisms for Black women.
Feminist Criminology, 8, 295–319. http://dx.doi.org/10.1177/
1557085113490783
Long, L. M., Ullman, S. E., Starzynski, L. L., Long, S. M., & Mason, G. E.
(2007). Age and educational differences in African American women’s
sexual assault experiences. Feminist Criminology, 2, 117–136.
Magidson, J. F., Roberts, B. W., Collado-Rodriguez, A., & Lejuez, C. W.
(2014). Theory-driven intervention for changing personality: Expec-
tancy value theory, behavioral activation, and conscientiousness. Devel-
opmental Psychology, 50, 1442–1450. http://dx.doi.org/10.1037/
a0030583
Miller, J. B., & Stiver, I. P. (1997). The healing connection: How women
form relationships in therapy and in life. Boston, MA: Beacon Press.
Miller, R. L., & Buchanan, N. T. (2015). Growing up biracial in the United
States. Identity in Multicultural Perspective, 3, 139–167.
Padela, A. I., & Heisler, M. (2010). The association of perceived abuse and
discrimination after September 11, 2001, with psychological distress,
level of happiness, and health status among Arab Americans. American
Journal of Public Health, 100, 284 –291. http://dx.doi.org/10.2105/AJPH
.2009.164954
Pearson, D. G., Deeprose, C., Wallace-Hadrill, S. M. A., Heyes, S. B., &
Holmes, E. A. (2013). Assessing mental imagery in clinical psychology:
A review of imagery measures and a guiding framework. Clinical
Psychology Review, 33, 1–23. http://dx.doi.org/10.1016/j.cpr.2012.09
.001
Pole, N. E., & Triffleman, E. E. (Eds.). (2010). Introduction to the special
issue on trauma and ethnoracial diversity. Psychological Trauma: The-
ory, Research, Practice, and Policy, 2, 1–3. http://dx.doi.org/10.1037/
a0018979
Porter, J., & McQuiller Williams, L. M. (2011). Intimate violence among
underrepresented groups on a college campus. Journal of Interpersonal
Violence, 26, 3210–3224. http://dx.doi.org/10.1177/0886260510393011
Rennison, C., & Planty, M. (2003). Nonlethal intimate partner violence:
Examining race, gender, and income Patterns. Violence and Victims, 18,
433–443. http://dx.doi.org/10.1891/vivi.2003.18.4.433
Richie, B. (1996). Compelled to crime: The gender entrapment of battered
Black women. New York, NY: Routledge.
Savali, K. W. (2014). HBCU president slut-shames female students . . . in
his convocation speech. Retrieved November 13, 2014, from http://
damemagazine.com/2014/11/10/hbcu¬president¬slut¬shames¬female¬
students¬...¬his¬convocation¬speech
Sellers, R. M., Rowley, S. A., Chavous, T. M., Shelton, J. N., & Smith,
M. A. (1997). Multidimensional Inventory of Black Identity: A prelim-
inary investigation of reliability and construct validity. Journal of Per-
sonality and Social Psychology, 73, 805–815. http://dx.doi.org/10.1037/
0022-3514.73.4.805
Sellers, R. M., Smith, M. A., Shelton, J. N., Rowley, S. A., & Chavous, T. M.
(1998). Multidimensional model of racial identity: A reconceptualization
of African American racial identity. Personality and Social Psychology
Review, 2, 18–39. http://dx.doi.org/10.1207/s15327957pspr0201_2
Simoni, J. M., Sehgal, S., & Walters, K. L. (2004). Triangle of risk: Urban
American Indian women’s sexual trauma, injection drug use, and HIV
sexual risk behaviors. AIDS and Behavior, 8, 33–45. http://dx.doi.org/
10.1023/B:AIBE.0000017524.40093.6b
Smith, C. P. (2014, April). Unawareness and expression of interpersonal
and institutional betrayal. Paper presented at the Western Psychological
Association Annual Conference, Portland, OR.
Smith, C. P., & Freyd, J. J. (2013). Dangerous safe havens: Institutional
betrayal exacerbates sexual trauma. Journal of Traumatic Stress, 26,
119–124. http://dx.doi.org/10.1002/jts.21778
Smith, C. P., & Freyd, J. J. (2014). Institutional betrayal. American
Psychologist, 69, 575–587.
Smith, C. P., Gómez, J. M., & Freyd, J. J. (2014). The psychology of
judicial betrayal. Roger Williams University Law Review, 19, 451–475.
Retrieved from http://docs.rwu.edu/cgi/viewcontent.cgi?article!1539&
context!rwu_LR
Snowden, L. R., & Yamada, A. M. (2005). Cultural differences in access
to care. Annual Review of Clinical Psychology, 1, 143–166. http://dx
.doi.org/10.1146/annurev.clinpsy.1.102803.143846
Tillman, S., Bryant-Davis, T., Smith, K., & Marks, A. (2010). Shattering
silence: Exploring barriers to disclosure for African American sexual
assault survivors. Trauma, Violence, & Abuse, 11, 59–70. http://dx.doi
.org/10.1177/1524838010363717
Wagner, A. W., Rizvi, S. L., & Harned, M. S. (2007). Applications of
dialectical behavior therapy to the treatment of complex trauma-
related problems: When one case formulation does not fit all. Journal
of Traumatic Stress, 20, 391–400. http://dx.doi.org/10.1002/jts
.20268
West, T. C. (1999). Wounds of the spirit: Black women, violence, and
resistance ethics. New York, NY: New York University Press.
Westphal, M., Olfson, M., Bravova, M., Gameroff, M. J., Gross, R.,
Wickramaratne, P.,...Neria, Y. (2013). Borderline personality
disorder, exposure to interpersonal trauma, and psychiatric comor-
bidity in urban primary care patients. Psychiatry: Interpersonal and
Biological Processes, 76, 365–380. http://dx.doi.org/10.1521/psyc
.2013.76.4.365
White, E. C. (1995). Chain chain change: For Black women in abusive
relationships. Seattle, WA: Seal Press.
Wright, C. V., Pérez, S., & Johnson, D. M. (2010). The mediating role of
empowerment for African American women experiencing intimate part-
ner violence. Psychological Trauma: Theory, Research, Practice, and
Policy, 2, 266–272. http://dx.doi.org/10.1037/a0017470
This document is copyrighted by the American Psychological Association or one of its allied publishers.
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
11
CULTURAL BETRAYAL TRAUMA & INTERNALIZED PREJUDICE