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WASHINGTON -- Most Americans have been traumatized by a controversial political or other modern world history event due to feeling "institutional betrayal," researchers reported here Thursday at the American Psychological Association annual conference, and said that healthcare providers should not dismiss these events as mere "distractions."

Elizabeth Straus, PhD, and Constance Dalenberg, PhD, of the San Diego-based Trauma Research Institute, that 95.1% of the 287 participants surveyed reported suffering moderate-to-severe levels of distress (5-10 on a 0-10 scale) because of at least one major event (P<0.001). Nearly four in five participants reported feeling continuing distress after the event departed the media cycle. Participants also reported that a mean 5.49 events caused at least moderate distress, while 3.06 events caused continuing distress and 2.59 events led to at least moderate feelings of betrayal.

Events featuring large organizations such as the federal government or the Republican Party influenced participants to a greater extent, Straus said, especially when they identified with or "depended" on that organization.

Participants reported signs of both issue schemas and person schemas, saying that they had lost trust in government because of political policy failures and in political institutions because of leaders' missteps, respectively.

Dissociative and post-traumatic stress disorder (PTSD) symptoms were found to positively correlate with distress levels. "These events are extraordinarily impactful," Straus said. "They are not distractions. Those large-scale events are accounting for [trauma]." It's important that the medical community recognize the impact of such events, she added, noting that feelings of distress and betrayal can prolong the need for treatment.

The researchers did not find a correlation between gender and distress and betrayal, nor was there a fully-supported correlation between race and outcomes.

Straus and Dalenberg issued their surveys via , a web-based survey tool, following a pilot study featuring group discussion of controversial events among 23 participants that helped the team design the survey protocol. The 10 events inquired about included governmental response to Hurricane Katrina, police shootings in communities, and the poor treatment of prisoners at Abu Ghraib.

The researchers completed the study before the 2016 presidential election and controversial orders invoked by President Trump that could be impacting American lives, such as the travel ban and calls to overturn the Affordable Care Act. Media coverage of such events has yielded plenty of recent anecdotal evidence of governmental betrayal's influence, Straus said. "Now we can acknowledge that these events can impact individuals."

She and Dalenberg defined institutional betrayal as: "Methodical failures of institutions to prevent and/or address acts of abuse or misconduct which subsequently impact the well-being of individual members," and cited a by Carly Smith, PhD, of Penn State University, and Jennifer Freyd, PhD, of the University of Oregon.

Straus and Dalenberg aimed to explore whether Americans experience distress and betrayal due to "controversial events involving the government and public entities." Practitioners had predicted that no correlations would be found, Straus said, emphasizing how this phenomenon has not been taken seriously in the medical community.

The study sample was mostly female (58.9%), with 52.3% of the total ages 25 to 44. Most were either white (48.8%) or black (39%).

Participants used a 13-item "Political Event Rating Form" for each of the 10 events; factor analysis revealed three factors: distress, betrayal, and behavioral changes. Participants were also asked to choose their top three distressing events, which were then categorized on a level ranging from "minor stress" (being stuck in traffic, for example) to "very significant and life-changing" (losing a home in a fire).

Study limitations, the researchers said, included selection bias (the 10 chosen events), including more "issue-related" events than "person" events; participants also self-reported.

The study did not assess causation; Straus said she and Dalenberg hope to explore that as well as conduct further qualitative research into politics and institutional betrayal, and they are currently studying the impact of newer events to validate the findings.

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