Childhood betrayal trauma, psychopathic traits, and PTSD symptomology: The role of ambiguity tolerance, distress tolerance, and impulse control difficulties.

OBJECTIVE: Childhood betrayal trauma has been linked to divergent outcomes such as posttraumatic stress disorder (PTSD) and psychopathic traits. Although these outcomes are often conceptualized as functional opposites, their co-occurrence suggests common underlying mechanisms. This study examined whether distress tolerance, ambiguity tolerance, and impulse control difficulties explain direct and indirect associations between childhood betrayal trauma, PTSD symptoms, and psychopathic traits. METHOD: A cross-sectional design was used with a sample of young adults (N = 753). Structural models tested hypothesized direct paths from childhood betrayal trauma to PTSD and psychopathic traits, as well as indirect effects through distress tolerance and ambiguity tolerance. Distress and ambiguity tolerance were further examined as indirect pathways through impulse control difficulties. Ambiguity tolerance was also tested as a moderator of the association between betrayal trauma and psychopathic traits. RESULTS: Childhood betrayal trauma demonstrated significant direct effects on both PTSD symptoms and psychopathic traits. Indirect effects emerged through distress tolerance, as well as through distress tolerance combined with impulse control difficulties. All indirect pathways via ambiguity tolerance were nonsignificant, and ambiguity tolerance did not moderate the association between betrayal trauma and psychopathic traits. CONCLUSIONS: Findings underscore the importance of distress tolerance and impulse control difficulties as shared mechanisms linking childhood betrayal trauma to both PTSD and psychopathic traits. These results highlight transdiagnostic processes that may serve as intervention targets for addressing divergent but functionally related trauma outcomes. (PsycInfo Database Record (c) 2026 APA, all rights reserved).