Trauma, existential isolation, and their associated clinical outcomes

Introduction: Across two studies, we examined the relationship between cumulative experiences of trauma, existential isolation (the felt sense of feeling alone with regard to one's experience of reality), psychological distress, and suicidal ideation. We hypothesized that as the amount of trauma people have experienced increases, so too does their existential isolation. We further hypothesized that the existential isolation associated with trauma would mediate the relationship between trauma and psychological distress. Method: Study 1 included n = 629 undergraduate participants who completed self-report measures of personal experience with interpersonally traumatic events, existential isolation, loneliness, psychological distress, and suicidal ideation. Study 2 included n = 937 adult participants from Amazon Mechanical Turk who completed measures of the same constructs, as well as an expanded trauma checklist that included both interpersonal and non-interpersonal forms of trauma. Mediation analyses were conducted in both studies to test the hypothesized relationships. Results: Both studies revealed that cumulative trauma correlates positively with existential isolation, even when controlling for loneliness. Moreover, this association between trauma and existential isolation mediates the relationship between trauma and depression, anxiety, stress, and suicidal ideation. Study 2 establishes that this relationship exists both for traumas that implicate other people as well as for non-interpersonal traumas. Discussion: The findings across two studies indicate that existential isolation plays a significant role in the relationship between cumulative trauma exposure and psychological distress, and that this is true regardless of whether the traumas are of an interpersonal variety or not. This research highlights the importance of addressing existential concerns in trauma treatment strategies.