A Systematic Review of Trauma Disclosure Behaviors to Informal Support Sources

Abstract

Objectives:

The process of trauma disclosure can positively impact recovery trajectories and prevent or reduce posttraumatic stress disorder (PTSD) symptoms. Notably, trauma disclosure to informal sources of support (e.g., family, friends) occurs more often than to formal sources (e.g., police, therapist). However, there is a gap in understanding various critical aspects of trauma disclosure behaviors, particularly to informal sources. This review synthesizes the extant literature of trauma disclosure behaviors to informal sources, examining behavioral aspects including whom survivors choose to disclose to, details that are shared, timing and frequency of disclosures, and reasons that motivate survivors to disclose their trauma.

Methods:

We conducted a systematic review utilizing three databases (PsycINFO, PTSDPubs, PubMed). Eligible papers were required to assess trauma disclosure behavior among adult samples with lifetime trauma history, resulting in a total of 113 articles in the final review.

Results:

Rates of disclosure ranged from 25% to 97.6%. Diverse patterns of trauma disclosure emerged, with variations in the recipients of disclosures and the content shared. The time to first disclosure ranged widely, from the day the traumatic event occurred to nearly two decades afterwards. Motivations for disclosing trauma were also varied, encompassing both psychological needs and social factors.

Discussion:

The limitations of existing literature and methodological considerations are highlighted, particularly as the majority of studies utilized study-specific, non-validated methods for assessing disclosure. Additional research is needed to understand the nuanced aspects of trauma disclosure behaviors and their implications for treatment outcomes and cultivation of social support for survivors.

Trauma disclosure in the context of therapy has typically involved sharing details of a traumatic event or associated feelings and thoughts resulting from the trauma (Foa & Kozak, 1986). Disclosure to others may also include the effects of trauma, such as mental health consequences and impacts on daily functioning (Salzmann-Erikson & Hiçdurmaz, 2017; Sherman et al., 2015). By interrupting the cycle of avoidance that maintains or worsens posttraumatic stress disorder (PTSD) symptoms (American Psychiatric Association, 2013), disclosure can facilitate the development of a cogent narrative and mitigate the detrimental impacts of trauma exposure. Research on emotional disclosure related to trauma has suggested that written disclosure is linked with positive health outcomes (e.g., immune functioning) and improved subjective well-being (Pennebaker & Susman, 1988; Pennebaker et al., 2001). Further, trauma disclosure in psychotherapy has been associated with beneficial outcomes such as a decrease in PTSD symptoms (e.g., Slavin-Spenny et al., 2011). Informed by Emotional Processing Theory (Foa & Kozak, 1986), which posits that activation of trauma structures in memory is necessary for the modification of fear networks and the promotion of a cogent trauma narrative, evidence-based trauma-focused psychotherapies such as prolonged exposure (Foa et al., 2019), cognitive processing therapy (Resick et al., 2024), written exposure therapy (Sloan & Marx, 2019), and cognitive-behavioral conjoint therapy for PTSD (Monson & Fredman, 2012) all include trauma disclosure as a key component of treatment. Taken together, trauma disclosure potentiates recovery following traumatization and the reduction of PTSD symptoms.

Notably, disclosures within therapy contexts are to formal sources. Although trauma can be disclosed to various formal sources (e.g., therapists, police, medical personnel), disclosure to informal sources (e.g., romantic partners, family, friends) tends to occur more often and prior to formal sources (Littleton, 2010; Marriott et al., 2016; Ullman & Filipas, 2005a). Trauma disclosure to informal sources has had implications for both individual and relational well-being. On an intrapersonal level, individuals who engaged in greater disclosure of trauma exhibited less psychological distress (Hébert et al., 2009) and lower levels of depressive symptoms (Southwick et al., 2000) relative to those who delayed disclosure or do not disclose. Those who disclosed also tended to have greater posttraumatic growth (Han et al., 2022), particularly when there was low or moderate pressure to disclose compared to high pressure (Kimbley 2023). Disclosure of trauma to romantic partners has been associated with greater perceived closeness to one’s partner (So & La Guardia, 2011). Further, more support from one’s partner and lower levels of relationship distress predicted greater disclosure of military combat experiences (Balderrama-Durbin et al., 2013). Monk and Nelson Goff (2014) found that, among a sample of male active-duty soldiers and their female spouses, trauma symptoms in either partner were negatively associated with other-rated relationship satisfaction only among dyads where disclosure was rated as low by one or both partners. When disclosure was rated as high by both dyad members, there was no association between one partner’s trauma symptoms and the other partner’s relationship satisfaction. When partners did not have the context to connect the behaviors and emotions their loved one is experiencing to past traumatic experiences, partners may have felt frustrated, resentful, hurt, or abandoned (e.g., Renshaw et al., 2014); disclosure may have allowed for a shared understanding within the dyad. Other work has shown that, as trauma survivors’ PTSD symptoms increased, higher levels of disclosure about combat experiences was associated with greater partner distress; however, when PTSD symptoms were below the clinical threshold for PTSD, increased disclosure was not associated with partner distress (Campbell & Renshaw, 2012). It may be that when more symptomatic patients share high levels of sensory details about the trauma experience, rather than disclose trauma-related thoughts and feelings to facilitate meaning-making, partners may become emotionally overwhelmed and distressed. These distinctions may affect the interpersonal impact of disclosure.

At the same time, there are many reasons to suggest that disclosure can be a beneficial process. Theoretical frameworks have described how disclosure in general may support recovery following trauma. Maercker and Horn’s (2013) socio-interpersonal model of PTSD posits that trauma disclosure serves as an important mechanism to enhance interpersonal functioning. In this model, emotional disclosure is framed as a necessary component to establish and maintain close relationships. Posttraumatic growth models also emphasize that disclosure of emotional responses to trauma is a necessary component for growth (Tedeschi & Lawrence, 2004). Disclosure to a close other that occurs proximal to trauma may facilitate adaptive processing of the event and elicitation of social support, potentially preventing the development of PTSD by promoting a cogent trauma narrative (Brewin et al., 2000; Ehlers & Clark, 2000). Although there are potential benefits of disclosure following trauma exposure, some research has indicated that only approximately half of survivors disclosed to informal sources (e.g., Bonnan-White et al., 2018; Dardis et al., 2021; Jacques-Tiura et al., 2010). Thus, it is crucial to understand the prevalence and nature of trauma disclosure to informal sources to leverage this process for the optimization of trauma recovery and resilience.

Much of the available literature on trauma disclosure to informal sources has focused on reactions to disclosure. Specifically, literature reviews and a meta-analysis have shown that positive reactions (e.g., emotional support, tangible aid) had either mixed findings with regard to predicting less psychopathology or no effects; however, negative reactions (e.g., blaming, disbelief, treating the survivor differently) were most impactful, demonstrating detrimental outcomes for psychopathology and subjective well-being (Dworkin et al., 2019; Ullman, 2002; Ullman, 2023). Although this literature on reactions to trauma disclosure is beneficial, basic details of trauma disclosure behavior have not been comprehensively examined. To our knowledge, there are no reviews or meta-analyses that have been conducted on trauma disclosure behaviors. Thus, we do not yet understand how often trauma disclosure occurs to informal sources, which categories of sources (e.g., significant others, mothers, etc.) are most likely to be the recipients of disclosure, or whether survivors of particular types of traumas (e.g., childhood sexual assault, combat) appear to have different patterns of disclosure. Given the potential importance of informal disclosure for trauma processing and recovery, it is critical to understand these details regarding how often and to whom survivors are likely to disclose, what details are disclosed, when disclosure typically occurs, and why survivors decide to disclose or not.

We conducted a systematic review of the available literature on trauma disclosure behaviors to informal sources, aiming to understand the average rates of trauma disclosure, whom survivors typically disclose to, how long after trauma survivors typically disclose, what level of detail survivors share, and the purpose of trauma disclosure. We also sought to understand how disclosure is measured in the current literature: specifically, whether validated or non-validated measures were being commonly used and what level of detail was assessed by typical measures.

Method

The protocol for this review was preregistered through PROSPERO International prospective register of systematic reviews (CRD# 42023469197) and can be accessed at https://www.crd.york.ac.uk/PROSPERO/view/CRD42023469197. This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (Page et al., 2021) and was declared not human subjects research by the VA Boston Healthcare System Institutional Review Board.

Search Strategy

Searches of the PsycINFO, PTSDPubs, and PubMed databases were conducted on August 25, 2025. The study team discussed relevant search terms to maximize the inclusion of articles. The following keywords were used in all searches: disclosure, self-disclosure, trauma disclosure, trauma communication, trauma-focused treatment, stress disorders, post-traumatic, traumatic, psychological trauma, posttraumatic stress disorder, PTSD. This initial search phase identified 2,811 articles. These were then uploaded into Endnote, where 308 duplicates were identified and removed. Then the remaining articles were uploaded into Covidence, wherein an additional 22 duplicates were identified and removed. A total of 2,481 articles were screened in the abstract phase. Three study team members (EB, MF, JTH) were involved in the abstract and full-text screening phases. All abstracts were screened independently by two authors for eligibility (criteria described below). Any discrepancies were discussed among the team for consensus. A total of 2,263 abstracts were excluded within this phase. For the full-text review phase, two independent coders again examined all 218 articles for eligibility criteria, and any discrepancies were discussed with the team. Figure 1 depicts the breakdown of exclusions for full-text phase. A total of 113 articles met eligibility criteria and are included in the current review.

Figure 1. PRISMA Flow Chart.

Eligibility Criteria

Eligibility criteria for the current review included: (1) sample of adults who experienced a Criterion A traumatic event within their lifetime, (2) measured trauma/trauma-focused treatment disclosure behavior in some way (e.g., quantitatively or qualitatively), (3) peer-reviewed article, and (4) written in English. Articles were excluded if: (1) the study included participants under the age of 18 (e.g., either as entirely youth-focused studies, or in a mixed-age sample of adolescents and adults), (2) disclosure occurred only to a health professional or other formal support source (e.g., police), (3) the study was a dissertation, thesis, or protocol paper, or (4) the study was a review or meta-analysis. Although all studies included in this review assessed disclosure behavior, it was not always clear to whom the survivors had disclosed (i.e., mix of formal or informal sources). If it was clear that disclosure was to formal sources only (e.g., police, therapist), then the study was excluded. However, if the disclosure was not explicitly stated as being exclusively to formal sources, then the study was kept in the current review, as research suggests that disclosure to informal sources is much more common than formal reporting/disclosure (e.g., Jacques-Tiura et al., 2010; Littleton, 2010; Ullman & Filipas, 2005a).

Selection and Data Collection Processes

All included studies were reviewed independently by two authors for study characteristics. Extracted data included information such as study methodology (e.g., cross-sectional versus longitudinal), percent of sample that disclosed, informal sources who were disclosed to, the trauma disclosure measure used, trauma type, and sample demographics. Consensus of all these variables were confirmed and any discrepancies discussed as a team. Not all studies reported all relevant variables.

Quality Assessment

The Johanna Briggs Inventory (JBI) was used for quality assessment – the JBI checklist for analytical cross-sectional studies (8 items; Moola et al., 2020) and JBI checklist for qualitative research (10 items; Lockwood et al., 2015). Both checklists included yes (1) or no (0) response options for items, resulting in a total score for each study. Two independent coders (EB, MF) completed quality assessments for all cross-sectional and qualitative studies such that each study was double coded. Any discrepancies were discussed as a team with a third study member (JTH). JBI assessments were unable to accommodate the longitudinal designs of some included articles; therefore, these studies (k = 6) did not undergo quality assessment.

Results

Sample Characteristics

Thirty-nine studies (34.5%) consisted of all women participants per inclusion criteria, whereas only five studies (4.4%) had samples of all men. For the remainder, 66 studies (58.4%) had mixed sex samples, and three (2.7%) did not report sample sex. The average age of participants across all studies was generally younger, with 21 studies (18.6%) having participants between 18 to 22 years old. This was likely related to recruitment, as all but one of these studies used college student samples. The average ages of the other studies ranged from mid-20s (k = 12, 10.6%), 30s (k = 33, 29.2%), 40s (k = 10, 8.8%), 50–64 (k = 9, 8.0%), and 65 and above (k = 5, 4.4%). The remaining studies (k = 23) did not report participant age or had different reported average sample ages for multiple subsamples. Trauma history examined was most often a form of sexual violence (SV), sexual assault or unwanted sexual experience (k = 49, 43.4%), followed by mixed trauma (k = 32, 28.3%), combat or war related trauma (k = 17, 15.0%), occupational (e.g., police work, first responder experiences; k = 6, 5.3%), and intimate partner violence (k = 3, 2.7%). There was a small number of studies examining other specific traumas (e.g., cardiac event, explosion; k = 6, 5.3%). A large majority of the studies were conducted in the United States of America (k = 76, 67.3%), followed by Canada (k = 6, 5.3%). Sixty-three studies (55.8%) explicitly identified that disclosure occurred to informal sources. For 24 studies (21.2%), trauma disclosure to someone was an inclusion criterion. A table of study characteristics is presented in Supplemental materials. The total number of published articles regarding trauma disclosure behavior has increased steadily over the past decade, as shown in Figure 2.

Figure 2. Number of Articles Included in This Review by Year of Publication.

Note. Numbers reflect only articles included in current review (k = 113). Publications in 2025 not fully reflected as literature search took place August 2025.

How is Trauma Disclosure Behavior Measured?

Methods for the included studies varied widely. A large majority were cross-sectional (94.7%, k = 107), whereas six were longitudinal (5.3%, k = 6). Additionally, most studies involved quantitative data (77.0%, k = 87), with fewer studies using qualitative methods (15.9%, k = 18) or both (i.e., mixed methods; 7.1%, k = 8). There were a total of 40 (35.4%) studies that indicated utilizing secondary analyses and cited the parent study. Of these, three were drawn from Nikulina (2009) (Carson et al., 2020, Carson, Babad, Brown, et al., 2021, Carson, Babad, Kosuri, et al., 2021) and two from Ullman & Peter-Hagene (2016) (Ullman et al., 2024, Ullman, 2025). Although these studies have participants from the same studies, they examined distinct questions using different methodologies (i.e., qualitative versus quantitative). The parent studies were not included in the current review, as they did not meet eligibility criteria. No other secondary studies that cited the parent study were drawn from overlapping samples. Another 13 studies (11.5%) reported using secondary analyses but did not cite the parent study. Regarding the assessment of disclosure behavior, the majority of studies created their own item or measure to assess trauma disclosure (71.0%, k = 81). These questions were variable, ranging from one dichotomous yes/no item asking whether or not disclosure had occurred to in-depth qualitative interviews. One study (0.9%) examined disclosure through unsolicited letters that were mailed in regarding a public legal case (Brown et al., 2024). In terms of validated measures, the Disclosure of Trauma Questionnaire (DTQ; both full and short versions; Müller et al., 2000; Müller et al., 2008) was the most frequently used scale (9.7%, k = 11). Other validated measures included the Partner Communication About Stressful Experiences Scale (3.5%; k = 4) (Allen & Renshaw, 2015; DiMauro & Renshaw, 2021), the Family Holocaust Communication Questionnaire (3.5%; k = 4) (Lichtman, 1984), the Combat/Trauma Disclosure Scale (2.6%; k = 3) (Balderrama-Durbin et al., 2013), the Sexual Assault Inventory of Disclosure (2.6%; k = 3) (Pinciotti et al., 2019), the Distress Disclosure Index (2.6%; k = 3) (Kahn & Hessling, 2001), the Likelihood of Disclosure Scale (1.8%; k =2) (Hoyt et al., 2010), the Betrayal Trauma Inventory (0.9%; k = 1) (Freyd et al., 2001), and the Self-Disclosure Scale (0.9%; k = 1) (Han et al., 2004). Many studies also assessed reactions to disclosure with some form of the Social Reactions Questionnaire (SRQ; Ullman, 2000) (k = 28, 24.8%) or the Partner Response to Disclosure Scale (1.8%; k =2) (Allen & Renshaw, 2015; DiMauro & Renshaw, 2021).

To Whom are Survivors Disclosing?

Rates of disclosure assessed by participant self-report measures ranged from 25% to 97.6%, with the exception of one study that assessed disclosure online by analyzing social media posts (7.3%; Pu et al., 2023). A subset of studies measured the average number of people disclosed to by each survivor, ranging from 2.68 to 8.25 individuals (Ahrens et al., 2010; Bolton et al., 2003 Dardis et al., 2021; Morris & Quevillon, 2021; Pinciotti & Orcutt, 2021; Pinciotti et al., 2024; Ullman, O'Callaghan, & Harris, 2025). Fifty-nine studies (52.2%) broke out the specific informal sources to whom survivors disclosed. Although studies varied in how they reported categories of disclosure recipients, the main categories were romantic partners, family members, and friends. Many individuals disclosed to romantic partners (9.1 to 69%) and friends (17.2% to 96.1%), although rates ranged widely. When disclosing to parents, individuals disclosed to mothers (19.9% to 52.8%) more often than to fathers (1.9% to 16.5%). Some patterns emerged, such as individuals tended to disclose to others with similar identities or experiences, including those with shared minority status (Temple et al., 2023) and other veterans or first responders with a similar trauma history (Danson et al., 2025; Hoyt et al., 2010; Rufa et al., 2022; Wilson et al., 2021). See Table 1 for more details.

Table 1.

Disclosure across Studies

		Informal Disclosure Recipient Sourcesa
Study	Overall Rate of Disclosure	Romantic partner	Family Broadly	Parent	Sibling	Other FM	Friend	Other or multiple categories
Ahrens et al., 2010	80.6%
Bhuptani & Messman, 2023	75.1%	31.9%					96.1%
Bhuptani et al., 2023	70.3%
Bolton et al., 2003	84%	69%	69%				62%	78% other military personnel
Bonnan-White et al., 2018	57.8%	9.5%		22.2% Mother, 6.3% Father	11.1%	7.9%	31.7%	3.1% mentor, boss
Brown et al., 2024	54.9%
Caretta et al., 2015	76%
Carson et al., 2020 c	75%
Carson, Babad, Brown, et al., 2021 c	75%
Carson, Babad, Kosuri, et al., 2021 c	75.3%
Cheng & Lo, 2016								To relatives and friends: African Americans: 20.1% Latinas: 16.3% European Americans: 17.6%
Dardis, Davin, Lietzau, et al., 2021	92.6%			52.8% Mother, 16.5% Father	30.1% Sister, 10.2% Brother		93.2% female friend, 44.9% male friend
Dardis, Davin, Rodriguez, et al., 2021	55.5%
Davidson & Moss, 2008	39.9%	100% b
DiMauro & Renshaw, 2018	68.0%	100% b
Ennis et al., 2023		28.7%		12.8%	9.6%	12.8%	43.6%	3.2%
Glover et al., 2010	52%
Hébert et al., 2009	78.7% (Men: 65.8%, Women: 84.3%)
Hien 1999	Physical abuse: 69.0%, CSV: 73.9%, Partner violence: 64.7%, SV in adulthood: 72.7%
Jacques-Tiura et al., 2010	58.6%	10%		24% Mother, 8% Father	22% Sister, 10% Brother	22% Other female FM, 8% other male FM	68% female friend, 24% male friend
Kalayjian et al., 1996	25%							100% Other Armenian individuals
Kelly et al., 1995	97.2%	20%		26%	9%		36%
Kimbley et al., 2023		43.8%	28.8%				20.7%
Köhler et al., 2018	94.7%		89.3%				69.5%
Levendosky et al., 2004	95%
Lindquist et al., 2013	Physical SV: 69.3%, Incapacitated SV: 55.7%
Littleton et al., 2006	84.3%
Littleton, 2010	77.1%	55.5%	31.9%				83.3%	3.0% Stranger
Littleton et al., 2018	87.6%
Long et al., 2007	97.4%	Bisexual women: 62.2%, Lesbian: 65.3%, Heterosexual women: 62.2%
López et al., 2025	75.8% in person, 24.2% in person and online
Lueger-Schuster et al., 2015				29.9% Mother		13.4%		29.1% friends and partners
Machisa et al., 2018	52.7%		52.7%
Moorman & Romano, 2023	62.3%
Morris & Quevillon, 2021		44%	32%				92%
Nagata & Cheng, 2003	96.4%					100% children b
Nikulina et al., 2019	75%						63% female friend
Nobles et al., 2018	72.7%		26.8%				41.2%	8.3% Other
Orchowski et al., 2013	74.6%
Paul et al., 2014	35.1%
Pinciotti, Horrocks, et al., 2024	59.1%	39.3%		21.0% Mother, 7.8% Father	16.3%	11.2%	71.5%
Pu et al., 2023	Sample 1: 27.3%, Sample 2: 9.3%, Sample 3: 7.3%							100% Facebook users b
Rajan et al., 2021	94.1%		16.5%	25.3% Mother	7.6%		19.0%	7.6%
Roesler, 1994	59.6%
Rufa et al., 2022		47.1%	17.6%				35.3%	11.7% Acquaintance
Ruggiero et al., 2004	71.9%	10.6%		28.8% Mother, 1.9% Father	9.1%	7.7%	32.2%
Salim et al., 2022		39.8%		19.9% Mother, 6.8% Father		9.9% sibling or cousin	20.5%
Salim et al., 2025	Sample 1: 60.6%, Sample 2: 72.3%	60%		27.4% Mother			83.5%
Smyth et al., 2008	Study 2.1: 92.8%; Study 2.2: 95%
Starzynski et al., 2005	97.6%
Taku et al., 2009	80.8%
Temple et al., 2023		40.0%	47.3%				67.3%	8.2% Coworker, other students
Tyagi, 2001	91.7%
Ullman, 2000	87%
Ullman & Filipas, 2001	87%
Ullman & Filipas, 2005b	80.6%	Females: 15.4%, Males: 9.1%	Females: 35.9%, Males: 45.5%		Females: 10.3%, Males: 18.2%		Females: 42.3%, Males: 45.5%	Females: 6.4%, Males: 0%
Ullman, 2007	66.5%		70.3%				63.4% Acquaintance	75% Stranger
Ullman & Najdowski, 2011	79%
Ullman et al., 2024 c		10.3%	13.8%				17.2%
Ullman, 2025 c		16%	33%				51%
Ullman, O'Callaghan, Bailey, et al., 2025		13%	9.3%				77.1%
Ullman, O'Callaghan, & Harris, 2025		12.6%	10.6%				76.4%

Note. For rates of disclosure, some percentages for overall rates of disclosure were based on initial samples, but studies ran analyses in a subsample where disclosure was an inclusion criterion;

^a= Categories of recipient sources are not necessarily mutually exclusive such that the sum may be >100%;

^b= Inclusion criterion;

^c= Articles that had the same parent study as another article in the review; Family Member (FM); Intimate Partner Violence (IPV); Sexual violence (SV)

When are Survivors Disclosing?

The timing of disclosures was wide ranging, as presented in Table 2. The average time for first disclosure ranged from same day to 18.8 years after the trauma occurred. Ahrens and colleagues (2010) found different disclosure patterns, characterizing individuals into (1) non-disclosers, (2) crisis disclosers (disclosed within 2–7 days), (3) slow starters (delayed at least 2 weeks), and (4) ongoing disclosers (within 1 week and continued). Characteristics of the trauma may influence when people disclose. For example, greater trauma severity or longer trauma duration were both associated with greater likelihood of disclosure (Smyth et al., 2008; Starzynski et al., 2005). Regarding trauma type, females who experienced traumas such as physical or sexual assault, particularly by someone close (i.e., betrayal trauma), were more likely to delay disclosure, whereas males had greater delay in disclosure if they did not have a history of betrayal trauma (Delker et al., 2018). Additionally, the relationship to the perpetrator was associated with timing of disclosure: those who experienced sexual violence (SV) by a relative or romantic partner disclosed later compared to survivors who experienced SV from a stranger (Carson, Babad, Kosuri, et al., 2021; Starzynski et al., 2005; Ullman, 2007). There may also be potential demographic differences in timing of disclosure such that males/men (Nagata & Cheng, 2003; Smyth et al., 2008; Ullman & Filipas, 2005b), older individuals (Carretta et al., 2015), and racial/ethnic minority individuals tended to delay disclosure (Delker et al., 2018). However, other studies did not find differences in sex, racial/ethnic, sexual orientation, or age (Hoyt et al., 2010; Long et al., 2007; Southwick et al., 2005; Ullman & Filipas, 2005a) or had opposite findings (e.g., greater disclosure among older individuals, Finestone et al., 2025).

Table 2.

Timing of Disclosures

Study	Timing of Disclosures
Ahrens et al., 2010	“Crisis disclosers” = average of 0.84 days, “Ongoing disclosers” = average of 1.34 days, “Slow disclosers” = average of 3.58 years
Dardis Davin, Lietzau, et al., 2021	51.1% Immediately, 23.3% Days after, 12.5% 1–3 months after, 2.8% 3–6 months after, 5.1% 6–12 months after, 3.4% One year or more
Delker et al., 2018	33.1% within hours, 39.9% delayed disclosure, 7.8% never disclosed
Hébert et al., 2009	21.2% within a month, 48.8% five or more years
Lueger-Schuster et al., 2015	Average disclosure delay 18.8 years (SD = 18.9)
Moorman & Romano, 2023	Average disclosure delay 13.6 years (SD = 9.4)
Morris & Quevillon, 2021	Average of 9 months for first disclosure (SD = 14.75)
Nikulina et al., 2019	52% disclosed within a week, 25% within a year, 22% over a year
Pinciotti & Orcutt, 2021	24.2% of first disclosures occurred same day, 27.3% within one to six days, 2.4% over 10 years after
Pinciotti et al., 2024	23.6% same day, 28.0% 1–6 days later, 8.2% 1–3 weeks later, 7.4% 1–3 months later, 7.4% 4–6 months later, 3.5% 7–12 months later, 11.0% 1–2 years later, 8.2% 3–5 years later, 4.3% 6–10 years later, 1.4% over 10 years later
Rajan et al., 2021	15.7 years (SD = 15.3) for first disclosure, with 30% of individuals delaying for 20 years or more
Ruggiero et al., 2004	30.3% within 1 month, 45.7% longer than 1 month, 24.0% could not recall when they disclosed
Taku et al., 2009	68.3% Immediate, 6.6% 1 week, 6.6% 1 month, 7.8% within 6 months, 10.7% 6 months or more
Ullman, 2000; Ullman & Filipas, 2001	30.3% Immediately, 32.5% days or weeks after, 37.2% a year or longer
Ullman & Filipas, 2005a	>50% in childhood; Two-thirds a year or more after the trauma, with more than 80% disclosing to informal sources only
Ullman & Filipas, 2005b	27.4% Immediately, 63.6% a year or more after; 44.8% in childhood, 55.2% after age 14
Ullman, 2007	27.4% Immediately, 63.6% a year or more after

What and How are Survivors Disclosing?

There were only 13 studies (11.5%) that had information on the content or extent of trauma disclosure. Moreover, across the 13 studies, there was limited elaboration to better characterize the extent of disclosure. The most common level of disclosure across studies was minimal (12.4% to 87.8% of the sample), whereas 27.7% to 49.8% reported disclosing a “moderate” or “intermediate” level of detail, and 12.4% to 35.9% reported disclosing greater (e.g., “extensive”) details (Johns et al., 2022; Smyth et al., 2008; Ullman, 2000; Ullman & Filipas, 2005b). Level of disclosure differed depending on the source such that moderate levels of disclosure have been found with romantic partners (DiMauro & Renshaw, 2018; Hinnenkamp & Owens, 2024). Generally, individuals tended to talk less than they would like about their trauma (Finestone et al., 2025). One study found that 70% of disclosure conversations lasted less than 15 minutes, though women tended to have longer conversations than men (Nagata & Cheng, 2003). Regarding the content of disclosure, topics typically included trauma survivors’ diagnosis or symptoms of PTSD, some information about the traumatic event itself, and how PTSD impacted their lives (Salzmann-Erikson & Hiçdurmaz, 2017; Sherman et al., 2015). The content and presentation of disclosure also appeared to be influenced by type of relationship. For example, parents tended to be vague in disclosures to their children (e.g., talking about consequences of the trauma such as PTSD or related emotions) instead of sharing specific trauma details for fear of provoking undue distress in their children (Meijer et al., 2025; Weine et al., 2004). When support persons were asked about survivors’ PTSD treatment disclosure, the support persons reported little communication about therapy goals, session content, homework, or therapy progress (Thompson-Hollands et al., 2021).

Why Did Disclosure Occur or Not Occur?

Survivors reported that they disclosed in order to seek social support (emotional, tangible), seek practical help (e.g., accessing medical or mental health care), share emotions with others, acknowledge the impact of trauma and symptoms on their relationships, and help others understand them/explain behaviors (Carson, Babad, Brown, et al., 2021; Lukacena & Mark, 2022; Sherman et al., 2015; Tyagi, 2001; Weine et al., 2004). For parents who disclosed to their children, some parents believed it was “inevitable” that their children would find out about their (i.e., the parent’s) trauma history or PTSD symptoms and tried to disclose “proactively” (Meijer et al., 2025) or disclosed more when children were older (Nagata & Cheng, 2003). Approximately 12% of disclosures were unintentional, meaning that others found out about the trauma inadvertently (Ullman, 2007). These can lead survivors to feel pressured to share more information about the trauma than they originally intended to or to report the trauma in a formal or legal manner (Paul et al., 2014; Ullman, 2007). However, if intentional, disclosure can help survivors cope with trauma-related symptoms (Ullman, 2025).

A common theme across qualitative studies was fears related to disclosure, especially concerns of secondary traumatization. Survivors reported worrying about “burdening” others (Weine et al., 2004; Wilson et al., 2021) or engaged in “protective buffering” (Hammock et al., 2019) so as not to cause others emotional pain. Some survivors reported fear of not being believed by others or worry that information about the trauma or their symptoms would be used against them. Avoidance behavior, a lack of close others to confide in, embarrassment, shame, perceived consequences, and cultural factors also emerged as elements that discouraged disclosure (Brown et al., 2024; Carson et al., 2020; Kalayjian et al., 1996; Rufa et al., 2022; Sherman et al., 2015; Tyagi, 2001). These reasons for non-disclosure may be also compounded in different populations, wherein military individuals tended to report fear of judgment and lack of trust in disclosing military related traumas to civilians (Danson et al., 2025) and males were hesitant disclosing SV traumas due to perceptions of masculinity and not wanting to be viewed as a “victim” (Wolff et al., 2024). As noted above, for studies examining disclosure from parents to their children, there was concern of what or what not to disclose due to concerns of transgenerational or secondary trauma (Dalgaard et al., 2019; Meijer et al., 2025). Type of trauma is also important, as service members were less likely to disclose morally injurious events to their romantic partners compared to experiences of threat and loss (Taverna et al., 2025).

Quality Assessment

For the quality assessment of quantitative cross-sectional studies, 55.1% (k = 49) clearly described inclusion criteria for their sample (item 1), 85.4% (k = 76) described their sample and setting in detail (item 2), and 94.4% (k = 84) measured trauma exposure in a valid and reliable way (item 3). We determined that all studies (k = 89) were objective in their criteria for measurement of the condition (item 4), which was trauma disclosure behavior. A total of 75.3% (k = 67) identified confounding factors (item 5), 71.9% (k = 64) reported the strategies in handling identified confounding variables (item 6), 85.4% (k = 76) measured their outcomes in a valid and reliable way (item 7), and 100% (k = 89) used appropriate statistical analyses (item 8). For the quality assessment of qualitative studies, the study team agreed that all 18 qualitative studies demonstrated congruity between their research methodology and data representation (item 4), congruity between methodology and interpretation of results (item 5), represented participants’ voices (item 8), and conclusions were representative of results (item 10). For other items, 88.9% (k = 16) had congruity between their theory and research method (item 1), 94.4% (k = 17) had congruity between their research method and stated objectives (item 2), 94.4% (k = 17) had congruity between research method and data collection (item 3), 27.8% (k = 5) reported cultural or theoretical perspectives of the researchers (item 6), 16.7% (k = 3) reported the influence of the researcher on the study (item 7), and 83.3% (k = 15) included an ethical approval processes statement (item 9). See supplementary materials for details.

Discussion

We sought to understand the characteristics of trauma disclosure behaviors to informal sources and how they were assessed in the literature. Across a large number of studies drawn from diverse samples, informal trauma disclosure appeared to be common. Most studies found that at least 7 in 10 participants had disclosed their traumatic event, and rates approaching or exceeding 9 in 10 were not unusual. When participants disclosed, a friend or romantic partner was the most typical recipient, with family members being somewhat less frequent. The timing of disclosure varied greatly across samples and participants. Little information was available regarding the average extent or content of disclosure, as most studies did not assess these constructs. However, preliminary results suggested that most disclosures were brief and do not include many details about the traumatic event or the survivor’s symptoms.

There was a general pattern of disclosing to women more often than to men. Bonnan-White et al (2018) found that 22.2% of participants had disclosed to their mother, whereas 6.3% disclosed to their father. Dardis et al. (2021) found that 93.2% of participants had disclosed to a female friend, whereas 44.9% disclosed to a male friend. Multiple other studies in the review replicated this imbalance. Women have been posited to engage in a social response pattern labeled “tend and befriend” (Taylor et al., 2000) that draws on the attachment-caregiving system and engages biobehavioral mechanisms to promote a sense of safety and reduce distress. This may explain the more frequent reliance on women as a source of support following trauma. Importantly, a large portion of our studies included all-women samples, which may partially explain the preference for disclosing to women. In studies with all women samples that identified the sex of the informal source (Dardis et al., 2021; Jacques-Tiura et al., 2010; Nikulina et al., 2019; Ruggiero et al., 2004; Salim et al., 2022, Salim et al., 2025), there was a consistent pattern of women disclosing to women (e.g., mothers, female friends). Mixed gender samples found higher disclosure to mothers compared to fathers or other family members (Bonnan-White et al., 2018; Rajan et al., 2021; Pinciotti et al., 2024). The very small number of studies with all-male samples precludes us from speculating about patterns in men disclosing to individuals of any sex. Specifically, of the five total studies with all males, two focused exclusively on males disclosing to their female romantic partner (Lapid Pickman et al., 2024; Monk & Nelson Goff, 2014), two did not report the informal sources disclosed to (Moorman & Romano, 2023; Wolff et al., 2024), and one did not specify sex of informal source (Bolton et al., 2003). Together, these findings demonstrate a gap in the literature regarding sex of the disclosure recipient, particularly among male trauma survivors, and should be further explored.

Moreover, age is likely to shape both the content and context of disclosure, as one’s willingness to disclose and the meaning they ascribe to disclosure may be influenced by age cohort events and cultural norms. Among the studies that reported participants’ mean age, only 12.4% (k = 14) included samples with an average age of 50 years or older. In certain cases, this age distribution reflected the specific research question of the studies, such as examining individuals who experienced particular historical conflicts (e.g., WWII, Holocaust, Ottoman-Turkish genocide). Age is likely to also affect the timing and prevalence/rate of disclosure. Younger samples may demonstrate lower average disclosure rates, as they have less time since the traumatic event to disclose compared to older individuals. Additionally, to whom people disclose could vary across the lifespan. For example, older individuals may be more likely to disclose to their adult children. Moreover, it is possible the reasons for disclosure differ by age range. Given the limited number of studies including older individuals, it is crucial for future research to focus on older populations to gain better understanding of how age interacts with trauma disclosure behaviors over time.

Survivors reported disclosing their traumas for practical reasons, such as access to healthcare, but primarily for social reasons, such as to seek support, share their emotions, or give context for their behavior and its impact on their current relationships. Maintaining social relationships is a key factor in psychological and emotional health (Beckes & Sbarra, 2022). To the extent that disclosure facilitates the deepening of relationships, which may depend on many factors, including the recipient’s response to disclosure (Dworkin et al., 2019), disclosure may adaptively serve important interpersonal needs. Of course, the decision to disclose in the first place is likely highly dependent upon the preexisting relationship with the recipient, such that those survivors who already have robust sources of social support or more satisfying relationships are more likely to disclose (and perhaps to disclose in more detail; e.g., Balderrama-Durbin et al., 2013). Relationship aspects such as trust, closeness, and quality may influence what is specifically disclosed, particularly to informal sources. If a survivor wants to disclose in order to seek emotional support, they most likely would disclose to a trusted source (e.g., romantic partner, close friend) and potentially provide more content with their disclosure. For example, Balderrama-Durbin and colleagues (2013) found that male military service members who reported greater partner support and less relationship distress were more likely to disclose combat-related experiences to their female partners. However, if one is seeking practical support, they may be likely to disclose vague information and rely on different informal sources. There is evidence of an association among disclosure, relationship functioning, and mental health symptoms (e.g., PTSD). For example, when romantic partners have attributed their veteran partner’s behaviors to external factors (e.g., PTSD, trauma), there was lower relationship distress (Renshaw et al., 2014). Notably, over 90% of studies in this review were cross-sectional; thus, temporal associations cannot yet be established. More longitudinal research is necessary to disentangle directional associations of how disclosure, relationship quality, and mental health symptoms relate over time. Nevertheless, the average rates of disclosure across studies in our sample indicated that disclosure is the norm, and positive experiences of social support could contribute to the survivor’s sense of connectedness and, therefore, wellbeing (Charuvasta & Cloitre, 2008).

Greater clarity around the timing and extent of disclosure behavior may reveal meaningful differences across event types. For example, individuals who have experienced events that are likely to evoke shame or otherwise threaten their sense of self and place in their communities are more likely to struggle with seeking support for these experiences. Thus, it is to be expected that disclosure behaviors will be less extensive in these cases. SV is associated with greater shame than other types of traumas (e.g., Pilkington et al., 2025). Although we did not observe consistent differences in overall rates of disclosure in studies that focused on SV compared to other samples, it is possible that there are important differences in the timing, extent of disclosure, or other features in this group. For example, Taverna and colleagues (2025) found service members were significantly less likely to disclose exposures to potentially morally injurious events (PMIEs) to their romantic partners compared to experiences of threat and loss. PMIEs are events that transgress deeply held moral beliefs, and the idea of sharing these experiences may make survivors feel vulnerable to social ostracism. Both SV and PMIEs have been associated with barriers to formal reporting (e.g., Nazarov et al., 2024; Griffin et al., 2022), and so it is reasonable to expect that there are also distinct patterns regarding informal disclosure. More nuanced assessment of disclosure behavior is needed to better understand potential differences among event types.

Survivors sometimes inhibit disclosure out of a desire to prevent their loved ones from feeling distress. This was particularly salient in our sample’s qualitative studies, where respondents spoke of wanting to avoid burdening or upsetting their loved ones. Carter et al. (2020) and others have described the concept of “protective buffering,” wherein survivors (or individuals who are still currently experiencing a traumatic situation, such as deployed service members) avoid sharing their experience to shield others. Although this buffering is intended to reduce short-term distress in the partner, it has been associated with higher levels of psychological distress for the survivor (Carter et al., 2020).

Our ability to study the impact of trauma disclosure behavior is hampered by the wide variability in how these disclosures are assessed across studies. Nearly three-quarters of studies in our review created their own measure of disclosure behavior, often consisting of just one or two items assessing whether disclosure occurred or not in a dichotomous manner. Given the brevity of these assessment methods, it is impossible to establish fundamental psychometric properties such as reliability or cohesion of items. Only 28% (k = 32) of studies used a validated measure of trauma disclosure behavior. The most utilized measure was the DTQ (Müller et al., 2000; Müller et al., 2008), which has been psychometrically evaluated and found to have good internal reliability and test-retest reliability. Other measures were rarely used, ranging between one to four studies. Across published measures of disclosure behavior, there is substantial variability in what aspects of disclosure are assessed. For example, the DTQ assesses urges to disclose and reluctance to disclose, but not frequency or extent of disclosure. Other measures do assess frequency and/or extent (e.g., Allen & Renshaw, 2015; Lichtman, 1984), and some further distinguish between sharing globally about deployment versus sharing about combat experiences specifically (Balderrama-Durbin et al., 2013), or sharing about particular affective states such as anger versus sadness (Hoyt et al.,2010). As a field we do not yet have a clear understanding of which of these aspects may be clinically relevant because of the disparate approaches to measurement across studies. It is necessary to develop a single measure that encapsulates much more detail and nuance if we are to truly understand disclosure behavior. In the related area of reactions to disclosure, there has been much progress; two widely used measures are available (Maercker & Müller, 2004; Ullman, 2000). Yet, without understanding when and whether disclosure behavior occurs and what information is shared during these disclosures, our understanding of the phenomenon is incomplete.

A more comprehensive assessment of disclosure behaviors would offer clinical utility in understanding what aspects of disclosure are associated with advantageous versus deleterious outcomes for individuals and relationships. Disclosure of emotional responses to a traumatic event can facilitate recovery and posttraumatic growth (Tedeschi & Calhoun, 2004). Disclosure that is focused on emotions and meaning making (e.g., cognitions about why the trauma occurred and its aftereffects), rather than sharing of sensory details, appears to be most adaptive for survivors and their loved ones (e.g., Balderrama-Durbin et al., 2013; Beaudreau, 2007; Campbell & Renshaw, 2012, 2013). Campbell and Renshaw (2013) found that the negative effect of emotional numbing on survivors’ and partners’ relationship satisfaction was largely accounted for by ratings of patients’ emotional disclosure. It is likely that a balance of high emotional disclosure with low sensory details helps the trauma survivor to form a cogent narrative and allows the disclosure recipient to correctly attribute the survivor’s reactions to an external event (Renshaw et al., 2014) and offer support. Indeed, existing dyadic interventions for PTSD focus on encouraging emotional disclosure and meaning making about the trauma and its impact while minimizing the sharing of sensory details (e.g., Monson & Fredman, 2012; Sautter et al., 2015). Yet the field lacks a validated instrument that captures these distinct dimensions of disclosure. We urge researchers to develop a theoretically based, empirically validated measure of disclosure behaviors that include items tapping both purportedly beneficial elements of disclosure (i.e., thoughts and feelings about the trauma and its aftereffects) and possibly detrimental elements (i.e., high levels of sensory detail) to advance this work.

Further, there is a need to explore how PTSD is associated with trauma disclosure behaviors. Social factors (a broad term that encompasses social support as well as related constructs, both positive and negative) are clearly and repeatedly related to PTSD development and severity (Wagner et al., 2016). Initial reactions to trauma disclosure, particularly if they are negative, are predictive of future psychopathology (Dworkin et al., 2019). Social disapproval from family and friends has been found to predict later PTSD symptoms (Ennis et al., 2023). As noted above, validated measures of social reactions to trauma disclosure exist; the development of a companion measure that adequately captures the nuance of disclosure behavior will allow for more sophisticated investigations into how a positive cycle of healthy disclosure and supportive responding can be cultivated.

In undertaking the first systematic review of trauma disclosure behavior to informal sources, we hope to provide a foundation from which to launch more sophisticated examinations of this important interpersonal process. Strengths of this study include pre-registering our search and following the PRISMA guidelines, double-coding of all articles and rating of quality assessment, and the inclusion of over 100 individual articles. By following best practice guidelines and ultimately reviewing a sizeable number of relevant articles, we have condensed a substantial amount of information regarding trauma disclosure and at the same time highlighted areas that require more attention to move our science and intervention efforts forward. Despite our comprehensive approach, which yielded many articles, there are related constructs (notably protective buffering, described above) which were not included in our search terms and are somewhat broader than trauma disclosure per se. Yet, the protective buffering literature may meaningfully overlap with our findings in the present review. Thus, we encourage researchers who are interested in conducting future studies of disclosure to consider whether to take a targeted focus on trauma disclosure or to include a broader range of information about sharing/withholding behaviors.

There are some additional limitations to this review. Some of the included studies were secondary analyses (46.9%; k = 53), with five of those derived from overlapping parent samples (three from Nikulina, 2009; two from Ullman & Peter-Hagene, 2016). As there is yet no published review on trauma disclosure behaviors to informal sources, to our knowledge, we included all relevant studies to ensure comprehensiveness. These studies had different study aims with varied methodologies (i.e., qualitative versus quantitative) and therefore provided distinctive findings, contributing novel insights regarding trauma disclosure behaviors. A related limitation is that there were 13 studies that the authors self-identified as secondary analyses but which did not give the parent study information. Continued research and the collection of diverse datasets are necessary to more thoroughly explore trauma disclosure behaviors. Additionally, although we excluded any studies that explicitly focused only on formal disclosure, some studies included (or may have included) information on both formal and informal disclosures, and it was often not possible to separate findings related to these two disclosure types. Given that most disclosures tend to occur to informal sources (e.g., Marriott et al., 2016; Ullman & Filipas, 2005a), we kept these studies for greater inclusivity. However, a majority of included studies explicitly specified that disclosure was to informal sources.

We originally hoped to review research on disclosures related to trauma treatment, in addition to disclosures of traumatic experiences and symptoms. However, we only identified one study that involved treatment disclosure (Thompson-Hollands et al., 2021), and this was focused on the reports of loved ones rather than survivors. Disclosure of treatment experiences, or disclosure of trauma that happens against the backdrop of the survivor engaging in treatment for that trauma, may be especially powerful and meaningful, as they could interact synergistically with treatment processes. However, this is clearly an area that has barely been explored from an empirical perspective. We suspect findings from dyadic treatments for PTSD such as Cognitive-Behavioral Conjoint Therapy for PTSD (Monson & Fredman, 2012), which encourages dyads to discuss trauma-related thoughts and feelings to facilitate healthy meaning making of why the trauma occurred and attendant beliefs about self and others without inclusion of sensory details and minute renditions of the trauma as it unfolded, would be especially ripe for such investigations, and we encourage their publication.

This systematic review of trauma disclosure to informal sources provides a foundation for understanding an important interpersonal process. Although other work has focused on reactions to disclosure, this is the first paper to delve into the behavioral aspects of disclosure itself. The literature on trauma disclosure behaviors remains relatively underdeveloped. We found that disclosure is common across trauma types, although the timing and recipients varied widely. Weaknesses in assessment across studies limited our ability to detect nuances in disclosure behavior and impacts, and the predominance of cross-sectional designs prevented us from understanding longitudinal changes in disclosure and temporal relations among disclosure, relationships, and psychopathology. Our hope is that this paper synthesized the state of the field while also providing clear directions for critical future work. Based on findings from this review, we encourage researchers to identify mechanisms that facilitate adaptive trauma disclosure and what characterizes a well-received disclosure by others (e.g., validation and other forms of emotional support). Identifying the most beneficial aspects of what and how trauma survivors disclose is essential for understanding what can lead to adaptive disclosure outcomes for the survivor. It is important to identify ways to mitigate potential harmful outcomes for survivors’ mental health or relationships and reactions to disclosure by reducing criticism, blame, and invalidation (Wagner et al., 2016). Additionally, greater understanding of adaptive trauma disclosure and receipt could enhance and advance the use of interventions that include trauma disclosure as an important ingredient for recovery from PTSD and other trauma sequelae by potentiating supportive reactions from others (e.g., Monson & Fredman, 2012; Sautter et al., 2015). As we grow in our understanding of the power of interpersonal relationships to enhance trauma recovery, the salience of informal trauma disclosure only increases. We are encouraged by how many researchers are including assessments of disclosure in their studies. We are hopeful that this work will continue to develop in breadth and sophistication, for the benefit of survivors and their loved ones.

Public Health Significance:

This systematic review highlights that rates of trauma disclosure to informal sources range widely from 25% to 97.6% and can occur from the day of the traumatic event to over 18 years after. The most common informal sources were romantic partners or friends. Women tended to disclose trauma more often than men. A greater understanding of trauma disclosure behaviors may enhance our understanding of interpersonal mechanisms of trauma recovery.