Several categories of posttrauma appraisals (e.g., fear, shame, self-blame) have been associated with different forms of trauma-related distress (e.g., posttraumatic stress disorder [PTSD], depression symptoms). In this paper, we extend previous research to consider two appraisal categories that have received little attention to date: alienation and betrayal. Alienation may be important following interpersonal traumas that disrupt one's connection to self and others. Betrayal trauma theory points to the importance of betrayal in motivating responses to interpersonal traumas, though little research has directly examined appraisals of betrayal. With three separate samples of adults (one undergraduate; two community-based), we examined the relative contributions of six distinct appraisal categories (alienation, anger, betrayal, fear, shame, and self-blame) to three forms of trauma-related distress (PTSD, dissociation, and depression symptoms). Participants' posttrauma appraisals accounted for variance in trauma-related distress above and beyond characteristics of the trauma itself. Further, specific appraisal categories accounted for unique variance in different forms of trauma-related distress. Across samples, alienation was significantly related to all three distress types, suggesting that appraisals of disconnection from the self and others are common across trauma-related distress responses. Several distress-appraisal patterns were replicated across samples, including links between self-blame and depression; shame and PTSD; and betrayal and dissociation. Betrayal-dissociation links have important implications for betrayal trauma theory. The results point to the importance of understanding specific appraisal processes associated with different forms of trauma-related distress.