Survivors of adversity and trauma experience high levels of distress, interpersonal challenges and poor physical health. We investigated the role of trust in trauma-related psychological and physiological responses. Serum concentrations of C-reactive protein, cortisol, tumour necrosis factor-alpha and interleukin-8 from 25 participants in Scotland were measured. Trauma history and experience were assessed using the Childhood Trauma Questionnaire and Life Events Checklist. Trauma symptomatology was measured by the Impact of Event Scale. Interpersonal trust was measured using the Trust Scale. Trauma history and inflammatory biomarker concentrations were significant predictors of trauma symptomatology with trust as a covariate. Psychological and physiological responses after trauma seem strongly linked. Trust can mediate distress and physiology in adversity.