Childhood abuse, distress disclosure, resilience, and alexithymia: testing a moderated mediation model

Abstract Previous studies have suggested that childhood abuse plays a significant role in the occurrence of alexithymia. However, the mediating mechanisms underlying the relationship between childhood abuse and alexithymia (particularly in non-Western cultural contexts) remain unclear. This study aimed to investigate whether distress disclosure mediates the relationship between childhood abuse and alexithymia, as well as the moderating role of resilience. A cross-sectional survey was conducted among 899 middle school students using the Childhood Trauma Questionnaire-Short Form (CTQ-SF), Distress Disclosure Index (DDI), Connor-Davidson Resilience Scale (CD-RISC), and Toronto Alexithymia Scale (TAS-20). The results showed that: Childhood abuse directly and positively predicted alexithymia; distress disclosure significantly mediated the relationship between childhood abuse and alexithymia; Resilience positively moderated the association between childhood abuse and distress disclosure, with highly resilient individuals exhibiting greater capacity to mitigate the negative impact of childhood abuse on distress disclosure. The findings emphasize the need to jointly examine the mechanisms of risk factors and protective factors in abused individuals with comorbid alexithymia.