The mediating effect of alexisomia between child abuse and depression/stress in a sample of Lebanese adults: a cross-sectional study

Objective: Mental health outcomes such as depression and stress are shaped by various factors, including childhood abuse, emotional and physical awareness deficits like alexisomia, and sociodemographic influences.This study aimed to investigate the mediating role of alexisomia in the relationship between childhood abuse and mental health outcomes, specifically depression and stress, among Lebanese adults. Methods: A cross-sectional study was conducted in July 2024, enrolling 1205 participants using a snowball sampling technique from various Lebanese regions.Participants completed a selfadministered questionnaire consisting of Childhood Abuse Severity Retrospective Scale (CASRS-12), Shitsu-Taikan-Sho Scale (STSS), Patient Health Questionnaire-9 (PHQ-9) and Stress Numerical Rating Scale (SNRS-11).Results: Higher childhood abuse was significantly associated with greater alexisomia, depression, and stress.Mediation analyses with adjustment for covariates (gender, smoking, socioeconomic status…) revealed that alexisomia mediated the association between childhood abuse and both depression (Beta = 0.018; Boot CI: 0.002-0.034)and stress (Beta = 0.005; Boot CI: 0.001-0.009).Higher childhood abuse was significantly associated with higher alexisomia and directly associated with higher depression/stress.Higher alexisomia was significantly associated with higher depression/stress. Conclusion:The findings highlight alexisomia as a mediator in the relationship between childhood abuse and mental health outcomes, suggesting the need for greater clinical focus and targeted interventions to enhance emotional and physical awareness and improve mental health outcomes, particularly for individuals with a history of trauma.