Childhood Trauma, Emotional Regulation, Alexithymia, and Psychological Symptoms Among Adolescents: A Mediational Analysis

Background: Adolescents’ mental health is influenced by childhood trauma, emotional regulation, and psychological symptoms. This study aimed to explore these interconnections among adolescents attending a child and adolescent clinic. Method: Adolescents aged 13-19 from a city were recruited through purposive sampling. Data were collected using the Child Behavior Checklist (CBCL), Childhood Trauma Questionnaire-Short Form (CTQ), Difficulties in Emotion Regulation Scale (DERS), and Toronto Alexithymia Scale-20. Adolescents with severe mental or physical illnesses were excluded. Results: A total of 100 participants were recruited aged 13-19. The CTQ scores positively correlated with DERS Scores ( r = 0.246, P < .05) and Internalizing scores ( r = 0.325, P < .01). DERS Scores strongly correlated with alexithymia ( r = 0.624, P < .001) and Internalizing scores( r = 0.556, P < .001). Regression analyses revealed CTQ, Alexithymia, and DERS scores significantly predicted Internalizing scores ( R 2 = 0.37). Mediation analysis showed that emotional regulation partially mediated the relationship between child trauma and Internalizing scores ( B = 0.059, 95% confidence interval CI = 0.011 to 0.133, t = 1.92, P = .01), as well as the relationship between Alexithymia and Internalizing scores( B = 0.255, 95% CI = 0.129 to 0.465, t = 3.31, P < .001). Conclusion: Findings highlight the importance of emotional regulation as a mediator in the connections between childhood trauma, alexithymia, and psychological symptoms among adolescents. This complementary mediation underscores the dual impact of direct and indirect effects on psychological well-being. The findings reveal intricate links between childhood trauma, emotional regulation, and alexithymia in adolescents with psychological symptoms. Emotional regulation proved to have a pivotal role in influencing psychological well-being. These results emphasize the importance of considering emotional regulation when assessing and maintaining mental health in adolescents, further contributing to understanding treatment needs.