Post-Traumatic Stress Disorder (PTSD) is a global mental health concern, with recent research focussing on the psychological mechanisms that contribute to its development and maintenance. Alexithymia, characterised by difficulty identifying and expressing emotions, has been identified as a potential risk factor for PTSD. This study was a preliminary investigation of a model of the relationship between alexithymia and PTSD symptoms, focussing on the potential mediating roles of self-compassion and difficulties in emotional regulation. Participants (N = 332), who were university students and members of the community, completed self-report measures of the key variables. As expected, alexithymia was strongly associated with higher levels of PTSD symptoms. Three mediation pathways were also significant. In one, alexithymia was associated with greater regulation difficulties for negative emotions, which was associated with higher levels of PTSD symptoms. In the second, higher alexithymia was associated with greater difficulties regulating positive emotions, which was associated with higher levels of PTSD symptoms. The final pathway involved a serial mediation in which higher alexithymia was associated with lower self-compassion, and lower self-compassion was associated with greater difficulties in regulating negative emotions, which were associated with higher PTSD symptoms. Contrary to expectation, self-compassion had no direct relationship with PTSD symptoms and did not relate to difficulties in regulating positive emotions. The general pattern of results was evident for the PTSD subtypes of negative alterations in cognitions and mood and alterations in arousal and reactivity. However, mediation by difficulties in regulating positive emotions was nonsignificant for the symptoms of re-experiencing and avoidance. The theoretical and clinical implications of the findings are discussed.
Fedorov et al. (2026) studied this question.