Childhood trauma and adolescent anxiety: Uncovering emotion regulation pathways through integrated machine learning...

Childhood trauma constitutes a significant risk factor for adolescent anxiety, with emotion regulation playing a critical role. This large-scale longitudinal study (N = 2461 at baseline, with external validation) examined differential relationships between childhood trauma subtypes and adolescent anxiety, focusing on the mediating roles of cognitive reappraisal and expressive suppression. Integrating machine learning with traditional mediation analysis, we not only identified emotional abuse as the strongest predictor of adolescent anxiety relative to other trauma subtypes, but also detected and systematically validated both cognitive reappraisal and expressive suppression as significant partial mediators in the emotional abuse-anxiety pathway, with these mediating effects being temporally stable and externally valid. These findings advance theoretical frameworks for trauma-related psychopathology and offer empirical support for interventions targeting emotion regulation in trauma-exposed adolescents.