Interrelationships between childhood trauma, alexithymia, and depressive symptoms: A network analysis and replication

Childhood trauma has been found to increase the risk of developing alexithymia and depressive symptoms. However, the complex interplay between childhood trauma, alexithymia, and depressive symptoms remains unclear.

To understand how different facets of childhood trauma, alexithymia across positive and negative emotions, and depressive symptoms interact with each other, this study adopted the network analysis approaches to examine this complex relationship.

An initial sample of 2918 Chinese college students completed a set of psychometric questionnaires measuring childhood trauma, alexithymia and depressive symptoms. Another independent sample (n = 858) was used to investigate the replicability of our results.

Undirected networks were estimated to explore the most relevant connections between the above variables. Bayesian network analysis was further used to explore the potential causal directions between the variables.

Findings from the initial dataset showed that childhood trauma was positively correlated with both alexithymia and depressive symptoms in the undirected networks. Physical abuse was the most central node. The Bayesian network analysis indicated that externally orientated thinking and depressed mood may be key drivers for activating other symptoms. Physical abuse might affect suicide ideation through difficulties in describing negative emotions. The replication dataset showed similar network structures as the initial dataset.

The findings suggest that childhood trauma, especially physical abuse, plays an important role in developing later depressive symptoms via valenced components of alexithymia. This study clarifies how early adversities link to depressive symptoms through emotional functioning and informs clinical interventions targeting influential symptoms in trauma-exposed populations.