Adult attachment insecurity and uncertain reflective functioning as mediators between traumatic experiences and alexithymia in young adults: a structural equation modeling approach

BACKGROUND: Alexithymia concerns a difficulty identifying, describing, and valuing feelings, and is regarded as a transdiagnostic dimensional construct, expressed at different levels in both non-clinical and clinical populations. Despite evidence supporting the relationship between traumatic experiences, adult attachment insecurity, uncertain reflective functioning, and alexithymia, there is a need to model their relationships to inform research, preventative actions, and clinical practice. Accordingly, this study aimed to investigate the mediating effect of adult attachment insecurity (M1) and uncertain reflective functioning (M2), on the relationship between traumatic experiences (X) and alexithymia (Y) in a community sample of young adults. METHODS: N = 1,510 community members (78% female, age range 18–30) were assessed for traumatic experiences, adult attachment insecurity, uncertain reflective functioning, and alexithymia using self-report questionnaires. A sequential multiple mediation model was tested using structural equation modeling. RESULTS: There was no evidence of a direct effect of traumatic experiences on alexithymia. Traumatic experiences showed an indirect effect on alexithymia through adult attachment insecurity and uncertain reflective functioning. The total effect was statistically significant and the total explained variance of the model was R2 = 0.737. CONCLUSIONS: Alexithymia implies difficulties in understanding, processing and verbalizing emotions, which may be associated with difficulties in mentalizing and adult attachment insecurities that may in turn be linked to traumatic experiences. These considerations may serve to promote effective, process-based clinical intervention aimed to improve reflective functioning and alexithymia.