Emotional Processing Deficits and PTSD: The Mediating Role of Alexithymia in Childhood Maltreatment Among Veterans

Abstract

ABSTRACT Childhood trauma is a pervasive public health issue with significant long-term psychological consequences, including increased vulnerability to post-traumatic stress disorder (PTSD). Although extensive research has explored the link between childhood trauma and PTSD, the role of alexithymia – a deficit in emotional recognition and regulation – remains unclear, particularly in high-risk populations such as veterans who perpetrate intimate partner violence (IPV). This study examines whether alexithymia mediates the relationship between different types of childhood trauma and PTSD symptoms in a sample of 127 male veterans with IPV histories. Participants completed the Childhood Trauma Questionnaire (CTQ), Toronto Alexithymia Scale (TAS-20), and PTSD Checklist (PCL). Mediation analyses were conducted using bootstrapping techniques. Results revealed that alexithymia significantly mediated the relationship between childhood sexual abuse and PTSD symptom severity, as well as between childhood emotional and physical neglect and PTSD symptom severity. No significant mediation effects were found for physical abuse or emotional abuse. Reverse mediation models did not support PTSD as a mediator between childhood trauma and alexithymia. Posthoc analyses indicated that alexithymia mediated relationships between sexual abuse, emotional neglect, and PTSD symptom categories of reexperiencing, avoidance/numbing, and hyperarousal, as well as between physical neglect and reexperiencing and hyperarousal. No direct effects were observed. Findings suggest that childhood emotional neglect and sexual abuse contribute to PTSD symptoms in IPV-perpetrating veterans through alexithymia. Results highlight the importance of emotional processing deficits in trauma-related psychopathology and suggest that clinical interventions targeting alexithymia may benefit veterans with PTSD and histories of childhood trauma.