The relationship between childhood trauma and complex PTSD symptoms among college students: the influence of emotional regulation strategies and gender differences

Abstract

Complex post-traumatic stress disorder (CPTSD) often persists long after childhood trauma. Growing evidence suggests that early adversities disrupt foundational cognitive frameworks, making maladaptive emotional regulation a critical bridge to chronic symptoms, particularly among young adults. To empirically test this framework, this study explored the underlying mechanisms between childhood trauma and complex post-traumatic stress disorder symptoms (CPTSS) among college students, specifically examining the roles of rumination and worry as well as the impact of gender differences. A questionnaire survey was conducted with 532 college students to collect data on childhood trauma experiences, rumination, worry, and CPTSS, followed by a moderated mediation analysis. The results indicated that childhood trauma significantly predicted CPTSS; furthermore, rumination mediated the relationship between childhood trauma and CPTSS, with this mediating effect being moderated by worry. Notably, the moderated mediation model exhibited gender differences: in the female group, the mediating effect of rumination was more significant and was moderated by worry, whereas in the male group, the moderating effect of worry was not significant. These findings suggest that college students with childhood trauma are more prone to rumination, which in turn triggers CPTSS—a mediating path moderated by worry—and that this mechanism is gender-sensitive, being particularly prominent and subject to the moderation of worry among females.