Early trauma exposure moderates associations between cortisol reactivity and youth anxiety and externalizing symptoms.

The interactive role of physiological reactivity and victimization responses on internalizing symptoms in early childhood.

The present short-term longitudinal study examined the associations between preschoolers' coping responses to their personal experience of peer victimization and later internalizing symptoms. This study prospectively tested autonomic nervous system reactivity (i.e., respiratory sinus arrhythmia reactivity, RSA-R; and skin conductance level reactivity, SCL-R) as moderators of these associations. This secondary data analysis assessed a relatively well-resourced sample of 83 preschoolers (M = 45.59 months old, SD = 3.80, 47.0% female) over the course of approximately 1 year: first during the spring of participants' preschool (Time 1) and again during the spring of the subsequent pre-kindergarten year (Time 2). Hypotheses were guided by polyvagal theory, which highlights the importance of interactive effects of the sympathetic and parasympathetic nervous systems in the stress response. Results demonstrated that approach coping was associated with decreases in later internalizing symptoms. In addition, avoidance coping was associated with decreases in internalizing symptoms for participants exhibiting SCL-R inhibition. RSA-R did not moderate associations between coping and later internalizing symptoms. These findings provide preliminary support for the hypothesis that the adaptive alignment between coping behaviors and physiological reactivity may serve as a protective factor in buffering against psychological distress.

Association of traumatic experiences with depressive symptoms among LGBTQ+ population in China.

Adverse childhood experiences and adolescent mental health: trajectories of internalizing, externalizing and prosocial behaviour in a longitudinal cohort study

Abstract Aims Adverse childhood experiences (ACEs) shape children’s socioemotional development, yet longitudinal evidence from low- and middle-income countries remains limited. This study examined how ACEs relate to internalizing, externalizing and prosocial behaviours from childhood to adolescence in a rural Pakistani cohort. Methods Data were drawn from the Bachpan Cohort, a longitudinal study including 1,791 observations across three waves: ages 4–5, 8–9 and 12–15 years. ACEs were assessed using an adapted ACE-International Questionnaire. Outcomes were measured using the Strengths and Difficulties Questionnaire. Network analysis, dose-response modelling and moderation analyses were employed. Results Emotional neglect was the most prevalent ACE (83.7%). Parental psychiatric issues, parental trauma exposure and emotional neglect were the most central ACE stressors. A dose-response relationship emerged: compared to children with no ACEs, those with four or more ACEs showed higher internalizing (incidence ratio [IR] = 4.24) and externalizing problems (IR = 3.42) and lower prosocial behaviour (IR = 0.90). Girls showed greater internalizing vulnerability; boys showed more externalizing problems. ACE effects on internalizing problems strengthened with age. Conclusions ACEs are strongly associated with internalizing, externalizing and prosocial outcomes from childhood to adolescence. Findings highlight the need for tiered, gender-sensitive and developmentally appropriate interventions in low-resource settings.

Associations between childhood trauma and heart rate variability: Serial mediation by alexithymia and anxiety symptoms.

PURPOSE Childhood trauma has been associated with long-term alterations in psychological functioning and autonomic regulation. However, the psychological processes linking early adverse experiences with individual differences in autonomic function remain insufficiently understood. The present study examined the associations between childhood trauma and heart rate variability (HRV), with particular attention to the potential mediating roles of alexithymia and anxiety symptoms. PARTICIPANTS AND METHODS A total of 152 university students (mean age = 22.19 years, SD = 1.63) participated in this cross-sectional study. Childhood trauma was assessed using the Revised Adverse Childhood Experience Questionnaire, alexithymia was measured using the Toronto Alexithymia Scale-20, and anxiety symptoms were evaluated using the Beck Anxiety Inventory. Heart rate variability was indexed by the root mean square of successive differences (RMSSD) derived from electrocardiogram recordings. Serial mediation analyses were conducted using the PROCESS macro (Model 6) with bootstrap resampling to examine the indirect associations among the study variables. RESULTS Childhood trauma was positively associated with alexithymia and anxiety symptoms and negatively associated with HRV. Alexithymia and anxiety symptoms were both negatively correlated with HRV and positively correlated with each other. Serial mediation analysis indicated that alexithymia and anxiety symptoms were statistically associated with the relationship between childhood trauma and HRV through both independent and sequential indirect pathways. CONCLUSION The findings suggest that higher levels of childhood trauma are associated with lower heart rate variability primarily in conjunction with elevated alexithymia and anxiety symptoms. Within a cross-sectional associational framework, alexithymia and anxiety may represent psychological characteristics linked to both early adverse experiences and variations in autonomic regulation. These results highlight the interconnected nature of emotional awareness, affective distress, and physiological regulation, and underscore the importance of considering emotional processing traits when examining psychophysiological correlates of childhood trauma.

Beyond posttraumatic stress disorder diagnosis: How specific trauma symptoms drive long-term disability in veterans.

The link between trauma-related symptomatology and psychosocial disability is well-established. However, the extent to which specific PTSD symptom clusters differentially contribute to distinct psychosocial disability domains remains unclear. This study examined these associations, hypothesizing that negative alterations in mood and cognition and hyperarousal symptoms would be the strongest predictors of concurrent and future psychosocial disability. We conducted a secondary analysis of longitudinal data from 332 veterans (30% female) with a range of trauma-related symptom severity, as measured by the PTSD Checklist for DSM-5 (PCL-5; M = 27.6, SD = 20.8). Linear mixed-effects models were used to assess the unique contributions of PTSD symptom clusters to psychosocial disability across six domains-understanding/communication, mobility, self-care, interpersonal relationships, life activities, and social participation-measured four times over 24 months. Across domains, negative alterations in mood and cognition and hyperarousal symptoms emerged as the most consistent predictors of psychosocial disability, with effect sizes ranging from small (β = 0.14) to large (β = 0.53). Avoidance symptoms showed more domain-specific associations, particularly for mobility and social participation. Time effects indicated improvement in several domains, though self-care disability remained stable. PTSD symptoms explained more variance in interpersonal and social functioning than in domains related to physical functioning and self-care. Negative alterations in mood and cognition and hyperarousal symptoms exert disproportionate influence on psychosocial disability, underscoring their importance as treatment targets. Avoidance may contribute to disability in specific life domains, highlighting the need for rehabilitation strategies tailored to both broad and domain-specific impairments in veterans with trauma-related symptomatology. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Association between trauma exposure and mental health among adolescents with attention-deficit hyperactivity disorder

ABSTRACT Background: Adolescents with attention-deficit/hyperactivity disorder (ADHD) may be particularly vulnerable to trauma; however, patterns of trauma exposure and psychological responses in East Asian contexts remain underexplored. Objective: To examine associations among ADHD, trauma exposure, and psychological outcomes, and to differentiate trauma-specific reactions from broader internalising symptoms. Methods: This cross-sectional study included 295 adolescents aged 12–18 years (149 with ADHD and 146 controls). Adolescents and their caregivers completed validated measures of trauma exposure (Trauma Exposure Experience Questionnaire), trauma reactions (Revised Child’s Reaction to Traumatic Events Scale), anxiety (Multidimensional Anxiety Scale for Children), depression (Centre for Epidemiological Studies Depression Scale), and self-esteem (Rosenberg Self-Esteem Scale). All measures demonstrated excellent internal consistency (Cronbach’s α = .92–.95). Intergroup differences were examined using chi-square tests and t-tests. Hierarchical regression models incorporating ADHD × trauma exposure interaction terms, along with sex-stratified analyses, were used to evaluate associations. Results: Adolescents with ADHD reported stronger trauma reactions (p = .039), greater depressive symptoms (p = .032), and lower self-esteem (p = .002) than controls. Logistic regression analyses indicated that physical assault (odds ratio = 3.11) and threats of violence (odds ratio = 3.77) were significantly associated with ADHD. Trauma reactions were strongly predicted by anxiety, depression, and trauma exposure across the sample. The interaction between ADHD and trauma exposure was not significant in the total sample (p = .600) or in stratified analyses. Conclusion: Adolescents with ADHD in Taiwan are highly vulnerable to interpersonal trauma. Although ADHD does not moderate the association between trauma exposure and subsequent reactions, trauma responses are closely associated with comorbid anxiety and depression. These findings highlight the need for trauma-informed ADHD care that addresses internalising symptoms within relevant familial and cultural contexts.