# The relationship between childhood trauma, early maladaptive schema and alexithymia: a multi-group path model of clinical and non-clinical samples

**Authors:** Qiuying Zhang, Quandong Liu, Menglu Jia, Sicen Zhang, Lixia Zhang, Zhengtu Cong

PMC · DOI: 10.3389/fpsyg.2026.1754917 · Frontiers in Psychology · 2026-02-20

## TL;DR

This study explores how childhood trauma relates to alexithymia through early maladaptive schemas in both clinical and non-clinical groups.

## Contribution

It introduces a multi-group path model examining mediation effects across clinical and non-clinical samples.

## Key findings

- EMS domains mediate the trauma-alexithymia link in both clinical and non-clinical samples.
- Over-vigilance and inhibition schema's link to depression is stronger in clinical groups.

## Abstract

Depression patients with comorbid alexithymia often experience difficulties in emotional expression and emotional recognition. Previous research has identified early maladaptive schemas (EMS) as mediators in the relationship between childhood trauma and alexithymia; however, no studies have examined this mediation in combined models across clinical and non-clinical samples.

This study included 134 non-clinical participants (Mean age = 37.75, SD = 18.41) and 137 clinical participants diagnosed with depression according to ICD-10 criteria (Mean age = 35.80, SD = 11.22). Participants completed the Childhood Trauma Questionnaire, Young Schema Questionnaire, Beck Depression Inventory, and Toronto Alexithymia Scale. Using multi-group path analysis, we tested a hypothesized model in which EMS mediate the relationship between childhood maltreatment and alexithymia in both clinical and non-clinical samples. Additionally, we examined whether structural paths differed between groups.

Results revealed that the disconnection and rejection, impaired autonomy and performance, other directedness, over-vigilance and inhibition and impaired limits schema domains significantly mediated the relationship in both samples. Notably, the association between the over-vigilance and inhibition schema domain and depression was significantly stronger in the clinical sample compared to the nonclinical sample.

These findings highlight the mediating role of EMS in the link between childhood trauma and alexithymia and underscore group-specific differences in schema depression associations, with implications for tailored clinical interventions.

## Linked entities

- **Diseases:** depression (MONDO:0002050)

## Full-text entities

- **Diseases:** dissociative disorders (MESH:D004213), EMS (MESH:C580055), Childhood trauma (MESH:D014947), emotion expression inability (MESH:D001039), anhedonia (MESH:D059445), intellectual disabilities (MESH:D008607), emotion-processing deficits (MESH:D001289), psychotic disorders (MESH:D011618), abuse (MESH:D019966), mental disorder (MESH:D001523), impaired autonomy and (MESH:D060825), anxiety (MESH:D001007), psychological disorders (MESH:D000067073), sexual abuse (MESH:D000082002), Depression (MESH:D003866), organic diseases (MESH:D000092124), affective disorders (MESH:D019964), suicidal ideation (MESH:D001072), emotional processing (MESH:D010335), stress-related disorders (MESH:D000068099), eating disorders (MESH:D001068), aggressive behaviors (MESH:D010554), incompetence (MESH:D001022), bipolar disorder (MESH:D001714), emotional and physical neglect (MESH:D058069), fatigue (MESH:D005221), inability to recognize (MESH:C564980), limits (MESH:D045745), mental distress (MESH:D012128), delusional (MESH:D012563), emotion recognition inability (MESH:D020238), alexithymic traits (MESH:C567520), anxiety disorders (MESH:D001008), cognitive vulnerabilities (MESH:D003072)
- **Chemicals:** CTQ (-)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Full text

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## Figures

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## References

61 references — full list in the complete paper: https://tomesphere.com/paper/PMC12964264/full.md

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Source: https://tomesphere.com/paper/PMC12964264