Childhood trauma, dissociation, alexithymia, and anger in people with autoimmune diseases: A mediation model

Background: Despite research linking dissociation, alexithymia, and anger with childhood trauma and ADs, the investigation addressing the relationships between the potential mediators has not yet been established within the literature. Objective: The present study examined the relationship between childhood trauma and autoimmune disorders, using a multiple mediation model that included dissociation, alexithymia, and anger as hypothesized mediators. Participants and setting: 306 autoimmune patients and 292 self-declared healthy controls were included in the study. They completed self-report questionnaires regarding childhood abuse, alexithymia, dissociation, and anger. Methods: Multiple mediation analysis was conducted to investigate the study's proposed model. Results: The results of the Structural Equation Model (SEM) suggest an indirect relationship between childhood trauma and autoimmune disorders, mediated by dissociation [z = 4.57, p < .01, beta = 0.19, 90% CI (0.08-0.10)], alexithymia [z = 10.74, p < .01, beta = 0.43, 90% CI (0.08-0.10)], but not by anger [z = 1.58, p = .11, 90% CI (0.08-0.10)]. Conclusions: These findings are in line with previous studies that show associations between childhood trauma, dissociation, alexithymia, and ADs. They indicate that mental health professionals and medical doctors should assess childhood trauma in autoimmune patients. They also should consider the possible maintaining role of dissociation and alexithymia in the treatment of autoimmune diseases.