The relationship between alexithymia, childhood trauma and anxiety: Comparison between joint and nuclear family system

Authors

  • Sadaf Maqbool MPhil Scholar, Department of Psychology, University of Peshawar, Pakistan Author
  • Dr. Roomana Zeb Department of Psychology, University of Peshawar, Pakistan Author
  • Shandana Yousafzai MPhil Scholar, Department of Psychology, University of Peshawar, Pakistan Author

DOI:

https://doi.org/10.71085/rjhsa.04.04.150

Keywords:

Childhood Trauma, Alexithymia, Anxiety, Family System, Young Adults, Pakistan

Abstract

The purpose of the current study was to investigate the association between childhood trauma, alexithymia, and anxiety in adults 18-40 years (M=23.43, SD=3.53). A comparison of differences in these variables was also examined with respect to family system (joint and nuclear). A correlational research design along with causal-comparative research design was used. The sample was made up of 301 adult members with various educational and social backgrounds gathered by convenience sampling. The data were collected by Childhood Trauma Questionnaire–Short Form (CTQ-SF; Bernstein et al., 2003), Toronto Alexithymia Scale (TAS-20; Bagby et al., 1994), and Generalized Anxiety Disorder Scale (GAD-7; Spitzer et al., 2006). The results showed both childhood trauma and alexithymia positively correlated with anxiety, and alexithymia had a significant positive correlation with childhood trauma. A preliminary analysis revealed that there were greater mean levels of childhood trauma, and alexithymia amongst people from joint family system compared to nuclear family system. In the amount of anxiety experienced in different family systems, however, no significant difference was found. The results indicated that experiencing adverse childhood events is linked to challenges with experiencing emotions and higher anxiety symptoms in adulthood. Alexithymia appears to be an important factor linked with the psychological consequences of childhood trauma. The study emphasizes a need to consider emotional awareness and childhood adversity in the context of mental health interventions and adds to the scant literature in situational Pakistani context.

Downloads

Download data is not yet available.

References

Abdullah, M., & Ijaz, S. (2025). Newborn gender, mode of delivery and family system, as determinants of postpartum depression among Pakistani mothers. Pakistan Social Sciences Review, 9(3), 50–59. https://doi.org/10.35484/pssr.2025(9-III)05

Afzal, A., Ahmad, W., & Hasan, S. T. (2024). Family structure, family processes and wellbeing of student: A study of district Gujrat, Punjab, Pakistan. Journal of Development and Social Sciences, 5(1), 224–238. https://doi.org/10.47205/jdss.2024(5-I)21

Ahmed, F., Ferdoos, A., & Faiz, F. A. (2021). Patriarchal family tendencies and socio-economic and psychological effects in Pakistan. Pakistan Journal of Social Research, 3(3), 458–467. https://ojs.pjsr.com.pk/index.php/PJSR/article/view/269

Ahmad, R., & Munaf, S. (2006). Nuclear family system as an important risk factor for the development of the baby blues. Pakistan Journal of Social and Clinical Psychology, 4(1–2), 67–74.

Allen, A. M., Mendes, W. B., West, T. V., Del Rosario, K. S., & Brown, C. K. (2026). Alexithymia in dyadic interactions: Associations with affective and sympathetic nervous system reactivity and empathic accuracy. Emotion (Washington, D.C.), 10.1037/emo0001725. PubMed. https://doi.org/10.1037/emo0001725

Bagby, R. M., Parker, J. D., & Taylor, G. J. (1994). The twenty-item Toronto Alexithymia Scale—I. Item selection and cross-validation of the factor structure. Journal of Psychosomatic Research, 38(1), 23–32. https://doi.org/10.1016/0022-3999(94)90005-1

Bernstein, D. P., Stein, J. A., Newcomb, M. D., Walker, E., Pogge, D., Ahluvalia, T., Desmond, J., & Zule, W. (2003). Development and validation of a brief screening version of the Childhood Trauma Questionnaire. Child Abuse & Neglect, 27(2), 169–190. https://doi.org/10.1016/S0145-2134(02)00541-0

Chiu, H. T. S., Low, D. C. W., Chan, A. H. T., & Meiser-Stedman, R. (2024). Relationship between anxiety sensitivity and post-traumatic stress symptoms in trauma-exposed adults: A meta-analysis. Journal of Anxiety Disorders, 103, Article 102857. https://doi.org/10.1016/j.janxdis.2024.102857

Chung, M. C., & Chen, Z. S. (2021). The interrelationship between child abuse, emotional processing difficulties, alexithymia and psychological symptoms among Chinese adolescents. Journal of Trauma & Dissociation, 22(1), https://doi.org/10.1080/15299732.2020.1788689

DePrince, A. P., Weinzierl, K. M., & Combs, M. D. (2009). Executive function performance and trauma exposure in a community sample of children. Child Abuse & Neglect, 33(6), 353–361. https://doi.org/10.1016/j.chiabu.2008.08.002

Dita, M., & Bubuioc, L. (2026). Childhood trauma and psychological symptoms: The role of emotional regulation and alexithimy. Vector European, 1, 282–286. https://doi.org/10.52507/2345-1106.2026-1.45

Ditzer, J., Wong, E. Y., Modi, R. N., Behnke, M., Gross, J. J., & Talmon, A. (2023). Child maltreatment and alexithymia: A meta-analytic review. Psychological Bulletin, 149(5–6), 311–329. https://doi.org/10.1037/bul0000391

Gibson, L. E., Alloy, L. B., & Ellman, L. M. (2016). Accounting for the associations between child maltreatment and internalizing problems: The role of alexithymia. Child Abuse & Neglect, 52, 20–28. https://doi.org/10.1016/j.chiabu.2015.12.008

Gul, N., Ghani, N., Alvi, S. M., Kazmi, F., & Shah, A. A. (2017). Family system's role in the psychological well-being of the children. Khyber Medical University Journal, 9(1), 29–32. https://www.kmuj.kmu.edu.pk/article/view/16202

Hogeveen, J., & Grafman, J. (2021). Alexithymia. In Handbook of Clinical Neurology (Vol. 183, pp. 47–62). Elsevier. https://doi.org/10.1016/B978-0-12-822290-4.00004-9

Holt, S., Buckley, H., & Whelan, S. (2008). The impact of exposure to domestic violence on children and young people: A review of the literature. Child Abuse & Neglect, 32(8), 797–810. https://doi.org/10.1016/j.chiabu.2008.02.004

Khan, A. N., & Jaffee, S. R. (2022). Alexithymia in individuals maltreated as children and adolescents: a meta‐analysis. Journal of Child Psychology and Psychiatry, 63(9), 963–972. https://doi.org/10.1111/jcpp.13616

Kick, L., Schleicher, D., Ecker, A., Kandsperger, S., Brunner, R., & Jarvers, I. (2024). Alexithymia as a mediator between adverse childhood events and the development of psychopathology: a meta-analysis. Frontiers in Psychiatry, 15, 1412229. https://doi.org/10.3389/fpsyt.2024.1412229

Kim, H. J., Kim, J., Yook, K. H., Choi, T. Q., & Lee, S. H. (202). Early trauma subtypes are differentially related to anxiety symptomatology and suicidal ideation in panic disorder. Psychiatry Investigation, 21(3), 240–250. https://doi.org/10.30773/pi.2023.0371

Kurtoğlu, M. B., Yücel, D., Coşkun, E., & Sezer Katar, K. (2024). The relationship between adverse childhood experiences and social anxiety disorder symptoms: The mediating role of rumination. Current Psychology, 43, 22418–22425. https://doi.org/10.1007/s12144-024-06021-5?urlappend=%3Futm_source%3Dresearchgate.net%26utm_medium%3Darticle

Kuzminskaite, E., Vinkers, C. H., Milaneschi, Y., Giltay, E. J., & Penninx, B. W. J. H. (2022). Childhood trauma and its impact on depressive and anxiety symptomatology in adulthood: A 6-year longitudinal study. Journal of Affective Disorders, 312, 322–330. https://doi.org/10.1016/j.jad.2022.06.057

Lodhi, F.S., Rabbani, U., Khan, A.A. et al. Factors associated with quality of life among joint and nuclear families: a population-based study. BMC Public Health 21, 234 (2021). https://doi.org/10.1186/s12889-021-10265-2

Lodhi, F. S., Ahmed Khan, A., Raza, O., Uz Zaman, T., Farooq, U., & Holakouie-Naieni, K. (2019). Level of satisfaction and its predictors among joint and nuclear family systems in District Abbottabad, Pakistan. Medical Journal of the Islamic Republic of Iran, 33, Article 59. https://doi.org/10.34171/mjiri.33.59

Luminet, O., & Nielson, K. A. (2025). Alexithymia: Toward an experimental, processual affective science with effective interventions. Annual Review of Psychology, 76(1), 741–769. https://doi.org/10.1146/annurev-psych-021424-030718

Margolin, G., & Gordis, E. B. (2000). The effects of family and community violence on children. Annual Review of Psychology, 51, 445–479. https://doi.org/10.1146/annurev.psych.51.1.445

Meganck, R., Vanheule, S., & Desmet, M. (2009). Alexithymia and interpersonal problems: A study of natural language use. Personality and Individual Differences, 47(8), 990–995. https://doi.org/10.1016/j.paid.2009.08.005

Milliken, C., & Lilly, M. M. (2020). Alexithymia and trauma narrative coherence among trauma-exposed adults. Master’s Theses and Doctoral Dissertations. https://huskiecommons.lib.niu.edu/allgraduate-thesesdissertations/7451

Mphaphuli, L. K. (2023). The Impact of Dysfunctional Families on the Mental Health of Children. Parenting in Modern Societies. https://doi.org/10.5772/intechopen.110565

Munaf, S., & Siddiqui, B. (2013). Relationship of post-natal depression with life and marital satisfaction and its comparison in joint and nuclear family system. Procedia - Social and Behavioral Sciences, 84, 733–738. https://doi.org/10.1016/j.sbspro.2013.06.636

Natiq, A. A. (2024). Family Structures and Child Development: A Comparative Analysis. Journal of Political Stability Archive, 2(3), 84-92. https://journalpsa.com.pk/index.php/JPSA/article/view/29

Naveed, S., Waqas, A., Chaudhary, A. M. D., Kumar, S., Abbas, N., Amin, R., Jamil, N., & Saleem, S. (2020). Prevalence of Common Mental Disorders in South Asia: A Systematic Review and Meta-Regression Analysis. Frontiers in Psychiatry, 11, 573150. https://doi.org/10.3389/fpsyt.2020.573150

Prajapati, R., & Liebling, H. (2021). Accessing Mental Health Services: a Systematic Review and Meta-ethnography of the Experiences of South Asian Service Users in the UK. Journal of Racial and Ethnic Health Disparities, 9(2), 598–619. https://doi.org/10.1007/s40615-021-00993-x

Preece, D. A., Mehta, A., Petrova, K., Sikka, P., Pemberton, E., & Gross, J. J. (2024). Alexithymia profiles and depression, anxiety, and stress. Journal of Affective Disorders, 357, 116–125. https://doi.org/10.1016/j.jad.2024.02.071

Preece, D. A., & Gross, J. J. (2023). Conceptualizing alexithymia. Personality and Individual Differences, 215, Article 112375. https://doi.org/10.1016/j.paid.2023.112375

Paulus, F. W., Ohmann, S., Möhler, E., Plener, P., & Popow, C. (2021). Emotional dysregulation in children and adolescents with psychiatric disorders. A narrative review. Frontiers in Psychiatry, 12(1), 1–32. https://doi.org/10.3389/fpsyt.2021.628252

Qureshi, F., Misra, S., & Poshni, A. (2023). The partition of India through the lens of historical trauma: Intergenerational effects on immigrant health in the South Asian diaspora. SSM - Mental Health, 4, 100246. https://doi.org/10.1016/j.ssmmh.2023.100246

Rauschenberg, C., van Os, J., Cremers, D., Goedhart, M., Schieveld, J. N. M., & Reininghaus, U. (2017). Stress sensitivity as a putative mechanism linking childhood trauma and psychopathology in youth’s daily life. Acta Psychiatrica Scandinavica, 136(4), 373–388. https://doi.org/10.1111/acps.12775

Sabir, A., Alam, N., & Ali, A. (2026). Parenting style, interpersonal relationships, family support, and marital satisfaction in joint and nuclear families. ACADEMIA International Journal for Social Sciences, 5(3), 679–692. https://doi.org/10.63056/academia.5.3.2026.2237

Salokangas, R. K. R., From, T., Salokangas, H. R. W., Lehtoranta, L., Suvisaari, J., Koskinen, S., Hietala, J., Joukamaa, M., & Karukivi, M. (2024). Effects of childhood adversities on alexithymia features vary between sexes. Results of a prospective population study. European Journal of Psychotraumatology, 15(1). https://doi.org/10.1080/20008066.2024.2407256

Scigała, D. K., Zdankiewicz-Ścigała, E., Chodkiewicz, J., & Kokoszka, A. (2021). The role of childhood trauma and alexithymia in emotional functioning. PeerJ, 9, e11323. https://doi.org/10.15557/PiPK.2018.0032

Sharma, P., Sen, M. S., Sinha, U. K., & Kumar, D. (2024). Childhood Trauma, Emotional regulation, alexithymia, and Psychological Symptoms among Adolescents: A Mediational analysis. Indian Journal of Psychological Medicine, 48(2), 140–147. https://doi.org/10.1177/02537176241258251

Spitzer, R. L., Kroenke, K., Williams, J. B., & Löwe, B. (2006). A brief measure for assessing generalized anxiety disorder: The GAD-7. Archives of Internal Medicine, 166(10), 1092–1097. https://doi.org/10.1001/archinte.166.10.1092

Sun, M., Piao, M., & Jia, Z. (2024). The impact of alexithymia, anxiety, social pressure, and academic burnout on depression in Chinese university students: An analysis based on SEM. BMC Psychology, 12, Article 757. https://doi.org/10.1186/s40359-024-02262-y?urlappend=%3Futm_source%3Dresearchgate.net%26utm_medium%3Darticle

Taylor, G. J., Bagby, R. M., Parker, J. D. A., & Grotstein, J. (1997). Disorders of affect regulation. In Cambridge University Press eBooks. https://doi.org/10.1017/cbo9780511526831

Turki, M., Hammemi, W., Ellouze, S., Barkallah, M., Mannoubi, I., Halouani, N., & Aloulou, J. (2024). The relationship between childhood trauma and adulthood anxiety and depression among Tunisian university students. European Psychiatry, 67(S1), S824–S824. doi:10.1192/j.eurpsy.2024.1719

Van Landeghem, C., & Jakobson, L. S. (2024). Isolating unique variance in mental health outcomes attributable to personality variables and childhood emotional abuse. Frontiers in Psychology, 15, Article 1345612. https://doi.org/10.3389/fpsyg.2024.1330483?urlappend=%3Futm_source%3Dresearchgate.net%26utm_medium%3Darticle

Wang, N., Chu, J., Chen, G., Pan, X., Wang, Z., & Wang, W. (2025). Effect of childhood trauma on emotional distress: A chain-mediated effects of alexithymia and psychological flexibility. Brain and Behavior, 15, Article e70825. https://doi.org/10.1002/brb3.70825

Wu, S. (2024). The influence of family nurturing environment on children’s emotions and behaviors. International Journal of Education and Humanities, 14(2), 274–278. https://doi.org/10.54097/ca4kqt80

Xiao, Z., Baldwin, M. M., Wong, S. C., Obsuth, I., Meinck, F., & Murray, A. L. (2023). The impact of childhood psychological maltreatment on mental health outcomes in adulthood: A systematic review and meta-analysis. Trauma, Violence, & Abuse, 24(5), 3049–3064. https://doi.org/10.1177/15248380221122816

Ye, Q., Zhang, S., He, X., Yang, Y., Ni, K., Yang, H., Wei, W., Preece, D. A., Chan, R. C., Li, B., & Cai, X. (2025). Interrelationships between childhood trauma, alexithymia, and depressive symptoms: A network analysis and replication. Child Abuse & Neglect, 172, 107877. https://doi.org/10.1016/j.chiabu.2025.107877

Zdankiewicz-Ścigała, E., & Ścigała, D. K. (2020). Attachment style, early childhood trauma, alexithymia, and dissociation among persons addicted to alcohol: Structural equation model of dependencies. Frontiers in Psychology, 10, Article 2957. https://doi.org/10.3389/fpsyg.2019.02957

Zhang, B., Li, X., Deng, H., Tan, P., He, W., Huang, S., Wang, L., Xu, H., Cao, L., & Nie, G. (2024). The relationship of personality, alexithymia, anxiety symptoms, and odor awareness: A mediation analysis. BMC Psychiatry, 24, Article 185. https://doi.org/10.1186/s12888-024-05653-y

Zhang, Q., Liu, Q., Jia, M., Zhang, S., Zhang, L., & Cong, Z. (2026). The relationship between childhood trauma, early maladaptive schema and alexithymia: A multi-group path model of clinical and non-clinical samples. Frontiers in Psychology, 17, Article 1754917. https://doi.org/10.3389/fpsyg.2026.1754917

Downloads

Published

2026-10-17

How to Cite

Maqbool, S., Zeb, R., & Yousafzai, S. (2026). The relationship between alexithymia, childhood trauma and anxiety: Comparison between joint and nuclear family system. Research Journal of Human and Social Aspects, 4(4), 243-258. https://doi.org/10.71085/rjhsa.04.04.150