Childhood Trauma, Alexithymia, and Internalizing Behavior in Female Adolescents: The Mediating Role of Cognitive Fusion
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Objective: This study examined the prediction of internalizing behavior problems in female adolescents based on childhood trauma and alexithymia, with cognitive fusion as a mediating variable.
Methods and Materials: This descriptive-correlational study used structural equation modeling. The population included female students in the second cycle of public secondary schools in Karaj, Iran, during the 2025–2026 academic year. A total of 250 students were selected through convenience sampling. Data were collected using a demographic checklist, the Achenbach Internalizing Behavior Questionnaire, the Childhood Trauma Questionnaire, the Toronto Alexithymia Scale, and the Cognitive Fusion Questionnaire. Data were analyzed using Pearson correlation, structural equation modeling, and bootstrap mediation testing in SPSS 29 and AMOS 24.
Findings: Childhood trauma was positively correlated with internalizing behavior problems (r = 0.518, p < 0.012), as were alexithymia (r = 0.563, p < 0.017) and cognitive fusion (r = 0.438, p < 0.011). The model showed acceptable fit: CMIN/DF = 1.95, RMSEA = 0.067, SRMR = 0.04, CFI = 0.92, GFI = 0.93, and TLI = 0.96. Direct effects of childhood trauma (β = 0.52, p = 0.011), alexithymia (β = 0.31, p = 0.015), and cognitive fusion (β = 0.34, p = 0.018) on internalizing behavior problems were significant. Cognitive fusion significantly mediated the effects of childhood trauma (β = 0.46, p = 0.002) and alexithymia (β = 0.35, p = 0.001) on internalizing behavior problems.
Conclusion: Childhood trauma and alexithymia predict internalizing behavior problems in female adolescents, partly through cognitive fusion. Interventions targeting cognitive defusion and emotion identification may help reduce internalizing symptoms.
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