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

Introduction: 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. Methods: 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: 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. Discussion: 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.