Metacognition and dissociation as mediators between childhood trauma and psychiatric symptoms

Abstract

Background

Childhood trauma (CT) is a significant risk factor for the development of psychopathology, including maladaptive personality traits and psychiatric symptoms. CT has been shown to impact various psychological outcomes, including mood disorders and personality pathologies, but the underlying mechanisms remain underexplored. This study investigates the roles of dissociation and metacognition as parallel mediators in the relationship between CT, personality disorders, and psychiatric symptoms in a general population.

Method

A total of 1881 adult participants from general population, were included in this cross-sectional study. Participants were administered several self-report questionnaires, including the Childhood Trauma Questionnaire (CTQ), the Metacognition Self-Assessment Scale (MSAS), the Dissociative Experiences Scale (DES-II), the Personality Inventory for DSM-5 (PID-5), and the Symptom Checklist-90- R (SCL-90-R). Data were analyzed using multiple linear regression models and parallel mediation analyses to test the hypotheses that dissociation and metacognition mediate the relationship between childhood trauma, personality disorder severity, and general psychiatric symptoms.

Findings

Results indicated that higher levels of childhood trauma were significantly associated with increased dissociative experiences, lower metacognitive abilities, greater maladaptive personality traits, and more severe psychiatric symptoms. Emotional abuse, in particular, was most strongly correlated with personality disorder severity and psychiatric symptoms. Dissociation and metacognition were found to be significant parallel mediators of the relationship between childhood trauma and both personality disorder severity and psychiatric symptoms. Dissociation was a stronger predictor than metacognition, especially in individuals with high personality disorder severity. In this subgroup, dissociation remained a significant mediator, while metacognition played a lesser role.

Conclusion

This study provides empirical support for the mediating roles of dissociation and metacognition in the relationship between childhood trauma and adult psychopathology. The findings suggest that these factors, particularly dissociation, are critical pathways linking childhood trauma to more severe personality disorders and psychiatric symptoms. These insights offer potential therapeutic targets, emphasizing the need to address dissociative tendencies and metacognitive deficits in interventions for individuals with histories of childhood trauma. Future research should further investigate these mechanisms longitudinally and explore how different types of trauma differentially affect psychological outcomes. Addressing these mediators could enhance the effectiveness of interventions aimed at reducing the long-term psychological impact of childhood trauma.