Examining the Relationship between Childhood Traumas, Alexithymia and Emotional Regulation Difficulties in University Students

Abstract

The aim of this study is to examine the relationship between childhood traumas, alexithymia, and difficulty in emotion regulation among university students. A relational screening approach was used in the research. A relational screening model was used in the research. The study sample group consists of 351 university students. 83.5% of the participants were women (n = 293) and 16.5% were men (n = 63). Informed Voluntary Consent Form, Sociodemographic Information Form, Childhood Trauma Scale, Toronto Alexithymia Scale and Emotion Regulation Scale Short Form were administered to the participants. Data collection was carried out online (Google Forms) through convenient sampling, examining the relationship and effect between nonparametric tests and sociodemographic characteristics, childhood traumas, alexithymia and emotion regulation difficulties by looking at normality curves in data analysis. As a result of the research findings, a significant and positive relationship was found between childhood traumas, alexithymia and emotion regulation difficulties of university students. In addition, it was determined that male individuals are more alexithymia than females, females are exposed to sexual abuse more than males, the 24–25 age group has more emotional dysregulation, and the rates of emotional dysregulation and alexithymia are low in the presence of a romantic relationship. It is thought that this study can contribute to the relevant literature.

1. Introduction

Childhood traumas negatively affect a child’s behavioural, cognitive, social and emotional development. Traumatic experiences have a significant impact on how the brain develops and functions. As a result of the stress encountered in early childhood, problems such as anxiety, depression, alexithymia and emotion dysregulation may occur. Cardiovascular stimulation and electrical activity in the brain develop gradually throughout the child’s growth and development. The physiological response of the child to stressful conditions is predicted by looking at early brain activations. It has been found that if the right frontal part of the brain is not symmetrical in the early period, there may be problems in controlling emotions such as fear and anxiety as well as speech flow [1]. Stressful situations affect the behavioural performances of the child by manifesting themselves in cerebral activation.

Factors such as environment and family may cause children to face some problems in managing anxiety disorders and fears. University years are also important periods that impact an individual’s life. These years are a period when individuals are separated from their families, express their thoughts and behaviours, and make their own decisions in social relations. Being a member of a group and adapting to a new school, a new city and a foreign environment during university years can sometimes cause problems [2, 3, 4].

Childhood traumas are generally defined as serious negative childhood experiences. A series of experiences classified as psychological trauma (physical, emotional, sexual abuse and physical neglect, emotional neglect, etc.) negatively affect the behavioural, cognitive, social and emotional development of the child [5, 6]. Childhood trauma experiences are common worldwide [7]. It has been found that people with a history of neglect and abuse in childhood have a higher rate of being diagnosed with anxiety disorders, substance abuse disorders, depression, and personality disorders in later life compared to people without a history of neglect and abuse [8]. In addition, frequent childhood neglect and abuse experiences cause some adjustment problems [9].

It is suggested that childhood traumas and insecure attachment styles are important life events that prepare the ground for alexithymia [10, 11]. Sifneos [12] introduced the concept of alexithymia and defined it as impaired emotion regulation and inability to understand and express emotions. The problem of alexithymia has been shown as a source of problems in emotional development that continue in early childhood [13]. Alexithymia is a dysfunction that occurs in the frontal cortex of the brain. It occurs as a result of inhibition of sensory stimuli that occur during the interaction of the limbic system and neocortex. In addition, people diagnosed with alexithymia have deficiencies in recognising, distinguishing, understanding and verbalising feelings and emotions [14, 15]. Alexithymia is a personality trait characterised by the inability to identify one’s own emotions [16]. Dysfunction in emotional awareness, social attachment and interpersonal relationships are among the distinctive features of alexithymia. In addition, people with high levels of alexithymia may have difficulty in recognising and appreciating the emotions of other individuals [17].

Emotion regulation is the ability to give the most appropriate response and reaction by thinking about the consequences of one’s reactions in a situation where one has difficulty in coping with emotion and managing emotion, behaviour and body. Emotion regulation difficulty is defined as having difficulty in conceptualising and making sense of emotions, which makes it difficult to establish a causal connection between emotions and events [18]. In other words, it is the observation of problems in the processes of defining one’s emotions, making sense of emotions and regulating emotions. The definition of regulating emotions refers to the ability to manage one’s emotional processes [19]. Bad experiences in childhood are seen to be effective in emotion regulation difficulties [20].

Difficulties in regulating emotions are associated with anxiety, anxiety, depression, use of addictive substances [21], borderline personality disorder, coping with problematic situations and problem-solving skills [22]. University years are one of the important periods that have an impact on an individual’s life. These years are an environment in which individuals are separated from their families, express their thoughts and behaviours, and make their own decisions in social relationships. Being a member of a group during university years, the necessity to adapt to school, city and other new environments may cause individuals to experience some problems in the adaptation process [2, 3, 4]. Psychological problems experienced by university students in this period, which brings many responsibilities, may cause a decrease in their quality of life and academic success. Every research on the problems experienced by university students is important for the measures to be taken and strategies to be developed. This study is aimed to examine the relationship between childhood traumas, alexithymia and emotion regulation difficulties in university students.

2. Childhood traumas

2.1 Trauma concept and childhood

The concept of trauma is an emotional response to an unusual event such as an accident, rape or natural disaster. Shock and denial appear immediately after the events are experienced. As much as the body integrity of people is important, their mental health is just as important. Mental health is defined as people being in regular harmony and balance with themselves and their environment [23]. Trauma is defined as events that significantly affect the physical and mental health of people and that people are struggling emotionally [23]. In psychological traumas, unusual and unexpected situations are often observed that make people feel extremely frightened, weak and helpless. According to these published definitions [24].

“If a person has encountered a serious injury or a situation that threatens the physical integrity of himself or herself or the people around him or her, has encountered death or the threat of death, has suffered or witnessed a severe injury (excessive fear, horror or helplessness is seen in the person’s reactions), it can be said that the person has encountered a traumatic event.”

2.2 Types of childhood trauma

The traumatic events experienced at a young age lead to being depressed and sad all the time, not enjoying life, not being able to solve daily life problems, not being able to make their own decisions in the future, not being able to communicate with their peers, and avoiding romantic relationships. In addition, it has been observed that children face multiple problems such as family dependency, feeling helpless, lack of self-confidence, depressive state, heroin, cannabis, technology and alcohol addiction [24, 25]. It has been found that abuse against children at a young age causes negative effects on development, communication, health and psychosocial [26].

2.2.1 Child abuse

Since the concept of child abuse covers a wide range of factors, including social criticism, stubbornness, corporal punishment, domestic violence and the child’s personality, many definitions have been made [27]. One of these definitions is stated as all kinds of behaviours that are experienced and shown to the child by the person raising the child, causing trauma and damaging and preventing the development process of the child [28]. In another definition, Dubowitz [29] explains it as behaviours that will negatively affect the child’s healthy life, and physical and psychosocial development and lead to different situations, consciously or unconsciously, by an adult.

2.2.2 Physical abuse

It is a set of events that adversely affect the communication, honour, health, development and life of the child after physical force is consciously applied against children. In line with this definition, behaviours such as strangling, biting, shaking, burning, kicking, suffocating, poisoning, damaging the body with a hard object, etc., can be given as examples of physical abuse. According to the reports of UNICEF, physical abuse of children in the family is usually shown under the title of punishment [26].

2.2.3 Emotional abuse

Another element that has a biological effect on people as much as organs is emotions, which are constantly in communication and interaction with the brain [30]. The concept of emotional abuse is called behaviours that cause negative effects on mental development, emotional development, self and personality of the person in adolescence or childhood by people in the environment or family [31]. Unlike sexual and physical abuse, emotional abuse may be difficult to detect because the findings are not concrete.

2.2.4 Sexual abuse

There are many definitions of sexual abuse, which is one of the sub-headings of child abuse and the most difficult to find and detect compared to other types of abuse. In one definition, UNICEF explained sexual abuse as adult individuals entering into a relationship with the child without the child’s consent to satisfy themselves, get sexual pleasure, and gain financial gain by directing the child to prostitution and pornography [32]. It has been observed that the traumas experienced by individuals in childhood have affected their lives emotionally, socially and behaviourally and caused some problems. The effects caused by these problems are explained in the research as follows: In a group with a history of sexual abuse in childhood, the rate of phobia, personality disorder, anxiety, lack of self-confidence, anxiety disorder, social phobia, depression, substance abuse and some problems that will affect their sexual life is higher [33].

2.2.5 Child neglect

The concept of neglect shown at an early age is at least as important as the concept of abuse [34]. It has been proven with concrete evidence that the consequences of neglect applied to children extend to ending their lives [35]. It can be said that the sensitivity of neglected children decreases and strengthens aggressive behaviours in children. The concept of neglect eliminates the effect of feelings of love, fear and shame, which are binding in many emotions in children [35].

2.2.5.1 Physical neglect

Sanctions such as neglect, exploitation and abuse against children hurt children’s future lives and are behaviours and attitudes that destroy the sense of trust to a great extent [36]. Understanding physical neglect manifests itself as a situation that depends on culture and environment. The concept of physical neglect differs in societies and cultures. In different societies, for the actions exhibited or applied to be labelled as physical neglect, the person’s life must be in danger in a very serious way. In some cultures, if no situation does not pose a risk to the integrity of the body, it is not considered under the title of physical neglect [37].

2.2.5.2 Emotional neglect

It is of great importance to know what emotional neglect is and who inflicts it on the child. Particular attention should be paid to the attitudes and behaviours of the parents towards the events and the child. It can be said that the attitudes and behaviours of parents lead to some psychological symptoms in children. Parents can show their emotional neglect towards their children, sometimes consciously and sometimes unconsciously. To avoid serious problems, emotional neglect should be intervened at the necessary and right time [38].

2.3 Alexithymia

Humans are psychosocial beings. The balanced and healthy relationships established in daily life are among the basic elements that enable him/her to lead a successful, meaningful and joyful life. The existence of emotions is one of the most important elements that distinguish a human being from other living species. Emotions can affect people’s lives and are decisive in creating the meaning and purpose of life. Emotions, which have such an important and effective place in a person’s life, are as important as the awareness of their emotions and the ability to express their emotions [39].

2.3.1 The concept and basic features of alexithymia

The concept of alexithymia consists of two general deficits, each of which is twofold: transactional thinking (externally oriented thinking with manifested cognitive style and reduced fantasy world processes) and reduced affect awareness (difficulty in understanding and identifying emotions and expressing them to other people) [40]. People with alexithymia have difficulty choosing the right words to express their feelings. Their speech is detailed and repetitive. They rarely dream and are far away from imaginary experiences [41]. Haviland et al. [42] referred to the typical characteristics of the concept of alexithymia in a meaningful way with Lesser’s [41] findings. According to their explanations, individuals with alexithymia generally show rigid, anxious and withdrawn symptoms. In a person with typical alexithymic characteristics, tension and anxiety are manifested and manifested by symptoms in the body instead of verbal expressions [42]. Another information is that alexithymic individuals cannot empathise [43]. Although it is assumed that alexithymic individuals have an emotionally limited life, the main reason is not that they do not have emotions but that their emotions are not differentiated [43]. Alexithymic people exhibit lower levels of physical functioning, more limitations due to physical and emotional reasons, poorer emotional well-being, less energy, less social functioning and more pain symptoms than people who do not show alexithymic characteristics [15].

The concept of alexithymia does not only include recognising emotions and expressing them verbally. On the other hand, alexithymia also includes the inability to display an emotion naturally in facial expression [44].

2.3.1.1 Difficulty identifying, verbalising and distinguishing emotions

The difficulty of alexithymic individuals in understanding and expressing their own emotions to the other party is their most prominent characteristic [41, 45]. According to Lesser, individuals with this characteristic use simple and plain expressions or show physical reactions when they want to express their emotions. For example, people with alexithymia may choose words that express themselves more easily, such as “relaxation and discomfort,” or they may frequently exhibit physical reactions such as “relaxation and tension.” This limitation in their emotional lives is also manifested by the inability to understand their facial expressions [41]. In addition, when alexithymic people were asked how and what they felt in the face of a negative situation, it was observed that they had difficulty in making sense of and distinguishing their emotions. In summary, the main problem that alexithymic people face in their routine lives is the difficulties in distinguishing their feelings and thoughts from each other and in understanding and expressing the difference between their emotions and physical reactions [39].

2.3.2 Difficulty in emotion regulation

It is defined as being aware of and understanding one’s emotions, accepting one’s emotions, having the ability to control impulsive behaviours, and acting in a way to advance the goals one wants to achieve when experiencing negative emotions and adjusting one’s emotional reactions accordingly [18]. The absence of one or more of these features randomly has been linked to emotion dysregulation [18]. Emotion dysregulation affects anxiety, anxiety, depression, addictive substance abuse, borderline personality disorder [22], coping with problematic situations and problem-solving skills. Bad experiences in childhood are effective in emotion dysregulation. It was observed that people who had bad experiences in childhood had more emotion regulation problems in their later life [42].

3. Methods

Model of the Research: The method of this research was determined as a relational survey model. The relational survey model is used in studies aiming to reveal the connection between two or more variables [46].

3.1 Sample group

The sample of the research consists of students from various universities in Istanbul. The research sample consists of 351 people (age range 17–55), of which 16.5% (58) are male and 83.5% (293) are female, as shown in Table 1.

Male		Female
N	%	N	%
58	16.5	293	83.5

Table 1.

Demographic information on gender variable (N = 351).

3.2 Data collection tools

Sociodemographic Information Form, Toronto Alexithymia Scale (TAS), Difficulties in Emotion Regulation Short Form Scale (ERDS) and Childhood Traumas Scale (CTS) were administered to the participants online.

3.2.1 Sociodemographic information form

To determine the demographic characteristics of the individuals who participated in the study, the sociodemographic information form created by the researchers inquired information such as gender, age, the place where most of their lives were spent, whether their parents were alive or not, the educational status of their parents, perceived income level and who undertook most of their care during infancy and childhood.

Table 2 shows that 259 of the 351 people included in the study were in the 18–25 age group. 34% (88) of 259 people were in the 18–20 age group, 41.3% (107) in the 21–23 age group and 24.7% (64) in the 24–25 age group. The ages of the remaining 92 people ranged between 17 and 55 years.

18–20		21–23		24–25
N	%	N	%	N	%
88	34	107	41.3	64	24.7

Table 2.

Demographic information on age variable (N = 351) (18–20, 21–23, 24–25).

Table 3 shows that 74.1% (260) of the 351 participants in the study lived mostly in the metropolis, 3.1% (11) lived mostly in the town, 2.3% (8) lived mostly in the village and 20.5% (72) lived mostly in the city.

Metropolis		Town		Village		City
N	%	N	%	N	%	N	%
260	74.1	11	3.1	8	2.3	72	20.5

Table 3.

Demographic information about where most of your life has taken place (N = 351).

Table 4 shows that 96% (337) of the 351 participants in the study had a living mother, while 4% (14) had a non-living mother. At the same time, while 91.5% (321) of the participants’ fathers were alive, 8.5% (14) of them were not alive.

Mother				Father
Alive		Not Alive		Alive		Not Alive
N	%	N	%	N	%	N	%
337	96	14	4	321	91.5	30	8.5

Table 4.

Demographic information on whether the mother and father are alive or not (N = 351).

Table 5 shows that 88.6% (311) mothers, 3.4% (12) fathers, 6% (21) grandparents, 2 (2) babysitter’s and 1.4% (5) others undertook the care of the 351 participants in the infancy/childhood period.

Mother		Father		Grandparent		Babysitter		Other
N	%	N	%	N	%	N	%	N	%
311	88.6	12	3.4	21	6	2	.6	5	1.4

Table 5.

Demographic information on the variable of who undertook your care in infancy/childhood (N = 351).

3.2.2 Toronto alexithymia scale-TAS-20

The validity and reliability study of the Toronto Alexithymia Scale (TAS-20), which was developed to evaluate the characteristics of individuals with alexithymia symptoms, was carried out by Güleç et al. The Toronto Alexithymia Scale (TAS-20), which is a Likert-type scale, is a 20-item self-report scale with a scoring scale between 1 and 5 (1 = never, 2 = rarely, 3 = sometimes, 4 = often, 5 = always). This scale assesses difficulties in three dimensions: recognising emotions, expressing emotions and expressing thoughts. The sub-parameter of difficulties in recognising emotions is presented to the participants to be evaluated with items numbered 1, 3, 6, 7, 9, 13, 14, the sub-parameter of difficulties in expressing emotions is presented with items numbered 2, 4 (reverse), 11, 12, 17 and the last sub-parameter of expressive thinking is presented with items numbered 5 (reverse), 8, 10 (reverse), 15, 16, 18 (reverse), 19 (reverse) and 20.

3.2.3 Childhood traumas scale (CTS)

The scale [47], which was developed to assess childhood abuse or neglect, consists of 28 items. The Turkish validity and reliability study of the scale was conducted by [48], and the internal consistency Cronbach alpha coefficient of the scale was found to be 0.93. Emotional abuse parameter was evaluated with items 3, 8, 14, 18, 25; physical abuse with items 9, 11, 12, 15, 17; emotional neglect with items 5, 7, 13, 19, 28; physical neglect with items 1, 4, 6, 2, 26; and sexual abuse with items 20, 21, 23, 24, 27 [48, 49].

3.2.4 Difficulty in emotion regulation scale (DERS)

The scale is used to determine the level of difficulty in emotion regulation. The scale, which shows five-factor sub-parameters, has openness, goals, impulse, strategies and non-acceptance sub-dimensions. The Emotion Dysregulation Difficulty Short Form scale is 5-point Likert-type and consists of 16 items. The Turkish adaptation study of the scale was conducted by [47]. The original and adaptation studies revealed that the internal consistency coefficient was 0.92.

3.3 Statistical analysis of data

Before the scales were applied, an Informed Voluntary Consent Form was presented to the participants, and the participants were informed that participation in the study was voluntary and that approval had been obtained. The data obtained were processed into the SPSS 26 package programme. Before starting the analysis of the related research questions, it was examined whether the variables were normally distributed to decide on the types of analyses to be performed. In this context, Kolmogorov-Smirnov and Shapiro-Wilks values for the Toronto Alexithymia Scale (TAS) score, Childhood Traumas Scale (CTS) and Difficulty in Emotion Regulation Scale (ERDS) scores and sub-parameters of these scales were determined as p < .01 significant. It was decided that these variables were not normally distributed, so nonparametric tests were used in the analyses related to these variables. Simple Regression Analysis was used to analyse the effects of the scales on each other.

The Mann-Whitney test was used to find out whether there was a difference between gender groups in terms of all scales and sub-dimensions scores. As a result of this analysis, a significant difference was found between males (S.deviation = 214.48, Mdn = 2.70) and females (S.deviation = 168.38, Mdn = 2.45) in terms of TAS score U(349) = 6264.5, p < .01, in terms of TAS – Difficulty in recognising emotions, males (S. deviation = 206.22, Mdn = 2.64) and women (Mdn = 170.02, Mdn = 2.14), U(349) = 6744, p = .01, a significant difference was found between men (Mdn = 208.66, Mdn = 2.80) and women (Mdn = 169.53, Mdn = 2.40), U(349) = 6602.5, p = .01, a significant difference was found between males (S.deviation = 199.69, Mdn = 2.81) and females (S.deviation = 171.31, Mdn = 2.63) in terms of externalised thinking, U(349) = 7123, p =. 05, and finally, a significant difference was detected between males (S.Mean = 158.40, Mdn = 1) and females (S.deviation = 179.48, Mdn = 1) in terms of CTS sexual abuse, U(349) = 9518, p = .05. No significant difference was observed between males and females in terms of other variables, as shown in Table 6.

	İn a relationship		No relationship		U (349)	p
	S.deviation	Mdn	S.deviation	Mdn
TAS	154.94	2.40	188.69	2.55	11674.5	.00
CTS	189.13	2.21	168.09	2.21	12721.5	.06
ERDS	165.78	2	182.16	2.25	13105.5	.14
ERDS clerance	159.91	2	185.7	2	12329.5	.02
ERDS aims	160.73	2.67	185.2	3.33	12,439	.03
ERDS impulse	175.99	2	176	2	14,453	.99
ERDS strategies	169.76	2	179.76	2.20	13,630	.37
ERDS refusal to accept	175.72	2	176.17	2	14417.5	.96
TAS Difficulty recognising emotions	158	2.14	186.85	2.43	12077.5	.01
TAS difficulty expressing emotions	156.22	2.40	187.92	2.60	11842.5	.00
TAS Externalised thought	165.34	2.63	182.42	2.75	13,047	.12
CTS Emotional Abuse	181.31	1.40	172.8	1.20	13753.5	.43
CTS Physical abuse	176.07	1	175.96	1	14444.5	.98
CTS Physical neglect	182.62	2.60	172.01	2.60	13,580	.31
CTS emotianal neglect	180.87	4.20	173.07	4.00	13811.5	.48
CTS sexual abuse	180.43	1	173.33	1	13,869	.39

Table 6.

The difference between the groups of having a romantic relationship in terms of all scales and sub-dimensions (N = 351).

In Table 7, spearman correlation analysis was applied to examine the relationship between the total averages and sub-dimensions of the scales. In this context, it was found that there was a positive, small, medium and large significant relationship between TAS and ERDS, TAS Difficulty recognising emotions, TAS Difficulty expressing emotions, TAS Expressive thinking, ERDS Openness, ERDS Goals, ERDS Impulse, ERDS Strategies, ERDS Non-acceptance, CTS Emotional abuse, CTS Physical abuse dimensions; (rs ≥ .17, p < 01). In addition, a weakly significant negative correlation was found between TAS and CTS Emotional neglect dimension; rs = −23, p < 01. A small and moderately significant positive correlation was found between CTS and TAS-Expressed thoughts, CTS Physical abuse, CTS Physical neglect, CTS Emotional neglect, CTS Sexual abuse dimensions (rs ≥ .15, p < .01).

Variable	$\overline{x}$	SS	1	2	3	4	5	6	7	8	9	10	11	12	13	14	15	16
1. TAS	2.53	.54	1	0	.51**	.66**	.33**	.40**	.48**	.42**	.88**	.86**	.46**	.25**	.17**	−.01	−.23**	.08
2.CTS	2.20	.28	0	1	.01	.02	.02	.05	−.04	.02	−.06	−.04	.15**	−.03	.15**	.51**	.65**	.20**
3.ERDS	2.43	.93	.51**	.01	1	.64**	.83**	.84**	.94**	.81**	.59**	.45**	.04	.34**	.20**	.02	−.22**	.18**
4.ERDS Clearance	2.27	.96	.65**	.02	.64**	1	.46**	.47**	.56**	.46**	.65**	.69**	.14**	.24**	.13*	.01	−.19**	.11*
5.ERDS Aims	3.09	1.14	.33**	.02	.83**	.46**	1	.59**	.73**	.52**	.43**	.32**	−.06	.20**	.12*	.09	−.12*	.10
6. ERDS Impulce	2.19	1.12	.40**	.05	.84**	.47**	.59**	1	.75**	.66**	.48**	.32**	.04	.34**	.23**	.02	−.18**	.22**
7.ERDS; Strategies	2.34	1.07	.48**	−.04	.94**	.56**	.73**	.75**	1	.74**	.55**	.43**	.03	.30**	.16**	−.02	−.22**	.16**
8.ERDS refusal to accept	2.29	1.11	.42**	.02	.81**	.46**	.52**	.66**	.74**	1	.44**	.38**	.08	.32**	.20**	0	−.20**	.18**
9. TAS Difficulty recognising emotions	2.39	.87	.88**	−.06	.59**	.65**	.43**	.48**	.55**	.44**	1	.72**	.11*	.24**	.13*	−.04	−.21**	.06
10.TAS difficulty expressing emotions	2.59	.82	.86**	−.04	.45**	.62**	.32**	.32**	.43**	.38**	.72**	1	.19**	.29**	.15**	−.01	−.25**	.09
11.TAS Externalised thought	2.61	.49	.46**	.52**	.04	.14**	−.06	.04	.03	.08	.11*	.19**	1	.02	.10	.05	−.02	.01
12.CTS Emotional Abuse	1.54	.67	.25**	−.03	.34**	.24**	.20**	.34**	.30**	.32**	.24**	.29**	.02	1	.42**	−.08	−.57**	.35**
13.CTS Physical abuse	1.14	.42	.17**	.15**	.20**	.13*	.12*	.23**	.16**	.20**	.13*	.15**	.10	.42**	1	−.03	−.32**	.37**
14.CTS Physical neglect	2.48	.38	−.01	.51**	.02	.01	.09	.02	−.02	0	−.04	−.01	.05	−.08	−.03	1	.35**	−.05
15.CTS emotianal neglect	3.90	.95	−.23**	.65**	−.22**	−.19**	−.12*	−.18**	−.22**	−.20**	−.21**	−.25**	−.02	−.57**	−.32**	.35**	1	−.26**
16.CTS sexual abuse	1.26	.67	.08	.20**	.18**	.11*	.10	.22**	.15**	.18**	.06	.09	.01	.35**	.37**	−.05	−.26**	1

Table 7.

The relationship between all scales and sub-dimensions (N = 351).

*

p < .05.

**

p < .01.

It was found that there was a positive, small, medium or large significant relationship between ERDS and ERDS Clarity, ERDS Goals, ERDS Impulse, ERDS Strategies, ERDS Non-acceptance, TAS Difficulty recognising emotions, TAS Difficulty expressing emotions, CTS Emotional abuse, CTS Physical abuse, CTS Sexual abuse, CTS Physical neglect sub-dimensions; (rs ≥ .18, p ≤ .05). In addition, it was found that there was a weak significant negative relationship between ERDS and CTS Emotional neglect sub-dimension; rs = −.22, p < .01.

It was found that there was a positive, small, medium and large significant relationship between the ERDS Impulse sub-dimension and ERDS Strategies, ERDS Non-acceptance, TAS Difficulty recognising emotions, TAS Difficulty expressing emotions, CTS Emotional abuse, CTS Physical abuse and CTS Sexual abuse sub-dimensions; (rs ≥ .22, p < .01). In addition, it was determined that there was a small, medium, large significant relationship between the ERDS Impulse sub-dimension and the CTS Emotional neglect sub-dimension; rs = −.18, p < .01. It was determined that there was a small, medium, large significant relationship between the ERDS Strategies sub-dimension and the ERDS Non-acceptance, TAS Difficulty recognising emotions, TAS Difficulty expressing emotions, CTS Emotional abuse, CTS Physical abuse and CTS Sexual abuse sub-dimensions; (rs ≥ .15, p < 01). In addition, it was found that there was a small significant negative relationship between the ERDS Strategies subscale and the CTS Emotional neglect subscale; rs = −.22, p < .01.

It was found that there was a moderately significant positive relationship between CTS Physical abuse sub-dimension and CTS Sexual abuse sub-dimensions; rs = .37, p < .01. In addition, it was found that there was a moderately significant negative relationship between CTS Physical abuse sub-dimension and CTS Emotional neglect sub-dimension; rs = −.32, p < .01. It was determined that there was a positive and moderately significant relationship between CTS Physical neglect sub-dimension and CTS Emotional neglect sub-dimension; rs = .35, p < .01. In addition, it was determined that there was a negative and slightly significant relationship between CTS Emotional neglect sub-dimension and CTS Sexual abuse sub-dimension; rs = −.26, p < .01 (Tables 8 and 9).

	Male Female		U (349)	p
	S.deviation	Mdn	S.deviation	Mdn
TAS	214.49	2.70	168.38	2.45	6264.5	.00
CTS	180.85	2.21	175.04	2.21	8215.5	.69
ERDS	176.34	2.09	175.93	2.25	8477.5	.97
ERDS Clearance	192.28	2	172.78	2	7553	.16
ERDS aims	177.47	3	175.71	3	8412	.90
ERDS impulse	175.68	1.67	176.06	2	8515.5	.97
ERDS strategies	175.37	1.90	176.12	2	8533.5	.95
ERDS non-acceptance	180.01	2	175.21	2	8264.5	.74
TAS Difficulty recognising emotions	206.22	2.64	170.02	2.14	6744	.01
TAS Difficulty expressing emotion	208.66	2.80	169.53	2.40	6602.5	.01
TAS Externalised thought	199.69	2.81	171.31	2.63	7123	.05
CTS Emotional Abuse	164.22	1.20	178.33	1.40	9180	.31
CTS Physical Abuse	163.22	1	178.53	1	9238	.12
CTS Physical Neglect	176.95	2.60	175.81	2.60	8442	.93
CTS Emotional Neglect	189.34	4.20	173.36	4.20	7723.5	.27
CTS Sexual Abuse	158.40	1	179.48	1	9518	.05

Table 8.

T-test for the difference between gender groups in terms of TAS.

Mann-Whitney U test was applied to find out whether there was a difference between the groups in a romantic relationship in terms of all scales and sub-dimensions scores. As a result of this analysis, a significant difference was found between the groups of being in a relationship (S.deviation = 154.94, Mdn = 2.40) and not being in a relationship (S.deviation = 188.69, Mdn = 2.55) in terms of TTS score U(349) = 11674.5, p < .01, and between the groups of being in a relationship (S. deviation = 159.91, Mdn = 2) and no relationship (S.deviation = 185.7, Mdn = 2), U(349) = 12329.5, p < .01. A significant difference was found between there is a relationship (S.deviation = 160.73, Mdn = 2.67) and no relationship (S.deviation = 185.2, Mdn = 3.33), U(349) = 12,439 p < .01, TAS A significant difference was found between there is a relationship in terms of difficulty in recognising emotions (S.Ort = 158, Mdn = 2.34) and no relationship (S.deviation = 186.85, Mdn = 2.43), U(349) = 12077.5, p =. 01, TAS A significant difference was found between having a relationship (S.deviation = 156.22, Mdn = 2.40) and having no relationship (S.deviation = 187.92, Mdn = 2.60) in terms of difficulty in expressing emotions, U(349) = 11842.5, p = .01.

	18–20	21–23	24–25	H (2, 348)	p
	S.deviation	S.deviation	S.deviation
TAS	119.39	134.49	137.09	2.72	.25
CTS	122.65	136.68	128.95	1.71	.48
ERDS	129.36	126.52	136.69	0.74	.68
ERDS Clearance	128.8	119.61	149.03	6.59	.04
ERDS Aims	134.14	126.28	130.53	0.54	.76
ERDS Impulse	132.72	128.92	128.07	0.18	.91
ERDS Strategies	120.39	132.06	139.78	2.63	.26
ERDS Refusal to accept	131.6	124.4	137.16	1.24	.53
TAS Difficulty recognising emotions	118.24	130.76	144.91	4.72	.09
TAS Difficulty expressing emotion	121.14	136.34	131.59	2.03	.36
TAS Externalised thought	127.94	133.99	126.16	0.54	.76
CTS Emotional Abuse	129.99	127.14	134.8	0.45	.79
CTS Physical Abuse	132.61	132.1	122.89	1.73	.42
CTS Physical Neglect	120.64	138.03	129.45	3.03	.21
CTS Emotional Neglect	126.8	132.27	130.6	0.26	.87
CTS Sexual Abuse	132.63	134.66	118.59	3.67	.15

Table 9.

Kruskal-Wallis analysis of the difference between age groups in terms of all scales and sub-dimensions.

Kruskal-Wallis test was used in Table 10 to determine whether there is a difference between age groups in all scales and sub-dimensions. As a result of the analysis, it was found that there was a difference between the age groups in terms of ERDS openness scores; H (2, 348) = 6.59, p = .04. According to the paired test data to examine which groups were different, it was found that there was a significant difference between the 21–23 age group (S.deviation = 126.52) and the 24–25 age group (S.deviation = 136.69); corrected = .03.

Independent Variable	Dependent Variable	R^2	B	F	p	β	t	p
CTS	ERDS Total	.01	1.63	4.31	.04
			.36			.11	2.07	.04
	ERDS; Clearance	.01	1.68	2.20	.13
			.27			..08	1.48	.13
	ERDS Aims	.01	2.39	2.21	.13
			.32			.08	1.48	.13
	ERDS Impulce	.03	.72	10.29	.00
			.67			.17	3.20	.00
	ERDS Strategies	.00	1.82	1.35	.24
			.23			.06	1.16	.24
	ERDS Refusal to Accept	.01	1.44	3.42	.06
			.38			.09	1.85	.06

Table 10.

Regression analysis of the effect of childhood trauma score on emotion dysregulation scale and its sub-dimensions (N = 351).

The Mann-Whitney u test was applied to find out whether there was a difference between the groups in a romantic relationship in terms of the scores of all scales and sub-dimensions. As a result of this analysis, a significant difference was found between the groups having a relationship (S.deviation = 154.94, Mdn = 2.40) and not having a relationship (S.deviation = 188.69, Mdn = 2.55) in terms of TAS score U(349) = 11674.5, p < .01, in terms of ERDS openness score, a significant difference was found between there is a relationship (S.deviation = 159.91, Mdn = 2) and no relationship (S.deviation = 185.7, Mdn = 2) U(349) = 12329.5, p < .01,

A significant difference was found between there is a relationship in terms of ERDS goals score (S.deviation = 160.73, Mdn = 2.67) and there is no relationship (S.deviation = 185.2, Mdn = 3.33) U(349) = 12,439 p < .01, TAS A significant difference was found between there is a relationship in terms of difficulty in recognising emotions (S.deviation = 158, Mdn = 2.34) and there is no relationship (S.deviation = 186.85, Mdn = 2.43), U(349) = 12077.5, p = .01, TAS A significant difference was found between there is a relationship between (S.deviation = 156.22, Mdn = 2.40) and no relationship (S.deviation = 187.92, Mdn = 2.60) in terms of difficulty in expressing their emotions, U(349) = 11842.5, p = .01.

A simple linear regression test was applied to examine whether or not the effect of the participants’ CTS scores on the ERDS and its sub-dimensions would be observed. As a result of the analysis, the CTS can explain 1% of the change in ERDS, R2 = .01. When this model was analysed, a significant result was obtained F (1, 349) = 4.31, p = .04. CTS is effective on ERDS; (t(349) = 2.07, p = .04, β = .11). In addition, as a result of the analysis, the CTS can explain 3% of the change on ERDS Impulse. When this model was analysed, a significant result emerged; F (1, 349) = 10.29, p < .01. The CTS is effective on the ERDS Impulse (t (349) = 3.20, p < .01, β = .17). There was no significant effect of the CTS on the other variables, as shown in Table 10.

A simple linear regression test was performed to examine whether the participants’ TAS scores affected the ERDS and its sub-dimensions. As a result of the data obtained, TAS can explain 28% of the change in ERDS, R2 = .28. When this model was analysed, a significant result was obtained F (1, 349) = 133.23, p < .01. TAS is effective on ERDS; (t (349) = 11.54, p < .01, β = .52). As a result of the analysis, TAS can explain 42% of the change in the FGOS openness, R2 = .42. When this model was analysed, a significant result was obtained F (1, 349) = 252.36, p < .01. TAS is effective on FGOS openness; (t (349) = 11.54, p < .01, β = .65). As a result of the analyses performed, the childhood trauma question (CTQ) can explain 11% of the change in the change in the ERDS goals. When this model was analysed, a significant result emerged, as shown in Table 11.

Independent Variable	Dependent Variable	R^2	B	F	p	β	t	p
TAS	ERDS total	.28	.14	133.23	.00
			.91			.52	11.54	.00
	ERDS; clearance	.42	−.63	252.36	.00
			1.15			.65	15.89	.00
	ERDS Aims	.11	1.31	44.82	.00
			.71			.34	6.69	.00
	ERDS Impulce	.18	−.01	74.88	.00
			.87			.42	8.65	.00
	ERDS strategies	.24	−.09	108.57	.00
			.96			.49	10.42	.00
	ERDS refusal to accept	.19	.02	82.45	.00
			.90			.43	9.08	.00

Table 11.

Regression analysis of the effect of childhood traumas score on the Toronto alexithymia scale and its sub-dimensions.

A simple linear regression test was applied to examine whether the variable of being in a romantic relationship was effective on the ERDS and its sub-dimensions. As a result of the analyses, no significant effect of being in a romantic relationship on any variable was found.

4. Discussion

In this study, which aimed to examine the relationship between childhood traumas, alexithymia and emotion dysregulation in university students, significant relationships were found between the total scores and sub-dimensions of the scales. A significant relationship was found between the sub-dimensions of “impulse,” “strategies,” “non-acceptance,” “difficulty in recognising emotions” and “difficulty in expressing emotions,” which are the sub-parameters of DERS, and the sub-parameters of “emotional abuse,” “physical abuse” and “sexual abuse,” which are the sub-parameters of CTS. Emotional and physical abuse encountered in childhood causes alexithymia and difficulty in emotion regulation and affects sub-parameters such as impulse, strategies and non-acceptance. In summary, it can be said that there is a relationship between alexithymia, childhood traumas, and difficulty in emotion regulation, and they are predictors of each other.

Looking at the literature, it is generally seen that there is a positive relationship between alexithymia and childhood traumas and emotion regulation difficulties. Studies are showing that emotion regulation difficulties may develop as a result of traumatic events [48, 49]. It was concluded that there was a significant positive relationship between CTS and ERD sub-dimensions, and as CTS increased, ERD also increased [6, 50]. In the study conducted by O’Bryan and colleagues [51], it was found that there was a significant positive relationship between experiencing trauma and ERD in university students. When the literature is examined, it is seen that there is a causality between childhood traumas and difficulties in emotion regulation [6]. In the study conducted by Koser [52], it was found that participants with higher levels of childhood trauma had significantly higher emotion dysregulation scores. In the study conducted by Ünal [53], it was determined that there was a significant positive correlation between the total scores of difficulty in emotion regulation and childhood traumas of university students. In people with emotion dysregulation difficulties, this situation may cause a breakdown in their relationships and communication with people and cause psychological problems [50].

In the study, a significant negative correlation was found between ERDS and TAS in the sub-dimension of emotional neglect. In this case, it can be said that neglect experienced as a child affects alexithymia and emotion dysregulation. Since attachment forms the basis of child development, child abuse and neglect have important effects on the attachment process. Emotional neglect is caused by the failure to provide basic emotional needs such as love, affection, and attention to the child’s primary caregiver or caregivers [54]. Emotional neglect is in question in children whose basic needs are not met, and neglect-related disorders may occur in children [27]. In this study, a significant relationship was found between emotional and physical abuse experienced in childhood and the parameters of having difficulty in expressing emotions and expressing thoughts, which are among the dimensions of alexithymia. Bermond and colleagues [55] found that people who had experienced sexual abuse in childhood had higher levels of alexithymia than those who had not. It is suggested that childhood trauma is an important determinant in the observation of alexithymia in adulthood [56]. People with alexithymia symptoms have difficulty in interpersonal relationships because they have problems recognising and expressing emotions [57].

In this study, it was found that male participants had higher alexithymia scores. It can be said that male participants have more difficulty in recognising and expressing their emotions, and expressing their outward thoughts is more difficult than female participants. There are studies supporting these results in the literature. Kokkonen et al. [58] reported that 9.4% of male students and 5.2% of female students had alexithymia. In another study conducted by Levant et al. [59], it was found that the level of alexithymia was higher in male individuals. Contrary to all these data, there are also studies indicating that alexithymia is observed more in women [60]. Another data obtained from the research is the result that women are sexually abused more than men. There are studies supporting these data in the literature [30, 31]. Since it requires specific evidence and is taboo to discuss, it is believed that the prevalence of sexual abuse is lower than other types. In another study conducted in Turkey, it was observed that this situation was quite close proportionally [61].

In previous studies, psychopathological conditions, especially those involving meaning, were seen as mood and anxiety disorders [62, 63]. “Dysfunctional coping with emotions, depression, bipolar disorder, borderline personality disorder, substance use disorders, eating disorders and somatoform disorders are commonly seen” [63]. Expression problems in children are associated with difficulties in emotion regulation [63].In addition, aggression, which can manifest itself in negative emotional states, is seen as a condition related to an increase in cortisol reactivity and difficulty in emotion regulation [64].

The American Psychological Association [65] defines empathy as evaluating the other person within his/her life and conditions, trying to understand him/her and trying to experience his/her thoughts [66]. Empathy is divided into two empathic tendencies and empathic skills. The empathic tendency is innate and expresses the potential of people to empathise, while empathic skill includes the situations of empathising [67]. In addition, different researchers in the literature have defined empathy in different ways. According to Pala, empathy is the ability to put oneself in the place of the person with whom one is communicating while communicating with the other person and to look at events and situations from his/her point of view. In this way, it tries to understand the feelings and thoughts of the other person in a transparent way [67]. Kalisch ([68], p. 1548) states that empathy is the ability to correctly understand/perceive the emotions experienced by someone by entering their life and what they express, while at the same time emphasising that empathy is one of the basic elements in the interpersonal communication process. Spiro ([69], p. 843) states that empathy is the ability to understand the other person within the framework of our feelings and thoughts. Similar to other definitions [70], empathy is a cognitive feature based on understanding the events or situations, emotions, and perspectives of individuals. Wispe ([71], p. 316) stated that empathy is the attempt to understand all positive and negative emotions and experiences without being judged by someone who is personally known. Gladstein ([72], p. 468) stated that empathy is divided into two parts: cognitive and emotional empathy. Early maladaptive schemas constitute the core beliefs of individuals and are of great importance in determining the way people perceive the world. It has been stated that individuals with high levels of alexithymia have early maladaptive schemas such as social isolation, inadequate self-control, approval seeking, pessimism, suppression of emotions, punishment, self-sacrifice, and high standards [73]. Early maladaptive schemas are also known to affect people’s empathy and emotion regulation skills. It is thought that alexithymia, which is related to emotions, is also related to prefrontal functions that develop through sensory and motor experiences, early stress, parent-child relationships and peer relationships. It is stated that prefrontal functions have nine dimensions including management of bodily functions, harmonious communication, response flexibility, insight, intuition, conscience, fear management, empathy and emotion regulation [74, 75]. When we look at the emotional and physical parameters carried out and examined in our study, we can see that the findings are in line with this information. Empathy ability can also change in direct proportion to the environment in which the person grows up and is raised, but there was no difference between these parameters in our study.

In our study, we can say that the high rate of alexithymia found in men is due to the inability to express their emotions, the difficulty in recognising their emotions, the difficulty in realising their outward thoughts, and the inability to read the expressions of the people in front of them, and that their empathy skills are less than female participants. It is stated that as the level of alexithymia increases, the empathy level of individuals decreases [76]. Empathy, in its most general definition, is defined as the ability to understand and feel the feelings of the other person. Empathy is not a one-dimensional but a multidimensional concept. Empathy has two dimensions: cognitive empathy and emotional empathy. Cognitive empathy is defined as the ability to understand the feelings of the other person and emotional empathy is defined as the ability to feel the feelings of the other person [77, 78, 79]. It is emphasised that people with high levels of alexithymia have impaired empathy skills, and these people have difficulty taking the perspective of others [80, 81].

Empathy is defined as understanding the feelings of the other person and acting by taking this into account [79]. It has been stated that individuals with high levels of alexithymia have difficulty remembering emotional expressions and identifying facial expressions related to their empathy skills. It is also stated that the difficulty of individuals with high levels of alexithymia in situations that arouse emotion is associated with impairments in empathy skills [80]. In other words, it is known that people with high alexithymia levels may have difficulty understanding the emotions of others as well as having difficulty expressing their own emotions [81, 82]. In other words, it is thought that the difficulty experienced is not due to the inability to experience the emotion but to the difficulty in understanding and expressing it. For this reason, it is stated that alexithymia and emotional intelligence are two separate concepts negatively related to each other [78]. The inverse proportion between alexithymia and emotional intelligence supports the findings of the research on the lack of empathy skills that require people with high alexithymia to take the perspective of others [82]. To summarise, people with high alexithymia levels have difficulty understanding and defining their own emotions, and they also have difficulty understanding and defining the emotions of others. This situation is associated with the fact that people with high alexithymia have fewer empathy skills than people with low alexithymia.

Emotions, which are largely related to empathy, are generally stated as a form of positive expression, but emotion regulation is needed in cases where emotions cause dysfunctional behaviours. Emotion regulation includes increasing positive emotions, decreasing negative emotions and creating behavioural, experiential and physiological changes with these changes in emotional dynamics. In cases where emotion regulation cannot be done, difficulty in emotion regulation emerges [83], and in studies examining the relationship between alexithymia and emotion regulation, it is stated that people with high levels of alexithymia have more difficulty in emotion regulation [76]. In our research, we have shown the relationship between alexithymia and emotion regulation, and we see that there is a direct proportion between them: the higher the alexithymia rates, the higher the difficulty in emotion regulation.

In the study, it was concluded that individuals without romantic relationships were more alexithymic. Another finding of the study was that individuals with high emotion regulation difficulties explained only 1% of the romantic relationship. This significant relationship was explained by the sub-parameter of the emotion dysregulation scale, namely goals. Goals sub-parameter shows that individuals who have experienced negative emotions have difficulty in goal-oriented behaviours. There is a negative significant relationship between individuals’ romantic relationship satisfaction and emotion regulation difficulties. The negative relationship between these two variables can be interpreted as those who have difficulty regulating emotions have lower satisfaction with romantic relationships. In a study conducted, although no significant relationship was found between couples’ emotion regulation and romantic relationship satisfaction, significant relationships were observed in some sub-parameters of the ERDS. It was found that access to perceived emotion management mechanisms and satisfaction with romantic relationships had a positive and significant relationship for both men and women [84]. In other words, people who can access and apply emotion management tools more easily report higher levels of satisfaction in romantic relationships.

Another finding of the study was that a significant relationship was found between the age groups of 24–25 years under the title of openness, which is a sub-parameter of ERD. This shows that the 24–25 age group has more emotion regulation difficulties. There are different results about this issue in the literature. In the study conducted by Karataş [85], the scores of ERDS differ significantly according to age. According to the data obtained from Ünal’s [53] research, it was determined that there was a statistically significant and negative relationship between the scores obtained from the difficulty in emotion regulation scale and age.

Another result found in the study was that there was no significant difference between gender, where the person grew up and the person who raised them when they were young and ERD. In a study examining the relationship between self-compassion, childhood traumas and emotion dysregulation in university students, no significant result was obtained when the relationship between gender variable and emotion dysregulation scale scores was examined [53]. This result supports the findings of the study. Contrary to the findings, there are different results in the literature. In a study conducted by Bender et al. [86] between emotion regulation difficulties and anxiety, girls had more problems than boys. Gender variables may differ in some studies. In a study examining the relationship between emotion dysregulation difficulties and cognitive distortions of childhood traumas in adults, it was reported that women had more emotion dysregulation difficulties than men [87]. No statistically significant relationship was found with other sociodemographic variables (such as perceived economic level, educational level of mother and father, and father being alive).

5. Conclusion

Within the scope of the research, the relationship between alexithymia, childhood traumas and emotion dysregulation in university students was examined. Emotional neglect experienced as a child was found to affect alexithymia and emotion dysregulation, and it was found that emotional and physical abuse experienced in childhood may cause people to experience difficulty in recognising and expressing their emotions and difficulty in transferring their thoughts in adulthood. It was observed that male participants were more alexithymic than female participants, but women were sexually abused more than men. In addition, no significant relationship was found between variables such as gender, who they were raised by, where they grew up, parental education level, perceived economic level and having a physical illness.

6. Recommendations

• University students can receive clinical support for recognising and revealing their emotions.

• Research can be conducted with larger and different sample groups.

• In this study, the links between childhood traumas, alexithymia and general and sub-dimensions of problems regulating emotions were examined. The examination of childhood traumas and alexithymia scores in terms of various sociodemographic factors allows researchers to look at the mediating effects of various factors.

• New studies can be planned by reorganising the limitations of the study.

• Considering the results obtained, a relationship was found between childhood traumas and alexithymia emotion regulation difficulties; in this case, seminars can be organised for families and people who will have children, and families can be informed.

Abbreviations and symbols index

TAS	Toronto alextymia scale
CTS	childhood trauma scale
ERDS	emotional regulation difficulties scale
ERD	emotional regulation difficulties
Rs.	Spearman correlation sign
U	Mann-Whitney U test
S.	standard deviation
S. Deviation	standard deviation
N	sample number
P	level of significance
F	Anova score
Mdn	median
%	percentage
t.	T-test score
β	beta value
<	small
>	large