Volume 1, Number 1 (2023)
Year Launched: 2023
Previous Issues

The Mediating Role of Childhood Traumas in the Relationship between Somatic Symptoms, Self-Perception, and Splitting in University Students

Volume 1, Issue 1, January 2023     |     PP. 1-17      |     PDF (1241 K)    |     Pub. Date: December 12, 2023
DOI: 10.54647/ajpc3181002    26 Downloads     658 Views  


Mahsum Avcı, Bingöl University, Turkey

This study aimed to examine the mediating role of childhood traumas in the relationship between somatic symptoms, self-perception and division in university students. Within the scope of the study, a total of 220 university students, 154 (70.0%) female and 66 (30.0%) male, participated in the study with the convenient sampling method, which is one of the non-random sampling methods. Since the study was conducted in predictive correlational design, Pearson Correlation Coefficient was used to determine the relationship between variables in the study. Then, Regression-based mediation analysis was performed for mediation through the Jamovi Package Program. In statistical analysis, the level of significance was taken as .05. Childhood trauma scores, which are mediator variables, have a positive relationship with somatic symptoms and division scores within the scope of the study, and a negative and low level significant relationship with self-perception scores. When childhood trauma level was included in the model as a mediator variable to this significant relationship, it was determined that the relationship between students' division levels and somatic symptom levels was statistically significant, but the effect decreased. According to this result, it was determined that the level of childhood trauma had a partial mediating role in the relationship between the social comparison level of university students and somatic symptoms. The model shows that childhood traumas negatively affect the division, somatic symptoms and self-perception of university students.

Childhood Trauma, Somatization, Split, Self-Perception, University Students

Cite this paper
Mahsum Avcı, The Mediating Role of Childhood Traumas in the Relationship between Somatic Symptoms, Self-Perception, and Splitting in University Students , American Journal of Psychology and Counselling. Volume 1, Issue 1, January 2023 | PP. 1-17. 10.54647/ajpc3181002


[ 1 ] Alkan, G. S. (2010). Coupling through projective identification: Bridging role of projective identification in the associations among early parenting experience, Yayınlanmamış Doktora Tezi, Ortadoğu Teknik Üniversitesi, Sosyal Bilimler Enstitüsü, Ankara.
[ 2 ] Aytaç, M., & Köse Karaca, B. (2017). Bölme Ölçeği’nin Türkçe formunun geçerlilik ve güvenilirlik çalışması. 15th European Congress of Psychology 11-14. Amsterdam, Netherlands.
[ 3 ] Barsky, A. J., Wool, C., Barnett, M. C., & Cleary, P. D. (1994). Histories of childhood trauma in adult hypochondriacal patients. The American Journal of Psychiatry, 151(3), 397–401.
[ 4 ] Bass, C., Bond, A., Gill, D., & Sharpe, M. (1999). Frequent attenders without organic disease in a gastroenterology clinic: patient characteristics and health care use. General hospital psychiatry, 21(1), 30-38.
[ 5 ] Bellis, M. A., Hughes, K., Leckenby, N., Perkins, C., & Lowey, H. (2014). National household survey of adverse childhood experiences and their relationship with resilience to health-harming behaviors in England. BMC Med 12, 72 (2014).
[ 6 ] Bendixen, M., Muus, K. M., & Schei, B. (1994). The impact of child sexual abuse—a study of a random sample of Norwegian students. Child abuse & neglect, 18(10), 837-847.
[ 7 ] Black, M., Dubowitz, H., & Harrington, D. (1994). Sexual abuse: Developmental differences in children's behavior and self-perception. Child Abuse & Neglect, 18(1), 85–95.
[ 8 ] Cantor, N., & Kihlstrom, J. F. (1987). Personality and social intelligence. Prentice Hall.
[ 9 ] Cash, T.F & Pruzinsky, T. (2002). Body image: a handbook of theory, research, and clinical practice. New York: Guilford Press, p. 65–126.
[ 10 ] Cicchetti, D., & Banny, A. (2014). A developmental psychopathology perspective on child maltreatment. In M. Lewis, & K. D. Rudolph (Eds.), Handbook of developmental psychopathology (pp. 723–741). Boston, MA: Springer US
[ 11 ] Chu, J. A., & Dill, D. L. (1990). Dissociative symptoms in relation to childhood physical and sexual abuse. The American Journal of Psychiatry, 147(7), 887–892.
[ 12 ] Cramer, P., & Block, J. (1998). Preschool antecedents of defense mechanism use in young adults: A longitudinal study. Journal of Personality and Social Psychology, 74(1), 159-169.
[ 13 ] Crosta, M. L., De Simone, C., Di Pietro, S., Acanfora, M., Caldarola, G., Moccia, L., ... & Di Nicola, M. (2018). Childhood trauma and resilience in psoriatic patients: A preliminary report. Journal of Psychosomatic Research, 106, 25-28.
[ 14 ] Cunningham, J., Pearce, T., & Pearce, P. (1988). Childhood sexual abuse and medical complaints in adult women. Journal of Interpersonal Violence, 3(2), 131-144.
[ 15 ] Dağ, I. (1991). Reliability and validity of the Turkish form of the SCL90–R. Türk Psikiyatri Derg, 2, 5-12.
[ 16 ] Derogatis, L.R. (1977). SCL-90: Administration, Scoring and Procedure Manual-I for the Revised Version. Baltimore, MD: John Hopkins Univ. School of Medicine, Clinical Psychometrics Unit.
[ 17 ] DiLillo, D., Lewis, T., & Loreto-Colgan, A. D. (2007). Child maltreatment history and subsequent romantic relationships: Exploring a psychological route to dyadic difficulties. Journal of Aggression, Maltreatment & Trauma, 15(1), 19–36.
[ 18 ] Dong, C., Xu, R., & Xu, L. (2021). Relationship of childhood trauma, psychological resilience, and family resilience among undergraduate nursing students: A cross‐sectional study. Perspectives in Psychiatric Care, 57(2), 852-859.
[ 19 ] Duhig, M., Patterson, S., Connell, M., Foley, S., Capra, C., Dark, F., ... & Scott, J. (2015). The prevalence and correlates of childhood trauma in patients with early psychosis. Australian & New Zealand Journal of Psychiatry, 49(7), 651-659.
[ 20 ] Ertek, İ. E., İlhan, M. N., Dikmen, A. U., & Gözükara, M. (2022). Prevalence and Association of Childhood Traumas, Dissociative Experiences and Post Traumatic Stress Disorder. GMJ, 33, 134-139.
[ 21 ] Gerson, M. J. (1984). Splitting: The development of a measure. Journal of Clinical Psychology, 40(1), 157-162.
[ 22 ] Granieri, A., La Marca, L., Mannino, G., Giunta, S., Guglielmucci, F. & Schimmenti, A.(2017. The relationship between defense patterns and DSM-5 maladaptive personality domains. Front. Psychol. 8, 19-26.
[ 23 ] Güleç, M. Y., Altintaş, M., İnanç, L., Bezgin, Ç. H., Koca, E. K., & Güleç, H. (2013). Effects of childhood trauma on somatization in major depressive disorder: The role of alexithymia. Journal of Affective Disorders, 146(1), 137-141.
[ 24 ] Kessler, R.C., McLaughlin, K.A., Green, J.G., Gruber, M.J., Sampson, N.A., Zaslavsky, A.M., et al. (2010). Childhood adversities and adult psychopathology in the WHO World Mental. Br J Psychiatry. 197(5), 378-385.
[ 25 ] Kirmayer, L. J., & Robbins, J. M. (1991). Three forms of somatization in primary care: prevalence, co-occurrence, and sociodemographic characteristics. The Journal of nervous and mental disease, 179(11), 647-655.
[ 26 ] Kisiel, C. L., & Lyons, J. S. (2001). Dissociation as a mediator of psychopathology among sexually abused children and adolescents. American Journal of Psychiatry, 158(7), 1034-1039. PMID: 11431224.
[ 27 ] Kramer, U., De Roten, Y., Perry, J.C. & Despland, J.N. (2009). Specificities of defense mechanisms in bipolar affective disorder: relations with symptoms and therapeutic alliance. J Nerv Ment Dis. 197(9):675-81. PMID: 19752647.
[ 28 ] Kramer, U., De Roten, Y., Michel, L., & Despland, J. N. (2009). Early change in defence mechanisms and coping in short‐term dynamic psychotherapy: Relations with symptoms and alliance. Clinical Psychology & Psychotherapy: An International Journal of Theory & Practice, 16(5), 408-417.
[ 29 ] Loos, M. E., & Alexander, P. C. (1997). Differential effects associated with self-reported histories of abuse and neglect in a college sample. Journal of Interpersonal Violence, 12(3), 340-360.
[ 30 ] Lopez, M. A., & Heffer, R. W. (1998). Self-concept and social competence of university student victims of childhood physical abuse. Child abuse & neglect, 22(3), 183-195.
[ 31 ] Magruder, K. M., McLaughlin, K. A., & Elmore Borbon, D. L. (2017). Trauma is a public health issue. European journal of psychotraumatology, 8(1).
[ 32 ] Negele, A., Kaufhold, J., Kallenbach, L., & Leuzinger-Bohleber, M. (2015). Childhood trauma and its relation to chronic depression in adulthood. Depression research and treatment. Article 650804.
[ 33 ] Nickel, R., & Egle, U. T. (2001). Coping with conflict as pathogenetic link between psychosocial adversities in childhood and psychic disorders in adulthood. Zeitschrift für Psychosomatische Medizin und Psychotherapie, 47(4), 332-347.
[ 34 ] Perry, J. C., Metzger, J., & Sigal, J. J. (2015). Defensive functioning among women with breast cancer and matched community controls. Psychiatry, 78(2), 156–169.
[ 35 ] Raschke, H. J., & Raschke, V. J. (1979). Family conflict and children's self-concepts: A comparison of intact and single-parent families. Journal of Marriage and the Family, 367-374.
[ 36 ] Roelofs, K., Keijsers, G. P., Hoogduin, K. A., Näring, G. W., & Moene, F. C. (2002). Childhood abuse in patients with conversion disorder. American Journal of Psychiatry, 159(11), 1908-1913.
[ 37 ] Rogers, C. R. (1975). The emerging person: A new revolution. In R. I. Evans, Carl Rogers: The man and his ideas (pp. 147–175). New York: Dutton.
[ 38 ] Sack, M., Boroske-Leiner, K., & Lahmann, C. (2010). Association of nonsexual and sexual traumatizations with body image and psychosomatic symptoms in psychosomatic outpatients. General Hospital Psychiatry, 32(3), 315-320.
[ 39 ] Sansone, R. A., Wiederman, M. W., & Sansone, L. A. (2001). Adult somatic preoccupation and its relationship to childhood trauma. Violence and Victims, 16(1), 39-47.
[ 40 ] Schnyder, U. (2013). Trauma is a global issue. European Journal of Psychotraumatology, 4.
[ 41 ] Shabanpour, R., Zahiroddin, A.R., Janbozorgi, M. & Ghaeli, P. (2012). Assessment of defense styles and mechanisms in iranian patients suffering from obsessive compulsive or panic disorders versus normal controls using Persian version of defense style questionnaire-40. Iran. J. Psychiatry 7(1):31-5. PMID: 23056115; PMCID: PMC3395963.
[ 42 ] Shapero, B.G., Black, S.K., Liu, R.T., et al. (2014). Stressful life events and depression symptoms: the effect of childhood emotional abuse on stress reactivity. J Clin Psychol.70(3):209‐223.
[ 43 ] Spertus, I. L., Yehuda, R., Wong, C. M., Halligan, S., & Seremetis, S. V. (2003). Childhood emotional abuse and neglect as predictors of psychological and physical symptoms in women presenting to a primary care practice. Child abuse & neglect, 27(11), 1247-1258.
[ 44 ] Spitzer, C., Spelsberg, B., Grabe, H. J., Mundt, B., & Freyberger, H. J. (1999). Dissociative experiences and psychopathology in conversion disorders. Journal of psychosomatic research, 46(3), 291-294.
[ 45 ] Stuart, S. & Noyes, R.J.(1999). Attachment and interpersonal communication in somatization. Psychosom J Consult Liaison Psychiatry, 40:34 – 43.
[ 46 ] Schilder, P. (1923). Das Körperschema. (The body scheme) Berlin: Springer
[ 47 ] Şahin, N.H. ve Şahin, N. (1992). Adolescent guilt, shame, and depression in relation to sociotropy and autonomy. The World Congress of Cognitive Therapy, Toronto. (pp. 17-21).
[ 48 ] Şar, V., Öztürk, P. E., & İkikardeş, E. (2012). Çocukluk çağı ruhsal travma ölçeğinin Türkçe uyarlamasının geçerlilik ve güvenilirliği. Türkiye Klinikleri Tıp Bilimleri Dergisi, 32(4), 1054-1063.
[ 49 ] Şar, V., Kundakci, T., Kiziltan, E., Bakim, B., & Bozkurt, O. (2001). Differentiating dissociative disorders from other diagnostic groups through somatoform dissociation in Turkey. Journal of Trauma & Dissociation, 1(4), 67-80.
[ 50 ] Teicher, M.H., Samson, J.A., Anderson, C.M., Ohashi, K. (2016). The efects of childhood maltreatment on brain structure, function and connectivity. Nat Rev Neurosci. 17(10):652–66.
[ 51 ] Taylor, S. E., Peplau, L. A., & Sears, D. O. (2006). Social psychology (12th ed.). New Jersey: Prentice Hall.
[ 52 ] Thompson, J.K. (1990) Body image disturbance: assessment and treatment. Elmsford (NY): Pergamon
[ 53 ] Xie, P., Wu, K., Zheng, Y., Guo, Y., Yang, Y., He, J., ... & Peng, H. (2018). Prevalence of childhood trauma and correlations between childhood trauma, suicidal ideation, and social support in patients with depression, bipolar disorder, and schizophrenia in southern China. Journal of affective disorders, 228, 41-48.
[ 54 ] Waldinger, R. J., Schulz, M. S., Barsky, A. J., & Ahern, D. K. (2006). Mapping the road from childhood trauma to adult somatization: the role of attachment. Psychosomatic medicine, 68(1), 129-135.
[ 55 ] Wang, L., Yin, Y., Bian, Q., Zhou, Y., Huang, J., Zhang, P., ... & Tan, Y. (2021). Immature defense mechanisms mediate the relationship between childhood trauma and onset of bipolar disorder. Journal of Affective Disorders, 278, 672-677.
[ 56 ] Warner, M. S. (2009). Defense or Actualization? Reconsidering the Role of Processing, Self and Agency within Rogers' Theory of Personality, Person-Centered & Experiential Psychotherapies, 8(2), 109-126.
[ 57 ] Watson, D. C. (2002). Predicting psychiatric symptomatology with the Defense Style Questionnaire-40. International Journal of Stress Management, 9(4), 275-287.
[ 58 ] Weiner, K.E. &Thompson, J.K. (1997). Overt and covert sexual abuse: relationship to body image and eating disturbance. Int J Eat Disord. 22:273–284.