Somatic Problems in Children Disclosing Sexual Abuse: The Mediating Role of Alexithymia and Dissociation

Child sexual abuse (CSA) is linked to heightened levels of medically unexplained symptoms. Research indicates that victims of CSA display alexithymia and dissociation symptoms. Alexithymia and dissociation may potentially contribute to developing somatic complaints in CSA victims. They represent mechanisms through which psychological distress is avoided and could then manifest as physical symptoms like somatic problems (e.g. headaches, nausea, stomachache, etc.). This study aimed to investigate if alexithymia and dissociation are mechanisms explaining the link between CSA and somatic complaints. The sample included 245 children who had disclosed child sexual abuse and 100 non-abused children aged 6-12 years old. Results of a sequential mediation model revealed that the CSA-somatic complaints relationship was mediated by alexithymia and dissociation. This study suggests that intense negative emotion leads children to focus on external stimuli to reduce psychological suffering. To mitigate somatic problems in victims of CSA, treatment should target overregulation of affect, namely alexithymia, and dissociation. In the long term, this could prevent unnecessary diagnostic testing and delay in appropriate interventions.