Unveiling Adolescent Struggles: Exploring the Interplay of Childhood Trauma, Emotional Regulation, and Externalizing Symptoms

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Aim: This study examines the interaction between childhood trauma, emotional regulation, and externalizing symptoms among adolescents aged 13 to 19 years, elucidating the role of emotional regulation as a mediator in the relationship between childhood trauma and externalizing behaviors. Design: This study utilizes a cross-sectional observational study design. Method: A sample of 182 adolescents attending child and adolescent services was assessed. Demographic characteristics were analyzed using descriptive statistics. Childhood trauma was measured using the Childhood Trauma Questionnaire—Short Form (CTQ), emotional regulation through the Difficulties in Emotion Regulation Scale (DERS), and externalizing symptoms using the Child Behavior Checklist (CBCL). Analysis: Hierarchical multiple regression and mediation analyses were conducted to explore the relationships. Results: Most participants were 16–19 years old (66.5%), and 54.9% were female. Notably, childhood trauma positively correlated with externalizing symptoms ( r = 0.39, P < .001) and difficulties in emotion regulation ( r = 0.25, P < .01). Emotional regulation, as measured by DERS, exhibited a significant positive correlation with externalizing symptoms ( r = 0.23, P < .01). Hierarchical regression analysis revealed that emotional regulation played a significant role in predicting externalizing scores ( β = 0.358, P < .001). Mediation analysis demonstrated both direct (B = 0.16, P < .001) and indirect effects (B = 0.036, P = .0273) of childhood trauma on externalizing behaviors through emotional regulation. Conclusions: This study underscores the multifaceted nature of externalizing behaviors and highlights the interconnectedness of childhood trauma and emotional regulation in their manifestation. Findings suggest that utilizing emotion regulation strategies is pivotal in treatment of externalizing symptoms among adolescents presenting with traumatic history. The proposed mediation model provides valuable insights for developing targeted interventions and preventive strategies in clinical settings.