Structural Relationship Model of Early Childhood Experiences and Suicidal Ideation: The Mediating Role of Emotion Regulation Deficits and Alexithymia
Keywords:
Early childhood experiences, suicidal ideation, emotion regulation deficits, alexithymiaAbstract
Purpose: The present study aimed to explain the structural relationship between early childhood experiences and suicidal ideation, with the mediating roles of emotion regulation deficits and alexithymia among university students.
Methods and Materials: This applied study employed a descriptive-correlational design based on structural equation modeling. The statistical population consisted of all students of the University of Tabriz during the 2024–2025 academic year, from whom 378 participants were selected using cluster random sampling. Data were collected using the Childhood Trauma Questionnaire (Bernstein et al., 2003), the Emotion Regulation Questionnaire (Gross & John, 2003), the Beck Scale for Suicidal Ideation (Beck, 1991), and the Toronto Alexithymia Scale (Bagby et al., 1994). Data were analyzed using Pearson correlation coefficients and structural equation modeling through SPSS-18 and AMOS-22 software.
Findings: The results indicated that adverse childhood experiences, emotion regulation deficits, and alexithymia all had significant positive effects on students’ suicidal ideation (p < .01). Emotion regulation deficits and alexithymia also played significant mediating roles in the relationship between adverse childhood experiences and suicidal ideation (p < .01). The final model accounted for 67% of the variance in suicidal ideation.
Conclusion: Adverse childhood experiences contribute to the development of suicidal ideation during university years by weakening emotional regulation capacities and increasing alexithymic traits.
Downloads
References
Agako, A., Ballester, P., Stead, V., McCabe, R. E., & Green, S. M. (2022). Measures of Emotion Dysregulation: A Narrative Review. Canadian Psychology/Psychologie Canadienne, 63(3), 376.
Atkinson, R., Nolen-Hoeksema, S., Bem, D., Smith, E., & Atkinson, R. (2024). Hilgard's Introduction to Psychology. Roshd.
Bagheri, M., Nematollahzadeh Mahani, K., & Pouramerollahi, M. (2020). The Mediating Role of Alexithymia in the Relationship between Coping Styles and Personality Traits with Obsessive-Compulsive Symptoms. Internal Medicine Today, 27(1), 62-81.
Bayliss, L. T., Christensen, S., Lamont-Mills, A., & du Plessis, C. (2022). Suicide Capability within the Ideation-to-Action Framework: A Systematic Scoping Review. PLoS One, 17(10), e0276070.
Besharat, M. A. (2013). Toronto Alexithymia Scale: Questionnaire, Administration Method, and Scoring: Persian Version. Developmental Psychology: Iranian Psychologists, 10(37), 90-92.
Bordalo, F., & Carvalho, I. P. (2022). The Role of Alexithymia as a Risk Factor for Self-Harm among Adolescents in Depression: A Systematic Review. Journal of affective disorders, 297, 130-144.
Colmenero-Navarrete, L., Garcia-Sancho, E., & Salguero, J. M. (2022). Relationship between Emotion Regulation and Suicide Ideation and Attempt in Adults and Adolescents: A Systematic Review. Archives of Suicide Research, 26(4), 1702-1735.
Deshpande, C. G. (2020). Suicide and Attempted Suicide. Geerwanjyoti Prakashan.
Dickie, D. T., Langhinrichsen-Rohling, J., & McAnulty, R. D. (2025). College students' adverse childhood experiences and their anticipated risky behaviors: Early maladaptive schemas and emotion regulation difficulties as potential mediators. Journal of American College Health, 73(8), 3134-3142. https://doi.org/10.1080/07448481.2024.2369854
Ebrahimi, H., Dezhkam, M., & Seghatoleslam, T. (2013). Childhood Traumas and Suicide Attempt in Adulthood. Iranian Journal of Psychiatry and Clinical Psychology, 19(4), 275-282.
Fitzhardinge, M., Blackman, L., & Pilkington, P. D. (2025). Adverse childhood experiences and emotional exhaustion in therapists: The mediating role of early maladaptive schemas. Clinical Psychology & Psychotherapy, 32(4), e70115. https://doi.org/10.1002/cpp.70115
Girard, C., & Almeida, T. C. (2025). Tracing the Impact of Adverse Childhood Experiences: Emotional Regulation and Substance Use Among French Prisoners and the General Population. Crime & Delinquency. https://doi.org/10.1177/00111287251335006
Hefazi Torghabeh, L., & Najafi, M. (2024). The Relationship between Childhood Trauma and Suicidal Ideation in Students: The Mediating Role of Mentalization and Mindfulness. Journal of Educational Psychology Studies, 21(56), 27-51.
Kamali Tabrizi, P., Balashour, B., Mohammadi, S., & Kamandlou, M. (2023). The Role of Perceived Stress, Alexithymia, and Mindfulness in Predicting Suicidal Ideation among Nursing Students. Nursing Management Quarterly, 12(2), 22-32.
Liu, L., Sun, Y., Wang, Y., Luo, N., Bai, R., Pan, M., & Wu, H. (2023). Impact of Alexithymia on Suicidal Ideation among Patients with Ovarian Cancer: A Moderated Mediation Model of Self-Perceived Burden and General Self-Efficacy. Supportive Care in Cancer, 31(3), 177.
Ludemann, J., Rabung, S., & Andreas, S. (2021). Systematic Review on Mentalization as Key Factor in Psychotherapy. International journal of environmental research and public health, 18(17), 9161.
Mohamed, B. E. S., & Ahmed, M. G. A. E. (2022). Emotional Intelligence, Alexithymia and Suicidal Ideation among Depressive Patients. Archives of Psychiatric Nursing, 37, 33-38.
Moshtaqi, S., & Hashemipour, F. (2024). Modeling Suicidal Ideation Based on Insecure Attachment Style, Mentalization Ability, and Alexithymia in Female Students. Journal of psychiatric nursing, 12(2), 98-110.
Nooraei, N., Goodarzi, M. A., & Aflakseir, A. (2024). The Mediating Role of Mentalization and Emotional Self-Regulation in the Relationship between Childhood Trauma and Suicidal Ideation. Clinical Psychology Quarterly, 16(2), 13-25.
Orsolini, L., Latini, R., Pompili, M., Serafini, G., Volpe, U., Vellante, F., & De Berardis, D. (2020). Understanding the Complex of Suicide in Depression: From Research to Clinics. Psychiatry Investigation, 17(3), 207.
Park, C. H. K., Lee, J. W., Lee, S. Y., Moon, J., Jeon, D. W., Shim, S. H., & Ahn, Y. M. (2020). Suicide Risk Factors across Suicidal Ideators, Single Suicide Attempters, and Multiple Suicide Attempters. Journal of psychiatric research, 131, 1-8.
Pruessner, L., Barnow, S., Holt, D. V., Joormann, J., & Schulze, K. (2020). A Cognitive Control Framework for Understanding Emotion Regulation Flexibility. Emotion, 20(1), 21-29.
Rahimzadeh Yengi Kand, A., Kord, B., & Aprooz, K. (2020). The Relationship of Defense Styles and Alexithymia with Suicidal Ideation. Cognitive Analytical Psychology Quarterly, 11(40), 13-24.
Sahle, B. W., Reavley, N. J., Li, W., Morgan, A. J., Yap, M. B. H., Reupert, A., & Jorm, A. F. (2021). The Association between Adverse Childhood Experiences and Common Mental Disorders and Suicidality: An Umbrella Review of Systematic Reviews and Meta-Analyses. European Child & Adolescent Psychiatry, 1-11.
Sajjadpour, S. H., Heydari Nasab, L., Shairi, M. R., & Gholami Fesharaki, M. (2021). Prediction of Suicidal Ideation Based on Components of Difficulties in Emotion Regulation in Patients with Suicidal Ideation. Journal of Military Medicine, 10(2).
Sher, L., & Oquendo, M. A. (2023). Suicide: An Overview for Clinicians. Medical Clinics, 107(1), 119-130.
Thompson, M. P., Kingree, J. B., & Lamis, D. (2019). Associations of Adverse Childhood Experiences and Suicidal Behaviors in Adulthood in a US Nationally Representative Sample. Child: Care, Health and Development, 45(1), 121-128.
Trevethan, M., & Francis, S. E. (2025). Protective Factors for Adverse Childhood Experiences: The Role of Emotion Regulation and Attachment. Journal of Child and Family Studies, 34(1), 25-40. https://doi.org/10.1007/s10826-024-02989-7
Wang, H., & Hall, N. C. (2018). A Systematic Review of Teacher Causal Attributions: Prevalence, Correlates, and Consequences. Frontiers in psychology, 9, 2305-2310.
Warrier, V., Kwong, A. S., Luo, M., Dalvie, S., Croft, J., Sallis, H. M., & Cecil, C. A. M. (2021). Gene-Environment Correlations and Causal Effects of Childhood Maltreatment on Physical and Mental Health: A Genetically Informed Approach. The Lancet Psychiatry, 8(5), 373-386.
World Health, O. (2020). Child Maltreatment. http://www.who.int/mediacentre/factsheets/fs150/en/index.html
Zahmatkesh, Y. (2022). Prediction of Suicidal Ideation Based on Alexithymia and Childhood Traumas in Divorced Women. Psychological Dynamics in Mood Disorders, 1(2), 47-55.
Downloads
Published
Submitted
Revised
Accepted
Issue
Section
License
Copyright (c) 2025 Touraj Hashemi (Author); Seyed Mahdi Hejazifar
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
