Cognitive Flexibility Mediates the Impact of Adverse Childhood Experiences on Somatization
Keywords:
Adverse Childhood Experiences, Cognitive Flexibility, Somatization, Structural Equation Modeling, Trauma, Mediation AnalysisAbstract
This study aimed to examine whether cognitive flexibility mediates the relationship between adverse childhood experiences (ACEs) and somatization in adults. A descriptive correlational design was employed using data from 440 adult participants in the United States. The sample size was determined based on the Morgan and Krejcie table. Participants completed standardized self-report measures including the Adverse Childhood Experiences Questionnaire (ACE-Q), the Cognitive Flexibility Inventory (CFI), and the Patient Health Questionnaire-15 (PHQ-15) for somatization. Data were analyzed using SPSS-27 for descriptive statistics and Pearson correlation coefficients, and AMOS-21 was used for Structural Equation Modeling (SEM) to test the hypothesized mediation model. The results revealed that ACEs were positively correlated with somatization (r = .46, p < .001) and negatively correlated with cognitive flexibility (r = –.39, p < .001). Cognitive flexibility also showed a significant negative correlation with somatization (r = –.41, p < .001). The structural model demonstrated good fit (χ²/df = 2.21, GFI = .96, CFI = .97, RMSEA = .052). SEM results indicated that ACEs significantly predicted somatization both directly (β = .31, p < .001) and indirectly through cognitive flexibility (β = .10, p < .001), with a total effect of β = .41 (p < .001). The mediating role of cognitive flexibility was statistically significant, confirming partial mediation. These findings suggest that cognitive flexibility plays a protective role in the pathway from childhood adversity to physical symptom expression. Interventions aimed at enhancing cognitive flexibility may reduce the severity of somatization among trauma-exposed individuals and contribute to more effective trauma-informed care.
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