The mediating role of alexithymia in the relationship between childhood trauma and exercise addiction

AI Summary

Alexithymia statistically mediated the association between childhood trauma and exercise addiction severity in regularly exercising adults.
Difficulty identifying feelings (DIF) correlated positively with exercise dependence; externally oriented thinking showed weak, non-significant correlations.
Assessment of exercise addiction should include alexithymic traits and childhood trauma history, as emotion-processing deficits may connect early adversity to maladaptive exercise.

Front Psychol. 2026 May 18;17:1803371. doi: 10.3389/fpsyg.2026.1803371. eCollection 2026.

ABSTRACT

BACKGROUND: Childhood trauma (CT) is a risk factor for addictive behaviors, including exercise addiction (EA). Alexithymia-difficulties in identifying and describing emotions-is associated with both CT and addiction. This study tested whether alexithymia mediates the relationship between CT and EA.

METHODS: In this cross-sectional study, 301 adults who exercised regularly (≥6 h/week) completed the Exercise Dependence Scale-21 (EDS-21), Toronto Alexithymia Scale-20 (TAS-20), and Adverse Childhood Experiences Questionnaire (ACE-Q). Group comparisons (alexithymia vs. non-alexithymia), Pearson correlations, and regression-based mediation analyses were performed.

RESULTS: Participants with alexithymia (n = 102) had significantly higher EDS-21 total and subscale scores than those without alexithymia (n = 199) (all p < 0.001). ACE-Q total scores did not differ significantly between groups, but were positively correlated with TAS-20 total score and difficulty identifying feelings (DIF). EDS-21 total and subscale scores were positively correlated with DIF, whereas correlations with externally oriented thinking (EOT) were generally weak and non-significant. In the mediation model, ACE-Q total score was significantly associated with EDS-21 total score (β = 0.180, p = 0.002), but this association no longer remained significant after TAS-20 total score was entered as a mediator (β = 0.090, p = 0.133). The indirect effect of ACE-Q on EDS-21 through TAS-20 was significant based on bias-corrected bootstrapped 95% confidence intervals.

CONCLUSION: Alexithymia statistically mediated the association between childhood trauma and exercise addiction severity in regularly exercising adults. These findings suggest that emotion-processing deficits may represent one pathway linking early adversity to maladaptive exercise patterns. Assessment of exercise addiction may therefore benefit from considering both alexithymic traits and childhood trauma history.

PMID:42233063 | PMC:PMC13222777 | DOI:10.3389/fpsyg.2026.1803371

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