Childhood Trauma, Early Maladaptive Schema Domains, and Health Anxiety: A Cross-Sectional Study of Indirect Associations

How childhood trauma and early maladaptive schemas (EMS) are linked to health anxiety, and the role of schema domains in these associations, remain unclear. This study aimed to investigate the association between childhood total, emotional, and sexual trauma and health anxiety severity, illness consequences beliefs, and screen-positive health anxiety, and to estimate indirect associations via schema domains. A total of 507 individuals participated in the study in Greece (65.5% female; mean age = 36.82 years, SD = 11.66). Participants completed the Early Trauma Inventory Self-Report-Short Form, the Young Schema Questionnaire-Short Form 3, and the Short Health Anxiety Inventory. Hierarchical multiple linear and logistic regression, and mediation analyses were conducted using SPSS, the PROCESS macro, and R. In the adjusted models, significant specific indirect associations were observed via impaired autonomy and performance (IAP) between total and emotional childhood trauma and health anxiety severity, illness consequences beliefs, and screen-positive health anxiety. In this study, childhood trauma was retrospectively self-reported in adulthood, whereas EMS and health anxiety were assessed concurrently; therefore, trauma reports may be affected by recall bias, and temporal ordering cannot be established. Total childhood traumatic experiences, particularly emotional trauma, and IAP are associated with various aspects of health anxiety. Future intervention studies should examine whether Schema Therapy targeting EMS within the IAP domain reduces health anxiety among individuals with early trauma histories.