Mentalization as a Mediator between Developmental Trauma and ADHD Hyperactivity/Impulsivity Symptoms in Adolescent Boys: A Structural Equation Modeling Study
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Objective: This study examined whether mentalization mediates the association between developmental trauma and hyperactivity/impulsivity symptoms in adolescent boys.
Methods and Materials: In a descriptive-correlational design using structural equation modeling, 550 male students aged 13–17 years were selected through multistage cluster sampling from public and private secondary schools in Tehran. Participants completed the Childhood Trauma Questionnaire, the 14-item Persian Reflective Functioning Questionnaire, and the SNAP-IV self-report for ADHD symptoms. Data were analyzed using SPSS and AMOS 24. Confirmatory factor analysis supported three latent constructs (developmental trauma, mentalization, and ADHD symptoms), and the structural model was tested to estimate direct and indirect effects.
Findings: The measurement model showed acceptable fit (χ²/df = 2.84, CFI = 0.95, TLI = 0.92, RMSEA = 0.075). Developmental trauma was positively associated with ADHD symptoms (β = 0.38, p < .01) and negatively associated with mentalization (β = –0.35, p < .001). Mentalization, in turn, was inversely related to ADHD symptoms (β = –0.41, p < .001). The indirect path from developmental trauma to ADHD symptoms via mentalization was significant (β = 0.15, p < .001), indicating partial mediation. The model explained 29% of the variance in ADHD symptoms.
Conclusion: Developmental trauma is linked to greater hyperactivity/impulsivity in adolescent boys both directly and through reduced mentalization. Integrating trauma-informed, mentalization-focused approaches into school-based prevention and clinical interventions may help improve emotional regulation and reduce ADHD-related behavioral problems.
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