When the body speaks for the mind: A parallel–serial mediation model of trauma, epistemic trust, reflective functioning, and somatic symptoms in emerging adults

Objective: Childhood trauma is a well-known risk factor for somatic symptoms, but the psychological mechanisms behind this link remain insufficiently understood. This study explored the association between childhood trauma and somatic symptoms through epistemic trust and reflective functioning in emerging adults. Method: Data from 2,041 emerging adults (M = 23.91 years, SD = 2.87; 72% identified as female) were analyzed. Latent profile analysis identified childhood trauma exposure profiles. Structural equation modeling tested a parallel-serial mediation model examining the direct and indirect effects of trauma on somatic symptoms (15-item Patient Health Questionnaire), with epistemic stances (trust, mistrust, credulity) and reflective functioning (uncertainty and certainty about mental states) as mediators. Indirect effects were estimated using bootstrapping with 1,000 resamples. Results: Two trauma profiles emerged, high trauma (n = 626) and low trauma (n = 1,415), reflecting a pattern of generalized severity. Membership in the high-trauma profile was linked to greater somatic symptoms through two serial pathways. Trauma was associated with higher mistrust and credulity, which predicted greater uncertainty about mental states and, in turn, higher levels of somatic symptoms. In a second pathway, trauma-related mistrust, but not credulity, was linked to greater certainty about mental states, also predicting somatic symptoms. Conclusions: Findings highlight how early relational trauma is associated with maladaptive epistemic stances and impaired reflective functioning, which in turn was associated with greater vulnerability to somatic distress. Interventions aimed at restoring epistemic trust and tolerance for mental-state uncertainty may mitigate somatic symptoms among trauma-exposed emerging adults. Clinical Impact Statement This study examines why some trauma-exposed young adults may primarily experience their emotional distress through physical symptoms. It shows that childhood trauma is associated with distorted trust in others and difficulties in understanding mental states, which in turn is linked to somatic symptoms. These insights emphasize the importance of addressing trust and mentalizing processes in therapy. Helping clients rebuild confidence in others and tolerate uncertainty about their own and others' minds may reduce physical expressions of psychological pain.