Journal of Shandong University (Health Sciences) ›› 2026, Vol. 64 ›› Issue (5): 96-105.doi: 10.6040/j.issn.1671-7554.0.2025.1388

• Public Health and Preventive Medicine • Previous Articles     Next Articles

Relationship between childhood abuse and frequent nightmares in adults with depressive disorders: mediating effect of somatic symptoms and moderating role of social support

MA Yihan1, YUAN Xinyun1, LI Jiani1, HAN Xu2, DIAO Qidi3, WANG Yan3, CHU Xu1, ZHANG Kun1, HU Lei3   

  1. 1. Medical Integration and Practice Center, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong, China;
    2. School of Mental Health, Jining Medical University, Jining 272067, Shandong, China;
    3. Shandong Mental Health Center(Shandong University Affiliated Mental Health Center), Jinan 250014, Shandong, China
  • Online:2026-05-13 Published:2026-05-13

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Abstract: Objective To investigate the associations among childhood maltreatment, somatic symptoms, and frequent nightmares in adults with depressive disorder, and to examine the moderating role of social support and the influence of key confounding factors. Methods A convenience sample of 264 adult patients diagnosed with depressive disorder was recruited. Participants completed the childhood trauma questionnaire-short form(CTQ-SF), the patient health questionnaire-15(PHQ-15), and the social support rating scale(SSRS). A moderated mediation model was tested using the SPSS 27.0 Process macro. Results Correlation analysis showed that nightmare frequency was positively correlated with somatic symptoms(P<0.001)and childhood maltreatment(P<0.01), whereas social support was negatively correlated with both somatic symptoms(P<0.05)and childhood maltreatment(P<0.001). Somatic symptoms fully mediated the association between childhood maltreatment and nightmare frequency( β=0.008 1, 95%CI: -0.004 8-0.021 0). Social support significantly strengthened the first half of the mediation pathway( β=0.010 4, P=0.010), with the effect of childhood maltreatment on somatic symptoms being greater at high levels of social support compared to medium-low levels. After adjusting for covariates-including sex, psychotropic medication use, and smoking-the moderating effect was attenuated to marginal significance(P=0.041). Female sex, use of sedative-hypnotic medications, and smoking may independently predict either somatic symptoms or nightmare frequency. Conclusion Somatic symptoms fully mediate the relationship between childhood maltreatment and nightmare frequency in adults with depressive disorder. Social support moderates this pathway, although this effect is partially confounded by factors such as sex and medication use. Clinical interventions should particularly target patients with high levels of social support to alleviate somatic symptoms.

Key words: Depressive disorder, Childhood maltreatment, Social support, Somatic symptoms, Nightmare frequency, Moderated mediation model

CLC Number: 

  • R749
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