The effects of post-traumatic cognitions, psychosomatic pain, and fatigue on anxiety and panic disorder symptoms

Aims: This study aimed to investigate the effects of post-traumatic cognitions on psychosomatic pain and fatigue, and their relationship with anxiety and panic disorder symptomatology. It also examined the mediating role of psychosomatic symptoms in the association between post-traumatic cognitions and anxiety/panic disorder. Understanding these relationships can clarify the comprehensive impact of trauma on both psychological and physical health. Methods: The sample consisted of 448 adults aged 18-65 who reported traumatic experiences. Data were collected via online questionnaires, including the Post-Traumatic Cognitions Inventory (PTCI), SCL-90-R Somatisation Subscale, Beck Anxiety Inventory (BAI), and Panic Disorder Severity Scale (PDSS). Normality assumptions were assessed using skewness and kurtosis coefficients, and reliability was confirmed via Cronbach’s alpha. Pearson correlation, multiple regression, and mediation analyses (PROCESS Macro v4.2) were conducted. Group differences based on demographics were analysed using independent samples t-tests, one-way ANOVA, and Games-Howell post hoc tests where appropriate. Results: Post-traumatic cognitions were significantly positively associated with somatisation (B=0.06, β=0.39), anxiety (B=0.10, β=0.40), and panic disorder symptoms (B=0.05, β=0.33), with psychosomatic symptoms partially mediating these relationships. Female participants reported higher scores than males on all measures. Age differences were observed for somatisation, anxiety, and panic symptoms, with younger adults scoring higher. Education level significantly affected post-traumatic cognitions and anxiety scores, with lower-educated participants reporting higher levels. No significant differences were found in somatisation or panic symptoms by education. Conclusion: The findings highlight the significant influence of post-traumatic cognitions on both physical and psychological outcomes, emphasising the mediating role of psychosomatic symptoms. These results support the integration of cognitive and somatic-focused interventions in trauma-informed treatments.