The impact of childhood trauma on both psychopathology and personality dysfunction is well documented in the literature (e.g., McKay et al., 2021; McLaughlin et al., 2020; Stepp et al., 2016; Battle et al., 2004). Such trauma typically involves repeated, relationally rooted adverse experiences in early development, such as physical, emotional and sexual abuse, and chronic emotional neglect (APA, 2013). Early childhood represents a sensitive period for brain maturation, during which environmental factors exert a particularly strong influence (Soares et al., 2021; Cecil et al., 2020; Herzog and Schmahl, 2018). Trauma in this period can significantly disrupt psychophysiological development and is considered a major risk factor for the onset of psychopathology and personality disorders (PDs; Felitti and Anda, 2010; Stepp et al., 2016; Herzog and Schmahl, 2018). Traumatic experiences are consistently associated with enduring difficulties in emotion regulation, mentalization, identity development, and interpersonal functioning (Cloitre et al., 2019; Herzog and Schmahl, 2018; Luyten et al., 2020a), all core domains of personality pathology. Individuals with PDs report higher rates of childhood maltreatment, including emotional and physical abuse and neglect (Bierer et al., 2003; Tyrka et al., 2009), with emotional abuse in particular emerging as a key predictor of psychopathological outcomes in adulthood (Alnassar et al., 2024). Early trauma has also been shown to affect and shape personality traits, increasing vulnerability to guilt, depression, low self-esteem, hostility, impulsivity, and social difficulties (Gander et al., 2024).

The Alternative Model for Personality Disorders (AMPD) conceptualizes personality disorders (PDs) as impairments in personality functioning, emphasizing a dimensional rather than a categorical approach (APA, 2013). It focuses on two core dimensions: self- and interpersonal functioning. These impairments, combined with pathological personality traits, define the severity and expression of personality pathology. Rather than fixed categories, personality disorders are understood as varying along a continuum of severity and trait expression, allowing for a more complex and individualized assessment (Krueger and Hobbs, 2020). While the AMPD acknowledges childhood trauma as a critical etiological factor influencing the different domains, it offers less insight into the mechanisms that confer self- and interpersonal dysfunction from childhood trauma.

A growing body of evidence highlights epistemic trust (ET) as an important mechanism linking early trauma to personality dysfunction (e.g., Kampling et al., 2022; Knapen et al., 2025; Luyten et al., 2020b), and as a core element within the developmental psychopathology framework, alongside neurobiological and psychological factors (Fonagy et al., 2017; Luyten et al., 2020a). ET refers to the capacity to treat social communication as trustworthy, relevant, and generalizable, facilitating social learning, stable relationships, and the development of a coherent sense of self (Fonagy and Allison, 2014; Fonagy, Luyten and Allison, 2015, Fonagy, Luyten, Allison and Campbell, 2017). By contrast, epistemic mistrust (EM) reflects a chronic stance of epistemic vigilance, marked by the assumption that others' intentions are untrustworthy or malevolent. This stance undermines attachment, mentalization, and the integration of social feedback, leading to impairments in interpersonal functioning (Fonagy, Luyten and Allison, 2015, Fonagy, Luyten, Allison and Campbell, 2017; Luyten et al., 2020b; Campbell et al., 2021; Kumpasoğlu et al., 2025). When children are exposed to chronic or severe adversity, such as emotional neglect or abuse, they may develop a hypervigilant, mistrustful orientation toward others (Fonagy et al., 2017; Luyten et al., 2020b). Over time, this adaptive response can become rigid and resistant to change, giving rise to enduring doubts about others' intentions, and contributing to epistemic freezing, a state that blocks social learning and reinforces dysfunctional interpersonal patterns (Fonagy, Luyten and Allison, 2015, Fonagy, Luyten, Allison and Campbell, 2017; Luyten et al., 2020b).

EM contributes to impairments in self-functioning and increases vulnerability to psychopathology, particularly PDs (Fonagy et al., 2017; Luyten et al., 2020b; Lashani et al., 2025; Kampling et al., 2022). By impairing relational learning, EM contributes to identity diffusion, emotion dysregulation, and maladaptive interpersonal patterns (Fonagy, Luyten and Allison, 2015, Fonagy, Luyten, Allison and Campbell, 2017; Luyten, Campbell, Allison and Fonagy, 2020a, Luyten, Campbell and Fonagy, 2020b; Kumpasoğlu et al., 2025). From this perspective, PDs can be seen as adaptive communicative strategies developed in hostile or unpredictable environments, manifestations of disrupted relational processes (Fonagy et al., 2017; Luyten et al., 2020b).

The focus on dynamic relational processes in the literature regarding EM is closely aligned with key concepts of Control Mastery Theory (CMT; Weiss et al., 1986), which emphasizes the role of pathogenic beliefs and interpersonal guilt in the development and maintenance of functional psychopathology (Gazzillo, 2023; Silberschatz and Aaefjes-van Doorn, 2017; Faccini et al., 2020; Leonardi et al., 2022a; Leonardi et al., 2023). According to CMT, pathogenic beliefs associate the pursuit of healthy and adaptive goals with dangers (Gazzillo, 2023), either internal (e.g., painful emotions such as fear, shame, guilt) or external (e.g., punishment, loss, or harm to oneself or others, or to important relationships). An example of such a belief might be: “If I didn't take care of others' needs before my own, then my loved ones would be hurt, and I would be selfish”. These beliefs typically originate in childhood or adolescence, in response to traumatic or threatening experiences — situations that severely, repeatedly, or persistently undermine a person's sense of safety (Fimiani et al., 2020) — and shape perception, cognition, motivation, and emotion, thereby contributing to the formation of personality and to its dysfunction (Gazzillo, 2023; Gazzillo et al., 2021).

Safety is a central concept in CMT (Fiorenza et al., 2023), conceived as a biologically rooted need that individuals pursue constantly and largely unconsciously in everyday life (Weiss, 2005; Bowlby, 1988). Consistently, and in line with research data (for a review see Leonardi, Gazzillo & Dazzi, 2022b; Tomasello and Vaish, 2013), CMT posits that internal, often unconscious, evaluations of safety and danger shape psychological functioning from early life, guiding how individuals adapt and react to relational environments (Sampson, 1990; Weiss et al., 1986).

Within this framework, a central consequence of pathogenic beliefs is the development of interpersonal guilt, a form of guilt rooted in relational experiences, which plays a key role in psychopathology. CMT identifies five distinct forms of interpersonal guilt (Weiss et al., 1986): survivor guilt (Fimiani et al., 2021), which stems from the belief that achieving more success, satisfaction, or positive traits than significant others may cause them harm; separation/disloyalty guilt, rooted in the belief that physical or emotional separation and differentiation from important figures may hurt them; omnipotent responsibility guilt (Gazzillo et al., Forthcoming), based on the belief of having both the duty and the power to ensure the happiness of loved ones, leading to the idea that prioritizing personal needs is selfish; self-hate (Gazzillo and Kealy, 2025), which reflects the belief of being inherently bad, unworthy, or inadequate and undeserving of love and protection; and burdening guilt (Gazzillo and Leonardi, 2023), which arises from the belief that expressing one's needs and emotions is a burden to others.

Empirical studies have linked interpersonal guilt to a range of psychological problems, including anxiety, depression, shame, pathological worry, and rumination (Faccini et al., 2020; Leonardi et al., 2020; Leonardi et al., 2023), as well as attachment-related avoidance and anxiety (Leonardi et al., 2022a; Leonardi et al., 2023). Among these guilt types, self-hate emerges as particularly significant, being closely associated with personality pathology (Faccini et al., 2020; Gazzillo et al., 2018; Kealy et al., 2021) and predicting both personality disorders, difficulties in mentalization, and attachment insecurity (Leonardi et al., 2022a; Leonardi et al., 2025). Self-hate, along with burdening guilt, frequently emerges as consequences of past traumatic experiences (Faccini et al., 2020; Leonardi et al., 2023) and shows strong associations with PTSD severity, and trauma-related guilt (McCue et al., 2024). Notably, self-hate is the only form of guilt not associated with empathy and shows a negative correlation with social desirability (Faccini et al., 2020; Leonardi et al., 2023).

Moreover, self-hate, survivor guilt, omnipotent responsibility guilt and separation/disloyalty guilt appear more prevalent among individuals who grew up feeling responsible for supporting their caregivers, perceived their caregivers as more troubled than themselves, or experienced their independence as harmful to their caregivers (Faccini et al., 2020). Consistent with these findings, survivor guilt has been empirically linked to severe psychopathology, including severe PTSD, drug and alcohol use, heightened suicide risk, impostor syndrome and self-handicapping and self-sabotaging behaviors (Fimiani et al., 2024; Henning and Frueh, 1997; Murray, 2018; Hendin and Haas, 1991). Additionally, survivor guilt, along with self-hate, is negatively correlated with therapeutic alliance, affecting patients' engagement and progress in therapy (Faccini et al., 2020). Self-hate and burdening guilt are also related to difficulties in emotion regulation, frustration tolerance and body appreciation, while mentalization impairments have been linked to self-hate and separation/disloyalty guilt (Leonardi et al., 2025). Finally, all forms of guilt have been found to negatively impact self-esteem, well-being, and overall mental health (Faccini et al., 2020; Leonardi et al., 2023).

Although both interpersonal guilt and epistemic mistrust have been independently linked to early trauma and personality dysfunction, to our knowledge no empirical study has examined their relationship, nor their combined contribution to this association. Therefore, the hypotheses of the present study are as follows:1)

There will be significant correlations between childhood trauma dimensions, the different types of interpersonal guilt, epistemic mistrust, and personality dysfunction. Specifically: a) the different types of childhood trauma will be positively associated with higher levels of personality dysfunction, interpersonal guilt, and epistemic mistrust. b) Among interpersonal guilt types, self-hate, burdening guilt, and survivor guilt will show stronger correlations with the different types of childhood trauma, personality dysfunction, and epistemic mistrust compared to the other guilt types.

2)

Exploratory regression analyses will be conducted to investigate which types of childhood trauma are most strongly associated with interpersonal guilt, in order to identify the trauma dimension most relevant to subsequent mediation analyses.

3)

Interpersonal guilt types – specifically self-hate, burdening guilt, and survivor guilt – and epistemic mistrust will mediate the relationship between the specific childhood trauma dimension(s) emerging from Hypothesis 2 and impairments in personality functioning. Both parallel and sequential mediation pathways involving interpersonal guilt and epistemic mistrust will be examined.