Gender Differences in Alexithymia, Emotion Regulation, and Impulsivity in Young Individuals with Mood Disorders

Abstract

Background/Objectives: Alexithymia, emotion regulation, and impulsivity are key factors in youths with mood disorders. However, gender differences within these dimensions remain insufficiently studied in this population. This study seeks to explore these dimensions in a sample of adolescents and young adults with mood disorders, aiming to identify gender-specific characteristics with important clinical implications. Methods: We assessed 115 outpatients aged 13 to 25 years with a DSM-5 diagnosis of mood disorder. The evaluation included the Toronto Alexithymia Scale (TAS-20), the Difficulties in Emotion Regulation Scale (DERS), and the UPPS-P Impulsive Behavior Scale. The associations with suicidal ideation were tested using two different multivariate models. Results were controlled for age and intelligence measures. Results: The first model (Wilks' Lambda = 0.720, p < 0.001) revealed significantly higher scores in women than men for TAS-20 (p < 0.001), DERS (p < 0.001), and the UPPS-P subscales "Lack of Premeditation" (p = 0.004) and "Lack of Perseverance" (p = 0.001). Regression analyses confirmed gender as a significant predictor of these variables, also controlling for age and intelligence. Furthermore, intelligence measure influenced Lack of Premeditation and age influenced Lack of Perseverance. Conclusions: Women with mood disorders exhibit greater alexithymia, emotional dysregulation, and impulsivity, particularly in difficulties with planning and task persistence. These findings highlight the need for gender-sensitive interventions that address emotional awareness and impulse control to improve clinical outcomes.

Keywords: adolescents; alexithymia; early intervention; emotion regulation; gender differences; impulsivity; mood disorders; psychiatric disorders; youth psychopathology.

Figure 1

Raincloud plots showing the distribution of scores obtained by females (F) and males (M): (a) on the Toronto Alexithymia Scale (TAS-20), (b) on the Difficulties in Emotion Regulation Scale (DERS), (c) on the Lack of Premeditation dimension of the UPPS-P Impulsive Behavior Scale (UPPS-P Premeditation), and (d) on the Lack of Perseverance dimension of the UPPS-P Impulsive Behavior Scale (UPPS-P Perseverance). (e) Distributions of aggregated z-scores, computed across the TAS-20, DERS, and UPPS-P subscales, are shown separately for each scale and for both groups (women and men), with corresponding box plots.