Body Emotional Investment and Emotion Dysregulation in a Sample of Adolescents with Gender Dysphoria Seeking Sex Reassignment

Abstract

Adolescents with gender dysphoria (GD) often have internalizing symptoms, but the relationship with affective bodily investment and emotion dysregulation is actually under-investigated. The aims of this study are: (1) the comparison of Self-Administrated Psychiatric Scales for Children and Adolescents’ (SAFA), Body Investment Scale’s (BIS), and Difficulties in Emotion Regulation Scale’s (DERS) scores between GD adolescents (n = 30) and cisgenders (n = 30), (2) finding correlations between body investment and emotion regulation in the GD sample, (3) evaluating the link between these dimensions and internalizing symptomatology of GD adolescents. In addition to the significant impairment in emotion regulation and a negative body investment in the GD sample, Spearman’s correlation analyses showed a relationship between worse body protection and impaired emotion regulation, and binary logistic regressions of these dimensions on each SAFA domain evidenced that they may have a role in the increased probability of pathological scores for depression. Our results focused on the role played by emotion regulation and emotional investment in the body in the exacerbating and maintenance of internalizing symptoms, in particular depression, and self-harming behaviors in GD adolescents.

Mental health profile in adolescents with Gender Dysphoria requiring Gender Affirmation: the experience of the University Hospital of Bari

“…Moreover, it is widely thought that there is an emotion-regulatory function of self-harm, and several research results support the existence of an emotion dysregulation trait among people who engage in these behaviors, which could decrease the perception of negative affect in many different ways: both intrapersonal, arising from within a person, and/or interpersonal [21]. In adolescents with GD a bidirectional link between low protective attitudes towards one's body and greater di culty in regulating emotions seems to exist [20] considering that they must learn to control emotions in adaptive ways to promote social functioning and psychological well-being despite social rejection, stigma, discrimination, violence and victimization, low access to health care providers experienced in transgender health, and limited availability of a multidisciplinary team of experts [55,56].…”

“…It is known that emotion dysregulation acts as a transdiagnostic factor of vulnerability for multiple psychiatric disorders [35]. Adolescents experiencing gender incongruities are exposed to a greater emotional burden than cisgender ones, both because of the increased social pressures they face and the complex maturation of their emotional regulation skills [20]. Although previous research has indicated that individuals with an early onset of GD could experience higher distress than individuals with a late onset which are usually older and potentially better at coping with distress [17], our results agree with more recent literature data and could support the idea that adolescents who experience gender incongruence later in time probably have fewer opportunities to adapt to such emotional and social burden [21,36].…”

“…A growing body of research reveals that youths with GD experience a range of psychiatric disorders at higher rates than the general population, including depression, anxiety, eating disorders and self-harm [15,16] and that early transitioning people may similarly manifest higher levels of emotional and behavioral symptoms [17]. To our knowledge there are quite a number of studies examining the psychopathological aspects in adolescent GD [18,19] but still few data examine body investment and emotion regulation in this population [20] despite the role that these dimensions may have in determining self-harm [21]. Considering such premises, the objective of this study is to clinically describe a sample of adolescents with Gender A rmation request who referred to the Child and Adolescent Neuropsychiatry and Psychiatry Units, Translational Biomedicine and Neurosciences (DiBraiN), University of Bari, Italy, in the attempt to better characterize internalizing symptoms, emotion regulation ability, and emotional investment in the body depending on whether the GD onset was early or late in life and whether GD is associated with selfharm or not.…”

Emotional dysregulation and eating symptoms in gender dysphoria and eating disorders: the mediating role of body uneasiness

“…Madeddu et al (2009) found a 22% prevalence of Cluster B personality disorders, characterized by outbursts of anger and impulsivity. Moreover, a recent study on adolescents with GD described a link between negative emotional investment in the body and broader difficulties regulating and managing negative emotions (Petruzzelli et al, 2022). Of note, a study by Lingiardi et al (2017), which applied the SWAP-200 to a sample of GD individuals, identified a histrionic/extroverted personality subtype characterized by emotional impulsivity, theatrical behavior, and lack of empathy, while also linking this personality profile to self-image stability, identity coherence, and body satisfaction.…”

Evidence of Validity, Invariance, and Reliability of the Body Image Dimension in the Body Investment Scale: A Study in Spanish University Students

“…This expansion prompted extensive studies on this construct in relation to mental health issues. Previous research has established connections between body investment factors and suicide risk, distinguishing between suicidal and non-suicidal individuals [2][3][4], the onset of depressive symptoms [5], non-suicidal self-injury behaviors [6], and acting as a mediator between emotion dysregulation and gender dysphoria in adolescents [7]. Additionally, it has been associated with physical health conditions; studies post-surgery have indicated that wound dehiscence negatively impacts body investment [8].…”