Gender Differences in Emotion Dysregulation, Impulsivity, and Personality Disorder Traits: A Comparative Study of Pakistani University Students

Abstract

Background: Epidemiological studies have consistently documented gender differences in personality disorder (PD) prevalence, with females overrepresented in borderline and histrionic PDs and males overrepresented in antisocial, schizoid, and paranoid PDs. Emotion dysregulation (ED) and impulsivity are transdiagnostic mechanisms underlying PD pathology, yet gender differences in these mechanisms—and whether they explain gender differences in PD traits—remain poorly understood, particularly in non-Western cultural contexts.

Objective: This study examined gender differences in (a) emotion dysregulation (total and subscales), (b) impulsivity (total and subtypes), and (c) personality disorder traits across Clusters A, B, and C. We also tested whether gender moderates the ED-PD and impulsivity-PD relationships, and whether impulsivity mediates the ED-PD relationship differently for males and females.

Method: University students in Pakistan (N = 366; 183 male, 183 female; age 17–19 years) completed the Difficulties in Emotion Regulation Scale (DERS), Barratt Impulsiveness Scale (BIS-11), and Short-Form of the Coolidge Axis II Inventory (SCATI). Independent-samples t-tests, moderation analysis (PROCESS Model 1), and moderated mediation analysis (PROCESS Model 7) were conducted with 5,000 bootstrap resamples.

Results: Females scored significantly higher than males on DERS total (d = 0.31, p = .02), non-acceptance of emotional responses (d = 0.42, p < .001), limited access to strategies (d = 0.35, p = .01), and Cluster B traits (d = 0.44, p < .001). Males scored significantly higher on lack of emotional awareness (d = 0.38, p = .003), Cluster A traits (d = 0.29, p = .03), and motor impulsivity (d = 0.49, p < .001). No gender differences emerged for Cluster C traits. Gender did not moderate the ED-PD relationship (interaction B = -0.12, p = .18) or the impulsivity-PD relationship (interaction B = 0.08, p = .34). Mediation analysis revealed that impulsivity partially mediated the ED-PD relationship for both genders, with slightly stronger indirect effects for females (indirect = 0.112) than males (indirect = 0.086), though the difference was not significant (index of moderated mediation = -0.026, CI [-0.089, 0.041]).

Conclusions: Gender differences in ED and PD traits mirror Western clinical epidemiology, with females showing higher ED and Cluster B traits and males showing lower emotional awareness and Cluster A traits. However, the pathways from ED to PD traits—and from ED to impulsivity to PD traits—are gender-invariant, suggesting that while mean levels differ, the underlying mechanisms operate similarly for males and females. These findings have implications for gender-sensitive assessment and intervention, with cultural considerations for the Pakistani context where gender norms shape emotional expression and help-seeking.