Alexithymia, Empathy, Temperament, and Emotion Dysregulation in Boys with Conduct Disorder

Abstract Background: Emotion-dysregulation frameworks emphasize impaired regulation of emotion in conduct disorder (CD). Alexithymia and empathy are theoretically linked to this framework but have rarely been examined together in youth with CD. Aim: The aim of this study was to examine alexithymia and empathy in boys with CD, aged 12 to <18 years, and their associations with temperament and emotion dysregulation, relative to matched typically developing controls. Materials and Methods: Seventeen boys with CD and 17 age- and education-matched controls completed child- and parent-rated alexithymia measures, an empathy questionnaire, the Difficulties in Emotion Regulation Scale, and a temperament questionnaire in a cross-sectional design. Group comparisons used Mann–Whitney U -tests; associations were examined using Kendall’s Tau (age) and Spearman’s correlations (within the CD group). Results: Self-reported alexithymia did not differ between groups, but parent-rated alexithymia and emotion-regulation difficulties were significantly higher in the CD group. The CD group also showed higher aggression and frustration. Depressive mood showed a nonsignificant upward trend. Within the CD group, self-and parent-rated alexithymia were positively correlated; parent-rated alexithymia correlated with aggression. Affiliation and attention were correlated positively with empathy. Attention and fear correlated negatively with emotion dysregulation. Age was unrelated to alexithymia or empathy. Conclusion: Parent-reported alexithymia and temperamental vulnerability – particularly Aggression and Frustration – appear central to the emotion-dysregulation profile of CD. Early identification of these factors, together with parental involvement in assessment, may inform prevention and intervention.