Introduction
Adolescence is a crucial developmental stage characterized by significant physiological, psychological, social, and cognitive changes, which often heighten vulnerability to mental health disorders, with depression being one of the most common. Affecting approximately 4.5% of adolescents, depression can impair social skills, relationships, and academic performance. Moreover, depression in children and adolescents often co-occurs with other psychological disorders. According to the DSM-5, depression is diagnosed when a persistently depressed mood or reduced interest lasts for at least two weeks, accompanied by at least four specific symptoms, including sleep disturbances, changes in appetite, low energy, and thoughts of death or suicide. It is primarily an internalizing disorder, frequently emerging through negative thought patterns, and its symptoms may remain unnoticed by caregivers, making early detection and intervention critical. Recent research has increasingly emphasized alexithymia—the difficulty in recognizing and expressing emotions—as a key factor contributing to depression. Studies by Kieraité et al. (2024) and Tang et al. (2022) have demonstrated that emotional awareness deficits and shifts in alexithymia are predictive of depression. While resilience and mindfulness have been shown to alleviate depressive symptoms, there has been limited exploration of their mediating roles in the relationship between alexithymia and depression in adolescents. Much of the existing literature focuses on adults, highlighting a gap in understanding how these factors influence adolescents. Thus, this study aims to explore whether mindfulness and resilience play a significant role in the relationship between emotional alexithymia and depression in adolescents?
Method
The research method was descriptive-correlational, employing structural equation modeling. The statistical population of this study consisted of all adolescents in the first and second years of high school in public schools in Rasht during the 2024-2025 academic year. The sample size was calculated as 200 participants based on Kline's (2023) guidelines, with the sample size increased to 240 to prevent sample attrition. Non-random convenience sampling was used, and the final analysis was conducted on 234 valid data points, with the remaining cases excluded as outliers and contaminated data. The participants had a mean age of 15.80 ± 3.19 years. Of the participants, 144 (61.5%) were female, and 90 (38.5%) were male. The data collection instruments included the Beck Depression Inventory II, the Toronto Alexithymia Scale (TAS), the Connor-Davidson Resilience Scale (RISC), and the Freiburg Mindfulness Inventory Short Form (FMI-SF). The psychometric properties of all instruments were examined and confirmed. Structural equation modeling was used for data analysis.
Results
The results indicated that alexithymia (β = 0.38), mindfulness (β = -0.19), and resilience (β = -0.34) had direct and significant effects on depression. Additionally, alexithymia had direct and significant effects on resilience (β = -0.58) and mindfulness (β = -0.57) (p < 0.05). The results of the bootstrap test showed that resilience (β = 0.26) and mindfulness (β = 0.17) served as mediators between alexithymia and depression (p < 0.05). Furthermore, the goodness-of-fit indices from the structural equation modeling supported the adequate fit of the conceptual model with the collected data (χ²/df = 1.44, CFI = 0.95, RMSEA = 0.05). Based on these findings, it can be concluded that the proposed model demonstrates a good fit. Overall, the proposed model accounted for 87% of the variance in depression among adolescents.
Discussion
This study's findings indicate that resilience and mindfulness fully mediate the relationship between alexithymia and depression in adolescents, based on structural equation modeling. Depression, marked by low mood, lack of interest, and negative self-reflection, is influenced by physiological, psychological, and social stressors, and can lead to academic and interpersonal difficulties. Alexithymia, or difficulty in expressing emotions, increases the risk of depression. Resilience and mindfulness help mitigate this impact by improving emotional regulation and coping skills, reducing negative emotions, and preventing depression. Thus, the findings of this study can be utilized in the prevention of adolescent depression and in developing various strategies for emotion regulation among adolescents.