Examining Biological Sex and Depression as Potential Moderators for Specific Emotion-Regulation (ER) Strategies in Older Adults

Haroon Malik, McLean Hospital, Belmont, United States
Sara Weisenbach, McLean Hospital, Belmont, United States
Jack Kaufman, McLean Hospital, Belmont, United States
Jeremy Maciarz, McLean Hospital, Belmont, United States
Nikhil Palekar, Stony Brook University, Stony Brook, United States
Joseph Kim, University of Utah, Salt Lake City, United States
Vincent Koppelmans, University of Utah, Salt Lake City, United States
Robert Welsh, UCLA, Los Angeles, United States
Scott Langenecker, University of Utah, Salt Lake City, United States
Megan Armstrong, Stony Brook University, Stony Brook, United States


Emotion regulation (ER) is a critical component of social-cognitive functioning across the adult lifespan. The vast majority of studies related to the choice of ER strategies have been conducted in younger adults, with many findings suggesting YA to prefer more active (i.e. reappraisal) ER strategies when presented with less emotionally intense stimuli (Scheibe et al., 2015), as well as emotion dysregulation being a key feature of clinical depression. Sex-specific differences in ER strategies have also been found in YA studies albeit more mixed (Joorman & Stanton, 2016). This literature has become a critical component towards providing scopes of behavioral health treatment amongst all adults, often focused on optimal ER strategies. The generalizability of this literature is likely limited within the context of OA populations, given the significant qualitative and quantitative differences in brain functioning during the aging process, well-supported relationship between EF decline with aging that can hinder the efficacy of such treatment interventions for the cognitively vulnerable older adult population. This study aims to expand on current ER literature by examining the relationship between known ER moderating factors in younger populations, namely sex and depression, and self-reported preferred ER strategy amongst OA.

Participants and Methods:

Participants were recruited from the community and outpatient psychiatry clinics at Stony Brook University. Depression assessed with the SCID-V and MADRS (i.e. 0 = never, 1 = remitted depression, 2 = mild depression, 3 = moderate depression). Statistical analyses included two regression models, each including psychiatric diagnosis and biological sex as predictors with self-reported ER strategy preferred (i.e. Cognitive Re-Appraisal versus Expressive Suppression) as measured by the 1-=item Emotion Regulation Questionnaire (Gross & John, 2003).


126 participants completed this study (50% male). 59.4% held no psychiatric diagnoses, compared to 14.8% with remitted depression status, 16.4% active mild depression, and 7% active moderate depression. Statistical analyses revealed biological sex to be a significant predictor for both self-reported cognitive re-appraisal ( B = .342; p < .001) and expressive suppression (B = -.262; p < .008), with males reporting greater expressive suppression and females reporting greater cognitive reappraisal. Findings were statistically not significant between psychiatric diagnosis as a predictive factor for cognitive re-appraisal (p = .437) or expressive suppression (p = .106) ER strategies.


These results suggest that, similar to YA, biological sex serves as a noteworthy predictor towards preferred ER strategy. Unlike limited literature suggesting broad-based preference for expressive suppression versus cognitive re-appraisal in OA populations, the current findings suggest male OA to have a higher propensity towards utilizing more short-term expressive suppression ER strategies, compared to females who strongly prefer a more adaptive, higher order, cognitive re-appraisal strategy. Understanding how biological sex impacts emotion regulation strategy choice is important toward personalizing interventions for depression and other disorders involving emotion dysregulation in older adults.

Category: Emotion Regulation

Keyword 1: emotional processes
Keyword 2: aging disorders
Keyword 3: aging (normal)