Shahrekord University of Medical Sciences Journal of Multidisciplinary Care 2783-3852 14 2 2026 07 21 A Model of Marital Adjustment Based on Self-Differentiation and Emotional–Sexual Needs Fulfillment, Mediated by Alexithymia, Among Students at Hormozgan University, Iran 91 101 10.34172/jmdc.1446 EN Zahra Ameri Siahooei https://orcid.org/0009-0002-0061-8129 Maryam Sadeghifard https://orcid.org/0000-0002-6837-1065 Eghbal Zarei https://orcid.org/0000-0002-7461-2021 Journal Article 10.34172/jmdc.1446 2025 11 10 2026 01 24 Introduction: Marital adjustment is an important indicator of family health. However, the simultaneous roles of self-differentiation and emotional–sexual needs fulfillment in marital adjustment, mediated by alexithymia—particularly among married university students—have rarely been examined within an integrated model. Therefore, the present study aimed to test a model examining the mediating role of alexithymia in the relationship between self-differentiation and emotional-sexual needs fulfillment with marital adjustment among married students at the University of Hormozgan. Methods: This research employed a descriptive-correlational design using a partial least squares structural equation modeling (PLS-SEM) approach. The statistical population of this study consisted of all married students at the University of Hormozgan. A sample of 316 individuals was selected through simple random sampling. Data were collected using the following instruments: the Self-Differentiation Inventory-Revised (DSI-R), the Emotional-Sexual Needs Questionnaire, the Toronto Alexithymia Scale (TAS-20), and the Locke-Wallace Marital Adjustment Test. Results: The SEM analysis indicated that the final model demonstrated a good fit and explained a substantial proportion of variance in the endogenous constructs (R²=0.671 for marital adjustment and R²=0.805 for alexithymia). The direct path coefficients from both self-differentiation (β=0.598, P<0.001) and emotional–sexual needs fulfillment (β=0.220, P<0.001) to marital adjustment were statistically significant and positive. In contrast, the direct path coefficient from alexithymia to marital adjustment was statistically significant and negative (β=−0.128, P<0.001). In addition, emotional–sexual needs fulfillment (β=−0.553, P<0.001) and self-differentiation (β=−0.298, P<0.001) had significant negative direct effects on alexithymia. Furthermore, the indirect effects on marital adjustment via alexithymia were statistically significant for emotional–sexual needs fulfillment (β=0.075, P<0.01) and self-differentiation (β=0.041, P<0.01), confirming the mediating role of alexithymia. Conclusion: The results demonstrate that self-differentiation and emotional-sexual needs fulfillment contribute positively to marital adjustment, while alexithymia exerts a negative influence. These findings can be explained within systemic theories and emotion-processing perspectives, suggesting that higher levels of self-differentiation and greater emotional-sexual needs fulfillment, enhance emotional awareness and expression, hereby improving marital adjustment.