2.1 Sex differences in depression Flashcards
Waar gaat artikel Kendler et al over?
Kendler et al. (2014)
Sex differences in the etiological pathway to MDD with a wide range of risk factors.
Results
Risk factors MDD: female
Kendler et al. (2014)
- Parental loss
- Divorce
- Low parental warmth
- Lifetime trauma
- Social support
- Merital dissatisfaction
Results
Strong, moderate, modest effects: females
Kendler et al. (2014)
- Social support and marital satisfaction = strongest
- Neuroticism and divorce = moderate
- Parental warmth = modest
Heritability of MDD is higher in females than in males
Risk factors MDD: males
Kendler et al. (2014)
- Low self-esteem
- Childhood sexual abuse (CSA)
- Conduct disorder (gedragsstoornis)
- Past history of MDD
- Drug use disorder
- Stressful life events
Results
Strong, moderate, modest effects: males
Kendler et al. (2014)
- Stressfull life events = strongest
- Conduct and substance disorder = moderate
- Sexual abuse and hisory of MDD = modest
Distal stressful life events that affected men more than women into 3 categories:
Kendler et al. (2014)
- Financial problems
- Work problems
- Legal problems
Anaclitic
Kendler et al. (2014)
Lack of supportive connections and unresolved reliance needs (females)
Introjective
Kendler et al. (2014)
Inability to fulfill internal expectations for one’s value and success (males)
Comparible effects on both gender
Kendler et al. (2014)
Relationship issues and serious illness in individuals in close social network
Waar gaat artikel Martin over?
Martin et al. (2013)
Misschien gender difference MDD omdat mannen andere soort symptomen ervaren dan vrouwen en dit nog niet wordt (h)erkent door DSM en therapeuten.
4 conceptual frameworks that addres how gender influences men’s experience, expressions and responses to depression:
Martin et al. (2013)
- Sex differences framework
- Masked depression framework
- Masculine depression framework
- Gender response framework
Two scales that evaluate male depression symptoms
Martin et al. (2013)
- The Gotland Male Depression Scale (GMDS)
- Masculine Depression Scale (MDS)
MSD
Martin et al. (2013)
Contains alternative male-type symptoms
Gender inclusive depression scale (GIDS)
Martin et al. (2013)
Combines the symptoms with traditional depression items
Results MDS en GIDS
Martin et al. (2013)
6
- GIDS: no sex differences found
- MDS: higher prevalence in men compared to women
- Mixed results that men would show more non-traditional symptoms than women
- No sign sex differences were seen at severity level
- Irritability was equal in men/women + depressed mood was main symptoms for both genders.
- Top 5 symptoms both genders: anger attacks/aggression, irritability, stress, anxiety
Behaviour more frequently seen in men
Martin et al. (2013)
- Substance use
- Anger/aggression
- Hyperactivity
- Risk taking behaviour
Behaviour more frequently seen in women
Martin et al. (2013)
- Indecisiveness
- Stress
- Sleep disturbance
- Anxiety
- Complaintiveness
- Depressed mood
Waar gaat artikel Christine Kuehner over?
Christine Kuehner (2017)
Gender differences within the internalizing spectrum
Prevalence
Christine Kuehner (2017)
- Before puberty = boys more likely MDD
- During puberty and after= depression rises twice as much in girls
- Females still more likely to develop depression after menopauze
Two course moderating factors
Christine Kuehner (2017)
- Completed suicide is higher in men
- Mortality excess in depressed individuals compared with general population is higher in depressed men than in women
Symptom profile
Christine Kuehner (2017)
Women:
- More atypical symptoms: increased appetite and hypersomnia
- More somatic symptoms: fatigue, pain
- More comorbidity with internalizing disorders
Men:
- More comorbidity with externalizing disorders
Comorbidity conditions during peripartum period
Christine Kuehner (2017)
- PTSD can be caused by traumatic experiences during pregnancy and childbirth and previous traumas.
- Peripartum depression and anxiety disorders = high comorbidity
Artefact hypothesis
Christine Kuehner (2017)
Depression is suggested to be equally likely in both genders, yet lower treatment utilization and decreased recognition of depression in men –> falselyhigher prevalence in women due to gender-specific symptoms.
Support for this is limited.
Individual differences: biological factors
Genetic factors
Christine Kuehner (2017)
Heritability = 30-40%.
Mixed findings that this is higher in women than in men.
Individual differences: biological factors
Gene-environment (G*E) studies
Christine Kuehner (2017)
This looks at whether genetic factors affect an individual’s psyhological susceptibility to be affected from stressful life events.
Short-allele variant of 5-HTT (serotonin transporter) carriers are susceptible to developing depression following environmental stress
Individual differences: biological factors
Hormones
Christine Kuehner (2017)
Hormonal fluctuations (puberty, post-partum, parinatal etc.) have been linked to increased depression risk for women
Individual differences: biological factors
Psychological stress response
Christine Kuehner (2017)
Men show stronger physiological responses to psychosocial factors, including HPA-axis activation, higher blood pressure, and more nega/aggressive responses.
Individual differences: psychological factors
Temperament, personality and coping styles
Christine Kuehner (2017)
Girls: more effortful control (attention regulation and impulse inhibition.
Boys: more active and impulsive (externalizing problems)
- Neuroticism and negative affect: not differ between sexes in early childhood, vanaf adolescence: women experience this more.
- Ruminative response stule: repetitive thinking about one’s problems –> mainly linked to neuroticism, which is more common in women
Individual differences: psychological factors
Previous anxiety disorders
Christine Kuehner (2017)
Comorbit anxiety disorders = higher in women.
Previous anxiety = higher risk depression in both genders, however, higher lifetime anxiety prevalence is higher in women
Childhood abuse
Christine Kuehner (2017)
Can lead to dysfunctional development of the endocrine stress response.
- Women: higher chance of facing partner violence
- Female victims are twice as likely to experience depression compared to women who have not experienced such violence.
Social structural gender inequalities
Christine Kuehner (2017)
Women with lower gender inequality faced depression more often than women with high gender equality.
Conclusion
Christine Kuehner (2017)
Study suggests that depression is more common among women than men due to a complex interplay of biological, psychological and societal factors.
