2.2 sex differences in depression Flashcards
method
(Kendler, 2014)
Sex Differences in the Pathways to Major Depression: A Study of Opposite-Sex Twin Pairs
Examined data from a 2-wave study of male-male and male-female pairs
Wave 1: interviews conducted (typically over the phone)
Wave 2: at least 1 year later - another interview (face to face)
The predictor variables were organized into ‘tiers’ approximating 5 developmental periods:
1. childhood
2. early adolescence
3. late adolescence
4. adulthood
5. past year
results
(Kendler, 2014)
Sex Differences in the Pathways to Major Depression: A Study of Opposite-Sex Twin Pairs
Risk factors that contribute to MDD for women:
- Low parental warmth
- Parental loss
- Neuroticism
- Lifetime traumas
- Divorce
- Social support
- Marital satisfactions
Risk factors that contribute to MDD for males:
- Low self-esteem
- Drug use disorder
- Past history of major depression
- Distal stressful life events
- Dependent proximal stressful life events
discussion
risk factors for females
(Kendler, 2014)
Sex Differences in the Pathways to Major Depression: A Study of Opposite-Sex Twin Pairs
factors reflect quality & continuity of interpersonal relationships
In context:
- Compared w/ men, women derive a larger component of their sense of self and self-worth from interpersonal relationships
- Women have larger social networks, are more intimate with and emotionally involved w/ the members of their network, and are more sensitive to adversities experienced by their network
discussion
risk factors for males
(Kendler, 2014)
Sex Differences in the Pathways to Major Depression: A Study of Opposite-Sex Twin Pairs
risk factors were divisible into 3 groups
- Externalizing psychopathology: males having higher rates of both conduct and drug abuse disorders, both of which are associated w/risk of MDD
- Prior depressive history: males had greater sensitivity to depressogenic effects of childhood sexual abuse and stressful life events occurring in the past year
- Greater sensitivity to specific stressors: males were more sensitive to the depressogenic effects of recent stressful life event
discussion
Blatt’s 2 depression forms
(Kendler, 2014)
Sex Differences in the Pathways to Major Depression: A Study of Opposite-Sex Twin Pairs
Anaclitic:
More prevalent in females
Arises from deficiencies in caring relationships and unmet dependency needs
E.g., i’m unlovable
Strongly associated with parenting deficient in nurturance
Introjective:
More prevalent in males
Emerges from the inability to meet internal demands for self-worth and achievement
E.g., i’m a failure
Strongly associated with key instrumental tasks, such as expected work achievements and failures to provide adequately for the family
alternative approach to gender gap in depression
(Martin, 2013)
The Experience of Symptoms of Depression in Men vs Women
Typically, women are diagnosed w/depression twice as often as men - most research focuses on explanations for why women are at greater risk for developing depression
alternative approach argues that the disparity is due to the fact that men may experience alternative depression symptoms
- bcuz traditional depressive symptoms are at odds with societal ideals of masculinity → men may be reluctant to report experiencing these symptoms
- men’s experience of depression may manifest w/ symptoms that are not currently included in traditional diagnostic criteria
4 conceptual frameworks addresssing how gender shapes depression in men
(Martin, 2013)
The Experience of Symptoms of Depression in Men vs Women
-
The sex differences framework: the construct of depression is the same in men and women - seeks to investigate sex differences in a range of related
variables - The masked depression framework: proposes that men are most likely to express their distress in the form of ‘depressive equivalents’ because direct admission of sadness and emotional weakness/vulnerability is socially unacceptable
- The masculine depression framework: posits that the struggle to adhere to hegemonic masculine norms places men at risk for experiencing an alternative depression variant often characterized by externalizing symptoms
- The gendered response framework: posits that men’s response to negative affect are shaped by men’s adherence to or rejection of hegemonic masculinity
method
(Martin, 2013)
The Experience of Symptoms of Depression in Men vs Women
Created 2 new depression measures by combining externalizing symptoms of depression, with traditional depression symptoms
Male Symptoms Scale (MSS) exclusively includes alternative male-type symptoms of depression
Gender Inclusive Depression Scale (GIDS) combines their symptoms w/traditional depression items
hypotheses
(Martin, 2013)
The Experience of Symptoms of Depression in Men vs Women
- MSS & GIDS will exhibit a positive strong correlation with MDE + be moderately correlated w/alcohol abuse, other drug abuse, and IED (intermittent explosive disorder)
- Male depression as measured by the MSS will be more prevalent among men than women
- The prevalence of male depression as measured by the GIDS will result in no gender differences
- Men will endorse the nontraditional symptoms w/greater frequency than women will
results
(Martin, 2013)
The Experience of Symptoms of Depression in Men vs Women
Hypothesis 1 supported - both alternative measures of depression were significantly positively correlated w/ a traditional measure of depression
Hypothesis 2 supported - depression is more prevalent among men when measured with the MSS
Hypothesis 3 supported - no sex differences in the prevalence of depression as assessed by the GIDS
Hypothesis 4 - mixed
conclusion
(Martin, 2013)
The Experience of Symptoms of Depression in Men vs Women
When the GIDS was used, men and women met criteria for depression in equal proportions
When alternative symptoms were included in depression case criteria, more male depression cases were identified than when traditional criteria were used, indicating that men experience these symptoms in greater numbers
possible explanation for the gender gap in depression
artifact hypothesis
(Kuehner, 2016)
Why is depression more common among women than among men?
Posits that depression is equally common in both genders - but lower treatment use and lower depression recognition in men, or gender specific-depression symptoms, would result in arbitrary higher prevalence among women
limited evidence
possible explanation for the gender gap in depression
individual difference susceptibility - biological factors
(Kuehner, 2016)
Why is depression more common among women than among men?
genetic factors: the heritability of MDD is around 30-40%, with mixed evidence for a stronger genetic risk for women than for men
hormonal influences: early pubertal timing is linked to the onset of girls’ increasing risk of depressive disorders
adolescent girls are particularly susceptible to the activation effects of sex hormones during pubertal transition
physiological stress responsiveness: generally, men show larger physiological responses to a variety of psychosocial stressors than do women
possible explanation for the gender gap in depression
individual difference susceptibility: psychological factors
(Kuehner, 2016)
Why is depression more common among women than among men?
effortful control: girls are better at regulating attention and inhibiting impulses - in line with boys’ greater incidence of externalising problems
neuroticism: doesn’t differ in early childhood however neuroticism scores of girls substantially increase during adolescence
guilt and shame: body shame and dissatisfaction have been implicated in the development of gender differences in depression in adolescents
co-rumination in response to stress appears to be particularly more detrimental for adolescent girls than for boys
previous anxiety disorders: comorbidity of depressive and anxiety disorders is higher in women than in men
possible explanation for the gender gap in depression
Environmental factors: individual (micro) level
(Kuehner, 2016)
Why is depression more common among women than among men?
Common stress exposure & stress susceptibility: adolescent girls have a greater number of interpersonal stressors, to which they are more susceptible than boys
Absence of social support is a stronger predictor of depression in women than in men
violence against girls and women
childhood sexual abuse: reduces the gender gap
conclusion: possibly, severe early adversity increases further risk during pubertal transition, particularly in girls, resulting in increased psychopathology later in life
