Depression Flashcards
Depression prevalence rates in women are ___x higher than in men
1.5-3x higher
F:M ratio of chronic MDD & Dysthymia is ____.
2:1
There is a significantly _________ mean level of depressed mood among females than males.
Higher
With regard to depression in children, there is no gender difference in ___________, but there is in ___________.
Clinical depression; depressed mood
At what age do gender differences in clinical depression emerge?
11-14 years
What role do sex hormones play in the prevalence of depression in women?
Women report changes in depressed mood associated with menopause, oral BC, and hormone replacement therapy BUT no epidemiological studies consistently found rates of MDD associated with any of these.
How have prevalence rates of MDD changed over the last half century
There has been a fivefold increase in the lifetime prevalence of depression in the U.S. between 1950s and 1990s. HOWEVER despite this increase over time, age of onset and gender difference in prevalence rates remained consistent.
Which two theories about the reasons for gender differences in depression emphasize the importance of differential persistence?
Sex-role theories and rumination theory. Both theories imply that higher point prevalence of clinically significant depression in women than men is at least partially due to higher chronicity.
What do sex role theories posit?
That chronic stress associated with traditional female roles lead to higher prevalence of depression in women than men.
What is rumination theory? Why would that lead to more chronicity? What is the evidence against it?
- Rumination theory posits that women are more likely than men to dwell on problems and thus allow transient dysphoric symptoms to grow into clinically significant depressive episodes.
- Even though women do show more chronicity in epidemiological studies, methodological studies show that this is due to a differential recall bias. In surveys where extra steps are taken to enable participants to have better lifetime recall, the gender difference in chronicity recurrence risk of depression disappears.
- Additionally, although epidemiological research has shown that women are significantly more likely to have days characterized by depressed mood than men, analysis of intertemporal consistency showed that women were likelier than men to have a depressed mood day ONLY following a day when they were NOT depressed. There was no gender difference in the probability of remaining depressed the day following a depressed mood day. This pattern undermines the notion that rumination grows into more clinically significant depression in women compared with men.
Some people say that higher prevalence of depression among women is due to their higher willingness to report than men. What are 3 of Kessler’s arguments against this?
- Higher prevalence of current depression among women than men is found in BOTH studies that use self-report measures AND studies that use informant reports.
- Several methodological studies using standard psychometric methods to assess potential biasing factors (e.g. social desirability, expressivity, lying, and yea- or nay-saying) have found no evidence that gender differences in self-reported psychological distress are due to these biasing factors.
- If the response-bias argument were correct, response-bias would show higher likelihood for women to report symptoms associated with depressed mood (e.g. feeling sad, blue, or depressed for 2+ weeks) than men and NO gender difference in reports of less stigmatizing symptoms (e.g. sleep disturbance, eating disturbance, lack of energy). However, symptom level assessments show opposite findings in clinical and community samples.
According to retrospective analyses of age of onset reports in epidemiological surveys, the prevalence of MDD has increased dramatically over the past few decades in both genders and is due to environmental factors (a cohort effect). What are some methodological limitations that would weaken this claim? What is some evidence supporting this claim?
Limitations
- The evidence for a cohort effect comes almost entirely from cross-sectional surveys that use retrospective age-of-onset reports.
- Recall failure might increase with age and would create the false impression of higher prevalence of depression in recent (i.e. younger) cohorts.
- Current perception of depression as more stigmatizing among older generations might make them more reluctant to report compared with younger generations
- Selective mortality or other forms of sample censoring due to depression might increase with age.
Supporting evidence
- Several long-term prospective epidemiological surveys (which are methodologically stronger than cross-sectional retrospective surveys) suggest that the cohort effect might represent a real temporal increase.
- The cohort effect for MDD is much more pronounced for secondary (i.e. a disorder that follows another disorder in occurrence) than primary disorders, which is unlikely to be caused by recall bias.
Some claim that environmental stresses related to sex roles increase the effects of sex hormones on depression in girls at mid-puberty. What are some findings that support this claim?
- A gender difference in low self-esteem emerges in 7th grade when students are in a school system that has a middle school, but not until 9th grade when students are in a school system with only primary school and a 4-year high school.
- Girls who physically mature early experience more psychological distress than their normal or late developing female peers. This distress is exacerbated by having mixed-sex rather than same-sex friends.
- Age related changes in gender socialization (e.g. increased concerns with weight and relationships with boys partly explained the increase in depressed mood in girls but not boys at mid-puberty.
What does twin research show about the gender difference in heritability of MDD?
There is no gender difference in heritability of MDD for adolescents and adults. It is equally strong for both.
According to Mezulis et al (2011), What is the ABC model of gender differences in depression?
The ABC model integrates multiple domains of vulnerability (affective, biological and cognitive) and examines how these factors emerge and converge in adolescence to form an overall level of depressogenic vulnerability. This model also accounts employs the concept of equifinality, which is the idea that people can arrive at the same psychological outcome via different developmental pathways.
