Female gender and depression

Question 1

Introduce the reasons why women are more likely than men to be diagnosed with depressive disorder

Answer 1

• Women are twice are likelyas men to experience a lifetime episode of major depression - one of most robust statements across almost all depression studies
• Observed across age, culture, and country (Boughton and Street, 2007)
• I will provide an overview for some of the reasons using a biopsychosocial approach, including the roles of comorbidity and diagnostic scales.

Question 2

Define depressive disorder and major depression

Answer 2

​Depressive disorder: a low state marked by significant levels of sandess, fatigue, low self-worth or related syndrome.

Major depression: severe patteren that is disabling and not cause by organic aetiology or substance use.

Question 3

Discuss the biological factors that increase depression in women

Answer 3

• Gender difference reported to beginin adolescence (aged 11-13)
• Largely disappears after age 55 (Bebbington et al., 1998)
• Social hypotheses such as martial status were unable to explain this phenomenon
• Room for biological role of progesterone, with production increasing from adolescence and puberty and ceasing around 55 with menopause
• Oestrogen flucuates prior to menstruation, and mood changes are commonly reported during this period. (NHS, 2018)
• However, the findings by the world health organisation (WHO) concluded that proposed effects of biological factors largely dissapear when psychosocial factors are accounts for.
• Stating the gender difference reflects women’s greater exposure to stressors and risks to mental health

Question 4

Categories the psychological factors that explain the gender difference in depression

Answer 4

• Personality traits
• Cognitive vulnerability
• Coping strategies

Question 5

Discuss the role of personality traits in gender difference in depression

Answer 5

• The personality of men and women differ partly due to social circumstance
• Adolescent girls demonstrate lower self-competence and percieved attractiveness than their male peers
• Due to upbringing, women tend to define themselves by their relationships
• Dependency is seen more often as a result, and acts as a siginificant vulnerability for depression (Blatt & Maroudas, 1992)
• Self-critical and neurotic personality traits are other independent vulnerabilites, seen more commonly in women. These are predictors of first depressive episodes (Bougton & Street, 2007)

Question 6

How are personality traits criticised in their role for gender difference in depression?

Answer 6

Boughton and Street (2007) argue that the importance of personality traits is overinflated due to the number of traits, stating that many can be correlated to neuroticism.

Question 7

Discuss the role of cognitive vulnerability in the gender difference in depression

Answer 7

• Women are at increased risk of negative views of self (Sakamoto, 2000)
• Both women and depressed individuals commonly demonstrate complex cognition when constructing causal relationships
• Locus of control (Rotter, 1966) is a spectrum of pereived causal relationship
  
  • ​Men more internal - own actions dictate outcome
  • Women more external - actions of others dictate outcome
• External locus associated with learned helplessness and lower self-esteem
• Individuals without control are worse off than those with a choice (Maltby et al, 2013)

Question 8

What role do coping strategies play in the gender difference of depression?

Answer 8

• Rumination is a common coping strategy amongst women and is associated with chronic severe depression (Nolen-Hoeksema et al, 1993)
• It funnels one’s attention to depressive symptoms and implications
• Men, due to internal locus, adopt a problem-solving coping style that also serves as a distraction from negative affect
• Rumination is also closely associated with emotion-based coping (slef-blame, venting). When this was controlled for, the gender difference was eliminated (Hanninen and Aro, 1996)
• Avoidant coping is commoner in women, resulting in less exposure to events that would develop resilience. Using the stress-diathesis model for depression, this helps to explain the increased prevelence in women
• Psychotherapy in part aims to provide better coping mechanisms to promote resilience adn alleviate depression. (Hutchinson, 2018).

Question 9

Categorise the social aspects to gender difference in depression

Answer 9

• Relational concept of self
• Restrictions and devaluation of role of women
• Marital quality and support

Question 10

Discuss the importance of relationships and depression in women

Answer 10

• Girls are encouraged towards more relationship orientated behaviour
• Creating a relational concept of self
• Difficult conflictual relationships are more detrimental to women as it challenges their sense of self (Boughton & Street, 2007)

Question 11

Discuss how the role of women in society affects depression

Answer 11

• Depression is frequently associated with restriction and devaluation of a woman’s role
• For example, the devaluation of homemakers in career-aspiring society
• In instances where this role is valued (Orthodox Jewish community), the gender difference dissapears (Loewenthal et al, 1995)
• Low rank is a powerful predictor of depression (WHO)
• This is reinforced in the work place, as women more likely occupr insecure, low status jobs lacking authority.
• These jobs are associated with more negative life events, chronic stressors, and reduced social support
• Traditional gender roles promote passivity, submission, and dependence
• Psychosocial resources act as vital protection against depression regardless of a women’s age (Zunzuneguie et al., 1998)

Question 12

Discuss the link between marital quality and depression

Answer 12

• Poor marital quality, as opposed to being married, is a key risk factor
• Wives recieves less support from their husband than previous female peers
• Conversely, husbands recieve more support as their wives serve as confidants
• The relational sense of self previously described makes women especially vulnerable to low support

Question 13

Discuss how comorbidities relate to the gender difference

Answer 13

• Anxiety and depression are markedly interwoven; presence of both signifies a worse prognosis, with more chronic and severe symptoms
• Previously discussed, neurotic personality and anxiety is commoner in women
• Other disorders such as eating disorders and EUPD predominantly occur in women, each adding to overall risk of depression

Question 14

Comment on how diagnostic scales are bias towards women

Answer 14

• Beck’s Depression Index (BDI) and Hamilton’s Depression Rating Scale (HAM-D)
• Overdiagnosis in women and under-diagnosis in men
• Weeping or crying seen more often in women
• Genital symptoms (HAM-D) provides example of menstraul disturbance without a male equivalent
• Weight loss (both) and measured in lb (BDI), more likely women are aware given the emphasis of female physical appearance in western culture (Boughton and Street, 2007)
• BDI uses terms old and ugly to describe physical appearance, which are unfortunately used with more negative connetations towards women

Question 15

Discuss the relationship between gender and work leading to depression

Answer 15

• Gender pay gap typically disadvantages women, earning around 2/3 of the average male wage
• Employment grade is characterised often by skill discretion and authority
• This account for much of the reasons why wellbeing is greater at higher grades
• Conversly, women are more likely to occupy lower grades than men, associated with higher negative life events, chronic stress, and less social support (Stanfeld et al, 1998)