Why Women Are More Susceptible to Depression Anhang 3: An Explanation for Gender Differences
[Christina M. Mulé]
This review describes the gender differences associated with depression.
On the basis of strong and consistent evidence, women appear to have higher
rates of depression than do men. However, the explanation for this difference
is not understood well. A series of topics further examined and analyzed, will
provide possible explanations for these findings. The topics of focus will
include biological differences (hormones), age prevalence of depression
differences, sex-/gender-role identity differences, depression rate and
recurrence differences, and comorbidity differences. In addition experiments
will be introduced to accompany and further support possible explanations. The
specific difference in depression between women and men cannot be easily
explained. In conclusion it seems likely that women are more susceptible to
depression because of gender differences in roles, which have led to
differences in the experience of life events.
This article reviews evidence and findings related to the severe
susceptibility of depression in women over men. Many different theories or
potential explanations will be offered to better understand this phenomenon.
These theories include: biological differences, age prevalence of depression
differences, sex/gender- role identity differences, depression rate and
recurrence differences, and comorbidity differences. Although there are many
theories that support why women are more susceptible to depression than men,
consider that these are just theories, not facts.
The sex-/gender-role identity difference theory, can best answer why
women are more susceptible to depression. In this theory gender, society, and
parenting roles will illustrate that there are many gender differences
influenced by environment which can lead to depression. Therefore it can be
concluded that the susceptibility of depression, is largely affected by
environmental roles and must be taken into account for when comparing women and
men.
Biological Differences
The degree to which biological factors impinge on the severe
susceptibility of depression in women over men is rather trivial; however it
still provides a possible explanation for the occurrence.
Hormones and heredity factors are taken into account and provide some evidence
of truth when comparing depression susceptibility between women and men.
Hormonal regulation largely affects the rate of depression in women.
Estrogen depletion, also known as menopausal symptoms, illustrates increased
depressive rates and vasomotor instability (hot flashes). When including
vasomotor instability rates as a cause of depression, rates of depression
increased from 39% to 55% (Formanek & Gurian, 1987). The increase in
depression rates can also be attributed to, women feeling less womanly. These
thoughts can occur at menopausal stages because women become infertile and feel
they have aged and are elderly. In addition it is true that men tend
to value attractiveness and youth in their mates much more than do
women. "Men prefer youthfulness because it is likely to be associated with
higher fertility, reproductive potential, and health"
(Ben Hamida, Mineka & Bailey, 1998). Following the rules of
evolution after a woman becomes infertile she is less desired by men because
the purpose in having intercourse is to produce offspring.
Both the many facts about hormones as well as the mind-set concerning
menopause cause uncertainty as to what exactly produces the depression. The
indistinctness remains unsolved because it is virtually impossible to perform
an experiment of having women separate their feelings of depression from
menopausal states. However, "depression may be a precursor rather than a
consequence of emotional responses associated with menopause" (Denmark
& Paludi, 1993).
To compare hormonal differences between men and women would be unfair.
It is certain that women experience many more hormonal changes than do men (due
to childbirth, premenstrual syndrome, menstruation, contraceptive drugs,
postpartum period, and menopause). However, parallel to women, men do have
symptoms similar to menopause, but are rather referred to as a
"mid-life" crisis or depression. It is almost impossible to explain
why women are more susceptible than men to depression when referring to
biological differences. "Such a specific difference cannot be explained
easily
as a result of biology, particularly among women because rates of
depression did not vary by parity" (Nazroo & Edwards, 1998).
Hereditarily speaking genetic transmission may cause women to be more susceptible
to depression. In support of genetic transmission as an explanation for the sex
differences there is reasonable evidence from twin and family studies that
genetic factors are operating in the genesis of depression and affective
disorders (Nazroo & Edwards, 1998). Two likely rationales will be given to
support the hereditary theory and provide evidence that causes women to be more
susceptible to depression.
One possible genetic explanation is x-linkage; that is, the position of
the relevant locus on the x chromosome. If the gene for depression is located
in the x-chromosome and the trait is dominant, females, who have two x
chromosomes, will be more often affected than males, with only one x-chromosome
(Nazroo & Edwards, 1998). However, we must remember that this is just a
hypothesis, a tentative explanation, not a concrete fact.
A second possible genetic explanation involves the phenotype (the
observable physical or biochemical characteristics of an organism, as
determined by both genetic makeup and environmental influences) of women. This
explanation hypothesizes that genetics and environmental influences together
may result in the depression of women. An example of this hypothesis would be:
If a woman’s parent was depressed, she is more than likely to become depressed
herself due to environment and genetic predisposition. Having a family member
present who is depressed, becomes a chronic environmental strain, which refers
to ongoing "background" stressors that tax one’s coping abilities and
resources. The sources of chronic strain are myriad; examples include unstable
or unsafe housing (Kimberling & Ouimette, 2002). Phenotypes affects men as
well; however its affects are stronger in women. This occurs because women have
a higher tendency of awareness of their surroundings and are typically closely
interconnected with their family members.
It is evident that phenotypic traits influence the rate of depression.
However, as stated previously, the phenotype theory is just a possible
explanation for the susceptibility of depression in women.
There can not be definite conclusions, based on theoretical hypotheses.
Gender Differences in Adolescent Depressive Symptoms
"Gender differences in depressive symptoms appear to emerge in
early adolescence and then remains throughout the adult life span"
(Nolen-Hoeksema, Larson, & Grayson, 1999). Consistent findings indicate
that adolescent girls develop depressive symptoms at an earlier age than do
adolescent boys. Emerging gender differences can be caused by individual
vulnerability, life stress, and pubertal transitional challenge. Although girls
and boys go through puberty at the relatively same age, it has been suggested
that girls are more vulnerable to depression than boys even before adolescence
(Ge & Conger, 2003). This hypothesis will be further examined
through the careful analysis of research and experimentation.
The experiment had many hypotheses that were evaluated. The following
hypotheses guided the analysis (Ge & Conger, 2003, pp. 4-5):
Girls will demonstrate higher average levels of depressive symptoms than
adolescent boys will during adolescence.
The higher average level of depressive symptoms among girls, compared
with boys, will become evident during early adolescence.
Boys and girls with advanced pubertal status during early adolescence
will manifest higher levels of depressive symptoms.
Boys and girls with higher levels of depressive symptoms in early
adolescence will show higher levels of depressive symptoms in mid- and late
adolescence.
Early depressive symptoms, the pubertal transition, and stressful life
events will have interactive as well as additive main effects on risk for
depressive symptoms.
The interactive and additive effects of early depressive symptoms, the
pubertal transition, and stressful life events will explain a significant
portion of the association between gender and depressive symptoms.
The choice of method was a 6-year longitudinal study of 451 families
that lived in central Iowa. Interviewers visited each family at their homes for
approximately 2 hours on each of two occasions. During the first visit, each of
the family members was asked to independently complete a set of questionnaires
focusing upon individual characteristics, emotions and life events experienced
by family members. These independently reported emotions and events were used
to come up with the conclusion (Ge & Conger, 2003).
The results found that early depressive symptoms carry forward to mid-
and late adolescence and that the interaction between gender-linked vulnerabilities
(diathesis) and the new biological and social challenges of early adolescence
(stress) creates greater risk for depression for adolescent girls than boys (Ge
& Conger, 2003). Studies have also found higher levels of depressive
symptoms in girls than in boys as young as 12 years of age and have
consistently found gender differences from then on out (Nolen-Hoeksema &
Girgus, 1994). However, although this conclusion was found from the experiment,
this has never been reported in earlier studies of adolescent depression.
Yet again, it is difficult to determine why women are more susceptible
to depression. The experiment provides conclusions and theories that have never
been proven prior. It is clear that girls are more susceptible to depression
even in adolescence, but there is no concrete evidence to prove why. However,
depressives (girls and boys) were found to come from families in which there
was marked striving for prestige with the patient as the instrument of this
need; the family showed marked concern for social achievement and the childhood
background was characterized by envy and competitiveness
(Weissman & Paykel, 1974).
Gender Stereotypes and Identity Roles
"The subtle influence of sex upon a person’s perceptions may vary
with each observer and play both an unconscious and conscious role in
influencing actions taken." -
Gesell, 1990
Recent evidence suggests that the higher prevalence of clinical and
subclinical depression among females results because one subtype of depression,
which is rooted in limitations placed upon women (Silberstein & Lynch,
1998). These limitations have been taken a long way, causing the likelihood of
depression in women. Gender roles will be closely examined, and will provide
examples of the limitations placed upon women. (Some explanations of why women
become more depressed then men are illustrated in Table 2 and focus on status
and gender identity.)
Many stereotypes that have been placed upon women help in the
gender-related limitations. The stereotypes concerning women are endless. A
catalog of different stereotypes between women and men is revealed in Table 3.
"Although women are usually socialized to be emotionally
expressive, nurturing, and to direct their achievement through affiliation with
others, men are usually socialized to be emotionally inhibited, assertive, and
independent" (Kimberling & Ouimette, 2002). Through the analysis of
these stereotypes, the belief that women are viewed as inferior to men is not
far fetched. Women are conflicted to live up to these stereotypical roles and
expectations of perfection everyday, no matter how many roles they take on in
their everyday life.
A woman’s role as a wife, worker, mother, and caretaker contribute to
the levels of everyday stress. The qualities of each of these roles are looked
at differently through the eyes of women and men.
In reference to marriage, it typically has value and merit if two
partners love each other. However, the quality of marriage is more strongly
related to home life satisfaction for women compared to men (Denmark &
Paludi, 1993). This difference may be attributed to gender differences in the
psychological purpose of marriage. Males may have more instrumental gains from
marriage (e.g., in the form of services, such as housekeeping). Females, who
have fewer alternatives, may invest more emotionally in their marital roles
(Denmark & Paludi, 1993). From this it can clearly be stated that these
differences may result in tension between two partners. And thus may result in
depressive feelings for women that may leave them feeling as if they were
servants to their husbands, not companions. Women reported higher rates of
their partners as less caring and as more likely to be a depressogenic stressor
(Wilhelm & Roy, 2002).
An additional role that women partake in that is parallel to marital
roles is parental roles. These roles are very closely related, because marriage
may be the main basis to raise children. Because women have been labeled in the
past as child caretakers, this stereotype has been hard to break. There are
very few families in our society that have males as the primary caretaker of
their children. Women even
if employed, spend about 70 hours a week with their children. On the
opposite spectrum, father’s involvement with children average about 30 hours a
week and do not significantly vary with wives employment (Denmark & Paludi,
1993). The average level of role strain for mothers who have careers was not
greatly affected. However, women who are employed feel dissatisfaction with the
amount of time they are allotted for their children and spouse. However,
because of stereotypes and misconceptions women tend not to complain about
their gender roles. Ratings by fathers revealed that the more time the mother
spent, relative to him, in child care tasks, the greater his satisfaction with
her work schedule and her overall time allocation (Denmark & Paludi, 1993).
Similarly to that statement, men’s perceptions over sharing tasks appeared to
depend only on how satisfied they were with the division of tasks. Thus, many
men appear to be happy when they are not sharing in domestic tasks, and the
fact that they know their wives are not happy about it does not lower their
marital satisfaction (Denmark & Paludi, 1993).
Through the analysis of these two gender roles, it is evident that women
are dissatisfied with their gender responsibilities. Women are faced with the
problem of how to make their lives meaningful.
With decreasing family size, increasing longevity, and increased
self-expectation, the time over which the married woman undertakes other roles
in addition to being a mother is becoming longer (Weissman & Paykel, 1974).
Correspondingly with gender roles; come gender identities. The gender
stereotypes can be said to affect gender identities the most severely.
Stereotypes that women should be beautiful and refined are ones that influence
the American culture to such a great extent. Some researchers have suggested
that information about physical appearance, and in particular physical attractiveness,
might be more crucial to impression of women than of men (Denmark & Paludi,
1993). Girls show less satisfaction with their physical appearance than do
boys, starting in third grade (Hankin & Abramson, 2001). In modern times
the idea that "thin is beautiful" has become the socially accepted
norm. The media publicizes what is beautiful; and more often than not women
don’t seem to equate to these looks. Thus, these contributing factors if taken
to the extreme can result in dangerous feelings and habits, such as depression
and eating disorders. When in reference to women, these two disorders are
extremely comorbid with each other. Eating disorders will be evaluated further
in the section of comorbidity.
Comorbidity
As stated in Table 1, comorbidity is the presence of coexisting or
additional diseases with reference to an initial diagnosis or with reference to
the index condition that is the subject of study. "Depressive disorders
show substantial comorbidity with other psychiatric disorder, especially anxiety,
externalizing, and eating disorders" (Hankin & Abramson, 2001). The
disorders that largely affect women include: eating disorders and anxiety.
Eating disorders result in mental and physical health problems. Two of
the most widespread eating disorders are anorexia and bulimia. Symptoms of
these eating disorders are: obsession with weight, frequent and long trips to
the bathroom (often with running water), food rituals (shifting food around,
cutting food into tiny pieces, or keeping utensils from touching lips, hiding
food), hair loss, and pale or "gray" skin. "These symptoms can
be linked with women, since more women have been diagnosed with lifetime
histories of eating disorder than men" (Hankin & Abramson, 2001).
A 4-year longitudinal study of community adolescent girls found the peak
risk for the onset of binge eating to occur at 16 and the peak onset for
purging to occur at age 18 (Hankin & Abramson, 2001). These eating
disorders seem to be age appropriate, because at these times girls are very aware
of their appearances. The awareness or sensitivity may be caused between the
ages of 16 and 18, because it is a prime time to prepare for physical
relationships with the opposite sex. Girls fear rejection so much that they are
willing to put the needs, interests, and desire of others above their own
(Smolak & Fairman, 2002). Women most obviously want to be desired by the
opposite sex and in result go to great lengths to appear attractive. The extent
to which women are concerned with their appearances may become quiet
frightening and create severe depressive cognitions.
The depressive thoughts of being unattractive may eventually lead to
obsessive thoughts of being beautiful, resulting in compulsions such as working
out and dieting. One theory is that depression, eating disorders and obsessive
compulsive disorders (anxiety disorder) are all interconnected. There is
certain proof that OCD (obsessive compulsive disorder) is comorbid with
depression, but well known documented studies have not been completed to show
the affects of this comorbidity on women.
Anxiety disorders, such as generalized anxiety disorder (GAD), social
phobia, panic disorder, obsessive-compulsive disorder (OCD), and specific
phobia, have been largely and functionally linked to depressive thoughts that
affect women and adolescent girls. Though research in this area is limited the
comorbidity between anxiety disorders and depression will help provide a
solution as to why it is that women are more susceptible to depression over
men. In this section of comorbidity, the focus will be directed to social
phobia consequently due to the large affects on women.
"Statistics prove that girls develop anxiety disorders earlier and
at a faster rate than boys, such that by age 6, twice as many girls have experienced
an anxiety disorder" (Hankin & Abramson, 2001). A potential reason for
the susceptibility of depression in girls and women is that they are at a much
higher risk for the potential to be raped or sexually assaulted in our society.
It is common for victims of interpersonal traumas, such as rape and domestic
violence to experience shame about their environment in the traumatic
experience and to be rejected or blamed by others. Rejection and blame from
others will occur because people believe that women subject themselves to
situations that can lead to no good. Shame and interpersonal rejection have
also been theoretically linked to the development of social phobia, raising the
possibility of shared etiology for the two disorders (Kimberling & Ouimette,
2002).
Social phobia comorbid with depression is likely to be one of the most
difficult disorders to treat. Depressed men and women comorbid with social
phobia may pose distinct treatment challenges because they may be less likely
to accept referral into a therapy group given their fear of being exposed to
the scrutiny of others and speaking in front of a group (Kimberling &
Ouimette, 2002).
The cumulative burden of multiple diagnoses (comorbidity) may be that it
has been strongly associated with decreased well-being, compromised health and
quality of life, and poor psychosocial adjustment (Kimberling & Ouimette,
2002). These obstacles are just additives to all the gender stereotypes and
identity roles that women already deal with.
Although women are diagnose with comorbidity of anxiety disorders and
depression twice as often as men, the rates and pattern of comorbid disorders
seem quite similar across the genders (Kimberling & Ouimette, 2002).
Nevertheless, it is a reminder that the comorbidity theory is just a possible
reason behind why women are more susceptible to depression.
Recurrence Rates
Recurrence is a new occurrence of a disorder after a period of remission
of symptoms lasting for over a period of 2 months. Recurrence may be easily
detected in some cases. Evident characteristics include: attempted suicide
(para-suicide), family troubles, and social inabilities.
The recurrence hypothesis states that equal proportions of males and
females will experience at least one episode of depression (the first episode),
but that more females than males will go on to have greater than one lifetime
episode (Hankin & Abramson, 1998). This hypothesis is later proven to be
incorrect by substantial data gathered. 74% of males had only one lifetime
depressive episode compared to 74% of females, whereas 26% of males had greater
than one depressive episode compared to 26% of females (Hankin & Abramson,
1998). However this study is only a small sample of a population, so therefore
this information should not be interpreted as a population recurrence rate.
Though the hypothesis that women have higher recurrence rates then men
has been found to be incorrect - it is still fact that recurrence increases
depressive cognitions. Thus resulting in a probable cause of susceptibility.
Summary of Women's Susceptibility
The noting of widespread gender differences in rates of depression now
dates back two decades, with women consistently reported as having a twofold
lifetime prevalence of depression, and a greater likelihood of seeking help for
depression than men (Wilhelm & Roy, 2002). Though this is true, it is still
not clearly evident as to why women are more susceptible to depression than
men. In the course of this review article, there are many possibilities given
to solve this indefinite difference. The possibilities of biological
differences, age prevalence, gender stereotypes and identity roles,
comorbidity, and recurrence rates, were all given. However none provided
concrete evidence to solve such a phenomenon. From the evidence given, I can
only conclude that the susceptibility of depression in women is so high,
because of environmental factors. The environmental factors include the gender
stereotypes and identity roles. The experiences women go through in life are
much different than the experiences that men do. Therefore, the life events for
women and men vary across the board; there is no way to possibly detect what
exactly causes the large difference in susceptibility of depression.
Definitions of Key Terms
Gender Typing - The process of developing the behaviors, thoughts, and
emotions associated with a particular gender.
Depression - A psychiatric disorder characterized by an inability to
concentrate, insomnia, loss of appetite, anhedonia, feelings of extreme
sadness, guilt, helplessness and hopelessness, and thoughts of death. Also
called clinical depression.
Gender Role - The accepted behaviors, thoughts, and emotions of a
specific gender based upon the views of a particular society or culture.
Biology - The science of life and of living organisms, including their
structure, function, growth, origin, evolution, and distribution.
DSM-IV - Diagnostic and Statistical Manual of Mental Disorders, 4th
edition.
Comorbidity - The presence of coexisting or additional diseases with
reference to an initial diagnosis or with reference to the index condition that
is the subject of study. Comorbidity may affect the ability of affected
individuals to function and also their survival; it may be used as a prognostic
indicator for length of hospital stay, cost factors, and outcome or survival.
Externalization - To project or attribute (inner conflicts or feelings)
to external circumstances or causes.
Social Roles - Accepted behaviors associated with a particular position
within a group.
Susceptibility - The capacity to be affected by deep emotions or strong
feelings; sensitivity.
A. Artifact
Differences in reporting stress and distress
Women are under more stress.
Women weigh events as more stressful
Women are more willing to acknowledge symptoms
Women seek help more often
Men use more alcohol
Men are more often in legal difficulties
B. Real
Psychosocial
Disadvantage of women’s social status
Learned helplessness
Demographic changes
Genetic Transmission
Female endocrine physiology
Characteristics of the Female Stereotype
Affectionate
Gullible
Cheerful
Childlike
Compassionate
Does not use harsh language
Eager to soothe hurt feelings
Feminine
Flatterable
Gentle
Loves children
Loyal
Sensitive to the needs of others
Shy
Soft-spoken
Sympathetic
Tender
Understanding
Warm
Yielding
Characteristics of the Male Stereotype
Acts as a leader
Aggressive
Ambitious
Intelligent
Assertive
Athletic
Competitive
Defends own beliefs
Dominant
Forceful
Has leadership abilities
Independent
Individualistic
Makes decisions easily
Masculine
Self-reliant
Self-sufficient
Strong personality
Willing to take a stand
Willing to take risks
Peer Commentary
It's Not Easy Being Male Either
[Josiah P. Allen] Rochester Institute of Technology
In "Why Women Are More Susceptible to Depression: An Explanation
for Gender Differences," by Christina M. Mulé, points were made that gloss
over the issue of depression in men. This commentary
is by no means an attempt to start a gender battle but is an honest look
at certain points in which faulty assumptions were made by the author to
support her arguments.
Near the end of her discussion on biological differences, the author
casually explained that women were more aware of their surroundings and
therefore were more prone to feel depressed around other depressed individuals.
Where this idea came from is unclear, and what arguments could support it is
also unclear. One can easily argue the opposite. Men are by general stature
more athletic, and a large part of athleticism is being constantly aware of the
situation. Men are bred to be competitive and thus are always watching for
possible threats or rivals, etc. The author also seemed to state that women
were more closely interconnected with family members. Again this statement did
not seem to have any merit, given that she declined to argue the point and
assumed that men were more often cold and distant in relation to their family.
Mulé strongly argued that gender stereotypes play a significant role in
how women are perceived and thus perceive themselves. She did not bother,
however, to discuss any possible stress in the lives of men. Mulé stated,
"Women are expected to live up to these stereotypical roles and
expectations of perfection everyday’," thus implying that men are not
conflicted by social stereotypes and expectations. She completely ignored the
fact that social roles could play an equal part in depression in both sexes.
Men are socialized to be independent and inhibited, which often leads to
loneliness and inability to communicate, which can lead to severe depression.
Mulé did not try to enlighten readers on why men did not get depressed in their
daily roles as compared with women, and this fact severely limited her
arguments for why depression was more common in women.
Later in the topic Mulé discussed how parental roles affect depression
and how women are more often than not the primary caretakers of children. Here
is where I believe the author could have made a bold point about the cognitive
failures of women to manage their stress, given the fact that women often have
a larger workload then men, because they choose to, whether they acknowledge it
or not.
She based her argument on Denmark and Paludi's (1993) work, which one
can assume is valid, but the results are obvious. Of course men are satisfied
with less work, just as women would be. Beck's cognitive theory states that
depression is caused by negative thoughts and dysfunctional beliefs, and the
belief that women must agree to a larger role in the household would be a
strong addition to her point. She simply concluded, however, that women in
general were not happy with their responsibilities.
Mulé’s work seemed to have an insistence that on average life is harder
for women, without bothering to look at the conflicts and stresses of men.
The author stated, "Women are faced with the problem of how to
makes their lives meaningful." And men do not have this problem? This may
be one of the largest contributors to male depression, especially during the
common male mid-life crisis. Mulé’s work is indeed admirable, but by ignoring
the plight of men for empirical comparison, it is still hard to pinpoint a
strong cause for the relatively high rates of female depression.
Don't Throw the Baby Out With the Bathwater
Joshua M. Rosenberg Rochester Institute of Technology
Mulé's paper offered several interesting explanations for the
demonstrated increased rate of depression in women, but it glossed over the
biological basis for the difference. Under the very first heading on Biological
Differences, she claimed several times that biological factors are "rather
trivial," while offering no effective backing for the statement. The one
article she cited (Nazroo & Edwards, 1998) had an essentially invalid
conclusion. In this study, the authors concluded that women are only at a
greater risk for depression following serious "life events." This
study specifically excluded all couples who did not experience such an event,
so this finding is baseless. Using this article as the only support for her
position that biological factors are trivial does not do a particularly good
job of convincing me.
Similarly Mulé claimed that studies of depression in early adolescence
cannot explain why women are more susceptible to depression, even though the
research did show that they were more depressed and provided likely causes for
the depression. This claim would be fine if Mulé did not do an about face in
the very next section on gender stereotypes and identity roles, using theories
that have spotty support as a basis for a sweeping claim that sociocultural
influences are to blame for the gender disparity. Although there is some
evidence for the theory in her references, there was equally valid evidence
discounted earlier. Alhtough Mulé's points are not intrinsically flawed or
necessarily wrong, it is obvious that author bias clouds the decision making
process where she evaluates competing theories.
Pointing out that girls have had twice the rate of anxiety disorders by
age 6 would seem to weaken Mulé's subsequent arguments, because I highly doubt
that the average 6 year old girl would worry about sexual assault,
interpersonal trauma, or other stresses any more than a boy. This finding seems
to be an argument for a difference that exists from birth, rather than a
socially ingrained response.
Aside from issues with author bias, Mulé's paper is well done. I
recommend evaluating her sources oneself to get a better idea of their results,
given that the quotes are often not directly related to the studies' primary
focus. The points Mulé made on the sociocultural origins of female depression
rates are often quite interesting. In the future, providing clear and valid
support for the arguments would be a good idea. Attempting to evaluate all of
the disparate theories rather than rejecting them out of hand would lend
authority to the paper. Trying to pin the blame on sociocultural influences
alone, while rejecting the other possible rationales, is reactionary, painting
an incomplete picture of the issue. Either acknowledge the opposing validity of
the other viewpoints, or come up with convincing evidence that they are flawed.
The Power of Gender Biases
[Irina V. Sokolova]
Rochester Institute of Technology
This is a commentary on C. M. Mulé's paper titled "Why Women Are
More Susceptible to Depression: Explanation for Gender Differences." In
her paper, Mulé explored the gender differences associated with depression. She
claimed that women tend to be more prone to get depressed than men for various
reasons. The reasons include biological or hormonal differences, age
prevalence, sex-/gender-roles, rates of depression, comorbidity, and
recurrence. After exploring each of the possible causes, she stated that it is
unclear exactly what causes depression. She reviewed several theories about
those causes and supported them with studies. There are several factors we need
to explore, however, which might help us to understand some biases in
gender-related stereotypes.
On the basis of strong evidence, women appear to have higher rates of
depression than men. Therefore, one would expect clinicians to see more
depressed females than depressed males. It is also possible that gender-related
bias exists in clinical identification of depression, because women are
stereotyped to be more prone to be depressed. Two studies (Verbrugge &
Steiner, 1981; Wallen, Waitzkin, & Stoechle, 1979) were based on medical
records and physicians' self-reports. The results showed that medical
clinicians were more likely to attend to psychological problems in women than
in men. Another study by Loring and Powell (1988) provided sufficient evidence
that psychiatric diagnosis is affected by a patient’s gender. These finding
suggest that depression is more likely to be identified in women than in men
with equivalent symptoms. Therefore, depression may be underdetected in men and
overdetected in women. These tendencies may contribute to inflated female
depression rates. Women are more prone to seek help than men, and they may be
more likely to be diagnosed with depression. Depressed women are also more
prone to express their symptoms than men who view depression as unproductive
and self-indulgent and deny it.
In research by S. Nolen-Hoeksema, she advances her own theory: that men
and women respond to depressing life events differently, and that whereas men
tend to cut off the depression before it ramifies, women tend to remain focused
on their depressed mood in ways that prolong its duration and extend its
impact.
In another study, Zamarripa, Wampold, and Gregory (2003) proposed to
investigate the generality of the gender role conflict constructs (success,
power, and competition; restrictive emotionality; restricted affection between
men; and conflicts between work and family) to women in terms of the presence of
the conflict in men and in terms of the relation of the constructs to the
mental health of women.
In terms of generality, three possibilities existed.
1st possibility was that men and women manifest equal levels
of the various conflicts, and that these conflicts are similarly related to
mental health. For example, in this scenario, levels of restricted emotionality
would be comparable for men and women, and moreover would be comparably related
to depression and anxiety; that is, restricted emotionality would be
detrimental to the mental health
of both men and women. This outcome would provide evidence against
gender specific effects and would not support a socialization explanation.
2nd possibility was that the correlations between the
conflicts and mental health are invariant across genders but that mean
differences exist. For example, it may be that men restrict emotions to a
greater extent than women, but that restricted emotionality is detrimental to
both (i.e., restricted emotionality is correlated with depression and anxiety
for men and women) (Zamarripa, Wampold & Gregory, 2003).
3rd possibility was that there are mean and correlational
differences, indicating, for instance, that men are less expressive and that
restricted emotionality is more detrimental for men than for women.
Also according to a socialization explanation, men are socialized to be
less expressive, and this creates particular intrapsychic conflicts for men
that lead to symptoms of depression and anxiety (Zamarripa, Wampold &
Gregory, 2003).
Indeed, studies have found that gender role conflict in men is
negatively related to mental health. Men who emphasized success, power, and
competition as a measure of their personal worth or value and men who
restricted their emotional expression tended to be more anxious and depressed
regardless of age (and were also less likely to seek psychological help) than
women. Such men also reported higher anxiety and decreased social intimacy.
Restrictive emotionality, as part of gender role conflict, was associated with
interpersonal insensitivity, paranoia, psychoticism, and depression (Zamarripa,
Wampold & Gregory, 2003).
The focus of gender role conflict in men, factors such as restricted
emotionality or conflict between work and family, are simply aspects of
personhood that are associated with mental health. There are, however, factors
of socialization and expectations placed on men by society. With regard to the
gender role conflict variables, mean differences appeared as expected. Men
showed higher levels of appropriate success, inappropriate success, and
restrictive emotionality than did women, consistent with a hypothesis that
suggested that men are socialized to emphasize success at the expense of
emotionality. There were no differences between men and women with regard to
conflict between work and family, a result that confirms findings in the
management literature. The means for restricted affection were arrayed as
expected, with men's affection toward other men most restricted, followed by
men's affection toward women and women's affection toward other women, and
women's affection toward men the least restricted (Zamarripa, Wampold &
Gregory, 2003).
Whereas the means for the various gender role conflict variables showed
expected gender differences, for the most part, the relation between these
variables and depression and anxiety revealed few gender differences. For men,
consistent with previous research, restricted emotionality was related to
depression; nevertheless, restricted emotionality was not related to anxiety. A
similar pattern emerged for women, indicating that the detrimental effects of
restricted emotion operate similarly in men and women (Zamarripa, Wampold &
Gregory, 2003).
It was hypothesized that only inappropriate success would lead to
depression and anxiety, but the results marginally supported a significant
relation between inappropriate success and depression only for women.
Generally, however, appropriate success produced less depression and anxiety,
whereas inappropriate success produced more depression and anxiety, as
predicted. The relation between success and depression and anxiety did not
differ by gender. These results contradict the notion posited by some that
aspects of power and competition are uniquely detrimental to men and suggest
that there are components of achievement that cannot be considered harmful in
any way and may be protective (Zamarripa, Wampold & Gregory, 2003).
Conflict between work and family was related to depression and anxiety
in both men and women. Clearly, the increase in women in the workforce has
changed the role of women from supporting men's career progress to having to
balance work and family roles. There is some evidence, however, that women's
experience of the conflict is problematic because they feel more responsible
for family commitments and home tasks than do men (Zamarripa, Wampold &
Gregory, 2003).
As can be seen, the topic of depression in men and women is
controversial. More studies should be conducted to find an exact and definite
answer to the question of gender differences in depression.
Author Response
[Christina M. Mulé, Rochester Institute of Technology]
Multiple Possible Causes, None Definitive
Perhaps this paper seems a bit gender biased; however, I can assure
readers that the information used in this paper was well researched. I in no
way wanted to create a "war of the sexes" theme for this paper, but
males seemed to be defensive in my saying that women are more susceptible to
depression than are men.
Allen made many good points in his peer commentary. In response to his
criticism that I mentioned no stressors from the male's perspective, it would
have been virtually impossible for me to compare and contrast the stressors in
each gender's lives. This paper was written in a timely fashion, but the number
of pages could have exceeded a book's length. I accept, however, the criticism
that having this information would have made for a stronger paper overall.
Rosenberg wrote, "Trying to pin the blame on sociocultural influences
alone, while rejecting the other possible rationales, is reactionary, painting
an incomplete picture of the issue." I feel that the paper continuously
stated that all given explanations for the susceptibility of depression in
women were just possible explanations. They offered no concrete answers, their
purpose was merely suggestive. There is no possible way to pinpoint one matter
as the cause of depression. There can be multiple reasons for the
susceptibility to depression in women, and that is the message that I tried to
convey in my paper.
Lastly, Sokolova gave the impression that the paper was well written but
that the issue should be further researched and evaluated. She concluded that a
"definite answer to the question of gender differences in depression"
should be found. I can assure readers that this will never happen. As stated
before, there is no way to pinpoint why there is such a gender difference in
depression.
This controversial issue will probably last a lifetime, and men will more than likely be offended by the standpoint that I proposed in this paper. In my defense, in almost every psychology textbook or reference, you will find that other researchers believe that women are more susceptible to depression than are men. (And these researchers include men.)
Vorwort/Suchen Zeichen/Abkürzungen Impressum