Gender differences in social support for socially anxious individuals

Given that social anxiety disorder is a common, chronic, debilitating disorder and socially anxious women appear to have different experiences related to social development and social support than men, it is essential that the gender differences in social anxiety and social support be understood. The present study examined perceived social support quantity and satisfaction in 23 women and 28 men seeking treatment for social anxiety disorder. Contrary to expectations, men and women did not differ on measures of social support. However, younger, unmarried women reported having smaller social support networks and less satisfaction with their social support networks than older, married women. Analyses of socially anxious men did not reveal such a pattern. The current study provides preliminary evidence that younger, single women have social support networks that are less satisfying than the social support networks of older, married women. Inclusion of social support modules within a cognitive behavioral treatment approach for social anxiety disorder may be warranted, particularly for young, unmarried women.     

Gender Differences in Social Support for Socially Anxious Individuals

Given that social anxiety disorder is a common, chronic, debilitating disorder and socially anxious women appear to have different experiences related to social development and social support than men, it is essential that the gender differences in social anxiety and social support be understood. The present study examined perceived social support quantity and satisfaction in 23 women and 28 men seeking treatment for social anxiety disorder. Contrary to expectations, men and women did not differ on measures of social support. However, younger, unmarried women reported having smaller social support networks and less satisfaction with their social support networks than older, married women. Analyses of socially anxious men did not reveal such a pattern. The current study provides preliminary evidence that younger, single women have social support networks that are less satisfying than the social support networks of older, married women. Inclusion of social support modules within a cognitive behavioral treatment approach for social anxiety disorder may be warranted, particularly for young, unmarried women.     

Psychologists and alcoholic women

Alcoholism among women often has been treated using a model based on research with alcoholic men. Women react differently to alcohol than men both physiologically and psychologically and their drinking patterns are different from men's. Treatment facilities for alcoholism have not been as available for women as for men and treatment must be individualized for the differences between men and women problem drinkers and for the differences among alcoholic women.     

SEXIST DISCRIMINATION MAY ACCOUNT FOR WELL-KNOWN GENDER DIFFERENCES IN PSYCHIATRIC SYMPTOMS

It was hypothesized that women may have more depressive, anxious, and somatic symptoms than men because they experience a deleterious stressor that men do not: sexist treatment. A total of 255 students (180 females, 75 males) at a state university completed an anonymous questionnaire containing measures of these symptoms. Women were found to exhibit significantly greater symptoms than men on all of them. Further, women who experienced frequent sexism had significantly more symptoms than men on all symptom measures, whereas women who experienced little sexism did not differ from men on any symptom measure. These findings suggest that gender-specific stressors not only play a role in psychiatric symptoms among women but may account for well-known gender differences in those symptoms as well.     

Using the Millon Behavioral Medicine Diagnostic (MBMD) to Evaluate the Need for Mental Health Services in Association with Biomarkers of Disease Status Among HIV Positive Men and Women

Psychological distress states have been related to rate of disease progression among HIV-positive individuals. However, the measures that have been used in this research as well as the treatment context of the populations studied are highly variable, making it challenging for clinicians to incorporate such measures into screening batteries. The present study examined the association of two summary scales of the Millon Behavioral Medicine Diagnostic (MBMD; Millon et al., Millon Behavioral Medicine Diagnostic. NCS Assessments, Minneapolis, 2001), with markers of HIV disease status (CD4 and CD8 cell counts, viral load) among an ethnically diverse sample of 147 HIV-positive individuals (52 men who have sex with men, 34 men who have sex with women, and 51 women) who had recently initiated Highly Active Antiretroviral Therapy (HAART). After controlling for age and months since HIV diagnosis, we found that higher scores on the overall MBMD Psych Referral Summary Scale, reflecting a need for mental health treatment, were related to greater HIV viral load but did not relate to CD4 or CD8 cell counts. Subgroup analyses revealed that Psych Referral scores were related to greater HIV viral load only for the men who have sex with men (MSM) subgroup. These results suggest that the MBMD may help in identifying psychosocial characteristics associated with some markers of disease status in persons with HIV and perhaps may also be useful in identifying individual differences in response to treatment and eventual disease outcome.     

Changes in HIV treatment beliefs and sexual risk behaviors among gay and bisexual men, 1997-2005.

OBJECTIVE: Beliefs about HIV treatment effectiveness and the impact of HIV treatments on HIV transmission risks were initially related to sexual risk-taking in the late 1990s when multidrug HIV treatments first became available. This study examined changes in beliefs about the effects of HIV treatment for preventing HIV transmission and their association to sexual risk behaviors between the years 1997 and 2005. DESIGN: Anonymous surveys were administered to a convenience sample of gay and bisexual men attending a large community event in Atlanta, Georgia in 1997 (N = 498) and again at the same community event in 2005 (N = 448). Analyses were performed for men living with HIV/AIDS and for men who have not been diagnosed with HIV/AIDS. MAIN OUTCOME MEASURES: Rates of unprotected anal intercourse in the previous 3 months. RESULTS: There were significant increases in high-risk sexual practices that coincided with increased beliefs that HIV treatments can reduce the chance of transmitting HIV. However, optimistic beliefs about the health benefits of HIV treatments decreased over the 8 years and were not related to risk behaviors. CONCLUSIONS: Beliefs about how HIV treatments impact HIV infectiousness remain associated with HIV transmission risk behavior and interventions targeting at-risk as well as HIV-positive men who have sex with men must directly address these beliefs and perceptions.     

A developmentally keyed scheme for the placement of gay men into psychotherapy groups

Patients can meet their needs for intimacy and individuation within the context of long-term psychotherapy groups. This is especially true for gay male patients as they work toward the development of a positive gay identity. Coming out is a social phenomenon, which is why groups are especially suited to the tasks involved. Historically, mixed groups of gay and nongay men and women have not been a safe or neutral treatment atmosphere for gay men due to therapists' prejudicial assumptions and a lack of understanding of gay male development. A developmental scheme will be presented which is keyed to the particular needs of gay men depending on their developmental stage of functioning. This scheme should serve as a more rational and appropriate guide for the diagnosis, treatment planning, and assigning of gay men to long-term psychotherapy groups.     

Men's heterosocial skill and attitudes toward women as predictors of verbal sexual coercion and forceful rape

This study assessed whether men's heterosocial skill and attitudes toward women are related to verbal and physical sexual coercion in a nonincarcerated population. We predicted that heterosocially skilled men would be more likely than unskilled men to have engaged in verbal sexual coercion, whereas unskilled men would be more likely than skilled men to have engaged in physical sexual coercion (i.e., forceful rape). We expected an interaction, with this pattern holding only for men who accepted traditional gender roles or male sexual dominance; men who did not accept these attitudes were expected to be unlikely to have engaged in either verbal or physical coercion. To identify sexually coercive men, we administered questionnaires to 1152 male introductory psychology students. They completed anonymous self-report measures of (a) heterosocial skill, (b) attitudes toward women, and (c) involvement with verbal and physical sexual coercion. Results showed that heterosocially skilled men were more likely than unskilled men to have engaged in verbal sexual coercion, but heterosocial skill was unrelated to forceful rape. Men who accepted traditional gender roles or male sexual dominance were more likely than other men to have engaged in both verbal sexual coercion and forceful rape. There were no interactions. Theoretical issues and treatment implications are discussed.The authors wish to thank Gayla Goolsby, Trudi Zaplac, Diane Collinge, Shelley Davis, Gina Benedicto, and DiAnne Poehl. This paper is based on the second author's Senior Honors Thesis, done as part of the Texas A&M University Undergraduate Fellows Program, which provided funding.     

Gender differences in major depressive disorder and bipolar disorder

This paper reviews the literature on gender differences in major depressive disorder (MDD) and bipolar disorder (BPD). Beginning in adolescence, women are at a higher risk than men of becoming depressed. Avenues of investigation that might ultimately help to explain this phenomenon include studies of gender differences in the processing of emotional stimuli, the psychotropic effects of gonadal steroids, and environment/gene interactions in men and women. With the exception of the elevated suicide rate among men, consistent gender differences in the course and symptoms of MDD have not been found. In BPD, women are more likely than men to develop a rapid-cycling course. Gender differences in treatment response, particularly in regard to mood stabilizing medications, warrant further study.     

Treating Depression in Men: The Role of Emotionally Focused Couple Therapy

While initial treatment recommendations for depression in the context of relationship problems have been outlined, attention typically has been focused on females experiencing depression. Less is known about the assessment and treatment of men with depression and relationship distress. This article presents the current literature on depression and relationship problems, including what is currently known about the occurrence, expression, assessment, and treatment of depression in men. Theoretical and empirically based assessment and treatment recommendations are then provided for Emotionally Focused Couple Therapy with depressed men in distressed relationships.     

Men's and women's reactions to fair and unfair treatment in relationship conflict

Abstract Evidence of gender differences in reactions to experienced fair and unfair treatment in relationship conflict was examined in 4 studies among dating, cohabiting, and married participants in The Netherlands. Using a critical incidents method and a scenario, this research provided convergent results suggesting that the relationship between fairness of treatment and affective feelings or relationship satisfaction is stronger for women than for men. This gender difference disappeared under conditions of high relationship commitment. Furthermore, men who identified strongly with their relationship showed stronger reactions to fair treatment than men who identified weakly with their relationships. Finally, the manipulation of relationship salience led to heightened sensitivity to fairness of treatment among men, but not among women.     

Cultural similarities in psychological reactions to infertility

A 74-item especially developed and validated questionnaire for Iranian culture was administered three times to 37 Iranian infertile couples and 10 fertile couples acting as control group, namely, initial consultation, during treatment, and on completion of treatment. In view of parallel data also reported for Western patients interest centered on the results of two out of the five factors measured by the questionnaire, i.e., Psychological Stress and Social Behaviour. Analysis generally showed significantly high stress and social withdrawal for the patient group, particularly at initial consultation and after an unsuccessful treatment cycle as compared to the control group. Moreover, men whose partners eventually conceived scored significantly lower on stress than men whose partners did not conceive. Similar results have also been reported for Western infertile patients. The implications of the findings are discussed.     

The Men's Stress Workshop: A Gender-Sensitive Treatment for Depressed Men

Over 10% of men will meet lifetime criteria for major depressive disorder, yet men often are unwilling to enter treatment, and have more negative attitudes toward therapy than do depressed women. The Men's Stress Workshop was developed as a gender-sensitive group therapy protocol for men that explicitly addresses the role of masculine norms in the treatment of depressive symptoms. In this article we: (a) provide an overview of the model that serves as the conceptual foundation for the workshop; (b) outline the major treatment components and hypothesized change mechanisms for the workshop; and (c) describe the research design and treatment development. Case material is presented to illustrate the treatment content and format.     

Another dragon in the kitchen: Psychological experiences of hepatitis C treatment among HIV‐hepatitis C co‐infected gay men

Background: Increasing numbers of HIV‐infected gay men acquire hepatitis C virus (HCV) co‐infection, which causes serious medical consequences. Treatment for HCV is associated with many severe side effects, in some cases psychological, and many patients subsequently fail to adhere, even when psychological services are utilised, to improve treatment adherence. Objective: This qualitative study aimed to explore the experiences of HIV‐infected gay men undergoing treatment for HCV in order to inform psychological services to better meet specific treatment needs of this population. Methods: Thirteen HIV‐infected gay men who had undergone HCV treatment were interviewed and a qualitative analysis was conducted. Participants described HCV and its treatments in the context of their relationships and lifestyles. Findings: Four domains emerged: HCV diagnosis and treatment; HCV treatment education; change in sense of self; and sexual risk‐taking. Adhering to treatment was a significant challenge for all participants and emerged across all domains. Discussion: Psychological services for this population of co‐infected gay men should assist this clinical population not only with adherence to hepatitis C treatment but should also be available at an earlier stage in the process to help patients make informed choices about whether or not to begin a course of treatment. Assessing factors such as coping strategies, treatment readiness and knowledge, self‐awareness, and level of risk‐taking, can guide clinicians in tailoring treatment and adherence planning for HIV/HCV‐co‐infected gay men.     

The psychological impact of AIDS on gay men

The profound psychological impact of the acquired immunodeficiency syndrome (AIDS) epidemic on gay men needs to receive greater attention from mental health professionals. The specific treatment approach depends upon the individual's location on the AIDS-related conditions continuum. For men already diagnosed with AIDS, psychological themes include fears of death and dying, guilt, concerns about exposure of a homosexual life-style, fear of contagion, loss of self-esteem, decreased social support and increased dependency needs, stigmatization, loss of occupational and financial security, confusion over medical treatment options, and severe depression. The integration of a mental health service into AIDS special care hospital wards and participation in support groups are particularly useful for men with AIDS. Anxiety is the major clinical symptom among those who have not developed full-blown AIDS, but show signs of immune suppression. Issues for men in this "gray zone" include isolation, poor social and occupational functioning due to fatigue, shame, and frustration of achievement needs. Stress- reduction techniques are especially important with this population, to eliminate further compromise to the immune system or even to strengthen it. Many asymptomatic gay men ("the worried well") are manifesting acute psychological symptoms such as panic, generalized anxiety, obsessional thinking about AIDS, and somatization. Training in the negotiation of safe-sex agreements can reduce some of this anxiety. In general, the AIDS epidemic has introduced an existential component to psychotherapy with gay men, with a concern over issues such as the meaning of life and death.     

Mental Illness and Psychiatric Treatment Among Women

When mental illness is precisely defined as a functional disorder involving acute distress or disorganization (or both), women are consistently found to have higher rates of mental illness than men. This sex difference appears to be real and not an artifact of response bias, patient behavior, or clinician bias. The higher rates of mental illness among women can be linked to aspects of their societal role and particularly to aspects of the marital role. Therapists who treat women whose mental illness is in part a response to the characteristics of conventional sex roles have no treatment alternatives that are not in some way problematic. The treatment alternative chosen has, in the broadest sense, political implications for the society at large.     

Functional analysis and generalized treatment of disruptive behavior during dental exams

Patient disruption during dental visits can impede treatment and may result in invasive approaches to care. The current study evaluated the efficacy of graduated exposure with and without extinction to decrease disruption during dental treatment for 4 young men with autism spectrum disorder (ASD). Modified functional analyses confirmed that disruption was maintained by escape from dental demands for all four young men. Initial treatment consisted of graduated exposure, whereby exam steps were initially removed and then gradually reintroduced as disruption remained low; throughout this phase, disruption resulted in a break from the exam. During the subsequent treatment phase, graduated exposure procedures continued and extinction for disruption was added. Graduated exposure alone did not result in sufficient treatment effects; however, the addition of extinction resulted in greater reductions in disruption and increases in exam completion for all 4 young men, and treatment effects generalized to a dental clinic setting.     

Breast Cancer in Men: Emasculation by Association?

The occurrence of breast cancer in men is rare in comparison to women. Public knowledge that men can get breast cancer and of male breast self-examination are lacking. Research in the course and treatment of breast cancer in men is needed. Men generally present in more advanced stages of breast cancer than women, and have a poorer prognosis. In this article, the epidemiology, common symptoms, diagnostic methods, and current treatment of breast cancer in men are described. Gender differences in presentation and course of illness are discussed. Additionally, the psychological implications of breast cancer for male gender roles and masculine identity are explored. Directions for further investigation are given. Treatment providers are encouraged to educate themselves and their male patients on breast cancer in men and male breast examination techniques so that this disease may be identified earlier in its course and survival rates improved.     

Characteristics of men who have sex with men on the internet but identify as heterosexual, compared with heterosexually identified men who have sex with women.

We compared men who have sex with other men on the Internet with the remainder of the sample of men who reported only sex with women on the Internet, in a sample of 1,846 Swedish men recruited from a major Swedish portal. We report on the self-identified heterosexual men in the sample who reported engaging in cybersex in the past year, and for whom there was complete data on sexual identity and the gender of cybersexual partners. Of the 244 cases with full data, 76% were heterosexual in both identity and behavior, 16% were gay or bisexual in identity and reported both male and female cybersexual contacts on the Internet, and 8% indicated their sexual preference was heterosexual but also reported at least one male sexual partner on the Internet. Thus, 11% of self-identified heterosexual men had sex with other men online. Comparing the two groups, the men who had sex with men (MSM) who did not identify (MSM-NI) spent significantly more time per week online, although a similar amount of time on sexual pursuits, as the heterosexual men. The MSM-NI were significantly more likely to agree that their online sexuality had affected their sexuality in a positive way, to have bought sex from prostitutes, to agree that they do things online that they would not do offline, have cybersex more often, use a web-camera and microphone more often, flirt and visit contact sites more often, and agree more often that sexual thoughts and behaviors are causing problems, desire to have sex creates problems, and sometimes fail to meet commitments due to their sexual behavior. These data taken together suggest that MSM-NI online are not uncommon and are characterized by the extent of their cybersexual involvement that sometimes extends to other men. Such men may rationalize this cybersex with other men as not, or minimally, sexual in much the same way as Humphreys characterized MSMs in public restrooms.