Gender Differences in Depression

From early adolescence through adulthood, women are twice as likely as men to experience depression. Many different explanations for this gender difference in depression have been offered, but none seems to fully explain it. Recent research has focused on gender differences in stress responses, and in exposure to certain stressors. I review this research and describe how gender differences in stress experiences and stress reactivity may interact to create women's greater vulnerability to depression.     

Gender Differences in Cognitive and Emotional Adjustment to Traumatic Brain Injury

This study examined gender differences in cognitive and emotional status after traumatic brain injury (TBI) among 262 men and 140 women with TBI referred for neuropsychological evaluations. In this cross-sectional study, cognition was measured in terms of both absolute level of functioning (i.e., raw/standard scores) and estimated decline from premorbid levels expressed as z-deficit scores in the following domains: intelligence [Wechsler Adult Intelligence Scale—Revised (WAIS-R)], memory and attention [Wechsler Memory Scale—Revised (WMS-R)], processing speed (Trails A), and cognitive flexibility (Trails B). Emotional functioning was measured in terms of depression (Beck Depression Inventory) and general emotional distress (Brief Symptom Inventory). Kruskal–Wallis nonparametric one-way ANOVAs indicated that women and men differed significantly on 2 of 8 raw/standard cognitive scores [men demonstrated lower WMS-R General Memory (p < .05) and Trails B scores (p < .0001) and 4 of 8 relative decline scores [women demonstrated more estimated change in VIQ (Verbal IQ) [p < .0001], FSIQ (Full Scale IQ) [p < .01], and Attention (p < .01)]; men demonstrated greater estimated z-decline scores on Trails B (p < .01)]. Women reported significantly higher levels of depression (p < .01), but men endorsed significantly greater general psychological distress (p < .05). Research and assessment recommendations are suggested.     

Coping Style and Depression in Early Adolescence: Relationships to Gender,Gender Role,and Implicit Beliefs

Three studies were designed to investigate the interrelationships among coping styles, gender roles, and level of depression for early adolescents. Girls displayed more depression than boys, and more highly depressed girls demonstrated coping patterns similar to those of depressed adolescent and adult women. Individuals who identified with the feminine gender role showed increases in depression with age. Participants' implicit beliefs about what constituted appropriate coping behavior were also linked to gender. Both genders believed that men should not ruminate but that they should distract themselves from problems. The implications of these findings are discussed.     

Peer Rejection in Childhood: Effects on Maternal Depression and Behavior Problems in Toddlers

The aim of this study was to develop a conceptual model that would clarify how a woman's recollections of peer and parent rejection in childhood influence her emotional well-being and, resultantly, her own child's behavior problems. Given current interest in peer versus parent influences, the authors used a design and analysis to reveal the unique contributions of peer and parent rejection. The participants were a community sample of 88 mothers and their 2 1/2-year-old children. The study found that mothers' recollections of peer rejection in childhood were significantly associated with depressive symptomatology, but recollections of parental rejection in childhood were unrelated to current depressive symptoms. Recollections of peer rejection during childhood, internal representation of self, and depressive symptoms made significant, unique contributions to the variance in behavior problems in their children. Together, these variables significantly explained 27% of the variance in the final model.     

Cognitive Vulnerability to Depression in Canadian and Chinese Adolescents

The goal of the current study was to compare diathesis-stress and transactional models of cognitive vulnerability to depression in samples of Canadian (n = 118) and Chinese (n = 405) adolescents. We utilized a six-month multi-wave, longitudinal design in order to examine whether (a) perceived control moderated the association between the occurrence of dependent interpersonal stressors and subsequent increases in depressive symptoms (i.e., a diathesis-stress perspective) and (b) dependent interpersonal stressors mediated the association between perceived control and subsequent increases in depressive symptoms (i.e., a transactional perspective). Results from idiographic, time-lagged, hierarchical linear modeling analyses indicated that for Canadian adolescents both diathesis-stress and transactional models were significant predictors of depressive symptomology. When examining the diathesis-stress model, boys, but not girls, who reported lower perceived control, reported higher levels of depressive symptoms following the occurrence of dependent interpersonal stress. Gender differences, however, were not present in the transactional model. In contrast, transactional, but not diathesis-stress, models were significant in Chinese adolescents, and gender differences did not emerge. Overall, these results may reflect culturally-relevant differences in the etiology of depression in Canadian and Chinese adolescents.     

Gender Differences in Self-Reports of Depression: The Response Bias Hypothesis Revisited

This study was designed to revisit the response bias hypothesis, which posits that gender differences in depression prevalence rates may reflect a tendency for men to underreport depressive symptoms. In this study, we examined aspects of gender role socialization (gender-related traits, socially desirable responding, beliefs about mental health and depression) that may contribute to a response bias in self-reports of depression. In addition, we investigated the impact of two contextual variables (i.e., cause of depression and level of intrusiveness of experimental follow-up) on self-reports of depressive symptoms. Results indicated that men, but not women, reported fewer depressive symptoms when consent forms indicated that a more involved follow-up might occur. Further, results indicated differential responding by men and women on measures of gender-related traits, mental health beliefs, and beliefs about depression and predictors of depressed mood. Together, our results support the assertion that, in specific contexts, a response bias explanation warrants further consideration in investigations of gender differences in rates of self-reported depression.     

Parental Discipline and Externalizing Behavior Problems in Early Childhood: The Roles of Moral Regulation and Child Gender

We tested whether individual differences in a component of early conscience mediated relations between parental discipline and externalizing behavior problems in 238 3.5-year-olds. Parents contributed assessments of discipline practices and child moral regulation. Observations of children's behavioral restraint supplemented parental reports. Parents and teachers reported on child externalizing symptoms. Parental induction, warm responsiveness, and less frequent use of physical punishment generally were associated with higher levels of moral regulation and fewer externalizing problems. Moreover, moral regulation partially mediated relationships between discipline and externalizing symptoms, with the clearest case of mediation involving induction. However, relationships were found for boys only. Results support a mediation model wherein inductive and physical discipline may influence the expression of boys' externalizing behavior through effects on conscience. Finally, results suggest that different developmental processes may be associated with early externalizing problems in boys and girls, and confirm that fathers' reports contribute to our understanding of the origins of child externalizing problems.     

Gender Differences in the Self-Assessment of Accuracy on Cognitive Tasks

Generally, self-assessment of accuracy in the cognitive domain produces overconfidence, whereas self-assessment of the accuracy of visual perceptual judgments produces underconfidence. The possible effect of gender differences on these robust findings appears to be underinvestigated. In this paper, I report two studies that take a step toward redressing this shortcoming. In Study 1, a group of young adults (N =185) were presented with a test of General Knowledge and a visual perceptual task. The results indicated the typical over/underconfidence phenomena noted above, but, when analyzed by sex, indicated statistically significant differences; men were more confident than women on both tasks. In Study 2, participants (N =303) with a wider age range completed 4 tests of cognitive ability, which were drawn from the theory of fluid and crystallized intelligence. Results indicated that the tendency for men to express higher levels of confidence than women in the accuracy of their work appears to remain constant across the life-span. These findings are discussed in relation to self-concept and gender stereotyping.     

自动思维及归因方式对抑郁症作用的多因素分析

目的：探讨抑郁症患者治疗前后自动思维、应付方式变化对抑郁严重程度变化的影响及其相互作用。方法：对97例抑郁症患者分别在其入、出院时进行测评,测评工具包括自评抑郁量表、自动思维问卷和归因方式问卷。此外对100例正常对照亦进行上述测评,其中29例在15—20天后重测。结果：自动思维问卷得分、归因方式问卷得分的logistic回归分析、路径分析表明,自动思维、对正性事件的整体性维度的归因方式对抑郁程度的影响有显著作用,自动思维的变化对SDS的变化的直接影响最大(路径系数为0．572),归因方式中正性事件整体性归因的变化为其次(路径系数为一0．193),而自动思维的变化与归因方式中正性事件整体性归因的变化的相互影响较小(路径系数为-0．188)。结论：自动思维、对正性事件的整体性维度的归因方式对抑郁严重程度有显著影响。     

儿童侵犯性性别差异的社会认知技能视角

影响侵犯性性别差异的因素众多,本研究认为的社会认知技能的性别差异与侵犯性性别差异有密切关系,认知技能是风险因素和行为之间的调节者。女性相比于男性侵犯性行为少与女性神经机制的发展缺陷概率小,生理成熟早,最终发展形成较男性更好的社会认知技能有密切关系。     

Cognitive Theories of Depression in Children and Adolescents: A Conceptual and Quantitative Review

This paper quantitatively reviews longitudinal studies examining three central cognitive theories of depression—Beck’s theory, Hopelessness theory, and the Response Styles theory—among children (age 8–12) and adolescents (age 13–19). We examine the effect sizes in 20 longitudinal studies, which investigated the relation between the cognitive vulnerability–stress interaction and its association with prospective elevations in depression after controlling for initial levels of depressive symptoms. The results of this review suggest that across theories there is a small relation between the vulnerability–stress interaction and elevations in depression among children (pr = 0.15) and a moderately larger effect (pr = 0.22) among adolescents. Despite these important findings, understanding their implications has been obscured by critical methodological, statistical, and theoretical limitations that bear on cognitive theories of depression. The evidence base has been limited by poor measurement of cognitive vulnerabilities and over reliance on null hypothesis significance testing; these have contributed to a field with many gaps and inconsistencies. The relative paucity of research on developmental applications of such theories reveals that surprisingly little is known about their hypothesized etiologic mechanisms in children and adolescents. Ways to advance knowledge in the area of cognitive theories of depression among youth are discussed.     

Relations of Age to Cognitive and Motivational Elements of Impulse Control in Boys With and Without Externalizing Behavior Problems

In a cross-sectional study of 83 unmedicated boys, 6 to 16 years of age (M = 10.6, SD = 2.1), attending public (N = 48) and therapeutic schools for behaviorally disturbed children (N = 35), we examined relations of externalizing psychopathology to age-dependent change in performance on cognitive and motivational dimensions of impulse control assessed by laboratory tasks. When we controlled for internalizing symptoms and IQ or school achievement, all children showed improving competence with increasing age on both dimensions over the age range of the sample. Children with externalizing problems performed more poorly on both dimensions at all ages than children without such problems. Comparing age-dependent competence for the two groups, a model of convergent maturation in cognitive aspects of impulse control, and a model depicting a stable deficit in motivational aspects of impulse control in those children with externalizing behavior problems, relative to those without such problems, emerged. Studies of individual growth in impulse control, together with correlates of growth, are needed to validate these observations.Project on Human Development in Chicago Neighborhoods     

Dysfunctional Beliefs and Marital Conflict in Distressed and Non-Distressed Married Individuals

To test the hypothesis that the irrational evaluative beliefs, postulated by Rational-emotive behavior therapy, are related to marital conflict, 17 individuals from distressed marriages and 20 from non-distressed marriages participated in the Articulated Thoughts during Simulated Situations procedure. Four scenes, representing different dimensions of marital conflict (power/control, boundaries, expressive investment and instrumental investment), were used. On all the scenes, the distressed group showed significantly more irrational cognitions than the non-distressed group, while the scenes elicited significantly more positive thoughts with the non-distressed individuals compared to the distressed group. The results also showed that the non-distressed group displayed significantly more positive than negative thoughts for all the conflict scenes combined. However, no significant difference between positive and negative thoughts was found for the distressed group.     

Prospective Longitudinal Associations Between Persistent Sleep Problems in Childhood and Anxiety and Depression Disorders in Adulthood

The objective of this study was to examine the associations between persistent childhood sleep problems and adulthood anxiety and depression. Parents of 943 children (52% male) participating in the Dunedin Multidisciplinary Health and Development Study provided information on their childrens sleep and internalizing problems at ages 5, 7, and 9 years. When the participants were 21 and 26 years, adult anxiety and depression were diagnosed using a standardized diagnostic interview. After controlling for childhood internalizing problems, sex, and socioeconomic status, persistent sleep problems in childhood predicted adulthood anxiety disorders (OR (95% CI) = 1.60 (1.05–2.45), p = .030) but not depressive disorders (OR (95% CI) = .99 (.63–1.56), p = .959). Persistent sleep problems in childhood may be an early risk indicator of anxiety in adulthood.     

Attitudes to Marriage and Sexual Behaviors: A Survey of Gender and Culture Differences in China and United Kingdom

This paper reports a survey carried out among 505 university students in China and 338 students in the United Kingdom. The survey included questions on attitudes toward mate-selection preferences, marriage, and sexual behavior. The findings show that traditional values in mate-selection preferences persist more in China than in the United Kingdom and indicate that, despite a profound social revolution over the last two decades, a relatively conservative sexual culture still exists in China today. Traditional morality and attitudes prevail especially among women. Gender and culture differences are discussed.     

The Comorbidity of Conduct Problems and Depression in Childhood and Adolescence

An extensive body of research documents the high prevalence of comorbidity among child and adolescent disorders in general and between conduct problems and depression in particular. These problems co-occur at significantly higher rates than would be expected by chance and their comorbidity may have significant implications for nosology, treatment, and prognosis. Four main hypotheses have been put forth to account for these high rates of comorbidity. First, comorbidity may be a result of shortcomings associated with referral or informant biases. Second, comorbidity may be an artifact of overlapping definitional criteria. Third, one disorder may cause the other disorder by influencing the developmental trajectory and placing an individual at increased risk for further difficulties. Finally, comorbidity between two disorders may be explained by shared underlying causal or risk factors. The purpose of this review is to explore these possibilities, concentrating primarily on the common risk factors of parent psychopathology, emotion regulation, and cognitive biases that may underlie the co-occurrence of these two disorders. Based on our review, we propose a model for the development of comorbidity between these two disorders.     

Maternal Antisocial Behavior, Parenting Practices, and Behavior Problems in Boys at Risk for Antisocial Behavior

We investigated the independent contributions of maternal history of antisocial behavior and parenting practices to the worsening course of sons' behavior problems in a sample of young urban boys at risk for antisocial behavior. Mothers reported on boys' behavior problems at baseline and one year later, as well as on their own history of antisocial behavior before and after age 15, and of lifetime depression and substance use disorders (provisional DSM-III-R diagnoses). Baseline reports of parenting practices were obtained. Lower involvement, lower monitoring, and higher levels of parent–child conflict and maternal Conduct Disorder (CD) before age 15 contributed to the worsening of boys' behavior problems one year later; mothers' symptoms of Antisocial Personality Disorder after age 15 did not. Mothers' lifetime history of Major Depression and Substance Use Disorder did not add to the worsening of boys' behavior problems after accounting for these other factors. Although maternal CD contributed directly to the worsening of boys' behavior problems, the effect of parenting was more substantial. We discuss clinical implications for prevention and treatment of children's antisocial behavior, and intergenerational implications of girls' early antisocial behavior.     

Individual Differences in Experiences of and Responses to Guilt and Shame: Examining the Lenses of Gender and Gender Role

How are experiences of and reactions to guilt and shame a function of gendered views of the self? Individual differences in guilt and shame responses were explored in a sample of 104 young adults, most of whom were European American. Results indicated that, although women reported greater proneness to guilt and shame, men reported more trait guilt. Heightened levels of guilt- and shame-proneness were observed among both men and women with traditionally feminine gender roles, whereas a more traditionally masculine self-concept was associated with decreased shame-proneness for women. Gender schematic women favored verbal responses to ameliorate the experience of guilt, whereas gender schematic men preferred action-oriented responses. These results are discussed as gendered outcomes of schematic versus aschematic gender role socialization.     

Development and Pilot Evaluation of Smartphone-Delivered Cognitive Behavior Therapy Strategies for Mood- and Anxiety-Related Problems: MoodMission

Given the ubiquity and interactive power of smartphones, there are opportunities to develop smartphone applications (apps) that provide novel, highly accessible mental health supports. This paper details the development of a smartphone app, “MoodMission,” that aims to provide evidence-based Cognitive Behavior Therapy (CBT) strategies for mood- and anxiety-related problems, contributing to the prevention of clinically significant depression and anxiety disorders and serving as an adjunct to therapeutic interventions delivered by trained health professionals. MoodMission was designed to deliver strategies in the form of real-time, momentary responses to user-reported low moods and anxiety. The development process involved: (a) construction of a battery of strategies, (b) empirical evaluation, (c) a software and behavioral plan design and testing process, (d) user feedback, and (e) a public launch. A pilot study of 44 participants completed the Mobile Application Rating Scale (MARS; Hides et al., 2014) for usability testing and feedback. MoodMission was rated significantly higher than standardized health app norms on the majority of the domains, including Entertainment, Interest, Customization, Target Group, Graphics, Visual Appeal, Quality of Information, Quantity of Information, Visual Information, Credibility of Source, Recommendation to Use, Estimated Frequency of Use, and Overall Rating (Hedges’s g range 0.57–1.97, p < .006). Case examples illustrate the practical uses of the app. In addition to clinical applications, MoodMission holds promise as a research tool either as an augmentation to clinician-delivered therapy, or as a vehicle for standardizing client access to specific CBT strategies (e.g., in studies intending to study different change processes).