GENDER DIFFERENCES

• LITTLE DIFFERENCE FOR PSYCHOSES• MOST VERY GENDER SPECIFIC• WOMEN = 2/3 OF DEPRESSION, ANXIETY,

DISTRESS, SUICIDE ATTEMPTS, ALMOST ALL EATING DISORDERS

• MEN = 2/3 OF ALCOHOL AND DRUG PROBLEMS, 4X SUICIDES, 5X VIOLENCE, ALMOST ALL GAMBLING

• OVERALL RATES EQUAL

FUNCTIONAL EQUIVALENCE

• ARE MALE AND FEMALE EXPRESSIONS OF MENTAL ILLNESS FUNCTIONAL EQUIVALENTS?

• E.G. EATING DISORDERS AND GAMBLING COMPARABLE SEX-TYPED EXPRESSIONS?

• E.G. DEPRESSION AND ALCOHOLISM

REASONS

• CULTURAL EXPECTATIONS ABOUT GENDER ROLES

• WOMEN INTERNALIZE

• WOMEN EXPECTED NOT TO EXTERNALIZE

• MEN EXTERNALIZE

• MEN EXPECTED NOT TO INTERNALIZE

FUNCTIONAL EQUIVALENCE

• EXPECT AFTER STRESSFUL EVENTS WOMEN’S DEPRESSION, BUT NOT ALCOHOL USE, GOES UP

• MEN’S ALCOHOL USE BUT NOT DEPRESSION GOES UP

• LITTLE EVIDENCE, THOUGH

IMPLICATIONS

• SHOULD USE MULTIPLE OUTCOMES TYPICAL OF EACH SEX

• WHEN HAVE BOTH MALE AND FEMALE OUTCOMES, FEWER DIFFERENCES IN MENTAL HEALTH

TREATMENT DIFFERENCES

• WOMEN ABOUT 2/3 OF OUTPATIENTS

• MEN ABOUT 60% OF INPATIENTS

INPATIENT TREATMENT

• MEN MORE LIKELY THAN WOMEN TO BE INPATIENTS

• MEN’S SYMPTOMS MORE TROUBLESOME AND VIOLENT

• MEN DELAY TREATMENT

• MEN’S TREATMENT OFTEN INVOLUNTARY

OUTPATIENT TREATMENT

• WOMEN MORE LIKELY TO DEFINE SELVES AS HAVING PSYCHOLOGICAL PROBLEMS

• WOMEN MORE LIKELY TO SEEK MENTAL HEALTH TREATMENT

• WOMEN MORE LIKELY TO REMAIN IN TREATMENT - PATIENT ROLE

SUMMARY

• ROLES AND EXPECTATIONS, AS WELL AS PERSONS, ARE IMPORTANT

• TO SOME EXTENT, SIMILAR ROLES MEAN SIMILAR RATES OF MENTAL ILLNESS

TYPES

• DO MEN AND WOMEN HAVE DIFFERENT TYPES OF M.I.?

• YES, WOMEN MORE LIKELY TO BE DEPRESSED AND ANXIOUS, MEN TO DRINK AND BECOME VIOLENT

TREATMENT

• MEN HAVE MORE INPATIENT, WOMEN HAVE MORE OUTPATIENT

• DUE TO GENDER ROLES

RECENT CHANGES

• 1950 – MARRIED COUPLES 80% OF ALL HOUSEHOLDS; 2000 – 50%

• 10X GROWTH OF COHABITATION SINCE 1970

• HUGE GROWTH OF DIVORCE IN 1960s-1970s, STABLE SINCE THEN

RECENT TRENDS

• PEOPLE DELAYING MARRIAGE UNTIL LATE 20’S

• HUGE GROWTH OF PEOPLE LIVING ALONE – NOW 26% OF TOTAL

• MARRIAGE WEAKENING?

THREE QUESTIONS

• HOW IS MARRIAGE RELATED TO MENTAL HEALTH?

• HOW IS DIVORCE RELATED TO MENTAL HEALTH?

• ARE MARRIAGE AND DIVORCE DIFFERENT FOR MEN AND WOMEN?

I. TRADITIONAL VIEW

• MARRIAGE IS GOOD FOR MENTAL HEALTH

• INTERPERSONAL - SOCIAL SUPPORT, EMOTIONAL SECURITY, INTIMACY

• SOCIAL INTEGRATION - TIES TO COMMUNITY

BENEFITS OF MARRIAGE

• ECONOMIC WELL-BEING - MARRIED EARN MORE (WOMEN + $12,000; MEN + $7,000)

• HEALTH BEHAVIOR - MARRIED FEWER RISKIER BEHAVIORS, MORE HEALTH PROMOTIVE BEHAVIORS

II. BENEFITS OF MARRIAGE DATED

• CHANGES IN SOCIAL NORMS• FREEDOM AND AUTONOMY• STAYING SINGLE AND GETTING

DIVORCED NOT STIGMATIZED• RISE OF COHABITATION• MORE CHILDREN OUT-OF-WEDLOCK

- 34% IN U.S.(VS. 5% IN 1960); 50% IN SCANDANAVIA

III. FEMINIST VIEW

• ADVANTAGES ONLY FOR MEN

• MARRIAGE SOURCE OF OPPRESSION FOR WOMEN

• ROLE OVERLOAD

• CONFLICT AND VIOLENCE

MARRIAGE AND DISTRESS

0

5

10

15

20

25

30

35

SM

SW

MM

MW

• BOTH MEN AND WOMEN BENEFIT

• MEN BENEFIT MORE

• SELECTION?