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Kanamori M, Stickley A, Takemura K, Kobayashi Y, Oka M, Ojima T, Kondo K, Kondo N. Community gender norms, mental health, and suicide ideation and attempts among older Japanese adults: a cross-sectional study. Int Psychogeriatr 2024; 36:385-395. [PMID: 37927096 DOI: 10.1017/s104161022300087x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2023]
Abstract
OBJECTIVES Gender norms embedded in communities may restrict opportunities and harm the mental health of older adults, yet this phenomenon has received little attention. This study investigates the connection between older adults' perceptions of community gender norms and mental health and suicide-related outcomes. DESIGN Cross-sectional. SETTING This study analyzed data from the 2019 wave of the Japan Gerontological Evaluation Study. PARTICIPANTS In total, 25,937 participants aged 65 years or older in 61 municipalities. MEASUREMENTS Perceptions of community gender norms were assessed by the respondents' perceptions of the gender-differentiating language used by those around them such as "You should/should not do XXX, because you are a man/woman." RESULTS The prevalence of all mental health outcomes was higher among both men and women who perceived community gender norms as restrictive. These associations remained in fully adjusted multivariable analyses. Prevalence ratios for men were 1.36 [95% confidence interval: 1.13, 1.65] for psychological resistance to obtaining help, 1.85 [1.54, 2.23] for depressive symptoms, 1.99 [1.34, 2.96] for suicidal ideation, and 2.15 [1.21, 3.80] for suicide attempts. The corresponding figures for women were 1.39 [1.17, 1.65], 1.80 [1.55, 2.10], 2.13 [1.65, 2.74], 2.62 [1.78, 3.87]. There was a more pronounced association between perceiving community gender norms as restrictive and depressive symptoms and suicidal behaviors among those with nonconventional gender role attitudes compared to those with conventional attitudes. CONCLUSIONS Considering the effects of community gender norms, in addition to individual gender role attitudes, may be critical in designing effective public health interventions for improving mental health.
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Affiliation(s)
- Mariko Kanamori
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
- Institute for the Future of Human Society, Kyoto University, Kyoto, Japan
- Department of Social Epidemiology, Graduate School of Medicine and School of Public Health, Kyoto University, Kyoto, Japan
- Department of Health and Social Behavior, Faculty of Medicine, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Japan
| | - Andrew Stickley
- Department of Social Epidemiology, Graduate School of Medicine and School of Public Health, Kyoto University, Kyoto, Japan
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | | | - Yumiko Kobayashi
- Department of Social Epidemiology, Graduate School of Medicine and School of Public Health, Kyoto University, Kyoto, Japan
- Department of Health and Social Behavior, Faculty of Medicine, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Japan
| | - Mayumi Oka
- Research Center for Medical and Health Data Science, The Institute of Statistical Mathematics, Tachikawa, Japan
| | - Toshiyuki Ojima
- Department of Community Health and Preventive Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Katsunori Kondo
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
- Department of Gerontological Evaluation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Moriokacho, Japan
| | - Naoki Kondo
- Department of Social Epidemiology, Graduate School of Medicine and School of Public Health, Kyoto University, Kyoto, Japan
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Gholi Zadeh Kharrat F, Gagne C, Lesage A, Gariépy G, Pelletier JF, Brousseau-Paradis C, Rochette L, Pelletier E, Lévesque P, Mohammed M, Wang J. Explainable artificial intelligence models for predicting risk of suicide using health administrative data in Quebec. PLoS One 2024; 19:e0301117. [PMID: 38568987 PMCID: PMC10990247 DOI: 10.1371/journal.pone.0301117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 03/11/2024] [Indexed: 04/05/2024] Open
Abstract
Suicide is a complex, multidimensional event, and a significant challenge for prevention globally. Artificial intelligence (AI) and machine learning (ML) have emerged to harness large-scale datasets to enhance risk detection. In order to trust and act upon the predictions made with ML, more intuitive user interfaces must be validated. Thus, Interpretable AI is one of the crucial directions which could allow policy and decision makers to make reasonable and data-driven decisions that can ultimately lead to better mental health services planning and suicide prevention. This research aimed to develop sex-specific ML models for predicting the population risk of suicide and to interpret the models. Data were from the Quebec Integrated Chronic Disease Surveillance System (QICDSS), covering up to 98% of the population in the province of Quebec and containing data for over 20,000 suicides between 2002 and 2019. We employed a case-control study design. Individuals were considered cases if they were aged 15+ and had died from suicide between January 1st, 2002, and December 31st, 2019 (n = 18339). Controls were a random sample of 1% of the Quebec population aged 15+ of each year, who were alive on December 31st of each year, from 2002 to 2019 (n = 1,307,370). We included 103 features, including individual, programmatic, systemic, and community factors, measured up to five years prior to the suicide events. We trained and then validated the sex-specific predictive risk model using supervised ML algorithms, including Logistic Regression (LR), Random Forest (RF), Extreme Gradient Boosting (XGBoost) and Multilayer perceptron (MLP). We computed operating characteristics, including sensitivity, specificity, and Positive Predictive Value (PPV). We then generated receiver operating characteristic (ROC) curves to predict suicides and calibration measures. For interpretability, Shapley Additive Explanations (SHAP) was used with the global explanation to determine how much the input features contribute to the models' output and the largest absolute coefficients. The best sensitivity was 0.38 with logistic regression for males and 0.47 with MLP for females; the XGBoost Classifier with 0.25 for males and 0.19 for females had the best precision (PPV). This study demonstrated the useful potential of explainable AI models as tools for decision-making and population-level suicide prevention actions. The ML models included individual, programmatic, systemic, and community levels variables available routinely to decision makers and planners in a public managed care system. Caution shall be exercised in the interpretation of variables associated in a predictive model since they are not causal, and other designs are required to establish the value of individual treatments. The next steps are to produce an intuitive user interface for decision makers, planners and other stakeholders like clinicians or representatives of families and people with live experience of suicidal behaviors or death by suicide. For example, how variations in the quality of local area primary care programs for depression or substance use disorders or increased in regional mental health and addiction budgets would lower suicide rates.
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Affiliation(s)
- Fatemeh Gholi Zadeh Kharrat
- Institut Intelligence et Données (IID), Université Laval, Québec, Québec, Canada
- Institut National de Santé Publique du Québec (INSPQ), Québec, Québec, Canada
| | - Christian Gagne
- Institut Intelligence et Données (IID), Université Laval, Québec, Québec, Canada
| | - Alain Lesage
- Department of Psychiatry and Addiction, Université de Montréal, Montreal, QC, Canada
- Centre de Recherche de l’Institut Universitaire en Santé Mentale de Montréal, Québec, Canada
| | - Geneviève Gariépy
- Centre for Surveillance and Applied Research, Health Promotion and Chronic Disease Prevention Branch, Public Health Agency of Canada, Ottawa, Canada
- Department of Social and Preventive Medicine, School of Public Health, University of Montreal, Montreal, Canada
- Montreal Mental Health University Institute Research Center, Montreal, Canada
| | - Jean-François Pelletier
- Department of Psychiatry and Addiction, Université de Montréal, Montreal, QC, Canada
- Centre de Recherche de l’Institut Universitaire en Santé Mentale de Montréal, Québec, Canada
| | - Camille Brousseau-Paradis
- Department of Psychiatry and Addiction, Université de Montréal, Montreal, QC, Canada
- Centre de Recherche de l’Institut Universitaire en Santé Mentale de Montréal, Québec, Canada
| | - Louis Rochette
- Institut National de Santé Publique du Québec (INSPQ), Québec, Québec, Canada
| | - Eric Pelletier
- Institut National de Santé Publique du Québec (INSPQ), Québec, Québec, Canada
| | - Pascale Lévesque
- Institut National de Santé Publique du Québec (INSPQ), Québec, Québec, Canada
| | - Mada Mohammed
- Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, Canada
| | - JianLi Wang
- Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, Canada
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Aguirre E, Benzeval M, Murray A. Parental gender attitudes and children's mental health: Evidence from the UK household longitudinal study. Soc Sci Med 2024; 344:116632. [PMID: 38316081 DOI: 10.1016/j.socscimed.2024.116632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 01/22/2024] [Accepted: 01/24/2024] [Indexed: 02/07/2024]
Abstract
Gender role attitudes have been found to be associated with the mental health of adults and adolescents, but little is known about whether parents' gender attitudes are associated with their children's mental health. Using data from Understanding Society, the UK Household Longitudinal Study (UKHLS), a large-population representative sample, we examine the links between parental gender role attitudes and child mental health outcomes as measured by the total and five components of the strengths and difficulties questionnaire (SDQ). We construct structural equation models, separately for mothers and for fathers and for children aged 5 and 8, and adjust for key sociodemographic variables. We find that children aged 5 years exhibit fewer emotional and peer relationship problems and are more prosocial when their mothers have more egalitarian (compared to traditionalist) gender role attitudes. We also find that children are more prosocial at age 8 when their mothers have more egalitarian gender role attitudes. No statistically significant mediation effect is observed via maternal parenting behaviour. Fathers' more egalitarian gender role attitudes were associated with higher hyperactivity at age 5 and more prosocial behaviour at age 8. Further, engaging in less negative parenting behaviour completely mediates the association of fathers' more egalitarian gender attitudes with children's mental health across the majority of the SDQ scales. This suggests that parental gender attitudes may be a possible target for the prevention of mental health difficulties among children; however, future research will be required to examine the extent to which the associations we identified reflect causality.
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Affiliation(s)
- Edith Aguirre
- Institute for Social and Economic Research, University of Essex, Wivenhoe Park, Colchester, Essex, C04 3SQ, United Kingdom.
| | - Michaela Benzeval
- Institute for Social and Economic Research, University of Essex, Wivenhoe Park, Colchester, Essex, C04 3SQ, United Kingdom
| | - Aja Murray
- Department of Psychology, University of Edinburgh, 7 George Square, Edinburgh, EH8 9JZ, United Kingdom
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Bentum JV, Sijbrandij M, Huibers M, Begeer S. Occurrence and predictors of lifetime suicidality and suicidal ideation in autistic adults. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024:13623613231225901. [PMID: 38340029 DOI: 10.1177/13623613231225901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2024]
Abstract
LAY ABSTRACT Over the past few years, more and more research is showing that many autistic people are at an increased risk for suicide. In this study, we asked participants from the Netherlands Autism Register, which is longitudinal register including individuals with autism, about their possible experiences with thoughts and feelings about suicide. Specifically, we looked at whether these thoughts and feelings in their lifetime and in the past month were related to various factors (such as their age, gender, and having psychiatric disorder diagnoses). We found that 80% of the participants had experienced thoughts about or even attempted to take their own life at least once throughout their lifetime. Furthermore, in a subgroup of participants, we found that the presence of a psychiatric disorder diagnosis, feelings of loneliness, and a higher number of autistic traits were associated with experiencing suicidal thoughts and feelings in their lifetime. For those who experienced these suicidal thoughts in the past month, we found that having (multiple) psychiatric disorder diagnoses and a higher number of autistic traits were related to more severe and frequent thoughts about suicide in the past month. Our findings show that additional factors in autistic individuals should be considered when assessing the suicide risk, and it brings us one step closer to understanding why suicide is more common for autistic people.
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Affiliation(s)
- J van Bentum
- Vrije Universiteit Amsterdam, The Netherlands
- Utrecht University, The Netherlands
| | | | | | - S Begeer
- Vrije Universiteit Amsterdam, The Netherlands
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Sunderland M, Batterham PJ, Calear AL, Chapman C, Slade T. Factors associated with the time to transition from suicidal ideation to suicide plans and attempts in the Australian general population. Psychol Med 2023; 53:258-266. [PMID: 33926588 DOI: 10.1017/s0033291721001501] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Suicide plans and attempts rarely occur without prior suicidal ideation but are hard to predict. Early intervention efforts need to focus on subgroups of the population who are more likely to transition from ideation to suicidal plans and attempts. The current study utilised data from a large nationally representative sample to investigate the time taken to transition and the demographic and mental health correlates of transitioning to suicidal plans and attempts among those with suicidal ideation. METHODS Data were from 1237 Australians aged 16-85 years who reported suicidal thoughts at some point in their life. Discrete time survival analysis was used to retrospectively examine the time in years and correlates of transitioning from suicidal ideation to suicide plans and suicide attempt. RESULTS The majority of those who transitioned to suicide plans or attempts typically did so within 2 years of first experiencing suicidal ideation. Several factors were independently associated with increased speed to transition, including alcohol use disorder, drug use disorder, major depressive episode, obsessive compulsive disorder, sexual minority status, and non-urban location. Older age, being male, older age of first ideation and greater family support were associated with a slower transition. CONCLUSION The current study suggests that pre-existing mental or substance use disorders, particularly drug use disorder, as well as sexual minority status, sex and greater family support play an important role in the transition from suicidal ideation to plans or attempts. These results highlight the potential importance of suicide prevention programs that aim to improve social connectedness.
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Affiliation(s)
- Matthew Sunderland
- The Matilda Centre for Research in Mental Health and Substance Use, the University of Sydney, Sydney, Australia
| | - Philip J Batterham
- Centre for Mental Health Research, Research School of Population Health, the Australian National University, Canberra, Australia
| | - Alison L Calear
- Centre for Mental Health Research, Research School of Population Health, the Australian National University, Canberra, Australia
| | - Cath Chapman
- The Matilda Centre for Research in Mental Health and Substance Use, the University of Sydney, Sydney, Australia
| | - Tim Slade
- The Matilda Centre for Research in Mental Health and Substance Use, the University of Sydney, Sydney, Australia
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Baek SU, Yoon JH, Won JU. Associations between wives' and husbands' attitudes towards women's economic participation and depressive symptoms, poor subjective health, and unemployment status in married women: A Korean longitudinal study (2014–2020). SSM Popul Health 2022; 20:101275. [PMID: 36353093 PMCID: PMC9637806 DOI: 10.1016/j.ssmph.2022.101275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 09/05/2022] [Accepted: 10/21/2022] [Indexed: 11/09/2022] Open
Abstract
Introduction Previous research has investigated the relationship between an individuals' gender role attitudes (GRAs) and their psychological health. We hypothesized that holding traditional GRAs or having a husband who holds traditional GRAs may adversely affect a woman's health. Methods Data were obtained from a nationally representative longitudinal survey. Women's negative attitudes towards women's economic participation and husbands' negative attitudes towards their wives' economic participation were measured. The associations between the two and depressive symptoms, poor subjective health, and unemployment status in married women was estimated using a generalised estimating equation. Odds ratios (OR) and 95% confidence intervals (CIs) were calculated. Results Women's negative attitudes towards women's economic participation was associated with depressive symptoms (OR [95% CI]: 1.19 [1.09–1.31]), poor subjective health (1.14 [1.04–1.25]) and unemployment status (1.10 [1.05–1.15]) in married women. In addition, there were significant associations between husbands' negative attitudes towards their wives working and depressive symptoms (1.41 [1.23–1.60]), poor subjective health (1.69 [1.48–1.92]), and unemployment (1.80 [1.69–1.92]) in their wives. The effect was strongest when both wives and their husbands have negative attitudes. In addition, the models considering cumulative years of negative attitudes showed that wives holding negative attitudes towards women's economic participation for 3 years or more was associated with depressive symptoms (1.70 [1.42–2.04]), poor subjective health (1.28 [1.04–1.57]), and unemployment status (1.39 [1.22–1.58]). Similarly, husbands' holding 3 years or more of negative attitudes towards their wives' economic participation was associated with depressive symptoms (1.32 [1.02–1.72])), poor subjective health (1.81 [1.40–2.35]), and unemployment status (9.02 [7.97–10.21]) in their wives. Conclusions Our results show that one's own or one's husband's attitude towards women's economic participation affects not only the employment status of married women but also their mental and subjective health. Policymakers should implement policies that encourage positive attitudes towards women's economic activities. Traditional gender role attitudes increase the odds of depressive symptoms. Traditional gender role attitudes increase the odds of poor subjective health. Husbands who oppose their wives working increase their wives' risk for depression. Husbands who oppose their wives working increase their wives' risk for poor health. A longer duration of traditional or negative attitudes increases the impact.
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Affiliation(s)
- Seong-Uk Baek
- Department of Occupational and Environmental Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
- The Institute for Occupational Health, Yonsei University College of Medicine, Seoul, South Korea
- Graduate School, Yonsei University College of Medicine, Seoul, South Korea
| | - Jin-Ha Yoon
- The Institute for Occupational Health, Yonsei University College of Medicine, Seoul, South Korea
- Graduate School of Public Health, Yonsei University College of Medicine, Seoul, South Korea
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Jong-Uk Won
- Department of Occupational and Environmental Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
- The Institute for Occupational Health, Yonsei University College of Medicine, Seoul, South Korea
- Graduate School of Public Health, Yonsei University College of Medicine, Seoul, South Korea
- Corresponding author. Department of Occupational and Environmental Medicine, Severance Hospital, Yonsei University Health System, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea.
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Butler-Barnes ST, Leath S, Inniss-Thompson MN, Allen PC, D'Almeida MEDA, Boyd DT. Racial and gender discrimination by teachers: Risks for Black girls' depressive symptomatology and suicidal ideation. CULTURAL DIVERSITY & ETHNIC MINORITY PSYCHOLOGY 2022; 28:469-482. [PMID: 35389693 PMCID: PMC9537365 DOI: 10.1037/cdp0000538] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVES The present study examines how race and gender-specific factors (i.e., racial centrality and gender role beliefs) serve as protective assets against the harmful impact of racial and gender discrimination on depressive symptomatology and suicidal ideation for Black girls. METHOD Our sample included 232 Black girls ages 15-17 years old (Mage = 16.85) from a socioeconomically diverse community context. RESULTS Our findings revealed that racial and gender discrimination from teachers was associated with higher levels of depressive symptomatology. Perceived gender discrimination by teachers and endorsing traditional gender role beliefs were associated with higher reports of suicidal ideation. Perceiving higher instances of racial discrimination from teachers and reporting lower levels of racial centrality were associated with higher depressive symptomatology. CONCLUSIONS The findings suggest the need to create safe spaces and to consider the interactions that occur in school settings that impact the mental health of Black girls. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
| | - Seanna Leath
- Department of Psychology, University of Virginia
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Griffin L, Hosking W, Gill PR, Shearson K, Ivey G, Sharples J. The Gender Paradox: Understanding the Role of Masculinity in Suicidal Ideation. Am J Mens Health 2022; 16:15579883221123853. [PMID: 36121234 PMCID: PMC9490473 DOI: 10.1177/15579883221123853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
It is important to understand the role of social determinants, such as gender, in suicidal ideation. This study examined whether conformity to specific masculine norms, particularly high self-reliance and emotional self-control, moderated the relationship between psychological distress and suicidal ideation for men. The other norms explored were those pertaining to behavioral-emotional or social hierarchy status aspects of masculinity, and whether they moderated the psychological distress-suicidal ideation relationship for men and women. The Conformity to Masculine Norms Inventory, the Kessler Psychological Distress Scale, and the Suicidal Ideation Attributes Scale were administered to an Australian community sample in an online survey (n = 486). As predicted, higher psychological distress was associated with higher suicidal ideation. Self-reliance enhanced the relationship and was the only moderator among men. High self-reliance levels might be an important indicator of risk, which can be used when assessing and working with men who are hesitant to openly discuss suicidal ideation with clinicians. For female participants, higher endorsement of behavioral-emotional norms and lower conformity to social hierarchy status norms appear to increase suicide risk in the presence of psychological distress. Our findings suggest that high self-reliance is of particular concern for men experiencing psychological distress. It is also important to consider the roles of masculine norm endorsement in the psychological distress-suicidal ideation relationship among women.
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Affiliation(s)
- Laura Griffin
- Institute for Health and Sport, Victoria University, Melbourne, Victoria, Australia
| | - Warwick Hosking
- Institute for Health and Sport, Victoria University, Melbourne, Victoria, Australia
| | - Peter Richard Gill
- Institute for Health and Sport, Victoria University, Melbourne, Victoria, Australia,Peter Richard Gill, Institute for Health and Sport, Victoria University, Footscray Park, Ballarat Rd, Melbourne 3011, Victoria, Australia.
| | - Kim Shearson
- Institute for Health and Sport, Victoria University, Melbourne, Victoria, Australia
| | - Gavin Ivey
- Institute for Health and Sport, Victoria University, Melbourne, Victoria, Australia
| | - Jenny Sharples
- Institute for Health and Sport, Victoria University, Melbourne, Victoria, Australia
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King T, Perales F, Singh A, Gurrin L, Crammond B. Traditionalism vs egalitarianism: Is there an association between gender attitudes and mental health? Aust N Z J Psychiatry 2022; 56:844-851. [PMID: 34313142 DOI: 10.1177/00048674211031488] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE This study sought to assess the extent to which gender attitudes are associated with mental health among Australian men and women. METHODS This study used a sample of 26,188 individuals drawn from five waves of the Household, Income and Labour Dynamics in Australia Survey. Gender attitudes were classified into three groups (traditional, moderate-egalitarian and egalitarian), and were constructed from six items. Mental health was measured using the Mental Health Inventory (MHI-5). We calculated the magnitude of associations between gender attitudes and mental health, stratified by gender, and adjusted for potential confounding. RESULTS Compared to men with egalitarian attitudes, poorer mental health was observed among men with moderate-egalitarian (-1.16, 95% confidence interval = [-1.84, -0.49]) and traditional gender attitudes (-2.57, 95% confidence interval = [-3.33, -1.81]). Among women, poorer mental health was observed among those with moderate-egalitarian (-0.78, 95% confidence interval = [-1.34, -0.22]) and traditional attitudes (-1.91, 95% confidence interval = [-2.55, -1.26]) compared to those with egalitarian attitudes. CONCLUSIONS For both men and women, egalitarian gender attitudes were associated with better mental health.
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Affiliation(s)
- Tania King
- Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Francisco Perales
- School of Social Science, The University of Queensland, Brisbane, QLD, Australia
| | - Ankur Singh
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Lyle Gurrin
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Bradley Crammond
- Health Transformation Lab, RMIT University, Melbourne, VIC, Australia
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Grigienė D, Skruibis P, Dadašev S, Rimkevičienė J, Gailienė D. Gender Self-Confidence as a Protective Factor for Suicide Risk: Analysis of the Sample of Lithuanian Men. Front Psychol 2022; 13:863688. [PMID: 35677116 PMCID: PMC9170287 DOI: 10.3389/fpsyg.2022.863688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 04/21/2022] [Indexed: 11/15/2022] Open
Abstract
Background Along with other suicide risk factors, masculinity has been analyzed as an important subject for suicidal behavior in men. This study examines masculinity as a gender self-confidence which is the intensity of an individual's belief that he meets his standards for masculinity. We use Hoffman and her colleague's concept, which provides two theoretical constructs as elements of gender self-confidence: gender self-definition and gender self-acceptance. Gender self-definition relates to how salient masculinity is in one's identity; gender self-acceptance relates to how positively one views his masculinity. Methods The quantitative research approach was applied in the study. The survey with a nonprobability quota sampling design was implemented to collect the data. The sample consisted of 562 Lithuanian men from various age groups and regions. The age of participants varied from 18 to 92 years (M = 42.99, SD = 17.18); 40.9% of men were from cities, 28.1% from towns, and 30.8% from rural locations. We used the Hoffman Gender Scale to measure gender self-definition and gender self-acceptance. Suicide risk was estimated with the Suicide Behavior Questionnaire—Revised. Patient Health Questionnaire-2 was used to measure depression symptoms as a controlled variable. Statistical analysis of regression and moderation was used to test the hypothesis. Results Higher gender self-definition and higher gender self-acceptance were associated with lower suicide risk. The moderation analysis showed that in men with relatively low gender self-definition, the effect of gender self-acceptance on suicidality was larger than in men with high or moderate gender self-definition. Discussion We conclude that a stronger gender self-confidence is an important protective factor in male suicide risk. Both, a smaller part of masculinity in one's identity and a negative view of one's masculinity have a cumulative effect on increased suicide risk. The findings have been discussed in accordance with the theories that explain suicidal behavior through the lenses of self-concept.
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Affiliation(s)
- Dovile Grigienė
- Centre for Suicidology, Institute of Psychology, Faculty of Philosophy, Vilnius University, Vilnius, Lithuania
| | - Paulius Skruibis
- Centre for Suicidology, Institute of Psychology, Faculty of Philosophy, Vilnius University, Vilnius, Lithuania
| | - Said Dadašev
- Centre for Suicidology, Institute of Psychology, Faculty of Philosophy, Vilnius University, Vilnius, Lithuania
| | - Jurgita Rimkevičienė
- Centre for Suicidology, Institute of Psychology, Faculty of Philosophy, Vilnius University, Vilnius, Lithuania
| | - Danute Gailienė
- Centre for Suicidology, Institute of Psychology, Faculty of Philosophy, Vilnius University, Vilnius, Lithuania
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Koçak O, Ergin M, Younis MZ. The Associations between Childhood Experiences and Occupational Choice Capability, and the Mediation of Societal Gender Roles. Healthcare (Basel) 2022; 10:healthcare10061004. [PMID: 35742055 PMCID: PMC9223097 DOI: 10.3390/healthcare10061004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 05/17/2022] [Accepted: 05/27/2022] [Indexed: 11/16/2022] Open
Abstract
Experiences in family, school, and social life during childhood are associated with gender roles and occupational choice capability. This study examines how competent individuals are in occupational choice capability and the relationships of childhood experiences and gender roles with their competencies in occupational choice capability. The research is composed of 805 individuals aged 18 and older, who reside in Turkey. In the research, we used the Personal Information Form, Childhood Experiences Scale, Gender Roles Attitude Scale, and The Scale of Occupational Choice Capability. The SPSS 25 program and PROCESS-Macro were used to analyze the variables. The relationship between the scales was investigated using Pearson correlation analysis and multiple regression analysis. According to the findings we obtained, individuals’ family and school life were positively correlated with their career choices, and family function sexism harmed their choice of profession. We also found gender roles had a mediating role in the relationship between school life and career choice.
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Affiliation(s)
- Orhan Koçak
- Faculty of Health Science, Istanbul University—Cerrahpasa, Istanbul 34320, Turkey;
- Correspondence:
| | - Meryem Ergin
- Faculty of Health Science, Istanbul University—Cerrahpasa, Istanbul 34320, Turkey;
| | - Mustafa Z. Younis
- College of Health Sciences, Jackson State University, 350 W. Woodrow Wilson Dr., Jackson, MS 39213, USA;
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Stark L, Seff I, Cohen F, Aldrich J, Allaf C. Stressful Life Events and Their Unique Associations with Psychosocial Outcomes: a Gendered Analysis Among High School Adolescents. GLOBAL SOCIAL WELFARE : RESEARCH, POLICY & PRACTICE 2021; 8:367-377. [PMID: 35004127 PMCID: PMC8734586 DOI: 10.1007/s40609-020-00179-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
INTRODUCTION There is substantial evidence linking stressful life events (SLEs) in childhood to poor mental health later in life, but few studies explore how various types of SLEs differentially impact mental health. The purpose of this study is to assess associations between SLEs and psychosocial outcomes in a diverse adolescent population in the USA and to examine whether and how these relationships are gendered. METHODS The sample comprises 181 high school students ages 13-21 years in Harrisonburg, Virginia. This study analyzed associations between 12 SLEs and eight psychosocial outcomes using ordinary least-squares and logistic regressions. Relationships were estimated for the full sample and for males and females, separately. RESULTS For boys, having ever been forced to leave one's family was associated with declines in resilience (B = - 4.646; 95% CI (- 8.79, - 0.50)) and increases in externalizing symptoms (B = 0.392; 95% CI (0.15, 0.63)). Furthermore, boys who experienced a drastic change in their family reported lower levels of school belonging (B = - 9.272; 95% CI (- 17.45, - 1.09)). For girls, having ever been forced to leave one's family was associated with decreases in depressive (B = - 0.961; 95% CI (- 1.88, - 0.05)) and anxiety symptomology (B = - 0.868; 95% CI (- 1.68, - 0.06)). Overall, students who experienced a life-threatening emergency exhibited greater depressive (B = 0.445; 95% CI (0.15, 0.74)) and anxiety symptoms (B = 0.287; 95% CI (0.05, 0.52)), and depressive symptomology was also associated with having ever been physically hurt by someone (B = 0.224; 95% CI (0.01, 0.44)). CONCLUSIONS Findings provide insights into how exposures might engender different mental health processes and outcomes, and how these processes may manifest differently across gender.
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Affiliation(s)
- Lindsay Stark
- Brown School, Washington University, Campus Box 1196, One Brookings Drive, St. Louis, MO 63130, USA
| | - Ilana Seff
- Mailman School of Public Health, Columbia University, 722 W168th St, New York, NY 10032, USA
| | - Flora Cohen
- Brown School, Washington University, Campus Box 1196, One Brookings Drive, St. Louis, MO 63130, USA
| | - Jeremy Aldrich
- Harrisonburg City Public Schools, 1 Court Square, Harrisonburg, VA 22801, USA
| | - Carine Allaf
- Qatar Foundation International, 1225 New York Ave NW #500, Washington, D. C 20005, USA
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Uhls YT, Felt L, Wartella E, Sanders A. Investigating Viewership of Season 3 of "13 Reasons Why" and the Mental Wellness of Adolescents: Partially Randomized Preference Trial. JMIR Ment Health 2021; 8:e25782. [PMID: 34524097 PMCID: PMC8482170 DOI: 10.2196/25782] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Revised: 03/21/2021] [Accepted: 04/19/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND A conflicting body of research suggests that additional investigation is needed to understand how globally watched television shows featuring social and mental health issues, such as 13 Reasons Why, might affect adolescents' mental wellness. OBJECTIVE This study aims to investigate adolescents' viewership of the third season of the Netflix drama 13 Reasons Why (13RW-3) and their engagement with show-related content, paying special attention to mental health outcomes and conversational partners. METHODS A panel-based research platform operated by the National Opinion Research Center at the University of Chicago recruited 157 adolescents aged 13 to 17 years from its nationally representative pool of participants. Participants answered questions about how they discussed and learned about social and mental health issues portrayed in 13RW-3 (eg, masculine role pressure and sexual assault) and questions about mental wellness (eg, mental health self-efficacy and depression). After the participants completed the survey (T1), they were directed to either watch 13RW-3 as it aired for the first time (intervention group) or not watch 13RW-3 (control group). Approximately one month later (T2), all the participants were asked to complete the postsurvey. Additional survey questions about conversational partners, information seeking because of watching the show, and use of show-related content were included in the intervention postsurvey. RESULTS Our sample (N=157) was 52.2% (n=82) female and 54.8% (n=86) White, with a mean age of 14.99 (SD 1.4) years. At T2, viewers of 13RW-3 spoke about suicide significantly more frequently than nonviewers (P=.007). From T1 to T2, viewers increasingly discussed issues explored by 13RW-3 (P=.002), especially suicide, mental health, and bullying. Adolescent viewers were most likely to speak with friends, and parents were the second most commonly named. Two variables emerged as consistent moderators of conversational choices-having depressive symptoms and being impacted by sexual assault. There was no association between conversational frequency and information seeking around social and mental health issues, and neither mental health self-efficacy scores nor masculine role pressure scores significantly differed between viewers and nonviewers at T2. CONCLUSIONS Viewing 13RW-3, a globally watched television show featuring social and mental health issues, led to adolescent conversations and information searches about topics explored by the show. Depressive symptoms and the impact of sexual assault moderated several relationships, guiding participants toward engaging with certain issues and seeking out specific conversational partners. As 13RW-3's stories drove conversations-and story-driven conversations can raise awareness, reduce stigma, shift attitudes, normalize certain behaviors, and strengthen supportive relationships-potential wellness implications for television shows featuring social and mental health issues are considerable.
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Affiliation(s)
- Yalda T Uhls
- University of California, Los Angeles, Los Angeles, CA, United States
| | - Laurel Felt
- University of Southern California, Los Angeles, CA, United States
| | - Ellen Wartella
- School of Communication, Northwestern University, Evanston, IL, United States
| | - Andrew Sanders
- University of California, Los Angeles, Los Angeles, CA, United States
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14
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Impacts of Dual-Income Household Rate on Suicide Mortalities in Japan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18115670. [PMID: 34070685 PMCID: PMC8199206 DOI: 10.3390/ijerph18115670] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 05/21/2021] [Accepted: 05/24/2021] [Indexed: 02/07/2023]
Abstract
To explore impact of enhancing social advancement of females in Japan, this study determined the effects of the dual-income household rate on suicide mortalities disaggregated by attributes of gender, age, and motives between 2009 and 2017 in Japan. This study analysed impact of dual-income household rate, other household-related factors (savings, liabilities and yearly incomes per household, minors and elderly rate per household), and social/employment factors (complete unemployment rate, employment rate, temporary male and female employment rates and certification rate of long-term care insurance) on suicide mortalities disaggregated by attributes of gender, age, and motives using hierarchical linear-regression model. Dual-income household rate was significantly/negatively related to suicide mortality of the working-age female population, but significantly/positively related to that of the elderly female population. Suicide mortalities of the working-age male population and the elderly male population were significantly/positively related to dual-income household rate. Male suicide mortalities caused by family-, health-, economy- and employment-related motives were significantly/positively related to dual-income household rate; however, the dual-income household rate was significantly/positively related to female suicide mortalities caused by family-, health-, economy- and school-related motives, but significantly/negatively related to suicide mortalities caused by romance-related motives. Dual-income households suppress social-isolation and develop economical/psychological independence of females, leading to reduced suicide mortality in working-age females. However, elderly and school-age populations, who are supported by the working-age female, suffer from isolation. Working-age males also suffer from inability to adapt from the traditional concept of work–life and work–family balances to the novel work–family balance concept adapted to dual-income households. These results suggest occurrence of new social/family problems in the 21st century due to vulnerability of traditional Japanese culture and life–working–family balance concepts as well as novel sociofamilial disturbances induced by declining birth rate and ageing population in Japan.
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15
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Zhang Y, Liu H. Individual's gender ideology and happiness in China. CHINESE SOCIOLOGICAL REVIEW 2021; 54:252-277. [PMID: 35814530 PMCID: PMC9268205 DOI: 10.1080/21620555.2021.1871727] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Gender ideologies encompass normative beliefs about how men and women should behave in certain contexts. Although many studies have examined factors predicting individuals' gender ideologies, little research has focused on the implications of gender ideology on individuals' subjective well-being, especially in Asian contexts. Using the pooled cross-sectional data from the China General Social Survey (CGSS, 2010/12/13/15), we explore the association between individual-level gender ideology and happiness in rural and urban China, paying special attention to potential variations in this association by gender and education level. Results suggest that an egalitarian gender ideology is positively associated with happiness in both rural and urban China. The association is stronger for urban men than for urban women and stronger for higher educated people than for lower educated people. The study highlights the importance of gender equality on individual subjective well-being and extends the literature by contextualizing individual-level gender ideology in China.
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Affiliation(s)
- Yan Zhang
- Michigan State University, East Lansing, Michigan, USA
| | - Hui Liu
- Michigan State University, East Lansing, Michigan, USA
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16
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Ridge D, Smith H, Fixsen A, Broom A, Oliffe J. How men step back - and recover - from suicide attempts: A relational and gendered account. SOCIOLOGY OF HEALTH & ILLNESS 2021; 43:238-252. [PMID: 33151571 DOI: 10.1111/1467-9566.13216] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 10/13/2020] [Accepted: 10/13/2020] [Indexed: 05/24/2023]
Abstract
Men account for three-quarters of suicide deaths in the UK, yet we know little about how at-risk men construct their experiences of moving towards - and then subsequently stepping back from - suicide, nor the part played by relational factors therein. An inductive thematic analysis was used to examine narrative interviews with eleven UK men who self-reported serious thoughts, plans and up-to and including suicide attempts in progress, but who consciously decided against carrying out an attempt. Their accounts suggest a highly social process of movements towards and away from suicide (e.g. frustrated help-seeking). Stepping back from suicide represents not a discrete issue, but a linked process in suicidality and wider recovery. Here, the use of military metaphors in particular (e.g. waging war, fighting back) highlights the gendered nature of the issue. Additionally, our article illuminates a range of social relations and forces that circulate in and around suicidality, which itself is embedded in varying forms of relationality, normativity and gendered practices.
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Affiliation(s)
- Damien Ridge
- College of Liberal Arts and Sciences, University of Westminster, London, UK
| | - Hannah Smith
- School of Social Sciences, University of Westminster, London, UK
| | - Alison Fixsen
- School of Social Sciences, University of Westminster, London, UK
| | - Alex Broom
- Department of Sociology and Social Policy, School of Social and Political Sciences, Faculty of Arts and Social Sciences, The University of Sydney, Camperdown, NSW, Australia
| | - John Oliffe
- Men's Health Research Program, School of Nursing, University of British Columbia, Vancouver, Canada
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17
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Effects of Values of Gender Role and Depression on Work-Parenting Conflicts of Fathers. ADONGHAKOEJI 2020. [DOI: 10.5723/kjcs.2020.41.3.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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18
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Jaehn P, Bobrova N, Saburova L, Kudryavtsev AV, Malyutina S, Cook S. The relation of gender role attitudes with depression and generalised anxiety disorder in two Russian cities. J Affect Disord 2020; 264:348-357. [PMID: 32056771 DOI: 10.1016/j.jad.2020.01.027] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 12/09/2019] [Accepted: 01/05/2020] [Indexed: 10/25/2022]
Abstract
BACKGROUND Reported traditional gender role attitudes (GRAs) have been related to worse mental health in western countries. This study examined the link of GRAs with symptoms of depression and generalised anxiety disorder (GAD) in two Russian cities. METHODS We used interview data from the cross-sectional Know Your Heart Study conducted among 5099 adults aged 35-69 in the Russian cities of Arkhangelsk and Novosibirsk between 2015 and 2017. Attitudes about gender inequality and division of labour between women and men at home or in the public sphere were measured by single items. Binary variables indicating presence of symptoms of depression and GAD were defined by a cut-off of ≥ 5 of the PHQ-9 and GAD-7 scores respectively. Multivariable logistic regression was used to determine crude and adjusted associations. RESULTS There was evidence that all types of GRAs were associated with symptoms of depression and GAD consistent with a U-shape after controlling for confounding with stronger evidence for all relationships for depression than for GAD. Odds of depressive symptoms were elevated among participants strongly agreeing to gender inequality and gender division of labour. There was good evidence for effect measure modification by age. LIMITATIONS The possibilities of measurement error of the exposure and outcomes, residual confounding and reverse causality are important limitations of this study. CONCLUSIONS Agreeing to gender inequality and gender division of labour was associated with reporting symptoms of common mental disorders in Russia. This study adds evidence for a link of GRAs with mental health from a non-western context.
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Affiliation(s)
- Philipp Jaehn
- Brandenburg Medical School Theodor Fontane, Institute of Social Medicine and Epidemiology, Hochstraße 15, 14770 Brandenburg an der Havel, Germany.
| | - Natalia Bobrova
- Department of Non-communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, United Kingdom.
| | - Lyudmila Saburova
- Institute of Philosophy and Law, Ural Branch of the Russian Academy of Sciences, 8th of March Street, Ekaterinburg, 620990, Russian Federation.
| | - Alexander V Kudryavtsev
- Northern State Medical University, Troitsky Prospekt 51, Arkhangelsk, 163000, Russian Federation; Department of Community Medicine, UiT The Arctic University of Norway, Hansine Hansens veg 18, Tromsø, 9019, Norway.
| | - Sofia Malyutina
- Research Institute of Internal and Preventive Medicine, Branch of Institute of Cytology and Genetics, Siberian Branch of the Russian Academy of Sciences, B. Bogatkova 175/1, Novosibirsk, 630089, Russian Federation; Novosibirsk State Medical University, Russian Ministry of Health, Krasnyy Prospekt 52, Novosibirsk, 630091, Russian Federation.
| | - Sarah Cook
- Department of Non-communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, United Kingdom; Department of Community Medicine, UiT The Arctic University of Norway, Hansine Hansens veg 18, Tromsø, 9019, Norway.
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Pesta R, Peralta RL, Novisky MA. Utilizing a General Strain Framework to Examine Behavioral Responses to Psychological Intimate Partner Violence: Are Responses Gendered? JOURNAL OF INTERPERSONAL VIOLENCE 2019; 34:3171-3198. [PMID: 27671952 DOI: 10.1177/0886260516669165] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
We know from the violence literature that a distinct sex disparity exists in the perpetration of other-directed violence (ODV). Some scholars suggest that this disparity is explained in part by gendered reactions to stress, strain, or violence victimization, in which males and females engage in different coping mechanisms, with males more likely to engage in ODV than females. Using a college sample, we investigate the behavioral responses of male and female victims of psychological intimate partner abuse. We find that although there is a sex disparity in the use of ODV as a coping mechanism, there is also a distinct gender orientation disparity. Our results indicate that victims who ascribe to a masculine identity are more likely than those of a feminine identity to engage in ODV, regardless of biological sex. These findings shed light on the impact of gender orientation as both a risk and protective factor in the use of ODV.
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20
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Seff I, Stark L. A sex-disaggregated analysis of how emotional violence relates to suicide ideation in low- and middle-income countries. CHILD ABUSE & NEGLECT 2019; 93:222-227. [PMID: 31125852 DOI: 10.1016/j.chiabu.2019.05.008] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 05/02/2019] [Accepted: 05/09/2019] [Indexed: 05/25/2023]
Abstract
BACKGROUND In recent years, research has increasingly focused on examining the relationship between one type of child maltreatment -- emotional violence -- and suicidal behaviors. However, the growing body of empirical evidence supporting these associations has been mostly limited to high-income contexts. OBJECTIVE This study examines how exposure to emotional violence is associated with suicide ideation in childhood and adolescence in low- and middle-income countries (LMICs), and whether this association differs by sex. PARTICIPANTS AND SETTING We employ nationally representative samples of 13-24 year-old males and females from the Violence Against Children Surveys in Tanzania (conducted in 2009), Kenya (2010), and Haiti (2012). METHODS We use logistic regressions to estimate the odds of ever reporting suicide ideation, separately, for each country; models control for self-reported exposure to emotional violence, physical violence from a caregiver, physical violence by an adult in the community, sexual violence, intimate partner violence, and age. Formal moderation by sex for each form of child maltreatment is tested using interaction terms. RESULTS We find the odds of suicide ideation are consistently and significantly greater for adolescents who report ever exposure to emotional violence. This same consistency is not observed for any other form of maltreatment across countries. The size of the relationship between emotional violence and suicide ideation is statistically significantly larger for males in Kenya only. CONCLUSION Research in LMICs should explore the mediating factors linking emotional abuse in childhood and adolescence to suicide ideation in adolescence, paying special attention to whether these pathways might operate differently by sex.
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Affiliation(s)
- Ilana Seff
- Department of Population and Family Health, Columbia University Mailman School of Public Health, 60 Haven Ave B-4 Suite 432, New York, NY, 10032, USA.
| | - Lindsay Stark
- George Warren Brown School, Washington University in St. Louis, 1 Brookings Dr, St. Louis, MO, 63130, USA
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21
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Genuchi MC. The Role of Masculinity and Depressive Symptoms in Predicting Suicidal Ideation in Homeless Men. Arch Suicide Res 2019; 23:289-311. [PMID: 29461153 DOI: 10.1080/13811118.2018.1428705] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Men's suicide rates may be influenced by difficulties recognizing externalizing depressive symptoms in men that adhere to hegemonic masculine gender role norms. The purpose of this study was to investigate the ability of externalizing depressive symptoms, internalizing depressive symptoms, and hegemonic masculinity in predicting the existence and severity of suicidal ideation. Homeless men (n = 94) completed questionnaires at a resource center in the Rocky Mountain Western United States. Internalizing symptoms predicted the existence of suicidal ideation, and both externalizing and internalizing symptoms predicted increased severity of suicidal ideation. The masculine norms violence and playboy were correlated with men's suicidal ideation. An externalizing-internalizing model of predicting suicide in men and men's adherence to certain masculine gender role norms may be valuable to further efforts in suicide assessment and prevention.
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22
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Kavanagh SA, Shelley JM, Stevenson C. Is gender inequity a risk factor for men reporting poorer self-rated health in the United States? PLoS One 2018; 13:e0200332. [PMID: 30016345 PMCID: PMC6049919 DOI: 10.1371/journal.pone.0200332] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 06/25/2018] [Indexed: 11/18/2022] Open
Abstract
Theoretical approaches suggest that gender inequity increases men's health risks. Previous findings from the United States support this contention, however only a small number of health outcomes have been explored. This study extends the range of health outcomes examined by using a cross-sectional, multilevel analysis to investigate whether measures of state-level gender inequity are predictors of men's self-rated health. Data were derived primarily from the Behavioral Risk Factor Surveillance System and the full-case data set included 116,594 individuals nested within 50 states. Gender inequity was measured with nine variables: higher education, women's reproductive rights, abortion provider access, elected office, management, business ownership, labour force participation, earnings and relative poverty. Covariates at the individual level were age, income, education, race/ethnicity, marital status and employment status. Covariates at the state level were income inequality and gross domestic product per capita. In fully adjusted models for all-age men the reproductive rights (OR 1.06 95% CI 1.01-1.11), abortion provider access (OR 1.11 95% CI 1.05-1.16) and earnings (OR 1.06 95% CI 1.02-1.12) measures all predicted an increased risk of men reporting poorer self-rated health for each 1 standard deviation increase in the gender inequity z-score. The most consistent effect was seen for the 65+ age group where the reproductive rights (OR 1.09 95% CI 1.03-1.16), abortion provider access (OR 1.15 95% CI 1.09-1.21), elected office (OR 1.06 95% CI 1.01-1.11) and earnings (OR 1.10 95% CI 1.04-1.16) measures all showed a significant effect. These findings provide evidence that some aspects of gender inequity increase the risk of poorer self-rated health in men. The study contributes to a growing body of literature implicating gender inequity in men's health patterns.
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Affiliation(s)
- Shane A. Kavanagh
- Department of Public Health, School of Psychology and Public Health, La Trobe University, Bundoora, Victoria, Australia
| | - Julia M. Shelley
- School of Health & Social Development, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Christopher Stevenson
- School of Health & Social Development, Faculty of Health, Deakin University, Geelong, Victoria, Australia
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Wiktorsson S, Rydberg Sterner T, Mellqvist Fässberg M, Skoog I, Ingeborg Berg A, Duberstein P, Van Orden K, Waern M. Few Sex Differences in Hospitalized Suicide Attempters Aged 70 and Above. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E141. [PMID: 29337907 PMCID: PMC5800240 DOI: 10.3390/ijerph15010141] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Revised: 01/10/2018] [Accepted: 01/11/2018] [Indexed: 11/21/2022]
Abstract
Relatively little research attention has been paid to sex issues in late life suicidal behaviour. The aim was to compare clinical characteristics of women and men aged 70+ who were hospitalized after a suicide attempt. We hypothesized higher depression and anxiety scores in women, and we expected to find that men would more often attribute the attempt to health problems and compromised autonomy. Participants (56 women and 47 men, mean age 80) were interviewed by a psychologist. In addition to psychiatric and somatic health assessments, participants responded to an open-ended question concerning attributions of the attempt. There were no sex differences in depression and anxiety. Forty-five percent of the men and 14% of the women had a history of substance use disorder (p = 0.02). At least one serious physical disability was noted in 60.7% of the women and 53.2% of the men (p = 0.55). Proportions attributing their attempt to somatic illness did not differ (women, 14.5% vs. men 17.4%, p = 0.79), and similar proportions attributed the attempt to reduced autonomy (women, 21.8% vs. men, 26.1%, p = 0.64). We found strikingly similar figures for depression scores, functional disability and attributions for attempting suicide in older men and women. Larger studies are needed in diverse settings as sex differences might be influenced by cultural context.
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Affiliation(s)
- Stefan Wiktorsson
- Institute of Neuroscience and Physiology, Department of Psychiatry, University of Gothenburg, Blå Stråket 15, SU/Sahlgrenska, 413 45 Gothenburg, Sweden.
| | - Therese Rydberg Sterner
- Institute of Neuroscience and Physiology, Department of Psychiatry, University of Gothenburg, Wallinsgatan 6, SU/Sahlgrenska, 431 41 Mölndal, Sweden.
| | - Madeleine Mellqvist Fässberg
- Institute of Neuroscience and Physiology, Department of Psychiatry, University of Gothenburg, Wallinsgatan 6, SU/Sahlgrenska, 431 41 Mölndal, Sweden.
| | - Ingmar Skoog
- Institute of Neuroscience and Physiology, Department of Psychiatry, University of Gothenburg, Wallinsgatan 6, SU/Sahlgrenska, 431 41 Mölndal, Sweden.
| | - Anne Ingeborg Berg
- Institute of Psychology, University of Gothenburg, Haraldsgatan 1, 413 14 Gothenburg, Sweden.
| | - Paul Duberstein
- University of Rochester Medical Center, 300 Crittenden Blvd, Box Psych, Rochester, NY 14642, USA.
| | - Kimberly Van Orden
- University of Rochester Medical Center, 300 Crittenden Blvd, Box Psych, Rochester, NY 14642, USA.
| | - Margda Waern
- Institute of Neuroscience and Physiology, Department of Psychiatry, University of Gothenburg, Blå Stråket 15, SU/Sahlgrenska, 413 45 Gothenburg, Sweden.
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Jang SH, Woo YS, Hong JW, Yoon BH, Hwang TY, Kim MD, Lee SY, Bahk WM. Use of a smartphone application to screen for depression and suicide in South Korea. Gen Hosp Psychiatry 2017. [PMID: 28622818 DOI: 10.1016/j.genhosppsych.2017.03.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJECTIVE This is a cross-sectional study using a free depression and suicide screening smartphone application, which contains the data from the Center for Epidemiological Studies-Depression (CES-D) and a Suicide Behaviors Questionnaire-Revised (SBQ-R). METHOD The free application was downloaded worldwide from Apple's App Store and Android Market, and the participants who downloaded the application were actively measured. RESULTS The subjects totaled 208,683 men and women. 72.6% of the subjects were females, and 81.4% of the subjects were aged between 10 and 29years. In total, 25.7% of the participants were recorded CES-D positive, and there were differences among the groups based on sex (χ2=1065.82, p<0.001), age (χ2=1420.75, p<0.001), and psychiatric history (χ2=1502.21, p<0.001). The highest score of CES-D, 40.69±15.79 and that of SBQ-R, 13.68±4.97 was reported by the participants with a history of schizophrenia. The characteristics associated with suicide were as follows: depression (OR 8.92, 95% CI: 8.71-9.13), female (OR 1.39, 95% CI: 1.36-1.43), 30-49 age group (OR 2.51, 95% CI: 2.29-2.72), 50 or older age group (OR 1.48, 95% CI: 1.35-1.61), and psychiatric history (OR 1.98, 95% CI: 1.89-2.06). CONCLUSION The smartphone application may be a useful tool for screening depression and suicide.
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Affiliation(s)
- Seung-Ho Jang
- Department of Psychiatry, School of Medicine, Wonkwang University, Iksan, Republic of Korea
| | - Young Sup Woo
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jeong-Wan Hong
- Department of Psychiatry, Iksan Hospital, Iksan, Republic of Korea
| | - Bo-Hyun Yoon
- Department of Psychiatry, Naju National Hospital, Naju, Republic of Korea
| | - Tae-Yeon Hwang
- Department of Psychiatry, National Center for Mental Health, Seoul, Republic of Korea
| | - Moon-Doo Kim
- Department of Psychiatry, College of Medicine, Jeju National University, Jeju, Republic of Korea
| | - Sang-Yeol Lee
- Department of Psychiatry, School of Medicine, Wonkwang University, Iksan, Republic of Korea.
| | - Won-Myong Bahk
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
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Ahmed T, Vafaei A, Auais M, Guralnik J, Zunzunegui MV. Gender Roles and Physical Function in Older Adults: Cross-Sectional Analysis of the International Mobility in Aging Study (IMIAS). PLoS One 2016; 11:e0156828. [PMID: 27258050 PMCID: PMC4892474 DOI: 10.1371/journal.pone.0156828] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2016] [Accepted: 05/22/2016] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES To examine the relationships between physical function and gender-stereotyped traits and whether these relationships are modified by sex or social context. METHODS A total of 1995 community-dwelling older adults from the International Mobility in Aging Study (IMIAS) aged 65 to 74 years were recruited in Natal (Brazil), Manizales (Colombia), Tirana (Albania), Kingston (Ontario, Canada), and Saint-Hyacinthe (Quebec, Canada). We performed a cross-sectional analysis. Study outcomes were mobility disability, defined as having difficulty in walking 400 meters without assistance or climbing a flight of stairs without resting, and low physical performance, defined as a score < 8 on the Short Physical Performance Battery. The 12-item Bem Sex Role Inventory (BSRI) was used to classify participants into four gender roles (Masculine, Feminine, Androgynous, and Undifferentiated) using site-specific medians of femininity and masculinity as cut-off points. Poisson regression models were used to estimate prevalence rate ratios (PRR) of mobility disability and poor physical performance according to gender roles. RESULTS In models adjusted for sex, marital status, education, income, and research site, when comparing to the androgynous role, we found higher prevalence of mobility disability and poor physical performance among participants endorsing the feminine role (PRR = 1.20, 95% confidence interval (CI) 1.03-1.39 and PRR = 1.37, CI 1.01-1.88, respectively) or the undifferentiated role (PRR = 1.23, 95% CI 1.07-1.42 and PRR = 1.58, CI 1.18-2.12, respectively). Participants classified as masculine did not differ from androgynous participants in prevalence rates of mobility disability or low physical performance. None of the multiplicative interactions by sex and research site were significant. CONCLUSION Feminine and undifferentiated gender roles are independent risk factors for mobility disability and low physical performance in older adults. Longitudinal research is needed to assess the mediation pathways through which gender-stereotyped traits influence functional limitations and to investigate the longitudinal nature of these relationships.
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Affiliation(s)
- Tamer Ahmed
- Département de médecine sociale et préventive, Université de Montréal, Montréal, QC, Canada
| | - Afshin Vafaei
- Department of Public Health Sciences, Queen's University, Kingston, ON, Canada
| | - Mohammad Auais
- Department of Public Health Sciences, Queen's University, Kingston, ON, Canada
| | - Jack Guralnik
- Department of Epidemiology and Public Health, Division of Gerontology, University of Maryland School of Medicine, Baltimore, Maryland, United States of America
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Moses I, Admiraal WF, Berry AK. Gender and gender role differences in student–teachers’ commitment to teaching. SOCIAL PSYCHOLOGY OF EDUCATION 2016. [DOI: 10.1007/s11218-016-9340-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Meissner B, Bantjes J, Kagee A. I Would Rather Just Go Through With It Than Be Called a Wussy: An Exploration of How a Group of Young South African Men Think and Talk About Suicide. Am J Mens Health 2015; 10:338-48. [PMID: 25631278 DOI: 10.1177/1557988314568183] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Worldwide suicide is a deeply gendered phenomenon. In South Africa, approximately 80% of suicide completers are male. This study aimed to investigate how a group of young South African men understand and think about suicidal behavior. In-depth semistructured interviews and thematic analysis using a grounded theory approach revealed that this group of young South African men had permissive attitudes to suicide and viewed suicide as a morally defensible alternative in specific situations. They spoke of suicide as a goal-directed behavior that provides a means of regaining control, asserting power, communicating, and rendering oneself visible. From this perspective, suicide was understood as a brave act requiring strength and determination. These data have congruence with the Theory of Gender and Health, which proposes that constructions of masculinity may be implicated in the attitudes and beliefs young men in South Africa hold toward suicide.
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Affiliation(s)
- Birte Meissner
- Department of Psychology, Stellenbosch University, Stellenbosch, South Africa
| | - Jason Bantjes
- Department of Psychology, Stellenbosch University, Stellenbosch, South Africa
| | - Ashraf Kagee
- Department of Psychology, Stellenbosch University, Stellenbosch, South Africa
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Coleman D. Traditional Masculinity as a Risk Factor for Suicidal Ideation: Cross-Sectional and Prospective Evidence from a Study of Young Adults. Arch Suicide Res 2015; 19:366-84. [PMID: 25383764 DOI: 10.1080/13811118.2014.957453] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Traditional masculinity is hypothesized to be associated with suicidal ideation, and traditional masculinity is predicted to interact with stressors, intensifying suicidal ideation. Cross-sectional and prospective data from a study of 2,431 young adults was analyzed using hierarchical regression main effects and interaction models. Traditional masculinity was associated with suicidal ideation, second only in strength to depression, including when controlling for other risk factors. Prospective effects were substantially weaker. There was mixed evidence for traditional masculinity by stress interactions. The results provide preliminary support for the role of traditional masculinity in suicidal ideation, but the relationship should be tested in studies of suicide attempts and mortality. Implications for prevention and intervention are explored.
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Karger A. Geschlechtsspezifische Aspekte bei depressiven Erkrankungen. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2014; 57:1092-8. [DOI: 10.1007/s00103-014-2019-z] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Bryan CJ, Andreski SR, McNaughton-Cassill M, Osman A. Agency is associated with decreased emotional distress and suicidal ideation in military personnel. Arch Suicide Res 2014; 18:241-50. [PMID: 24712868 DOI: 10.1080/13811118.2013.824836] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Suicides in the U.S. military continue to rise at a rapid rate. Identification of protective factors that reduce risk for suicidal thoughts and behaviors among military personnel are therefore needed. Agency--the sense that one is competent, effective, and in control of one's life--has shown to reduce the effects of hopelessness and emotional distress on suicidal thoughts and attempts in non-military populations. The current study explores the association of agency with suicidal ideation in a sample (n = 273) of active duty Air Force Security Forces personnel. Results of generalized regression modeling suggest that agency is directly associated with decreased emotional distress and severity of suicidal ideation, but does not moderate the effect of emotional distress on suicidal ideation.
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Affiliation(s)
- Craig J Bryan
- a National Center for Veterans Studies , The University of Utah , Salt Lake City , Utah , USA
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Changing gender roles and attitudes and their implications for well-being around the new millennium. Soc Psychiatry Psychiatr Epidemiol 2014; 49:791-809. [PMID: 23907414 PMCID: PMC4024124 DOI: 10.1007/s00127-013-0730-y] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2013] [Accepted: 06/17/2013] [Indexed: 11/28/2022]
Abstract
PURPOSE Given evidence that gender role attitudes (GRAs) and actual gender roles impact on well-being, we examine associations between GRAs, three roles (marital status, household chore division, couple employment) and psychological distress in working-age men and women. We investigate time-trends reflecting broader social and economic changes, by focusing on three age groups at two dates. METHODS We used British Household Panel Survey data from 20- to 64-year-olds in heterosexual couple households in 1991 (N = 5,302) and 2007 (N = 6,621). We examined: levels of traditional GRAs according to gender, age, date, household and employment roles; associations which GRAs and roles had with psychological distress (measured via the GHQ-12); whether psychological distress increased when GRAs conflicted with actual roles; and whether any of these associations differed according to gender, age or date. RESULTS Gender traditionalism was lower among women, younger people, those participating in 2007 and in 'less traditional' relationships and households. Psychological distress was higher among those with more traditional GRAs and, particularly among men, for those not employed, and there was some evidence of different patterns of association according to age-group. There was limited evidence, among women only, of increased psychological distress when GRAs and actual roles conflicted and/or reductions when GRAs and roles agreed, particularly in respect of household chores and paid employment. CONCLUSIONS Although some aspects of gender roles and attitudes (traditionalism and paid employment) are associated with well-being, others (marital status and household chores), and attitude-role consistency, may have little impact on the well-being of contemporary UK adults.
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Easton SD, Renner LM, O'Leary P. Suicide attempts among men with histories of child sexual abuse: examining abuse severity, mental health, and masculine norms. CHILD ABUSE & NEGLECT 2013; 37:380-387. [PMID: 23313078 DOI: 10.1016/j.chiabu.2012.11.007] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2012] [Revised: 07/30/2012] [Accepted: 11/19/2012] [Indexed: 06/01/2023]
Abstract
OBJECTIVE Men who were sexually abused during childhood are at risk for a variety of long-term mental health problems, including suicidality. However, little is known about which factors are related to recent suicide attempts for this vulnerable, under-researched population. The purpose of this study was to examine the relationship between abuse severity, mental health, masculine norms and recent suicide attempts among men with histories of child sexual abuse (CSA). METHODS We analyzed survey data gathered from a purposive sample of 487 men who were sexually abused during childhood. The age of the sample ranged from 19 to 84 years (μ = 50.4 years). Recent suicide attempts served as the dependent variable in the study. Self-reported measures of sexual abuse severity, child physical abuse, mental health, masculine norms, and demographic information (age, race) represented the independent variables. RESULTS The results from logistic regression modeling found that five variables - duration of the sexual abuse, use of force during the sexual abuse, high conformity to masculine norms, level of depressive symptoms, and suicidal ideation - increased the odds of a suicide attempt in the past 12 months. CONCLUSION To improve mental health services for men with histories of CSA, mental health practitioners should incorporate sexual abuse severity, current mental health, and adherence to masculine norms into assessment and treatment planning.
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Affiliation(s)
- Scott D Easton
- Graduate School of Social Work, Boston College, Chestnut Hill, MA 02467, USA
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Straiton ML, Hjelmeland H, Grimholt TK, Dieserud G. Self-harm and conventional gender roles in women. Suicide Life Threat Behav 2013; 43:161-73. [PMID: 23293983 DOI: 10.1111/sltb.12005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2012] [Accepted: 10/22/2012] [Indexed: 11/30/2022]
Abstract
A total of thirty-two women admitted to a general hospital for medical treatment after self-harming completed measures of conventional positive and negative masculinity and femininity. Comparisons were made with two control groups with no self-harm history; 33 women receiving psychiatric outpatient treatment and a nonclinical sample of 206 women. Multinomial logistic regression analyses showed that those with lower scores on Instrumentality and Unmitigated Agency (positive and negative masculinity) and higher scores on Insecurity (negative femininity) had greater odds of self-harming. Relationships were weaker after accounting for generalized self-efficacy. Results are discussed in relation to previous findings and suggestions for prevention are made.
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Affiliation(s)
- Melanie L Straiton
- Division of Mental Health, Norwegian Institute of Public Health, Oslo, Norway.
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Handley TE, Inder KJ, Kelly BJ, Attia JR, Kay-Lambkin FJ. Urban-rural influences on suicidality: gaps in the existing literature and recommendations for future research. Aust J Rural Health 2012; 19:279-83. [PMID: 22098210 DOI: 10.1111/j.1440-1584.2011.01235.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Suicide is a major public health issue of particular concern among rural populations, which experience a consistently higher suicide rate than urban areas. Although extensive research efforts have been directed towards understanding suicidality and related factors, there is a continued lack of clinically useful factors to target preventive measures, particularly among some regional and demographic groups. This suggests limitations in the conceptualisation of this important construct. A review of the literature was undertaken, using a snowballing and saturation approach. Literature was considered relevant if it addressed the research question 'what are the current limitations in research on urban/rural influences on suicidality?' Findings were used to develop a set of guidelines to inform future research. A number of gaps in existing research relevant to limitations in rural suicide research were identified: inconsistencies in terminology; a focus on high-end suicidal behaviours; a disproportionate focus on urban populations; a dominance of cross-sectional research; and a high use of clinical samples. These limitations are discussed in terms of their implications for rural suicidality, and are used to support the development of recommendations for future research, with a focus on encouraging consistency and standardisation. A number of limitations can be identified in existing research on suicide. Targeting these specific areas can be an important step in addressing the current gaps in knowledge relating to rural suicide prevention.
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Affiliation(s)
- Tonelle E Handley
- Centres for Brain and Mental Health Research, University of Newcastle, Callaghan, New South Wales, Australia.
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Kageyama T. Views on suicide among middle-aged and elderly populations in Japan: their association with demographic variables and feeling shame in seeking help. Psychiatry Clin Neurosci 2012; 66:105-12. [PMID: 22353323 DOI: 10.1111/j.1440-1819.2011.02313.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIMS The purpose of this study was to investigate the relationship between inappropriate views on suicide, such as it being a personal choice, inevitable, unpreventable, and permissible, with demographic variables and the feeling of shame in seeking help among the general population. METHODS A self-administered questionnaire on mental health and suicide was distributed to all residents aged 40-74 in four areas in Oita Prefecture, Japan, and 4487 responded. The association of seven inappropriate views on suicide with demographic variables was examined by multiple logistic analyses. The association between feeling shame in seeking help with demographic variables and the above views on suicide was similarly analyzed. RESULTS Inappropriate views on suicide were associated with gender (i.e. men). Some of these views also correlated with age, never having been married, and living in rural areas or areas with high suicide mortality rates. Multivariate analysis revealed that feeling shame in seeking help when distressed was associated with being aged 70-74, living in rural areas or areas with high suicide mortality rates, the view on suicide as a matter of self-choice, and a pessimistic view toward life. CONCLUSION These findings suggest that inappropriate views on suicide adversely affect coping strategies and mental health. Suicide prevention programs aimed at improving mental health literacy in a community should take into consideration the characteristics of elderly male residents.
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Affiliation(s)
- Takayuki Kageyama
- Department of Mental Health and Psychiatric Nursing, Faculty of Nursing, Oita University of Nursing and Health Sciences, Oita, Japan.
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Abstract
This study investigates whether positive and negative conventional gender roles relate to suicidal ideation and self-harming in different ways among young adults. Participants completed an online survey about previous self-harm, recent suicidal ideation, and positive and negative aspects of conventional masculinity and femininity. Logistic regression analyses showed that negative femininity positively predicted self-harm and recent suicidal ideation status. Positive femininity was unrelated. Positive masculinity was negatively related to suicidal ideation and self-harming while negative masculinity was negatively related to self-harming only. The findings suggest that it is not the conventional feminine gender role per se that is associated with suicidality but specific negatively evaluated aspects. Conceptualizing gender as a multivariate construct may be useful in the gender socialization theory of suicidal behavior.
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38
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Coleman D, Kaplan MS, Casey JT. The Social Nature of Male Suicide: A New Analytic Model. ACTA ACUST UNITED AC 2011. [DOI: 10.3149/jmh.1003.240] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Månsdotter A, Lundin A. How do masculinity, paternity leave, and mortality associate? –A study of fathers in the Swedish parental & child cohort of 1988/89. Soc Sci Med 2010; 71:576-583. [DOI: 10.1016/j.socscimed.2010.05.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2009] [Revised: 03/14/2010] [Accepted: 05/12/2010] [Indexed: 10/19/2022]
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Oliffe JL, Ogrodniczuk JS, Bottorff JL, Johnson JL, Hoyak K. "You feel like you can't live anymore": suicide from the perspectives of Canadian men who experience depression. Soc Sci Med 2010; 74:506-14. [PMID: 20541308 DOI: 10.1016/j.socscimed.2010.03.057] [Citation(s) in RCA: 112] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2009] [Revised: 03/02/2010] [Accepted: 03/15/2010] [Indexed: 11/17/2022]
Abstract
Severe depression is a known risk factor for suicide, yet worldwide men's suicide rates continue to outnumber reported rates of men's depression. While acknowledging that the pathways to suicide are diverse, and being mindful of the complex challenges inherent to studying suicide, we interviewed men who experienced depression as a means to better understanding the processes they used to counter and contemplate suicide. This novel qualitative study provides insights on how masculine roles, identities and relations mediate depression-related suicidal ideation in a cohort of 38 men in Canada, ranging in age from 24 to 50 years-old. Constant comparative analyses yielded the core category of reconciling despair in which men responded to severe depression and suicidal ideation by following two pathways. To counter suicide actions, connecting with family, peers and health care professionals and/or drawing on religious and moral beliefs were important interim steps for quelling thoughts about suicide and eventually dislocating depression from self-harm. This pathway revealed how connecting with family through masculine protector and father roles enabled men to avoid suicide while positioning help-seeking as a wise, rational action in re-establishing self-control. The other pathway, contemplating escape, rendered men socially isolated and the overuse of alcohol and other drugs were often employed to relieve emotional, mental and physical pain. Rather than providing respite, these risky practices were the gateway to men's heightened vulnerability for nonfatal suicidal behaviour. Men on this pathway embodied solitary and/or risk taker identities synonymous with masculine ideals but juxtaposed nonfatal suicidal behaviours as feminine terrain.
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Affiliation(s)
- John L Oliffe
- University of British Columbia, School of Nursing, 302-6190 Agronomy Road, Vancouver, British Columbia, V6T 1Z3, Canada.
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Kposowa AJ, D’Auria S. Association of temporal factors and suicides in the United States, 2000-2004. Soc Psychiatry Psychiatr Epidemiol 2010; 45:433-45. [PMID: 19536447 PMCID: PMC2834764 DOI: 10.1007/s00127-009-0082-9] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2008] [Accepted: 06/03/2009] [Indexed: 10/25/2022]
Abstract
OBJECTIVE The purpose of the study was to examine the association of temporal factors, in particular days of the week and seasons of the year and death from suicide in the United States. METHOD Data were pooled from the Multiple Cause of Death Files. Hierarchical logistic regression models were fitted to all deaths occurring in 2000 through 2004 by suicide. RESULTS The incidence of suicide was significantly higher on Wednesdays, compared to Sunday. Specifically, individuals were 99% more likely to kill themselves on Wednesday than on Sunday. Suicides were more prevalent in the summer months, and they were less likely to occur in winter. The state suicide rate significantly elevated individual suicide risk. The results held even after controlling for the potentially confounding effects of socio-economic and demographic variables at both the individual and state levels. CONCLUSION It was concluded that the observed association between seasonality and suicide cannot be discounted as a mere coincidence. Future research ought to focus on integrating individual level data and contextual variables when testing for seasonality effects.
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Affiliation(s)
- Augustine J. Kposowa
- Department of Sociology, University of California, 1150 Watkins Hall, Riverside, CA 92521 USA
| | - Stephanie D’Auria
- Department of Sociology, University of California, 1150 Watkins Hall, Riverside, CA 92521 USA
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Abstract
Reducing inequalities in health, including mental health, is of high priority in many national policies. However, it is not yet known how mental health nurses might respond to these policies. Using examples from the available evidence, we argue that the causes of mental health inequalities are complex and thought to arise from fundamental divisions in society. These divisions are formed by social relationships, which are influenced by deep social structures, such as the economy or culture. The extensive range of social determinants means that there is no single explanation of why inequalities in mental health might occur. It also suggests that these determinants may act synergistically to create pockets of inequity where health needs are most complex. This poses difficult challenges for mental health nurses who undoubtedly have a key role in addressing mental health inequalities, although their role is likely to be restricted to service redesign and delivery. Mental health nurses are unlikely to address some of the deeper structural determinants of mental health inequalities, such as poverty, which can only be tackled through government-led reforms. Furthermore, we must be mindful of the possibility that services offered by mental nurses may have an uneven uptake across social classes, which in turn could serve to maintain or worsen mental health inequalities. Therefore, a key question for mental health nursing, policy and training is whether these limitations are clearly recognized.
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Affiliation(s)
- L Elliott
- Centre for Integrated Healthcare Research, Edinburgh, UK.
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Abstract
OBJECTIVE The aim of this paper is to examine gender differences in relation to negative life events and suicidal behaviours in patients presenting to an acute community mental health team in Auckland, New Zealand. METHOD Clinical files of all patients referred to one of the Auckland community crisis teams in 2007 were surveyed (n = 442). Those presenting with suicidal behaviours were included in the study ('suicidal behaviours' refers to the presence of suicidal ideas or suicide attempts). Demographic information and reasons for presentation were collected from the file. RESULTS Seventy patients aged 18-65 years met the inclusion criteria. For 86% of women and 85% of men separation from their partners and relationship conflicts were the main stressors precipitating suicidal behaviours and referral to the local community crisis team. Suicidal behaviours did not differ between males and females. CONCLUSION Irrespective of gender, relationship loss and conflicts were the most commonly identified negative life events precipitating suicidal behaviours in the acute community setting. These findings can have important implications in risk assessment, suicide prevention and provision of acute community services.
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Affiliation(s)
- Denise Cupina
- St. George Hospital, Mental Health Services, 11 South Street, Kogarah, NSW 2217, Australia.
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Hobbs M, McLaren S. The interrelations of agency, depression, and suicidal ideation among older adults. Suicide Life Threat Behav 2009; 39:161-71. [PMID: 19527156 DOI: 10.1521/suli.2009.39.2.161] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The high rates of suicide among older men are cause for concern, and have prompted the investigation of factors that might explain these elevated rates. The current research examined whether the gender role construct agency was associated with depression and suicidal ideation among older adults. The results, based on self-report data from a sample of older Australian men (n = 69) and women (n = 90), indicated that depression mediated the relation between agency and suicidal ideation. In addition, for older men only, agency moderated the depression-suicidal ideation relation. The results suggest that older adults, and particularly men, with low levels of agency should be the targets for interventions aimed at increasing levels of agency and improving mental health.
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Affiliation(s)
- Mitchell Hobbs
- School of Behavioral & Social Science & Humanities, University of Ballarat, Mt. Helen, Victoria, Australia
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45
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Benzeval M, Der G, Ellaway A, Hunt K, Sweeting H, West P, Macintyre S. Cohort profile: west of Scotland twenty-07 study: health in the community. Int J Epidemiol 2008; 38:1215-23. [PMID: 18930962 DOI: 10.1093/ije/dyn213] [Citation(s) in RCA: 75] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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46
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Kapusta ND, Zorman A, Etzersdorfer E, Ponocny-Seliger E, Jandl-Jager E, Sonneck G. Rural-urban differences in Austrian suicides. Soc Psychiatry Psychiatr Epidemiol 2008; 43:311-8. [PMID: 18264807 DOI: 10.1007/s00127-008-0317-1] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2007] [Accepted: 01/21/2008] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The answer to the question whether suicide rates are higher in urban than in rural areas may have changed over the years. This study analyzes the longitudinal trends of rural and urban suicides in Austria from 1970 to 2005. The most recent decade, 1995-2005 was also investigated cross-sectionally in terms of age groups, gender, suicide methods and family status. METHODS Official suicide statistics were calculated in a Poisson regression model to determine trends in suicide rates according to gender in rural and urban regions as well as the ratios of rural- to urban-suicide rates. Population density levels were used as a measure of urbanization. Differences in suicide rates across the rural-urban categories were investigated in terms of genders, age groups, suicide methods and family status using Spearman correlations. RESULTS The ratio of rural to urban suicide rates has continuously increased in both genders over the past 35 years, indicating a growing risk in rural areas. Suicide methods used in rural and urban areas vary significantly and suicide rates among men, but not women, were found to decrease with increasing urbanicity. CONCLUSION In line with recent findings from other western countries, we showed a growing gap between rural and urban suicide rates. This suggests a need for rural-specific suicide prevention efforts, especially aimed at the male rural population.
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Affiliation(s)
- Nestor D Kapusta
- Department of Psychoanalysis and Psychotherapy, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria.
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Payne S, Swami V, Stanistreet DL. The social construction of gender and its influence on suicide: a review of the literature. JOURNAL OF MENS HEALTH 2008. [DOI: 10.1016/j.jomh.2007.11.002] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Emslie C, Ridge D, Ziebland S, Hunt K. Exploring men's and women's experiences of depression and engagement with health professionals: more similarities than differences? A qualitative interview study. BMC FAMILY PRACTICE 2007; 8:43. [PMID: 17650340 PMCID: PMC1941733 DOI: 10.1186/1471-2296-8-43] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/19/2006] [Accepted: 07/24/2007] [Indexed: 12/05/2022]
Abstract
Background It is argued that the ways in which women express emotional distress mean that they are more likely to be diagnosed with depression, while men's relative lack of articulacy means their depression is hidden. This may have consequences for communicating with health professionals. The purpose of this analysis was to explore how men and women with depression articulate their emotional distress, and examine whether there are gender differences or similarities in the strategies that respondents found useful when engaging with health professionals. Methods In-depth qualitative interviews with 22 women and 16 men in the UK who identified themselves as having had depression, recruited through general practitioners, psychiatrists and support groups. Results We found gender similarities and gender differences in our sample. Both men and women found it difficult to recognise and articulate mental health problems and this had consequences for their ability to communicate with health professionals. Key gender differences noted were that men tended to value skills which helped them to talk while women valued listening skills in health professionals, and that men emphasised the importance of getting practical results from talking therapies in their narratives, as opposed to other forms of therapy which they conceptualised as 'just talking'. We also found diversity among women and among men; some respondents valued a close personal relationship with health professionals, while others felt that this personal relationship was a barrier to communication and preferred 'talking to a stranger'. Conclusion Our findings suggest that there is not a straightforward relationship between gender and engagement with health professionals for people with depression. Health professionals need to be sensitive to patients who have difficulties in expressing emotional distress and critical of gender stereotypes which suggest that women invariably find it easy to express emotional distress and men invariably find it difficult. In addition it is important to recognise that, for a minority of patients, a personal relationship with health professionals can act as a barrier to the disclosure of emotional distress.
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Affiliation(s)
- Carol Emslie
- MRC Social & Public Health Sciences Unit, Glasgow, UK
| | - Damien Ridge
- School of Integrated Health, Westminster University, London, UK
| | - Sue Ziebland
- Department of Primary Health Care, Oxford University, Oxford, UK
| | - Kate Hunt
- MRC Social & Public Health Sciences Unit, Glasgow, UK
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Hunt K, Lewars H, Emslie C, Batty GD. Decreased risk of death from coronary heart disease amongst men with higher 'femininity' scores: a general population cohort study. Int J Epidemiol 2007; 36:612-20. [PMID: 17440023 DOI: 10.1093/ije/dym022] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
CONTEXT At all ages men have higher rates of coronary heart disease (CHD) than women, although similar proportions of men and women eventually die of CHD. Gender differences in CHD incidence and mortality are often explained in relation to biological (hormonal) and behavioural risk factors (e.g. smoking), but psychological factors and broader social constructions of gender are rarely considered. OBJECTIVE To examine the relationship between measures of gender role orientation at baseline in 1988 and mortality from CHD over 17 years (to June 2005). DESIGN Prospective cohort study linked to national mortality reporting. SETTING Socially varied, mainly urban area centred on city of Glasgow in West Central Scotland, UK. PARTICIPANTS In total, 1551 participants (704 men and 847 women) aged 55 years took part in detailed interviews with nurses trained in survey methods in 1988. These included a wide range of measures of physical development and functioning, self reported health and health behaviour, personal and social circumstances and a measure of gender role orientation (yielding scores for 'masculinity' and 'femininity'). MAIN OUTCOME MEASURES Mortality from CHD up to June 2005 (88 CHD deaths in men; 41 CHD deaths in women). RESULTS After adjusting for smoking, binge drinking, body mass index, systolic blood pressure, household income and psychological well-being, higher 'femininity' scores in men were associated with a lower risk of CHD death (hazards ratio per unit increase in 'femininity' score 0.65, 95% CIs 0.48-0.87, P = 0.004). No such relationship was observed amongst women. 'Masculinity' scores were unrelated to CHD mortality in either men or women. CONCLUSIONS These results suggest that social constructions of gender influence the risk of ill health, here death from CHD. Men who are less able to identify themselves with characteristics identified as 'feminine' or expressive (who have a more limited stereotypically masculine self-image) may be at increased risk of coronary disease. Further research on the link between social constructions of gender and health is needed.
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Affiliation(s)
- Kate Hunt
- MRC Social and Public Health Sciences Unit, 4 Lilybank Gardens, Glasgow, Scotland, UK.
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