■ Females are more likely than males to report depressive symptoms as well as major depressive disorder.
■ Sex differences persist across a variety of cultures but are not observed in some homogenous populations, such as college students and the widowed.
■ The sex difference in depression is related to the onset of depression—not recurrence.
■ There are elevated rates of mental health problems among sexual minorities.
■ Sex differences in depression among clinic populations may be exaggerated to the extent that physicians overdiagnose depression in women and underdiagnose depression in men.
■ Sex differences in depression among community populations may be exaggerated to the extent that men are less willing than women to admit or recognize symptoms of depression.
■ There is some evidence that people respond more negatively to depression in men than in women.
■ It is possible that women and men are equally distressed, but that they manifest distress in different ways. Women may show symptoms of depression, and men may have alcohol problems.
■ Biological factors, including genes and hormones, most certainly contribute to depression but cannot alone explain the sex difference in depression.
■ Females’ low status in society may lead to lower perceptions of control. A lack of control could contribute to perceptions of helplessness, a precipitant of depression.
■ It is not the case that men exhibit more problem- focused coping, and women exhibit more emotion- focused coping. Instead, there are specific coping styles related to sex. Women seek support and ruminate in response to stress more than men.
■ Women’s tendency to ruminate interferes with instrumental behavior, increases access to other negative cognitions, and decreases social support, all of which have been linked to depression.
■ Women may be more likely than men to respond to stressful events by becoming introspective—that is, privately self-conscious, a construct related to rumination.
■ Women are more likely than men to experience relationship events and more vulnerable than men to the negative effects of relationship stressors. It is the latter that is most strongly linked to sex differences in depression.
■ There are multiple aspects of the female gender role. Although communion is not related to depression, un- mitigated communion is.
■ People who score high on unmitigated communion become involved in others’ problems to the neglect of themselves, both of which may increase women’s risk for depression.
■ Aside from unmitigated communion, women are more likely than men to find themselves in the caregiving role. Women report greater caregiver burden than men, increasing their risk of depression.
■ Gender intensification suggests that gender-role norms become salient during adolescence. One reason that girls’ depression may increase during adolescence is that they become aware of the limitations of the female gender role.
■ A variety of events occur during adolescence—body image changes, challenges to relationships with parents and peers—that may pose a greater risk for depression among girls than boys.
■ Girls not only have a poorer body image than boys but body image is more strongly related to depression among girls than boys. Girls are also more likely than boys to suffer from body objectification, a related cause of depression.
■ Clear-cut sex differences in adjustment to chronic illness are not apparent.
■ Gender provides an important framework within which we can understand the issues that women and men with a chronic illness face.
■ The male gender role is advantageous to the extent a chronic illness is construed as a problem meant to be solved, but disadvantageous to the extent it implies weakness and limits men’s feelings of control.
■ The female gender role can facilitate adjustment to chronic illness by providing support resources but can impede adjustment when physical attractiveness and caregiving issues interfere with taking proper care of oneself.
■ There are three major kinds of eating disorders: anorexia nervosa, bulimia nervosa, and binge eating disorder. Anorexia is the most lethal of the three.
■ Eating disorders tend to emerge during adolescence.
■ It is during adolescence that girls experience body changes (in particular, an increase in body fat), become dissatisfied with their bodies, and become increasingly concerned with their appearance and how others view them. During adolescence, girls also recognize limiting factors associated with the female gender role.
■ Contributing factors to eating disorders include genes, gender roles, psychological factors (e.g., need for control and perfectionism), and the social environment.
■ Media exposure has been implicated in eating disorders for both women and men. Experimental studies have shown that media exposure affects girls’ views of their bodies.
■ Men commit suicide more than women. This sex difference appears across the life span and persists across cultures.
■ Women attempt suicide more than men.
■ This gender paradox is partly explained by methodological issues. Suicide in women may be underestimated because women are more likely to use ambiguous methods (e.g., overdose of pills) than men, which may be misclassified as accidents. Men’s suicide attempts may be underestimated because men are less likely than women to admit to a failed suicide attempt.
■ Suicide in both women and men—adults and adolescents—is likely to be associated with other mental health problems, such as depression and substance abuse.
■ Among adults, marital breakup and unemployment are linked to suicide—especially in men.
■ Among both adolescents and adults, relationship difficulties have been linked to suicide.
Anorexia nervosa—Eating disorder characterized by the continual pursuit of thinness, a distorted body image, and refusal to maintain a weight that is more than 85% of what is considered normal for the person’s age and height.
Binge eating disorder—Eating disorder characterized by recurrent binge eating without purging or fasting.
Body objectification—The experience of one’s body being treated as an object to be evaluated and used by others.
Bulimia nervosa—Eating disorder characterized by recurrent binge eating followed by purging via vomiting, laxatives, diuretics, enemas, and/or exercising.
Clinical depression—Another name for major depressive disorder, the critical feature of which is that the person must have experienced a set of depressive symptoms for a period no shorter than two weeks.
Different cause theory—Suggestion that there are different causes of girls’ and boys’ depression and the cause of girls’ depression increases during adolescence.
Differential exposure—Idea that men and women are exposed to a different number of or kinds of stressors.
Differential item functioning—Idea that some items are more likely to be associated with a trait, such as depression, among men versus women.
Differential vulnerability—Idea that certain stressors are more strongly linked to distress in one sex than the other.
Emotion-focused coping—Approach to stressful situations in which individuals attempt to accommodate themselves to the stressor.
Gender intensification—Gender roles becoming salient during adolescence, causing boys and girls to adhere more strongly to these roles.
Interactive theory—Suggestion that being female always poses a risk for depression and the events of adolescence activate that risk.
Learned helplessness—Learning that our actions are independent of outcomes, which then leads us to stop responding (give up) in other situations.
Precipitating factors—Environmental events that trigger the emergence of a disorder (e.g., depression).
Problem-focused coping—Approach to stressful situations in which we attempt to alter the stressor itself.
Psychological reactance—Reaction to a perceived threat to control that involves doing the opposite of what is demanded.
Relative coping—Likelihood that men or women use one coping strategy compared to another strategy.
Same cause theory—Suggestion that the same factor could cause depression in both men and women, but the factor increases during adolescence only for girls.
Susceptibility factors—Innate, usually biological, factors that place one group (e.g., women) at greater risk for a disorder (e.g., depression) than another group.