Wednesday 24 October 2018

Gender and Psychological Distress

Gender and Psychological Distress

You have probably got here because you know me, or know of this blog. However, there is just a chance you got here after a search engine search and were hoping for something helpful. So here are some links out to places that might help. My top four audience sources appear to be the UK, the USA, Russia, and France. I couldn't find an English language site in Russia and have added a world wide one instead.

UK Help https://www.samaritans.org/
USA Help https://suicidepreventionlifeline.org/
France Help http://www.soshelpline.org/ 

Worldwide https://www.befrienders.org/

I am going to start by extracting some charts from the Adult Psychiatric Morbidity Survey for England, data collection done in 2014, published in 2016. It is worth just thinking about the strengths and weaknesses of the survey.

We used to get data for the UK, but now there are different data collection and reporting regimes in the consituant countries of the UK.

It is a household survey, so various groups of people are excluded from the sample, for example prisoners, homeless people, some members of the armed forces, students living in halls of residence, people in hospital.

This is not the same as people who have accessed services, and while the survey is carefully carried out, and there is good training for the people carrying out the survey, it is not quite the same as people going through a diagnostic process.

The survey uses proper sampling techniques, so the sample is not self selecting, and with the caveats I have already mentioned is representative of the population of England.

You might want to look at the earlier examples of the survey to get some idea of trends, but be aware there are differences between precise questions asked and what categories are used.

GAD is generalised anxiety disorder, OCD is obsessive-compulsive disorder, CMD-NOS is common mental disorder not otherwise specified. Statisitical significance in the difference between men and women is found for GAD, phobias, panic disorder and CMD-NOS. The question was about symptoms in the past week.




A third (35.6%) of people identified by the survey as currently having a CMD had never been diagnosed with one. I could not see (but they may be there) any gender breakdown on that figure, which is a shame as one commonly held belief is that men are less likely to seek diagnosis.

Any sex/gender effects are much smaller than the following

Post Traumatic Stress Disorder


Overall, 3.0%of adults screened positive for current PTSD. While men were more likely than women to have experienced a trauma; there was no significant difference by sex in rates of screening positive for current PTSD (2.6%of men, 3.3%of women).

Suicide attempts

Previous surveys had  reported self harm and suicide attempts together, the current survey recognises that people self harm without intent to kill themselves.

 

This is attempts ever. I will note that women attempt suicide more often than men, and perhaps, while of course it is important that men are more likely to successfully commit suicide, the public frameworking that suicide is a male problem is perhaps unhelpful.


Explanations

There are some researchers who persue the idea that, compared to men, women are biologically vulnerable to psychological distress. Wiener et al (2014)  doi:10.1016/j.eurpsy.2013.05.006, outline this idea

“Studies have consistently shown that oxidative stress is a common feature across major psychiatric disorders, including major depressive disorder (MDD) and bipolar disorder (BD)”

They go on to analyse their data, finding a sex difference in oxidative stress, but their analysis led them to conclude that was not the cause of gender differences in diagnosis.

There has been work on social factors, while the paper I cite is quite old is, in my opinion, an excellent example of the genre.

Nolen-Hoeksema, S., Larson, J., & Grayson, C. (1999). Explaining the gender difference in depressive symptoms. Journal Of Personality And Social Psychology, 77(5), 1061-1072. doi:10.1037/0022-3514.77.5.1061

They have an impressive sample size, they used a community based (i.e. not in-patients) sample of 1,100 people aged 25-75. They were measuring depressive symptoms, not diagnosed depression.


“The results of this study suggest that women carry a triad of vulnerabilities to depressive symptoms compared to men: more chronic strain, a greater tendency to ruminate when distressed, and a lower sense of their mastery over their lives. In turn, these variables contribute to each other. So what is a depressed woman, under chronic strain and ruminating or lacking a belief that she can control her life, to do? Helping women achieve a greater sense of control over their circumstances and engage in problem solving rather than ruminating should be useful. Changing the social circumstances that many women face so that they do not have so much to ruminate about is equally important.” p1071

Taking a step back from the individual with psychological distress there are other things going on. The criteria for depression may not include the behaviours that (at least some) men engage in when depressed. Men who seek help may not get a diagnosis, with the normal caveats about memory being unreliable, when I saw a GP aged 17 because a school teacher was worried I may be depressed the GP told me that young men don't get depression, something I found very unhelpful. Less anecdotally GPs may be more likely to diagnose women, and less likely to diagnose men (Lyons and Janca 2009).

So in summary. There are differences between men and women with regard to psychological distress. In the survey cited above there is not a statistically significant difference in depression. Trying to unpick cause and effect is really difficult.

Monday 8 October 2018

Masculinity

Masculinity


While feminism and feminist psychology does look at the gender system as a whole (see for example the work of Sandra Bem discussed last week) in this blog I want to focus specifically on masculinity. In doing so I will consider three positions around masculinity. The Gender Role Strain paradigm, Connell's work on Hegemonic masculinity, and Edley & Wetherell's work on their discursive psychology framework.

If you do not have access to academic resources then Sci Hub remains a possibility.

So with that in mind some papers that are influential in writing this blog.


Connell, R. W., & Messerschmidt, J. W. (2005). Hegemonic Masculinity: Rethinking the Concept. Gender and Society, (6). 829.
Levant, R. F. (2011). Research in the psychology of men and masculinity using the gender role strain paradigm as a framework. American Psychologist, 66(8), 765-776. doi:10.1037/a0025034
Luyt, R. (2012). Constructing hegemonic masculinities in South Africa: The discourse and rhetoric of heteronormativity. Gender & Language6(1), 47-77. doi:10.1558/genl.v6i1.47
Wetherell, M., & Edley, N. (2014). A Discursive Psychological Framework for Analyzing Men and Masculinities. Psychology of Men & Masculinity. http://dx.doi.org/10.1037/a0037148 

Gender Role Strain Paradigm

The idea as Levant makes clear comes from Pleck (1981). Pleck claimed an urgent need for a new psychology of men, according to Pleck men are  disproportionately represented among many problem populations -substance abusers, the  homeless, perpetrators of family and interpersonal violence, parents estranged from their  children, sex addicts and sex offenders, victims of - homicide, suicide, and fatal  automobile accidents; and victims of life-style and stress-related fatal illnesses. Pleck argues that this is because of the male gender role. Pleck was also arguing against over valorisation of the male gender role, and against biological explanation for masculinity. I have seen lists like this used to justify 'men's rights' with the addition of blaming feminism (and/or cultural Marxism) for the problems rather than the male role itself.

Nevertheless by 2011 Levant felt that the gender role strain paradigm was in need of rescuing.

This role strain has multiple causes;

Gender Role Strain Paradigm proposes that contemporary gender roles  are contradictory and inconsistent,
the proportion of persons who violate gender roles is high,
that violation of gender roles leads to condemnation and negative  psychological consequences,
that actual or imagined violation of gender roles leads people  to over-conform to the extremes,
that violating gender roles have more severe consequences for males than for females; and that certain prescribed gender role traits (such as male  aggression) are often dysfunctional.

Pleck & Thompson talked about the different ideas, existent within and across culture, of masculinity as ideologies of masculinity. 


Levant (2011) provides an overview of the current state of the field with regard to GRSP. For Levant masculinity is socially constructed, with different men and women holding different constructions. With constructions of masculinity potentially changing across time and cultures.
However Levant and others who adopt GRSP use the Male Role Norms Inventory to assess the degree to which men and women agree with questions about what men should be like.
It could be argued that measuring tools like this, while they are not personality inventories as such,they still essentialise the notion of masculinity.

Hegemonic Masculinity

Developed by Connell in 1985. Connell provides an extended critique of role theory, and in this there is a difference between Connell's work and GRSP which uses it. Connell points out how gender role theory ignores social structural issues and an over emphasis on role models over and above other forms of social influence.

The concept of Hegemonic masculinity reflects both the historical dynamics of how certain aspects of masculinity become favoured; and the notion that there is a form of masculinity, as patterns of practice that acts to be dominant over other forms of masculinity (sub-ordinate masculinities) and is part of the reproduction of patriarchy.

According to Connell, as the dominant configuration of gender practice at any historical moment (Hearn 2004), the concept of hegemonic masculinity embodies a culturally idealised form which serves the interests of powerful men by legitimating and maintaining patriarchal gender relations. 

These include texts, images and ideas (Hall 2002). Representations of the ideal are made familiar through institutions such as the mass media (Connell 1995). For example, television advertising in South Africa continues to reflect traditional hierarchical relations in society, where men are represented as being dominant vis-à-vis women (Luyt 2011), and ‘white’ men are represented as exemplars of hegemonic masculinity, whilst ‘black’ men are marginalised.

Connell points out in, a similar way to GRSP theorists, that very few men can live up to hegemonic masculinity. Yet many men who cannot live up to it still have an emotional investment in hegemonic masculinity ideals.

Discursive approaches to masculinity

Wetherell & Edley say our particular interest is in the discursive patterns that lie at the heart of these everyday practices. We investigate men’s narratives, accounts, and interactions. We focus on the making of meaning around masculinity, taking a qualitative rather than a quantitative approach.

This explains how masculinity is achieved psychologically. It refers to a process in which individuals adopt subjectivities relative to discourses of hegemonic masculinity, through situated psycho-discursive practices.

These positions are ‘imaginary’ in that, although they serve as the basis for identity, they are constantly discursively re-instantiated. Self-positioning merely exists as a discursive strategy in which multiple meanings of masculinity are selectively drawn upon, according to the vagaries of the interactional context.

Thus, individual men should not be labelled as particular character types, for example, complicit or subordinate (Wetherell and Edley 1999).

Rather they ‘can adopt hegemonic masculinity when it is desirable; but the same men can distance themselves strategically from hegemonic masculinity at other moments’

Comparing the approaches 

Gender role strain paradigm treats belief in traditional masculinity as something that people have, that can be measured and compared across different groups of men and women. Men who believe in traditional masculinity may be at risk of a range of issues, including psychological distress.

Hegemonic Masculinity treats masculinity as (several) somethings created in society, that benefit a subset of men, but that many men feel a need to support it. It also has a number of impacts on (most) men.

Wetherell & Edley's approach highlights the way that individuals may be able to discursively shift their position depending upon audience and topic. While I find this idea appealing it the one that least explains the potential impacts of masculinity as it is upheld in society.

In later blogs I will invoke some of these ideas to explain the operation of gender in society.