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.

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 & Language, 6(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.

Feminist Psychology

Feminism and Psychology

So my argument is at follows. When we do work on men and women in the laboratory (or by properly sampled surveys) we persistently fail to find psychological differences. Yet there are clearly differences between men and women in society, some of which we can expect to affect psychology, or be affected by psychology, from the education gender gap, the gender pay gap, differences in diagnosis rate for the medicalised versions of psychological distress. All of this speaks to me of a need for tools beyond empirical measurement.

There are a variety of such tools available to social science, and I am going to look at three of them over the next few weeks, Feminism this week, theories of masculinity next week, and my historical version of social constructionism the week after.

Of those I find feminist psychology the hardest to teach, because I am constantly struck by the issue that the majority of my students are female and I am male; am I mansplaining feminism?

I have also failed to find any music that appeals enough to me to want to play it in class, but I do have distant memories of listening to the Au Pairs.

After some time I settled on a way of teaching this material by teaching about feminist psychologists. This also gives me a way to celebrate some voices that are often missing from the history of psychology. If you are interested in that then this website is amazing. Also where I got a lot of the biographic information from.

I begin the lecture talking about the various 'waves' of feminism.

Helen Thompson Woolley

Gained her PhD in psychology at the University of Chicago  in 1900. She was working at a time when women were largely dismissed.

W.L.Distant "modern, domesticated women, like Mr. Darwin's rabbits, were frailer and dumber than either their primitive ancestors or their contemporary mates”

William James claimed that women before motherhood as "vain, egotistic, irritable, and nervous" but, "instantly transformed when they have a baby. They become totally selfless, no longer need sleep, function unconsciously and intuitively, find absolute delight in their hideous infants”

I do not know if it was intentional but that description of women James used is very similar to descriptions of hysteria, more of that in a few weeks.

Woolley's work failed to find large scale differences between men and women, but was dismissed at the time.

The meta analytical tradition

I have already talked about this, two week ago. Most of the women who created meta analysis were feminist psychologists, Maccoby & Jacklin, and Hyde & Linn.

They had the hope that if they could find the 'real' differences between men and women then they could try to explain the stereotypes. However, as I have already discussed they found very few 'real' differences. 

Also their work (still on going) did not have the impact one might have imagined, areas that the evidence suggests have no differences still attract current peer reviewed journal articles. It is almost as if people only look for recent papers that back up their point of view when they do the literature review.

Sandra Bem

Bem's (June 22, 1944 – May 20, 2014) career is illustrative of how, at least some, feminist thinking within psychology changed across time.

She begins by suggesting that both men and women have masculine and feminine traits, and the most mentally healthy people have higher levels of both (Psychological Androgyny). This does break up the old status quo that masculine and feminine are opposites. BUT she later repudiates the test, after some scholarly discussion about what it means. However, the BSRI continues to be used, quite why modern researcher think measuring 1970s stereotypes about men and women is useful escapes me. This is quite good as an informal discussion of the problems of trying to use it today.

She then develops the Gender Schema idea. I saw this in the syllabus for last years GCSE psychology, so I think it had an impact. While doing that work she becomes increasingly concerned with why society invests so much into the idea that men and women are opposites, the idea she calls the Gender Polarizing Lens.

Rhoda Unger

One of figures whose work centres on making psychology a better science. Ironically though by making sure that psychologists are careful about removing (unwanted) social influence in the laboratory we just end up with the dilemma I talked about in the first week. Unger's (1979) work if it had been listened to more widely would have meant there was no need for Fine's critique of neuro-psychological sex and gender work.

The F Word

 There does  seem to be some reluctance to listen to criticism, especially when that criticism comes from people who self identify as feminist psychologists, or feminists more generally. 

While there are feminist psychologists who attack the very idea of a scientific practice of psychology, many argue for doing science, while also exploring the nature of society.

Next week Masculinity! How psychologists and others have tried to study what makes men, men.

Sexuality, an obsession with categories

Sexuality, an obsession with categories

Going to try to avoid loads of definitions, although the lecture does do a lot of that.

Billy Bragg, Sexuality (Link to you tube video).

 However, lets go with some sort of definition of sexuality. Sexuality the human capacity to have erotic experiences and responses.

Sexual orientation, the enduring pattern of sexual and/or romantic attraction to people of the same sex or gender, the other sex or gender, or to both sexes or more than one gender, or to none.

A concern with categorisation

My argument is that very often psychology has followed societal concerns. What are those concerns.

The concern with categorisation has a history, both a legal history and a medical history.   Across history, and across cultures, there have been differing moral and legal codes dealing with sexuality. 

While the diversity of human sexuality has (probably) been with us across time, seeing sexuality as a major part of personal identity may be modern.

Legal frameworks, in a UK context, moved from specific sexual acts, towards more general behaviours, and then to decriminalisation and finally equality.

UK Legal history

Buggery Act 1533 – prior to this sexuality offences were tried through the Church (by this point the split with the Church of Rome had happened).

‘Unnatural sex’ Convictions for anal intercourse or oral intercourse by a man with a man or woman; and sex by men or women with animals.

Death by hanging, unlike many other offences land, titles and wealth were not passed on but went to the crown. Unlike (e.g.) murder, Clergy could be executed for buggery.

Suspicion it was often used politically because of that.

Replaced by the Offences against the Person Act 1828, which provided that buggery would continue to be a capital offence.  Offences against the Person Act 1861 removed death penalty.

The United Kingdom Parliament repealed buggery laws for England and Wales in 1967 (in so far as they related to consensual homosexual acts in private). (Scotland 1980, Northern Ireland 1982)

Up until the 1st May 2004 while (male) homosexuality was decriminalised a series of laws remained on the books that effectively made asking someone to have sex and having sex with a partner in a private room of a shared house illegal for gay men.

This came from the Labouchere amendment to the 1885 Criminal Law Amendment Act

“Any male person who, in public or private, commits or is a party to the commission of, or procures or attempts to procure the commission by any male person of any act of gross indecency with another male person, shall be guilty of a misdemeanour.”

The act above was an act about the suppression of brothels and prostitution.

 

Age of consent

Age of consent following Sexual Offences Act 1967 for sex between men was set at 21.

1994 age of consent for male same sex activity lowered to 18. 2000 age of consent for all sexual acts equalised at 16 (first time UK law acknowledged lesbians).

Equality legislation

Equality act 2010 (UK wide)

Civil partnership act 2004 (UK wide)

Same sex marriage England and Wales 2013, Scotland 2014, not recognised in Northern Ireland

 

The legal framework matters, but arguably of more importance was the change in the psychiatric view.

The Psychiatric Viewpoint

TRB Glad to Gay (Link to you tube video)

DSM and World Health Organisation International Classification of Diseases.

DSM I (1952) and II (1968) included homosexuality as a diagnosis of psychiatric disorder.

The seventh printing of DSM II (1974) had removed homosexuality as a psychiatric disorder. (Although egodystonic homosexuality remained until DSM IV)

ICD-9 1977 included homosexuality as a disease

ICD – 10 1990 removed homosexuality as a disease

Some Effects on Psychology

Conflation of sexuality and gender identity, such that early masculinity-feminity scales were used as part of a diagnostic process for identifying homosexuality.

Terman and Miles  (1936) Masculinity femininity test.

Mf scale in first edition Minnesota Multiphasic Personality Test – originally normed on (male) GIs for masculine sample and (male) GIs in the stockade for homosexuality for feminine sample.

Development of sexuality

 

Little effort to understand general development of sexuality.

When homosexuality was seen as a mental disorder effort to understand what caused the ‘abnormality’.

—reudian concepts used (hence egodystonic homosexuality).

Radao (1940) Failure to resolve the Oedipus Complex in a ‘successful’ way.

Often led to ‘mother blaming’

Later ‘mother blaming’ would continue under a guise of social learning theory, having ‘too strong’ a female role model, and/or ‘too weak’ a male role model.

Little to no empirical evidence to back up the theorising.

 

The heterosexuality questionnaire

I use this in class, I don't want my students to tell me their answers to the questions, the point is to get out the way we treat straight people differently to Lesbian, Gay and Bisexual people. So if you are heterosexual try to answer these questions.

1. What do you think caused your heterosexuality?

2. How and when did you decide to become a heterosexual?

3. Is it possible that your heterosexuality is just a phase you may grow out of?

4. Is it that your heterosexuality stems from a neurotic fear of having intimate relationships with those of your own sex?

5. If you have never slept with a person of the same sex, is it possible that all you need is a good gay or lesbian lover?

6. Why do people like you insist on flaunting your heterosexuality?  Can’t you just be who you are and keep it quiet?

7. Why do heterosexuals place so much emphasis on sex?

8. Why do heterosexuals feel compelled to seduce others into their lifestyle?

9. Despite the social support (and tax breaks) that marriage receives the divorce rate continues to grow.  Why is it that heterosexuals cannot form committed stable relationships?

10. How can you become a whole person if you limit yourself to compulsive, exclusive heterosexuality?

11. There seem to be very few truly happy heterosexuals.  Techniques have been developed that may enable to change your sexual orientation if you want to.  Have you ever considered, for example, aversion therapy?

12. Would you really want your child to be a heterosexual, knowing all of the problems that s/he may face?

And Finally

If you have got time I recommend this to you, it is the video of a talk by Dr. Lisa Diamond on sexual fluidity. It is 45 minutes long.

https://youtu.be/m2rTHDOuUBw