3 Reminder: Paper Topic due date: March 20 (Option A or B, 3-5 sentence summary; e-mail to your TA for approval). Paper due date: April 3.
4 Physical and Mental Health: 2. Are there sex differences in depression? 1. What factors account for sex differences in health? (continued)
5 By the end of today’s class, you should be able to: 1. review gender-related factors that contribute to sex differences in mortality and morbidity. 2. discuss the relationship between physical health and: agency, unmitigated agency, communion, and unmitigated communion. 3. review the diagnostic criteria for major depressive disorder.
6 4. discuss sex differences in rates of depression. 6. consider the role of genes in accounting for sex differences depression. 7. consider the role of hormones in accounting for sex differences depression. 5. discuss the developmental trajectory associated with sex differences in depression.
7 3. Gender-Related Factors (continued) What factors account for sex differences in health? (continued) (d) Gender-Related Traits Agency: greater physical activity, health eating, subjective and objective physical health (Danoff-Burg et al., 2002; Ghaed & Gallo, 2006).
8 Communion: unrelated to physical health (Ghaed & Gallo, 2006; Helgeson, 1994). Unmitigated communion: poorer health practices and objective physical health (Ghaed & Gallo, 2006; Helgeson et al., 2007; Yu & Xie, 2008). Unmitigated agency: feelings of invulnerability and greater risk-taking contribute to poorer physical health and shorter life expectancy (Danoff-Burg et al., 2002; Ghaed & Gallo, 2006; Yu & Xie, 2008).
9 Are there sex differences in depression? According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR), major depressive disorder (i.e., clinical depression) is characterized by five or more of the following symptoms, present for at least 2 weeks:
Depressed mood most of the day, nearly every day.* Markedly diminished interest in activities.* Significant weight loss. Insomnia. Psychomotor agitation or retardation. Fatigue or loss of energy. Feelings of worthlessness. Diminished ability to think or concentrate, or indecisiveness. Recurrent thoughts of death. * One of these symptoms must be included in the five symptoms. DSM-IV-TR Criteria for Major Depressive Disorder (APA, 2000) 10
Sample Items from the Center for Epidemiological Studies in Depression Scale (Radloff, 1977) 1. I did not like eating; my appetite was poor. 2. I felt I could not shake off the blues even with the help of my family or friends. 3. I felt that I was just as good as other people.* 4. I had trouble keeping my mind on what I was doing. 5. I felt depressed. 6. I felt that everything I did was an effort. 7. I thought my life had been a failure. 8. My sleep was restless. 9. I felt lonely. 10. People were unfriendly. 11. I enjoyed life.* 12. I had crying spells. 13. I felt sad. 14. I felt that people disliked me. 15. I could not get “going.” * Reverse-scored items. 11
12 Females are more likely than males to be diagnosed with depression (Culbertson, 1997; Hasin et al., 2005; Kessler, 2003; Kessler et al., 2003): General population: females are two times more likely than males to report depressive symptoms. Clinical samples: females are two to four times more likely than males to be diagnosed with major depressive disorder.
13 Significant sex differences in rates of major depressive disorder emerge in adolescence, peak in young adulthood, and subsequently decrease, with the elderly showing a minimal sex difference in depression: 12% of Canadian females and 7% of Canadian males report symptoms of depression (urban centres; Smith, Matheson, Moineddin, Glazier, 2007).
CDI Score CDI (Depression) Scores for Girls and Boys as a Function of Age (Twenge and Nolen-Hoeksema, 2002) 14
15 Percent Rates of Depression in Past Year by Sex and Age (Statistics Canada, 2009)
16 Sex differences in depression do not appear among college and university students (Grant et al., 2002).
17 Depression Rates of Depression Across Educational Levels (Ross & Mirowsky, 2006)
18 Sex differences in depression are found across nations (Alansari, 2006; Seedat et al., 2009).
Female to Male Odds Ratio for Depression in 15 Countries (Seedat et al., 2009) 19
20 A number of factors have been proposed to account for sex differences in depression: 1. Genes Some theorists have speculated that the X chromosome carries a gene for depression. However, there is a greater likelihood of father-son pairs exhibiting depression than father-daughter pairs (Helgeson, 2013).
21 2. Hormones (a) Some theorists maintain that testosterone “protects” males from depression. However, midrange levels of testosterone are associated with the lowest levels of depression among males (Booth et al., 1999).
22 (b) Some theorists maintain that the hormonal fluctuations associated with the female reproductive system make females more susceptible to depression than males. However, research has failed to demonstrate that the hormonal (e.g., estrogen) changes associated with menstruation or menopause are consistently linked to depression among females (Erdincler et al., 2004; Nolen-Hoeksema & Girgus, 1994).
23 (c) Some theorists maintain that changes in oxytocin regulation during puberty cause females to be more reactive to interpersonal stressors and, thus, more vulnerable to depression. However, some research has shown that oxytocin reduces women’s reactivity to stress (e.g., by lowering blood pressure; Grewen et al., 2005)
24 Physical and Mental Health: 2. Are there sex differences in depression? 1. What factors account for sex differences in health? (continued)