Gender roles and women’s mental health: their influence on the demand for psychological care
Abstract
The prevalence of certain diagnoses, such as eating disorders, depression, anxiety, and borderline personality disorder, is higher among women than among men. When it comes to women’s mental health, focusing on social aspects influencing the way women fall ill becomes crucial. Using a sample of 368 women, we studied the classification ability of a number of clinical variables and sociocultural factors (conformity to gender norms) in order to ascertain whether or not women were receiving psychological care and determine the importance of each of the variables when predicting which women were receiving therapy. Our results showed that women were more likely to be receiving psychological treatment when scoring high on certain clinical variables (such as Suicidal Ideation and Borderline Features) and on a number of variables related to conforming to gender norms (Care for Children, Nice in Relationships, and Sexual Fidelity). Therefore, we believe that integrating the gender perspective into educational, health-related, and psychological care programmes is essential so that gender roles can become more diverse and less constricting of people’s potential, resulting in improved health.
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Asociación Americana de Psiquiatría (2013, 2014). Guía de consulta de los criterios diagnósticos del DSM-5. Arlington, V. A.: Asociación Americana de Psiquiatría.
Bahamón, M. J., Alarcón-Vasquez, Y., Trejos-Herrera, A. M., Vinaccia, S., Cabezas, A. & Sepúlveda-Aravena, J. (2019). Efectos del programa CIPRES sobre el riesgo de suicidio en adolescentes. Revista de Psicopatología y Psicología Clínica, 24(2), 93-91. doi:10.5944/rppc.23667
Belle, D. & Doucet, J. (2003). Poverty, inequality, and discrimination as sources of depression among U.S. women. Psychology of Women Quarterly, 27, 1–12.
Bleichmar, E. D. (1999). La depresión en la mujer. Madrid: Temas de Hoy.
Bott, N. T., Radke, A. E. & Kiely, T. (2016). Ethical issues surrounding psychologists’ use of neuroscience in the promotion and practice of psychotherapy. Professional Psychology: Research and Practice, 47(5), 312-329. doi:10.1037/pro0000103.
Breiman, L. (2001). Random Forests. Machine Learning, 45, 5-32.
Cialdini, R. B., & Trost, M. R. (1999). Social influence: social norms, conformity, and compliance. En D. Gilbert, S. Fiske, & G. Lindzy (Eds.), The handbook of social psychology (Vol. 2, pp. 151–192). Boston: McGraw-Hill.
Corona, B., Hernández, M. & García, R. M. (2016). Revista Habanera de Ciencias Médicas, 15(1), 90-100.
Cuéllar-Flores, I., Sánchez-López, M. P. & Dresch, V. (2011). El Inventario de Conformidad con las Normas de Género Masculinas (CMNI) en la población española. Anales de Psicología, 27(1), 170-178.
Dohrenwend, B. & Dohrenwend, B. S. (1977). Sex differences in mental illness: a reply to Gove and Tudor. American Journal of Sociology, 82, 1336-41.
Eaton, N. R., Keyes, K. M., Krueger, R. F., Balsis, S., Skodol, A. E., Markon, K. E. & Hasin, D. S. (2012). An invariant dimensional liability model of gender differences in mental disorder prevalence: Evidence from a national sample. Journal of Abnormal Psychology, 121, 282–288. doi.org/10.1037/a0024780.
Ellis, L., Hershberger, S., Field, E., Wersinger, S., Pellis, S., Geary, D., Palmer, C., Hoyenga, K., Hetsroni, A. & Karadi, K. (2008). Sex differences: Summarizing more than a century of scientific research. Nueva York: Psychology Press. doi:10.1007/s10508-009-9538-y.
Engel, G. L. (1980). The clinical application of the biopsychosocial model. American Journal of Psychiatry, 137(5), 535-544. doi:10.1176/ajp.137.5.535.
Escribano, T. (2006). Trastorno Límite de la Personalidad: Estudio y tratamiento. Intelligo, 1(1), 4-20.
Fernández, J. (2004). Perspectiva evolutiva: Identidades y desarrollos de comportamientos según el género. En Barberá, E. y Martínez, I. (Comp.), Psicología y género (pp. 35-53). Madrid: Pearson.
Fine, C. (2018). Testosterona Rex. Mitos sobre sexo, ciencia y sociedad. Barcelona: Paidós.
Fletcher-Janzen, E. (Ed.). (2009). The neuropsychology of women. Nueva York: Springer.
Garandillas, A., Zorrilla, B. & Sepúlveda, A. R. (2003). Trastornos del comportamiento alimentario: Prevalencia de casos clínicos en mujeres adolescentes en la Comunidad de Madrid. Recuperado del sitio de internet del Instituto de Salud Pública https://www.comunidad.madrid/servicios/salud
García, M. T., Martín, M. F. & Otín, R. (2010). Tratamiento integral del trastorno de personalidad límite. Revista de la Asociación Española de Neuropsiquiatría, 30, 263-278. doi:10.4321/S0211-57352010000200005.
Garfinkel, P. & Newman, A. (2001). The Eating Attitudes Test. Twenty-five years later. Eating and weight disorders, 6(1), 1-24. doi:10.1007/BF03339747.
Garner, D. M., & Garfinkel, P. E. (1979). The Eating Attitudes Test: An index of the symptoms of anorexia nervosa. Psychological Medicine, 9, 273-279. doi:10.1017/s0033291700030762.
Garner, D. M., Olmsted, M. P., Bohr, Y. & Garfinkel, P. E. (1982). The Eating Attitudes Test: psychometric features and clinical correlates. Psychological Medicine, 12, 871-878. doi:10.1017/s0033291700049163.
Garnica de Cos, E. (2015). Gender differences in personality disorders. En Sáenz-Herrero, M. (Ed.). Psychopathology in women. Incorporating gender perspective into descriptive psychopathology (pp. 527-559). Nueva York: Springer.
Giddens, A. & Sutton, P. W. (2014). Sociología. Madrid: Alianza Editorial.
Gove, W. (1984). Gender differences in mental and psychical illness: the effects of fixed roles and nurturant roles. Social science and medicine, 19(2), 77-91. doi:10.1016/0277-9536(84)90273-9.
Hartung, C. M. & Lefler, E. K. (2019). Sex and gender in psychopathology: DSM-5 and beyond. Psychollogical Bulletin, 145(4), 390-049. doi: 10.1037/bul0000183.
Jiménez, R. & Vázquez, A. (2012). Esquizofrenia y género. Apuntes de Psicología, 30(1-3), 419-434.
Kienast, T., Stoffers, J., Bermpohl, F. & Lieb, K. (2014). Borderline personality disorder and comorbid addiction. Deutsches Ärzteblatt International, 111(16), 280-286. doi:10.3238/arztebl.2014.0280.
Kohen, D. (Ed.). (2010). Oxford textbook of women and mental health. Nueva York: Oxford University Press.
Kuhn, M. (2020). caret: Classification and Regression Training. R package version 6.0-85. https://CRAN.R-project.org/package=caret.
Leal, C. (2006). Psicopatología y mujer: introducción. En J. Ezcurra, A. González-Pinto & M. Gutiérrez-Pinto (Eds.), Psiquiatría y mujer (pp. 1-8). Madrid: Aula Médica.
Mackenzie, C. S., Visperas, A., Ogrodniczuk, J. S., Oliffe, J. L. & Nurmi, M. A. (2019). Age and sex differences in self-stigma and public stigma concerning depression and suicide in men. Stigma and Health, 4(2). doi:10.1037/sah0000138.
Mahalik, J.R., Locke, B., Ludlow, L., Diemer, M., Scott, R.P.J. & Gottfried, M. (2003). Development of the Conformity to Masculine Norms Inventory. Psychology of Men and Masculinity, 4(1), 3-25. doi:10.1037/1524-9220.4.1.3.
Mahalik, J.R., Morray, E.B., Coonerty-Femiano, A., Ludlow, L.H., Slattery, S.M. & Smiler, A. (2005). Development of the Conformity to Feminine Norms Inventory. Sex Roles, 52(7), 417-435. doi:10.1007/s11199-005-3709-7.
Matud, M. P. & Aguilera, L. (2009). Roles sexuales y salud mental en una muestra de la población española general. Salud Mental, 32, 53-58.
Meyer, L. & Melchert, T. P. (2011). Examining the content of mental health intake assessments from a biopsychosocial perspective. Journal of Psychotherapy Integration, 21(1), 70-89. doi:10.1037/a0022907.
Ministerio de Sanidad, Consumo y bienestar social. (2018). Encuesta Nacional de Salud de España 2017. Recuperado de https://www.mscbs.gob.es/estadEstudios/estadisticas/encuestaNacional/home.htm
Ministerio de Sanidad, Consumo y bienestar social. (2018). Encuesta Nacional de Salud de España 2017. Informe monográfico sobre salud mental. Recuperado de https://www.mscbs.gob.es/estadEstudios/estadisticas/encuestaNacional/encuestaNac2017/SALUD_MENTAL.pdf
Montero, I., Aparicio, D., Gómez-Beneyto, M., Moreno-Küstner, B., Reneses, B. & Usall, J. (2004). Género y salud mental en un mundo cambiante. Gaceta Sanitaria, 18(1), 175-181. doi:10.1157/13062523.
Morey, L. C. (2007). Personality Assessment Inventory: Professional manual (2nd ed.). Odessa, FL: Psychological Assessment Resources.
Nazroo, J. Y., Edwards, A. C. & Brown, G. W. (2001). Gender differences in the prevalence of depression: artefact, alternative disorders, biology or roles? Sociology of Health and Illness, 20(3), 3112-330. doi:10.1111/1467-9566.00104.
Organización Mundial de la Salud (2018). Salud de la mujer. Datos y cifras. Recuperado de https://www.who.int/es/news-room/fact-sheets/detail/women-s-health
Organización Mundial de la Salud (2018). Género y salud. Datos y cifras. Recuperado de https://www.who.int/es/news-room/fact-sheets/detail/gender
Organización Mundial de la Salud. (2019). Género y salud. Recuperado de https://www.who.int/es/news-room/fact-sheets/detail/gender
Ortiz-Tallo, M., Cardenal, V., Ferragut, M., & Cerezo, M. V. (2011). Personalidad y síndromes clínicos: Un estudio con el MCMI-III basado en una muestra española. Revista de Psicopatología y Psicología Clínica, 16(1), 49-59. doi:10.5944/rppc.vol.16.num.1.2011.10350
Ortiz-Tallo, M., Cardenal, V., Ferragut, M., & Santamaría, P. (2015). Spanish and chilean standardizations of the personality assessment inventory: The influence of sex. The Spanish Journal of Psychology, 18, 1. doi:10.1017/sjp.2015.57.
Ortiz-Tallo, M., Santamaría, P., Cardenal, V. & Sánchez-López, P. (2011). Inventario de Evaluación de la Personalidad PAI. Manuel de aplicación, corrección e interpretación. Madrid: TEA Ediciones.
Pérez, P. & Gaviña, J. (2015). Affective disorders. En Sáenz-Herrero, M. (Ed.), Psychopathology in women. Incorporating gender perspective into descriptive psychopathology (pp. 527-559). Nueva York: Springer.
Pérez, J. & Serra, E. (1997). Influencia del rol tradicional femenino en la sintomatología ansiosa en una muestra de mujeres adultas. Anales de Psicología, 13(2), 155-161.
Pike, K. M., Roberto, C., Wolk, S. L., Gluck, M. & Walsh, B. T. (2008). Eating disorders measures. En A. J. Rush, M. B. First & D. Blacker, D. (Eds.), Handbook of Psychiatric Measures (pp. 621-47). Washington, D. C.: American Psychiatric Publishing.
R Core Team (2019). R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. URL https://www.R-project.org/.
Revelle, W. (2019) psych: Procedures for Personality and Psychological Research. Northwestern University, Evanston, Illinois, USA. https://CRAN.R-project.org/package=psych Version = 1.9.12.
Rivas, T., Bersabé, R., Jiménez, M. & Berrocal, C. (2010). The Eating Attitudes Test (EAT-26): Reliability and Validity in Spanish Female Samples. The Spanish Journal of Psychology, 13(2), 1044-1056. doi:10.1017/S1138741600002687.
Ruiz, P. M., Peláez-Fernández, M. A., Calvo, D., Pérez, J., Gómez, A. & Calado, M. (2016). Diferencias por género de los trastornos de la conducta alimentaria en adolescentes españoles. Aequalitas, 39, 29-36.
Sáenz-Herrero, M. (Ed). (2015). Psychopatology in women. Incorporating gender perspective into descriptive psychopathology. Nueva York: Springer.
Salk, H., Hyde, J. & Abramson, L. (2017). Gender differences in depression in representative national samples: Meta-analyses of diagnoses and symptoms. Psychological Bulletin, 143(8), 783-822. doi:10.1037/bul0000102.
Sánchez-López, M. P. & Cuéllar, I. (2013). Salud mental y género. En M. P. Sánchez-López (Coord.), La Salud de las Mujeres (pp. 189-213). Madrid: Síntesis.
Sánchez-López, M. P., Cuéllar-Flores, I., Dresch, V. & Aparicio-García, M. (2009). Conformity to feminine gender norms in the Spanish population. Social behavior and personality, 37(9), 1171-1186. doi:10.2224/sbp.2009.37.9.1171.
Sánchez-López, P. & Limiñana, R. (Ed.) (2017). The psychology of gender and health. Conceptual and applied global concerns. Londres: Elsevier.
Sánchez, T. (2018). Políticas sanitarias e igualdad entre mujeres y hombres. Revista de Bioética y Derecho, 43, 179-192.
Skodol, A. E. & Bender, D. S. (2003). Why are women diagnosed borderline more than men? Psychiatric Quarterly, 74(4), 349-360. doi:10.1023/A:1026087410516.
Stevenson, M. (2020). epiR: Tools for the Analysis of Epidemiological Data. R package version 1.0-11. https://CRAN.R-project.org/package=epiR.
Velasco, S. (2007). Evaluación de una intervención biopsicosocial para el malestar de las mujeres en atención primeria. Feminismo/s, 10, 111-131.
Velasco, S. (2009). Sexo, género y salud. Teoría y métodos para la práctica clínica y programas de salud. Madrid: Minerva Ediciones.
Wood, W. & Eagly, A. (2013). Biology or culture alone cannot account for human sex differences and similarities. Psychological Inquiry, 24(3), 241-247. doi: 10.1080/1047840X.2013.815034
Wickham, H. (2016). ggplot2: Elegant Graphics for Data Analysis. Nueva York: Springer.
Yagahmaian, R. & Miller Smedema, S. (2019). A feminist, biopsychosocial subjective well-being framework for women with fibromyalgia. Rehabilitation Psychology, 64(2), 154-166. doi:10.1037/rep0000226.
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