Gender and Psychological Disorders Maitlin, Ch 12

1. Gender and Psychological Disorders (Maitlin, Ch 12) Women are more likely than men to suffer from depression, certain anxiety disorders, and eating disorders. They are also more likely to seek therapy for these problems. Men are more likely to abuse alcohol and other drugs, and have antisocial personality disorder.

2. Depression Women are two to three times more likely than men to experience depression during their lifetime. Gender differences hold for race and cross-culturally (in developed countries) Gender differences do not hold true in homogeneous groups (a class of medical students) or underdeveloped countries.

3. Characteristics of Depression Emotional symptoms feeling sad, gloomy, tearful, guilty, apathetic, irritable, and unable to experience pleasure Cognitive symptoms thoughts of inadequacy, worthlessness, helplessness, self-blame, and pessimism; these depressed thoughts interfere with normal functioning, so that the individual has trouble concentrating, and making decisions

4. Behavioral symptoms decreased ability to work, neglected personal appearance, social withdrawal, sleep disturbance, suicidal. Women are more likely to attempt but men are more likely to die from suicide. Physical symptoms indigestion, headaches, dizzy spells, fatigue, generalized pain.

5. Additional characteristics For a woman, likelihood of depression increases if she has several young children in the home, low income, or unhappily married. Personality characteristics associated with depression include: low self-esteem, low sense of personal accomplishment, traditional feminine gender typing, little sense of control over one�s own life.

6. Explanations of gender differences in depression Diagnostic biases in therapists Therapists tend to overdiagnose women and underdiagnose men. Discrimination seems to contribute depression. Poverty Housework Emphasis on physical appearance Violence: the stress of violence clearly contributes to depression

7. Women typically give more social support in relationships. They may also become overly involved in the problems of their friends and family members. Women respond differently than men Ruminative style: turn inward to focus on symptoms Distracting style: distract with some sort of activity. If you think you are ruminative, do some activity that takes your mind away from your emotions.

8. Anxiety disorders Women are only slightly more likely than men to experience social phobias. Social phobia has excessive fear of social situations, especially situations where they will be evaluated. Women are more likely than men to experience specific phobias and agoraphobias.

9. Cont. Anxiety Specific phobias Afraid of one kind of situation or object. 70% to 95% of people with specific phobias are female. Agoraphobia Fear of being in public places from which to escape. Women are 3 X as likely as men. It begins with a series of panic attacks.

10. Eating disorders and related problems Anorexia Nervosa Fear of becoming obese. Refuses to maintain an adequate body weight 85% of expected weight. 90-95% of anorexics are female. Consequences: amenorrhea: cessation of menstrual periods heart, kidney, gastrointestinal disorders. 5 -10% die; treatment is difficult.

11. Cont. Eating disorders Bulimia Nervosa characterized by binge eating and by inappropriate methods used to prevent weight gain. Force vomiting or abuse laxatives. Typically maintain normal body weight. Consequences: gastrointestinal, heart, metabolism problems, dental problems.

12. Emphasis on being slim Media images Barbie Doll: only 1 in 100,000 real-life women would have a waistline or hips as slender as hers. Discrimination against overweight women Receive lower salaries, job discrimination, not sexually attractive and less likely to marry. Females are more dissatisfied with their bodies.

13. Race, body image and slimness Black women are more satisfied with their body image than are Eu-Am women. Black males prefer average-weight women, whereas White males prefer thinner women. Research on Latina women is contradictory. Dominican Republic did not value thinness; Upper-class Argentinian family emphasized thinness.

14. Being overweight and dieting Defined as 20% more than the recommended weight on standardized medical charts. 35% of US women and 31% of US men are overweight; not a mental disorder. 40% of US women and 24% of men are currently dieting. 17,000 diet plans; many are ineffective because people regain the lost weight.

15. Treatment Psychotherapy is a process in which a therapist aims to treat psychological problems most often through verbal interactions. 400 different kinds of psychotherapy. Drug therapy: use of medication to treat psychological disorders.

16. Bias in Psychotherapy Educators and therapists may overlook learning disabilities in girls. 1% to 4% of male therapists and .2% to .5% of female therapists have had sexual relationships with their clients.

17. Psychotherapy and Race People of color are not as likely as Eu-Am to use mental health services. Reasons: shame in talking about personal problems to a stranger suspicion language and economic barriers reluctance to recognize that help is necessary culturally based preferences for other interventions such as prayer

18. Therapeutic issues For Af-Am Black women suffer two second-class statuses: black and female May report stressful factors such as extreme poverty, inadequate housing, and neighborhood crime

19. Cont. Therapeutic issues Latinas Gender stereotypes are strong Some latinas have come to North America as refugees from a country beseiged by war and turmoil Asian-American Strong gender stereotype Reluctant to use mental health services because avoid shame to family as psychological problems are judged harshly.

20. Cont. Therapeutic issues Native Americans High rates of alcoholism and depression. High rates of unemployment and poverty leading to high suicide rates.

21. General strategies Look for client�s strengths Do not assume the client holds the values that are common to their culture; ask. Show empathy, caring, and appreciation. Learn about the history, experiences, religion, and cultural values of the client�s ethnic group. Some immigrants might want to become more acculturated than others. Explore how racism may have played a role in their life. Address language barriers.

22. Cognitive-behavioral approach This approach asks the client to question any irrational thought patterns they may have. A therapist may help the woman to see alternate points of view.

23. Drug therapy Women are more likely to use sedatives and tranquilizers than men.

24. Gender-sensitive therapy Non-sexist therapy Women and men should be treated similarly. Therapists should not use power as a tool to encourage more feminine behavior in women or to bias women�s decisions about sexual orientation.

25. Cont. Gender-sensitive therapy Feminist therapy 2 primary components social inequalities have been responsible for shaping women�s behavior the distribution of power between the client and therapist should be as egalitarian as possible. Social forces operate to devalue women women are less powerful than men; societal problem. Must focus on women�s strengths

26. Cont. Feminist therapy Therapist should try to enhance the client�s power in the therapeutic relationship. Clients are encouraged to become more self-confident and independent. Client is their own best expert Self-disclosure Group therapy