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.

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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.

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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 ones
  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.

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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.

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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

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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

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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.

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Cont. Therapeutic issues

• Native Americans
• High rates of alcoholism and depression.
• High rates of unemployment and poverty leading to
  high suicide rates.

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General strategies

• Look for clients 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 clients 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.

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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.

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Drug therapy

• Women are more likely to use sedatives and
  tranquilizers than men.

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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 womens decisions about sexual orientation.

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Cont. Gender-sensitive therapy

• Feminist therapy
• 2 primary components
• social inequalities have been responsible for
  shaping womens 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 womens strengths

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Cont. Feminist therapy

• Therapist should try to enhance the clients
  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