Department of Psychiatry, University of Rochester Medical Center, Rochester, New York, USA.
Psychiatr Serv. 2011 Jul;62(7):740-6. doi: 10.1176/ps.62.7.pss6207_0740.
Given their prevalence and persuasive power in our culture, gender norms--commonly described as socially reinforced, learned expectations of what it means to be a man or a woman--likely contribute to sex differences in service utilization for depression. This study investigated whether sex differences in toughness, a gender-linked norm characterized by a desire to hide pain and maintain independence, were associated with a preference to wait for depression to resolve on its own without active professional treatment ("wait-and-see" approach).
Participants (N=1,051) in the California Behavioral Risk Factor Surveillance System (BRFSS) survey were contacted in a follow-on survey to assess toughness, the kind of treatment they would prefer were they to receive a diagnosis of depression, and current symptoms of depression. Participants who reported ever having been diagnosed as having a depressive disorder on the BRFSS were oversampled threefold. Analyses were conducted using linear and logistic regressions.
Men and women who scored higher on toughness had a greater preference for the wait-and-see approach (OR=1.14, p<.01). Women were less likely to prefer the wait-and-see approach (OR=.58, p<.04) and scored lower on toughness (B=-.70, p<.01). Men's greater levels of toughness partially mediated the sex difference in treatment preferences (OR=.91, p<.03).
Men's greater adherence to the toughness norm explained part of the sex difference observed in treatment-seeking preferences, but toughness undermined women's treatment seeking as well. Findings could be used to inform novel public health communications intended to attract both men and women to psychiatric services.
鉴于性别规范在我们的文化中普遍存在且具有说服力，这些规范通常被描述为社会强化的、对男性或女性意味着什么的习得期望，它们可能导致抑郁症服务利用方面的性别差异。本研究调查了坚韧不拔的性别规范差异是否与等待抑郁症自行缓解而不寻求积极专业治疗的倾向（“观望”方法）有关，坚韧不拔是一种与性别相关的规范，其特征是渴望隐藏痛苦并保持独立性。
在加利福尼亚行为风险因素监测系统（BRFSS）调查中联系了后续调查的参与者，以评估坚韧不拔、他们在被诊断出患有抑郁症时会选择哪种治疗方法以及当前的抑郁症状。在 BRFSS 上报告曾被诊断为患有抑郁症的参与者被三倍抽样。使用线性和逻辑回归进行分析。
坚韧不拔得分较高的男性和女性更倾向于观望方法（OR=1.14，p<.01）。女性不太倾向于观望方法（OR=.58，p<.04），坚韧不拔得分较低（B=-.70，p<.01）。男性坚韧不拔程度的提高部分解释了治疗偏好性别差异（OR=.91，p<.03）。
男性对坚韧不拔规范的坚持程度解释了在寻求治疗的偏好方面观察到的性别差异的一部分，但坚韧不拔也破坏了女性寻求治疗的意愿。研究结果可用于为旨在吸引男女双方寻求精神科服务的新型公共卫生宣传提供信息。
