The University of Utah, Department of Sociology, 380 S 1530 E, Rm 301, Salt Lake City, UT 84112-0250, USA.
Soc Sci Med. 2013 Sep;92:83-91. doi: 10.1016/j.socscimed.2013.05.025. Epub 2013 Jun 4.
In this paper, we critically examine three propositions that are widely (but not universally) accepted in the gender and mental health literature. First, women and men have similar or equal rates of overall psychopathology. Second, affective disorders like anxiety and depression, which are more common among women, and behavioral disorders like substance abuse and antisocial personality, which are more common among men, are functionally equivalent indicators of misery. Finally, women are more likely to respond to stressful conditions with affective disorders while men are more likely to respond to stressful conditions with behavioral disorders. Our review of previous research shows little to no consistent empirical support for any of these propositions. Results from national studies of overall psychopathology or "any disorder" are, at best, mixed and limited to a narrow range of mental health conditions. A comprehensive test of gender differences in overall psychopathology would require a systematic and exhaustive examination of gender differences across the known universe of mental health conditions, but this may be impossible to achieve due to a lack of consensus on the universe, the proliferation of diagnostic categories, and the tendency to pathologize the mental health of women. There is no empirical evidence to suggest that women substitute affective disorders for behavioral disorders or that men substitute behavioral disorders for affective disorders. There is no theory to suggest that affective and behavioral disorders should be treated as comparable indicators of misery. Some studies support the idea that women and men respond to stress in different ways, but most do not. Numerous studies show that women and men respond to stressors with higher levels of emotional distress, substance abuse, and antisocial behavior. We conclude with seven recommendations to advance theory and research and several general reflections on the sociological study of gender and mental health.
在本文中，我们批判性地考察了在性别与心理健康文献中广泛（但并非普遍）接受的三个命题。首先，女性和男性的整体精神病理学发病率相似或相等。其次，女性中更为常见的焦虑和抑郁等情感障碍，以及男性中更为常见的物质滥用和反社会人格等行为障碍，被认为是痛苦的等效指标。最后，女性更有可能对压力状况产生情感障碍，而男性更有可能对压力状况产生行为障碍。我们对先前研究的回顾表明，这些命题几乎没有一致的经验证据支持。对整体精神病理学或“任何障碍”的全国性研究结果充其量是混杂的，并且仅限于心理健康状况的狭窄范围。对整体精神病理学中的性别差异进行全面检验，需要系统而详尽地考察已知心理健康状况范围内的性别差异，但由于缺乏对宇宙的共识、诊断类别激增以及将女性心理健康病态化的倾向，这可能难以实现。没有证据表明女性用情感障碍代替行为障碍，或者男性用行为障碍代替情感障碍。也没有理论表明情感和行为障碍应该被视为痛苦的可比指标。一些研究支持女性和男性以不同方式应对压力的观点，但大多数研究并不支持这一观点。许多研究表明，女性和男性对压力源的反应是情绪困扰、物质滥用和反社会行为水平更高。最后，我们提出了七点建议，以推动理论和研究的发展，并对性别与心理健康的社会学研究进行了几点一般性思考。
