Centre for Youth Mental Health, Orygen Youth Health Research Centre, University of Melbourne, Parkville, VIC, Australia School of Psychology, Australian Catholic University, Melbourne, VIC, Australia
School of Psychology, Deakin University, Melbourne, VIC, Australia.
Int J Soc Psychiatry. 2015 May;61(3):236-40. doi: 10.1177/0020764014540149. Epub 2014 Jun 29.
Clinical reports indicate that men tend to engage in a range of externalising behaviours in response to negative emotional states. Such externalising behaviours have been theorised to reflect a male sub-type of depression that is inconsistent with current diagnostic criteria, resulting in impeded detection and treatment rates of depressed men.
In addressing previous study design limitations, this article presents self-report longitudinal data for the multidimensional Male Depression Risk Scale (MDRS-22) against ratings of diagnostic criteria for major depressive disorder as assessed by the Patient Health Questionnaire-Depression Module (PHQ-9). Longitudinal psychometric properties of the MDRS-22 are reported and symptom trajectories described.
A sample of 233 adults (males = 125; 54%) completed measures of externalising and prototypic depression symptoms at Time 1, and again at Time 2 (15 weeks later). Psychometric properties were examined and within-subjects analyses undertaken.
The MDRS-22 demonstrated stable internal consistency and test-retest correlations equivalent to those observed for the PHQ-9. Both prototypic and externalising depression symptoms increased with experiences of recent negative life events. Marked gender differences were observed. Males experiencing ≥ 2 stressful negative life events reported significantly higher MDRS-22 scores at both Time 1 and Time 2 relative to comparable females.
Findings contribute to the validity of the MDRS-22 as a measure of externalising depression symptoms. Results suggest that while both males and females experience externalising depression symptoms, these symptoms may be particularly elevated for men following experiences of negative life events. Findings suggest that externalising symptoms may be a special feature of depression for men. Given the problematic nature of such externalising symptoms (e.g. excessive substance use, aggression, risk-taking), their clinical assessment appears warranted.
临床报告表明，男性在应对负面情绪时往往会表现出一系列外化行为。这些外化行为被认为反映了一种不符合当前诊断标准的男性亚类型抑郁症，导致抑郁男性的检测和治疗率受到阻碍。
为了解决先前研究设计的局限性，本文提出了多维男性抑郁风险量表（MDRS-22）的自我报告纵向数据，该量表针对的是患者健康问卷抑郁模块（PHQ-9）评估的主要抑郁障碍的诊断标准。报告了 MDRS-22 的纵向心理测量特性，并描述了症状轨迹。
233 名成年人（男性=125；54%）完成了外化和典型抑郁症状的测量，时间为 1 次，15 周后再次测量。检查了心理测量特性并进行了个体内分析。
MDRS-22 表现出稳定的内部一致性和与 PHQ-9 观察到的等效测试-再测试相关性。典型和外化的抑郁症状随着最近负面生活事件的经历而增加。观察到明显的性别差异。经历≥2 次压力性负面生活事件的男性在时间 1 和时间 2 报告的 MDRS-22 得分明显高于可比女性。
研究结果为 MDRS-22 作为外化抑郁症状的测量工具提供了有效性证据。结果表明，尽管男性和女性都经历了外化的抑郁症状，但在经历负面生活事件后，这些症状可能在男性中尤为突出。研究结果表明，外化症状可能是男性抑郁的一个特殊特征。鉴于这些外化症状的问题性质（例如过度使用物质、攻击性、冒险行为），对其进行临床评估似乎是合理的。
