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心理与生理疾病中的性别差异:固定角色与养育角色的影响。

Gender differences in mental and physical illness: the effects of fixed roles and nurturant roles.

作者信息

Gove W R

出版信息

Soc Sci Med. 1984;19(2):77-91. doi: 10.1016/0277-9536(84)90273-9.

Abstract

A decade ago it was widely assumed that there were no gender differences in mental illness/mental health and that any evidence that suggested that women experienced more psychological distress than men was due to women being more willing to admit to psychological distress, being more willing to seek treatment and/or sex bias on the part of clinicians. Furthermore, although it was widely recognized that on most indicators of physical illness women appeared to have higher rates of morbidity, it was generally assumed that the apparent higher rates of women did not reflect real differences in morbidity, but gender differences in illness behavior. A survey of the recent literature, however, shows that there is now a general consensus among social scientists that women experience more psychological distress than men and that this is largely due to aspects of their societal roles. Furthermore, in the last few years the cumulative evidence indicates that women do in fact have higher rates of morbidity than men and that this probably is also largely a consequence of their social roles. The present paper focuses on two aspects of the roles typically occupied by men and women, namely that the roles of men tended to be more structured or 'fixed' than the roles of women, while women are more likely to occupy nurturant roles than men. It is argued that highly structured or 'fixed' roles tend to be causally related to good mental health and low rates of morbidity. In contrast nurturant roles tend to impose a strain and to impair one's ability to effectively adopt a sick role and as a consequence nurturant roles are linked to poor mental health and the higher rates of morbidity. In short, it is suggested that the fixed role-hypothesis and the nurturant role hypothesis complement each other and together partially explain the higher rates of physical illness and psychological distress among women.

摘要

十年前,人们普遍认为在精神疾病/心理健康方面不存在性别差异,任何表明女性比男性经历更多心理困扰的证据都被认为是因为女性更愿意承认心理困扰、更愿意寻求治疗和/或临床医生存在性别偏见。此外,尽管人们普遍认识到在大多数身体疾病指标上女性的发病率似乎更高,但通常认为女性发病率较高并非反映实际的发病差异,而是疾病行为的性别差异。然而,一项对近期文献的调查表明,社会科学家们现在已普遍达成共识,即女性比男性经历更多心理困扰,这在很大程度上归因于她们社会角色的某些方面。此外,在过去几年中,累积证据表明女性的发病率实际上确实高于男性,这可能在很大程度上也是她们社会角色的结果。本文聚焦于男性和女性通常所占据的角色的两个方面,即男性的角色往往比女性的角色更具结构性或“固定性”,而女性比男性更有可能承担养育性角色。有人认为,高度结构化或“固定”的角色往往与良好的心理健康和低发病率存在因果关系。相比之下,养育性角色往往会带来压力并损害一个人有效扮演病人角色的能力,因此养育性角色与心理健康不佳和较高的发病率相关。简而言之,有人提出固定角色假说和养育性角色假说相互补充,共同部分地解释了女性中较高的身体疾病发病率和心理困扰发生率。

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