2-A Negative State of Mind - Patterns of Depressive Symptoms Among Men With High Gender Role Conflict

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DOI: 10.1037/1524-9220.3.1.3

ISSN: 1524-9220

Registro: 00128141-200201000-00001

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A Negative State of Mind: Patterns of Depressive Symptoms Among MenWith High Gender Role Conflict

Autor(es): Shepard, David S.1,2

Nmero: Volume 3(1), January 2002, p 38

Tipo de publicacin: [Article]

Editor: 2002 by the American Psychological

Association

Instituciones:

1Department of Counseling, California State

University2Correspondence concerning this article should

be addressed to David S. Shepard, Department

of Counseling, California State University, 6868,

Fullerton, California 92834-6868. E-mail:

[email protected]

An earlier version of the study reported in this

article was presented at the 108th Annual

Convention of the American Psychological

Association, Washington, DC, August 2000. This

study is based on new analyses of data initially

collected for my doctoral dissertation under the

supervision of Rodney K. Goodyear. I thank Dr.

Goodyear for his encouragement and advice. I

also thank John M. Robertson for his generous

assistance with the preparation of this article.

Finally, I thank Linda Long for her assistance

with the statistical analyses.

Received January 24, 2000; Revision received

March 29, 2001; Accepted June 1, 2001

AbstractThe author investigated the relationship between patterns of depressive symptoms and subscales of the

Gender-Role Conflict Scale (GRCS; J. M. O'Neil, B. J. Helms, R. K. Gable, L. David, & L. S. Wrightsman, 1986) in a

sample of college-age men. A factor analysis of the Beck Depression Inventory (A. T. Beck, A. J. Rush, B. F. Shaw, &

G. Emery, 1979) identified 3 factors: Negative Attitudes, Performance Difficulties, and Physiological Symptoms. The

study revealed that the factor Negative Attitudes, characterized by such symptoms as self-dislike, feelings of failure,

guilt, and pessimism, was associated with higher levels of GRCS Restrictive Emotionality. The study's limitations,

directions for future research, and the implications for the counseling of male clients are discussed.

Since the late 1970s, researchers studying sex differences in depressive symptomatology have found a number of

symptoms characteristic of men, including an avoidance of crying, withdrawal from their social world, and

somatization (Funabiki, Bologna, Pepping, & Fitzgerald, 1980; Hammen & Padesky, 1977; Oliver & Toner, 1990;

Ovid: A Negative State of Mind: Patterns of Depressive Symptoms... http://0-ovidsp.tx.ovid.com.columbus.uhu.es/spb/ovidweb.cgi

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Padesky & Hammen, 1981). One feature of these symptoms is that they imply a reluctance or inability to talk about or

reveal feelings of depression. This tendency has been called the male intolerance of depression (Warren, 1983, p.

147), or male covert depression (Real, 1997, p. 41). The reluctance to display feelings of distress may help explain

the oft-cited statistic that twice as many women experience depression as do men (Amenson & Lewinsohn, 1981;

Weissman & Klerman, 1977). The discrepancy may be the result not of women's greater vulnerability to depression but

of differences in how depression is expressed.

The above-cited researchers have all speculated that the male tendency to experience covert depressive

symptoms is a result of male socialization, which includes the idea that it is not masculine to admit weakness and

display vulnerable feelings. Thus, there appears to be a link between conformity to our culture's definition of the

male gender role and how males show symptoms of depression.

O'Neil and his colleagues (O'Neil, 1981; O'Neil, Helms, Gable, David, & Wrightsman, 1986) have argued that

conformity to the traditional male gender role may create a state of gender role conflict for men. That is, men may

constrict their own potentials and expression of human needs (e.g., tender or vulnerable feelings) out of a fear of

feeling or behaving in any way feminine. Male gender role conflict theory has implications for the expression of

depression; men who are socialized to adhere to the traditional norms and who fear being unsuccessful, vulnerable, or

feminine may find it easier to acknowledge symptoms less sick than those the word depression implies. In otherwords, there may be a relationship between gender role conflict and the denying or camouflaging of depression.

Exploratory in nature, this study was designed to discover whether gender role conflict is linked with certain

patterns of symptoms in a sample of college-age men. For example, it would be theoretically reasonable to predict

that men with high levels of gender role conflict would tend to report symptom patterns consistent with intolerance

of depression: that is, somatic and/or behavioral symptom clusters. These men would be less likely than men with low

levels of gender role conflict to report affective and/or cognitive symptoms, which would imply self-awareness of

depressive experiences. However, no empirical study to date has attempted to demonstrate a relationship between

gender role conflict and covert depressive symptoms nor looked for a relationship between gender role conflict and

any other pattern of depressive symptoms. The purpose of this study was to fill this gap in the literature.

MethodMeasures

Gender-Role Conflict Scale (GRCS)

The GRCS (O'Neil et al., 1986) was designed to measure levels and patterns of gender role conflict in men. Gender

role conflict was defined as a fear of femininity, which may have negative consequences for men or negatively impact

others. The GRCS consists of 37 items rated on a Likert-type scale ranging from strongly disagree (1) to strongly agree

(6). The scale includes four factors: Success, Power, and Competition (SPC; the high value that men are supposed to

place on success and winning), Restrictive Emotionality (RE; the traditional male's reluctance to cry and to openly

express vulnerable feelings), Restrictive Affectionate Behavior Between Men (RABBM; the male fear of any behavior

that could be construed as homosexual), and Conflicts Between Work and Family Relations (the state of tension many

men experience in balancing the demands of work with the responsibilities of home and family). This fourth factor wasomitted from the study's analysis because of concerns that it measures situational stress rather than gender role

rigidity (Mahalik, Cournoyer, DeFranc, Cherry, & Napolitano, 1998).

Subscale scores are obtained by summing the responses to individual items; higher scores reflect greater conflict.

O'Neil et al. (1986) determined reliability using Cronbach's alpha (alphas ranged from .75 to .85) and a testretest after

a 4-week interval (reliability ranged from .72 to .86). Good, Dell, and Mintz (1989) found Cronbach's alphas ranging

from .78 to .88 for the subscales; more recently, internal and factorial validity was supported in analyses by Rogers,

Abbey-Hines, and Rando (1997) and Moradi, Tokar, Schaub, Jome, and Serna (2000).

Beck Depression Inventory (BDI)

The BDI was designed to measure the cognitive, behavioral, affective, and somatic symptoms associated withdepression. The version used in this study (Beck, Rush, Shaw, & Emery, 1979) measures 21 variables, each

representing a symptom.


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Because of the widespread use of the BDI, Beck, Steer, and Garbin (1988) were able to conduct a meta-analysis of

the instrument's reliability and validity. Internal consistency reliability ranged from .73 to .92 in 15 studies with

nonpsychiatric samples.

The BDI is a self-report instrument in which the respondent chooses one of four statements describing the

intensity with which he or she is experiencing a particular symptom. Scores of 0 to 3 are given for each item, ranging

from an absence of a particular symptom to a severe experience of it.

Procedure

Students enrolled in an introductory psychology course at a Roman Catholicassociated university were required

to participate in a research study and could elect the study of their choice. Participants chose a study on the basis of

information on a posted sign-up sheet; the sheet for this study read, A Study About Men. Thus, although students

were fulfilling a course requirement, participation in this study was voluntary. All of the 111 students who volunteered

completed the protocols.

An additional 40 protocols were given to instructors in an introductory counseling course at a private nonsectarian

university. Students were invited by the instructors to volunteer for a study about men. Forty students requested

protocols, and 16 returned them.

ResultsPreliminary Analyses

Because I looked at patterns of symptoms in this study, I conducted a factor analysis of the BDI in order to see

whether individual symptoms would load on factors that could be interpreted as distinct categories of symptoms.

Although previous studies have identified BDI factors, I needed to conduct a new analysis for two reasons. First,

several of the previous studies used clinical samples. Second, studies using nonclinical samples have been inconsistent

in the number of factors identified; one study found two factors (Endler, Rutherford, & Denisoff, 1999) and another,

nine (Hill, Kemp-Wheeler, & Jones, 1986). Consequently, it was appropriate to conduct a new analysis.

In this study, a principal-components analysis and the derived scree plot indicated three factors, which wererotated using a varimax procedure. The rotated solution indicated that all three factors were interpretable (see Table

1). Factor loadings below .40 were not considered in the interpretation. Notably, these three factors were similar in

meaning to the factors found in several previous analyses of the BDI using clinical samples, including an analysis of the

original sample Beck used to create the instrument (Beck & Lester, 1973; Tanaka & Huba, 1984). Consequently, I gave

the factors similar labels: Negative Attitudes (NA), Physiological Symptoms (PHYS), and Performance Difficulties (PD).

As in previous analyses, some factors contained overlapping symptoms, and others contained symptoms that rendered

interpretation somewhat less precise. The clearest factor was NA, with high loadings on the symptoms sense of failure,

self-dislike, guilt, and pessimism. The PHYS factor included the items weight loss, loss of appetite, and insomnia. The

third factor, PD, included the symptoms fatigue, work difficulty, irritability, and indecisiveness. Reliability

coefficients were .67 for NA and .65 for both PHYS and PD.


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Table 1 Factor Loadings for the Three Beck Depression Inventory (BDI) Factors

Descriptive Analyses

Means and standard deviations for all variables are presented in Table 2. GRCS scores were similar to those that

O'Neil et al. (1986) found with a sample of undergraduate men. The mean score on the Beck Depression Inventory was

slightly but not meaningfully higher than those reported by Hammen and Padesky (1977) and by Hill et al. (1986) with

similar populations.

Table 2 Means, Standard Deviations, and Ranges for All Measures, Total Sample (N = 127)

Correlation and Regression Analyses

A correlation analysis (see Table 3) indicated that RE was associated with all depression factors; RABBM correlated

with NA and PHYS, and SPC correlated with PHYS. However, in order to get a clearer picture of which gender role

subscales might be associated with symptom patterns, I conducted three regression analyses, with the GRCS subscales

entered at once as the predictor variables and the BDI factors as criterion variables. The analyses revealed that when

NA was the criterion, GRCS subscales together accounted for 12% of the variance, R2 = .12, adjusted R2 = .10, F(3,

123) = 5.71,p = .001. GRCS subscales also accounted for 9% of the variance in PHYS, R2 = .09, adjusted R2 = .06, F(3,

123) = 3.80,p = .01. GRCS subscales were not significantly related to PD.


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Table 3 Correlations of Gender-Role Conflict Scale (GRCS) Subscales With Total Beck Depression Inventory (BDI) and

BDI Factors (N = 127)

As shown in Table 4, RE was the only subscale to significantly affect a criterion variable ([beta] = .32,p = .01).

The squared semipartial correlation coefficient for RE indicated that RE significantly accounted for 7% of the variance

in NA, after controlling for RABBM and SPC. Neither RABBM nor SPC significantly affected NA. In the equation withPHYS as the dependent variable, none of the subscales uniquely affected the criterion. Consequently, the results of

the three regression analyses indicated that the relationship between RE and NA was the central finding in this study.

Table 4 Simultaneous Regression Analyses of Beck Depression Inventory (BDI) Factors on Gender-Role Conflict Scale

(GRCS) Subscales (N = 127)

DiscussionThis study was designed to investigate whether gender role conflict was associated with specific patterns of

depressive symptoms. The findings demonstrate that for college-age men, a connection may exist between RE and a

pattern of depressive symptoms characterized by a negative state of mind and, specifically, such symptoms as

self-dislike, feelings of failure, guilt, and pessimism. The findings are noteworthy on two other counts: RE was the

only predictive GRCS factor to emerge from the analyses, and RE did not predict the somatic or behavioral factors that

would be consistent with covert depression.


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Perhaps most important, these findings lend support to four other studies suggesting that RE is the strongest

gender role conflict predictor of psychological distress for men in both clinical and nonclinical samples (Cournoyer &

Mahalik, 1995; Good et al., 1995, 1996; Sharpe & Heppner, 1991). Previous studies, however, have related RE only to

global measures of distress; this study's findings illuminate in more detail the role of RE by linking it specifically to a

negatively colored internal world. Hill et al. (1986), in their factor analysis of the BDI, called a similar pattern of

negative symptoms Feelings of Unworthiness, suggesting a sense of not measuring up to some internalized personal or

societal standard. An implication of the present study's findings is that this sense of unworthiness may be a pricecollege-age men pay if they have difficulty expressing and experiencing vulnerable or tender emotions and believe

those emotions reflect a lack of masculinity.

There are several ways sense can be made of these findings. For example, it may be that higher scores on the RE

scale reflect the rigidity with which these men are adhering to the traditionally defined male role. This rigidity may

characterize their personal standards in a variety of aspects of life. If these men have rigid personal standards, they

are likely to feel they have not measured up in some ways and will experience depressive symptoms such as self-dislike

and sense of failure.

High RE scores may suggest a lack of human contact and exchange of emotions with others; the attendant

isolation may contribute to a negative state of mind. As a result of their tendency to restrict emotions, these men maylack the opportunity to obtain soothing and normalization of their feelings from others.

Finally, it may be helpful to explore the RENA relationship from an early infant development perspective. The

psychoanalytic theorists Stolorow, Brandchaft, and Atwood (1987) described what happens when caregivers fail to

reliably validate and tolerate the child's emotional states, including the child's inevitable, at times, depressive

feelings. According to Stolorow et al., when children lack this empathic resonance, they learn to disavow and cut off

much of their affective life. In such cases, they wrote, the emergence of affect often evokes painful experiences

of shame and self-hatred. Emotionality thereby comes to be experienced as a solitary and unacceptable state, a sign

of a loathsome defect within the self (p. 72).

Stolorow et al. (1987) were theorizing that the emotional restriction that develops from a child's belief that hispainful emotions are intolerable to his parents leads to a sense of internal defectiveness in the adult, a sense of

something being wrong. This sense is reflected in the NA symptom cluster. Stolorow et al.'s observations, though

applicable to both sexes, suggest what it must be like for boys whose earliest experiences teach them to restrict their

tender emotions. Subsequent socialization (e.g., the experience of being shamed by boy peers) reinforces what they

learned during early development about the negative costs of having feelings.

This study's findings highlight the dilemma in which men with depressive symptoms who come for counseling may

find themselves. On the one hand, they are experiencing self-attacking cognitions and feel discouraged about their

lives and futures. At the same time, they may be reluctant to talk with their counselor about how bad they feel inside.

Counselors may need to be sensitive to these clients' dilemma and to help them explore their hidden fears about the

meaning of emotional expression and its relationship to not being masculine. It may be necessary for these fears to beaddressed and resolved before a healing unburdening of emotions can occur. When clients finally begin to express

painful feelings and the therapist empathizes rather than judging them as unmasculine, they may discover that

vulnerable feelings are not a sign of defectiveness. In this way, the freeing up of hidden or disavowed emotion may

also weaken the intensity of self-criticism, sense of failure, and pessimism.

This study has several limitations. Fifty-nine percent of the participants were Catholic. Although the mean BDI

score of the Catholic group was not different from that of the non-Catholics, the results may not be generalizable to a

more diverse population. This study's participants included men who were mildly to moderately depressed and men

who were not depressed, and thus the findings may not be generalizable to a population with clinical depression. The

BDI dimensions found in this study may not be replicated with other populations. Finally, the BDI is a self-report

instrument; it is possible that those men highest in gender role conflict may have been reluctant to report, evenanonymously, depressive symptoms.

Future research is needed to look at larger populations that are more diverse in which there is more severe


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depression. Future research might also use scales that more specifically assess RE and feelings of low self-worth. In

addition, the present study highlights the need for qualitative research on men and depression. Only one qualitative

study on men and depression exists (Heifner, 1997). Because of the limitations of self-reportbased research, it would

be valuable to hear men describe their depressive experiences, their negative thoughts and feelings, and their

definitions of masculinity in their own voices.

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2-A Negative State of Mind - Patterns of Depressive Symptoms Among Men With High Gender Role Conflict