Conceptualizing men: A transdiagnostic model of male distress

Abstract

This review aims to produce a comprehensive, parsimonious, and empirically based model of male psychological distress from the perspective of cognitive behaviour therapy (CBT) that may apply in the majority of clinical situations involving men in Britain and possibly elsewhere. This paper reviews studies that pertain to male psychological distress. Studies are selected via examination of the literatures around men's psychological health. Criteria for inclusion of studies are direct and indirect relevance to male distress. Studies are examined on the basis of their possible contribution to a comprehensive yet critical model of male functioning, and are grouped according to their neurological, developmental, and cultural origins. The review suggests that certain factors inform the psychological presentation of males across disorders, and can help predict therapy-interfering behaviours and outcomes. A transdiagnostic model of male distress emerges from existing data and theory containing the hypothesized reflection abandonment mechanism (RAM) that helps account for characteristic male externalizing and therapy-interfering behaviours. Existing data and theory can be synthesized to produce a cognitive behavioural model of male distress that adds value to case conceptualizations regardless of the disorder involved, and has predictive value regarding men's access to and engagement with psychological services.