Masculinity norms and occupational role orientations in men treated for depression.

Reinhold Kilian,Maria Panzirsch,Karel Frasch,Tobias Staiger,Silvia Krumm,Felicitas Söhner,Maja Stiawa,Petra Beschoner,Max Schmauß,Annabel Müller-Stierlin,Harald Gündel,Thomas Becker,Stephan Doering

doi:10.1371/journal.pone.0233764

Abstract

A traditional male role orientation is considered to increase the risk of depression and preventing men from disclosing symptoms of mental illness and seeking professional help. Less is known about the variance of masculinity orientations in men already treated for depression and their role in the treatment process. In this study, patterns of masculinity norms and work role orientations will be identified among men treated for depression. Associations of these patterns with depressive symptoms, stigma and delay in professional help-seeking will be investigated. In a cross-sectional study, male role orientations (MRNS), work-related attitudes (AVEM), symptoms of mental disorders (PHQ), and attitudes related to stigma of mental illness (DSS) were assessed by standardized methods in a sample of 250 men treated for depression in general medical, psychiatric and psychotherapeutic services. Data were analyzed by means of latent profile analysis (LPA), by multinomial and linear regression models, and by path analysis. The results of LPA revealed three latent classes of men treated for depression. Men assigned to class one reported a less traditional male role orientation, low professional ambitions and low coping capacities; men assigned to class two reported a traditional masculinity orientation, high professional ambitions but low coping capacities; men assigned to class three reported less traditional masculinity tended orientations, medium professional ambitions and high coping capacities. Men assigned to classes one and two to have more stigmatizing attitudes, longer periods of untreated illness and more severe symptoms of mental disorders, in comparison to men assigned to class three. Overall, this study reveals that traditional masculinity norms and work-role orientations in men treated for depression are associated with a worse mental health status. Our study results also suggest that a slackening of traditional masculinity norms is associated with improved psychological well-being if it does not coincide with a complete distancing from professional ambitions and a lack of ability to cope with professional stress.

Highlights

While the worldwide depression prevalence among women is about twice that in men, suicide rates among men are significantly higher than among women [1,2,3]
Men assigned to class one reported a less traditional male role orientation, low professional ambitions and low coping capacities; men assigned to class two reported a traditional masculinity orientation, high professional ambitions but low coping capacities; men assigned to class three reported less traditional masculinity tended orientations, medium professional ambitions and high coping capacities
This study reveals that traditional masculinity norms and work-role orientations in men treated for depression are associated with a worse mental health status

Summary

Introduction

While the worldwide depression prevalence among women is about twice that in men, suicide rates among men are significantly higher than among women [1,2,3]. In order to explain this paradoxical relation several authors hypothesize that a majority of men affected by depression regard their symptoms as incompatible with their masculine self-image and that they are reluctant to seek help which in turn increases the risk of suicide [4,5,6,7,8,9] This hypothesis is supported by study results indicating that adherence to a traditional masculine role orientation in depressed men was found to be related to increased self-stigma, which in turn worked as a mediator toward reduced willingness to seek help [10,11]. A prospective study on depression among male college students revealed that endorsement of self-reliance, playboy attitude and violent masculine norms increased the risk for depression, while adherence to winning and power over women was associated with lower depressive symptoms [13]

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