Men's Psychotherapy Use, Male Role Norms, and Male-Typical Depression Symptoms: Examining 716 Men and Women Experiencing Psychological Distress.

Lukas Eggenberger,Claudio Ludwig,Nikola Komlenac,Andreas Walther,Seraina Weber,Callia Fordschmid,Jessica Grub

doi:10.3390/bs11060083

Abstract

Men as compared to women are half as often affected by depressive and anxiety disorders and seek significantly less help for mental health issues than women. Adherence to traditional male role norms (AtTMRN) may hinder men from describing prototypical depression symptoms and from seeking psychotherapy. The current study compared whether AtTMRN, gender role identity, or the experience of prototypical or male-typical externalizing mental health symptoms were associated with psychotherapy use in men and women. In an anonymous online survey, 716 participants (37% men) reporting to currently experience psychological distress were examined. Information was obtained on psychotherapy use, depression and anxiety symptoms, gender role identity, and traditional male role norms. Although experiencing similar levels of depression, men compared to women showed a reduction in psychotherapy use by 29%. Masculine role identity was directly associated with reduced psychotherapy use in men (β = −0.41, p = 0.029), whereas AtTMRN was not (men: β = −0.04, p = 0.818; women: β = −0.25, p = 0.064). Higher externalizing depression symptomatology (β = −0.68, p = 0.005), but not prototypical depression symptomatology (β = −0.02, p = 0.499), was associated with reduced psychotherapy use in men but not women (p > 0.05). Interactions revealed that men, but not women, with high AtTMRN use psychotherapy only when exhibiting elevated symptom levels. The results corroborate previous reports showing reduced psychotherapy use in men as compared to women and identify elevated masculine role identity and male-typical externalizing depression symptomatology as direct factors associated with reduced psychotherapy use in psychologically distressed men. AtTMRN interacts with mental health symptoms to predict psychotherapy use, indicating that men with high AtTMRN only use psychotherapy when exhibiting high symptomatology.

Highlights

IntroductionA nationally representative sample from Germany comprised of 24,016 adults revealed that 8.1% men but 11.2% women used any form of outpatient psychiatric or psychotherapeutic service in the past year [3]
Considering the findings of the interaction analyses in men, we found a consistent interaction between Adherence to traditional male role norms (AtTMRN) and mental health symptoms with regard to psychotherapy use
The present study revealed higher externalizing depression symptoms, higher self-identified masculinity, and lower anxiety symptoms as factors directly associated with reduced psychotherapy use in men with experienced psychological distress

Summary

Introduction

A nationally representative sample from Germany comprised of 24,016 adults revealed that 8.1% men but 11.2% women used any form of outpatient psychiatric or psychotherapeutic service in the past year [3]. This gender difference seems to be even more pronounced in patients with depression, where men are only half as likely to start psychotherapy compared to women [4,5]. In a large sample from Germany examining help-seeking for mental disorders over a 12-year period, a significant reduction in women who do not seek help was identified, but no difference in help-seeking behavior in men was observable [7].

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Discussion

Conclusion