Higher Rates Of Mental Illness Research Articles

Sex Roles and Alcohol Consumption: A Research Note

Inconsistencies in the role sets of women in modern societies are believed by some to account for the difference in rates of mental illness between men and women. In an analysis of rates of neurotic disorders and functional psychoses, Gove (1972) found that the higher rates of mental illness for women, compared to those of men, were due to disproportionately high rates among married women. Gove and Tudor (1973) maintain that the reason for this is that married women are more likely to occupy conflicting role sets. They contend that the role of the housewife involves unskilled labor and low status, both of which are often not consonant with a woman's intellectual attainment. In addition, they argue that the married woman who works outside the home occupies a conflicting role set when her employment involves discrimination in the job market and assignment to positions that are not commensurate with her educational background. Gove and Tudor constructed their roleconflict model to explain mental health differences between women and men, but others have questioned this application. A persistent criticism has been that such between-gender

Sex, Marital Status, and Psychiatric Treatment: A Research Note

In 1972 I reviewed the published studies conducted in Western industrial nations since World War II which used some indicator of mental illness and provided a breakdown by sex and marital status. All of the studies (n = 17) showed married women to have higher rates of mental illness than married men, and most of them showed never-married men (11 studies out of 15), divorced men (8 studies out of 11) and widowed men (7 studies out of 9) to have higher rates of mental illness than their female counterparts. This paper has been widely cited and has played a critical part in the literature on sex rules, marital roles, and mental illness. All of the studies in Gove (a) deal with limited populations or samples, and I have recently become aware of NIMH reports which present much more comprehensive data. Because these data deal with a critical issue, are very comprehensive, and because they are not entirely consistent with the studies reviewed in Gove (a), it is important that they be introduced into the literature. Redick and Johnson present data on all admissions to state and county (henceforth referred to as public) mental hospitals for 1970, Meyer presents data for all admissions to outpatient psychiatric services for 1970-71 and Bachrach presents data for all discharges from psychiatric units in general hospitals for 1970-71. The data are derived from very large representative surveys from all treatment centers involved and in the reports the rates have been generalized to cover the nation as a whole for a year. For all treatment settings the rates included both first admissions and readmissions. As the data involve the same time period, I have provided-in addition to the separate rates-the overall rates of episodes of treatment. The rates of treatment in three settings, and for all settings combined, are presented in Table 1. The sex ratio by marital status and treatment setting are presented in Table 2 and the ratios comparing the married and the various unmarried statuses are presented in Table 3. As is shown, perhaps most clearly in Table 2, overall married women have higher rates of treatment than married men. This overall statistic is consistent with previous studies. However, in the specific case of public mental hospitals,

Sex differences in mental illness among adult men and women: An evaluation of four questions raised regarding the evidence on the higher rates of women

In a paper which limited the definition of mental illness to non-organic disorders where there was acute distress and/or disorganization, Jeanette Tudor and I found that since World War II in western industrial societies the data from a variety of sources consistently indicated that women have higher rates of mental illness than men. This sex difference was attributed to differences in the sex and marital roles of men and women. The publication of this article produced a debate on a number of topics. First, an apparent contradiction in the literature was noted: while women manifest more psychiatric symptoms they appear to be as happy and satisfied as men. Second, questions have been raised about the reliability and validity of the data presented. Third, there have been investigations with somewhat conflicting results with regard to the role explanation suggested. And fourth, an alternative, primarily biological, explanation of the data has been proposed by Dohrenwend and Dohrenwend. The present paper reviews the evidence bearing on these four questions. It is concluded that, in toto, the evidence suggests that in our society women do have higher rates of mental illness than men and that this difference is due primarily to their sex and marital roles. However, it is clear that we know relatively little about the precise nature of the interaction of sex roles, marital roles, socialization and personality which produces the higher rates in women.

Sex, Marital Status, and Mental Health: A Reappraisal

Previous research (cf. Gove) has suggested that the higher rates of mental illness among females may be due to the greater stress associated with the marital role for women in our society. Using data (N = 3674) gathered as part of a major epidemiologic study in the southeastern United States, the authors examine the relationships between Health Opinion Survey scores (a widely used psychiatric assessment instrument), marital status, marital history, length of marital status, and several sociodemographic variables. As anticipated, higher scores for females across race and in most marital statuses were found. But when data were analyzed via multiple regression which controlled for sociodemographic and marital status factors, it was found that low socioeconomic status (SES) was the strongest predictor of high scores. Being female was also significant. The only significant marital status variable in the equation was being separated. Persons who had been married more than once also had significantly elevated scores. Marital status, length of present status, and history of previous marital statuses were not powerful predictors of mental health problems: most of the explained variance was subsumed by sociodemographic variables. The authors conclude that the disproportionately high rates of mental illness among females cannot be accounted for by marital status and its incumbent stresses and suggest that other explanations need to be explored. The relationship between sex roles, marital status, and mental illness has received recently an increasing amount of attention in the social science and psychiatric literature (Brodsky: Clancy and Gove; Cooperstock; Gittleman-Klein and Klein: Gove; Gove and Tudor; Overall; Pokorny and Overall; Redick; Rosen et al.)1 Findings from these and other studies indicate that females in our society have higher rates of mental illness than males and/or that they more often seek treatment for problems related to psychiatric distress. The reasons for these differential rates have not been definitively established although a number of hypotheses have been offered. For example, Phillips and Segal have argued that the higher rates for females are due to methodological factors associated with response biases, e. g., naysaying and social desirability, a position refuted by Clancy and Gove. Gurin et al. have suggested the higher rates for females result from their finding marriage less satisfying than males. Others have contended that role strain, particularly as engendered by the changing status of females in industrial societies, produces ambiguous *This research was made possible by MH Grant No. 24740-01.

Stress and Mental Illness Among the Young: A Comparison of the Sexes

The sociological and psychological literature almost uniformly suggests that young boys experience more stress than young girls, in part because of social expectations and in part because of different rates of biological development and other physiological factors. But it also suggests that with advancing age the sex difference in experienced stress tends to disappear and by late adolescence the situation of girls appears to be at least as stressful if not more so than that of boys. On the premise that the differences in experienced stress would be reflected in rates of treated mental illness, the national rates of males and females in psychiatric treatment between ages five and nineteen are compared. The data consistently show preadolescent males to have higher rates of mental illness, while by late adolescence females appear to have as high if not higher rates of mental illness than males.

Stress and Mental Illness among the Young: A Comparison of the Sexes

The sociological and psychological literature almost uniformly suggests that young boys experience more stress than young girls, in part because of social expectations and in part because of different rates of biological development and other physiological factors. But it also suggests that with advancing age the sex difference in experienced stress tends to disappear and by late adolescence the situation of girls appears to be at least as stressful if not more so than that of boys. On the premise that the differences in experienced stress would be reflected in rates of treated mental illness, the national rates of males and females in psychiatric treatment between ages five and nineteen are compared. The data consistently show preadolescent males to have higher rates of mental illness, while by late adolescence females appear to have as high if not higher rates of mental illness than males.

Sex Differences in Mental Illness: An Analysis of Response Bias in Self-Reports

Phillips and Segal (1969) and Cooperstock (1971) have argued that the consistent finding that women have higher rates of mental illness than men is a product of response bias and does not reflect actual difference in rates of mental illness. In the present paper we look at the effect three forms of response bias-perceived trait desirability, need for social approval, and naysaying-have on respondents' reports of psychiatric symptoms. When these three forms of response bias are controlled for, the difference between the sexes does not diminish but instead increases.

Adult sex roles and mental illness.

This paper looks at the relationship between adult sex roles and mental illness.A fairly precise definition of mental illness is used limiting it to functional disorders characterized by anxiety (neurosis) and/or mental disorganization (psychosis). A number of characteristics of the woman's role in modern industrial societies that might promote the development of mental illness are discussed. The rates of mental illness for men and women following Wolrd War II are then compared by looking at community surveys, first admissions to mental hospitals, psychiatric treatment in general hospitals, psychiatric outpatient clinics, private outpatient psychiatric care, and the practices of general physicians. These data uniformly indicate that adult women have higher rates of mental illness than adult men. A survey of other disorders which appear to be a response to stress also shows women to have higher rates than men. Alternatives to the role explanation of the observed relationships are shown to be inadequate.

The Relationship Between Sex Roles, Marital Status, and Mental Illness

In modern Western societies women have higher rates of mental illness than men. In this article it is suggested that this difference can be attributed to the role of married women. More specifically, it is shown that married women have noticeably higher rates of mental illness than married men. In contrast, it is shown that when single women are compared with single men, divorced women with divorced men, and widowed women with widowed men, these women do not have rates of mental illness that are higher than their male counterparts. In fact, if there is a difference within these marital categories, it is that women have lower rates of mental illness. In a recent paper Gove and Tudor (1972) looked at the proportion of men and women who were mentally ill in modern industrial societies as indicated by community surveys, first admissions to mental hospitals, psychiatric treatment in general hospitals, psychiatric outpatient clinics, private outpatient psychiatric care, and psychiatric illness in the practices of general physicians. All of these sources indicated that women are more likely to be mentally ill than men. As most studies indicate that never married and formerly married persons have higher rates of mental illness than those who are married, one might expect that the difference between the rates of men and women could be attributed to unmarried women having extremely high rates of mental illness. This would conform to the stereotype of the carefree bachelor and the rejected spinster (or former wife). However, in this article I will indicate that this expectation is incorrect and that it is the relatively high rates of mental illness in married women that account for the higher rates of mental illness among women. Furthermore, I will attempt to show that it is the roles confronting married men and women that account for the high rates among women and not some other factor such as women being biologically more susceptible to mental ill-

Sex differences in mental illness: an analysis of response bias in self-reports.

Phillips and Segal (1969) and Cooperstock (1971) have argued that the consistent finding that women have higher rates of mental illness than men is a product of response bias and does not reflect actual difference in rates of mental illness. In the present paper we look at the effect three forms of response bias-perceived trait desirability, need for social approval, and naysaying-have on respondents' reports of psychiatric symptoms. When these three forms of response bias are controlled for, the difference between the sexes does not diminish but instead increases.

6. Africa

F. PISZTORA, an Hungarian psychiatrist who spent a prolonged period at the psychiatric department of the University of Algiers, describes sociocultural factors relevant to mental ill health in Algeria. Conflict areas which have been identified concern the relationship between men and women, the in dividual versus the tribe, and the traditional Moslem style of life versus the modern European style of life. Another Hungarian author, E. VARGA, presents the case history of a schizophrenic Sudanese student treated at Budapest, who, despite superficial acculturation to European life, adhered at least during his mental illness to the belief system shared by the majority of the uneducated indigenous population of his country of origin. M. ASSAEL and G. A. GERMAN reporting from Uganda concern themselves with the question of whether the ongoing process of migration from village to city in Uganda proper, or country to country within the African continent, accounts for higher rates of mental illness. Finally D. DE CASO, C. GIORDANO, and J.-P. LEHMANN report from the Ivory Coast the case history of a patient suffering from an acute anxiety state (bouffée délirante), whose clinical picture vividly reflects his cultural back ground. The effectiveness of the treatment of this patient by traditional procedures can be demonstrated.