Academic journal article International Journal of Men's Health

Anger and Hostility as Primary Externalizing Features of Depression in College Men

Academic journal article International Journal of Men's Health

Anger and Hostility as Primary Externalizing Features of Depression in College Men

Article excerpt

Epidemiological investigations of Major Depressive Disorder (MDD) diagnostic rates historically demonstrate notable discrepancies in prevalence and incidence rates between men and women. Over the course of a lifetime, approximately 13% of men and 20% of women in the United States are expected to develop MDD (Kessler et al., 2005). In contrast, men engage in substance abuse and commit suicide at notably higher rates than women (Centers for Disease Control and Prevention, 2012). Therefore some have suggested that the diagnostic criteria encompassed in the Diagnostic and Statistical Manual of Mental Disorders which is now in its fifth edition (American Psychiatric Association, 2013) may not adequately capture the full range of depressive symptoms, specifically when depression is experienced by men who adhere to hegemonic masculine gender role norms. This perspective, that some men may present with atypical depressive symptoms has received increased amounts of focus in research and is noted by both the American Psychological Association (APA, 2005) as well as the National Institute of Mental Health (NIMH, 2014) as a significant issue in the diagnosis of depressive disorders.

MASCULINE VARIATIONS OF DEPRESSIVE SYMPTOMS

The rapidly increasing body of literature on atypical presentations of depression in men currently includes theoretical discussions on the influence of masculinity on depressive symptom presentation (e.g. Addis, 2008; Fields & Cochran, 2010; Kilmartin, 2005; Lynch & Kilmartin, 2013; Oliffe & Phillips, 2008), conceptual models of atypical depressive symptoms in men (Cochran & Rabinowitz, 2000; Pollack, 1998), several measures to assess symptoms of masculine depression (Fields, 2010; Magovcevic & Addis, 2008, Rice, Fallon, Aucote, & Möller Leimkiiller, 2013; Rutz, von Knorring, Pihlgren, Rhimer, & Walinder, 1995), as well as results of investigations of atypical depressive symptoms in some ethnic minority groups of men (Perkins, 2013; Watkins, Abelson, & Jefferson, 2013).

With an increased level of focus on understanding the range of depression symptoms in traditional men, one of the current issues in the study of depression is the clarification of terminology and range of symptomotology associated with atypical depression in men (Addis, 2008; Genuchi & Valdez, 2014), which has been termed masculine depression (Kilmartin, 2005; Magovcevic & Addis, 2008), male depression (Rice, Fallon, Aucote, & Möller Leimkiiller, 2013; Rochlen, Whilde, & Hoyer, 2005), masked depression (Cochran & Rabinowitz, 2000, 2008), and major depression-male type (Pollack, 1998). The specific term masculine depression as conceptualized by Addis (2008) as well as Magovcevic and Addis (2008), is a phenotypic variant of prototypic depression. Within this conceptualization, the fundamental negative core affect (e.g. low mood, stress, lethargy) of the depressive disorder is the same or similar, whether a man experiences prototypic or masculine depression (Green & Addis, 2012; Russell & Barrett, 1999). Masculine depression and prototypic depression therefore, are not mutually exclusive syndromes, and masculine depression may include a conglomeration of symptoms that are both prototypic and masculine in nature. Moreover, each individual man's subsequent expression of depressive symptoms will then be influenced by a variety of factors, including each man's history of masculine gender role socialization. Those individuals adhering more strongly to traditional masculine norms would be expected to present with more masculine symptoms but not necessarily exclusively masculine symptoms.

Such a conceptual understanding of masculine depression as a phenotype or subtype of prototypic depression provides a rationale for men endorsing prototypic as well as masculine depressive symptoms. Therefore a primary focus of research on masculine depression has been on the investigation of the broad range of symptoms reported by men, as well as the relationship between these symptoms and men's adherence to hegemonic masculine gender role norms. …

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