User:Axolotl61/Mental disorders and gender

LINK TO Target Article for convenience: Mental disorders and gender

Hi guys, nice work! I made my peer review comments and hope they will be helpful moving forwards~

Anxiety
Women experience a higher rate of General Anxiety Disorder (GAD) than men. Women are around 15% more likely to experience comorbidities with GAD than men. Anxiety disorders in women are more likely to be comorbid with other anxiety disorders, bulimia, or depression. Women are two and a half times more likely to experience Panic Disorder (PD) than men. Women are also twice as likely to develop specific phobias. Additionally, Social Anxiety Disorder (SAD) occurs among women more frequently than men. Obsessive-compulsive Disorder (OCD) is present among women and men at similar rates, though women tend to have a later onset of symptoms. With OCD, men are more likely to experience more aggressive, sexual-religious, and social impairments while women are more likely to experience fear of contamination.

Gender is not a significant factor in predicting the effectiveness of pharmacological interventions or cognitive behavioral therapy in treating GAD.

Depression
Major depressive disorder is twice as common in women compared to men. This increased rate is partially related to women's increased likelihood to experience sexual violence, poverty, and higher workloads. Depression in women is more likely to be comorbid with anxiety disorders, substance abuse disorders, and eating disorders. Men are less likely to seek treatment for or discuss their experiences with depression. Men are more likely to have depressive symptoms relating to aggression than women. Women are more likely to attempt suicide than men however, more men die from suicide due to the different methods used. In 2019, the suicide rate in the United States was 3.7 times higher for men than women.

The presence of a gender bias results in an increased diagnosis of depression in women than men.

Postpartum depression
Men and women experience postpartum depression. Maternal postpartum depression affects around 15% of women in the United States. Postpartum depression is under-diagnosed. Women experiences PPD have trouble seeking treatment due to the difficulties of accessing therapy and not being able to take some psychiatric medications due to breastfeeding. Around 8-10% of American fathers experience paternal postpartum depression (PPPD). Risk factors for PPPD include a history of depression, poverty, and hormonal changes.

Gender Bias in Medicine
The World Health Organization notes gender differentials in both the diagnosis and treatment of mental illness. Gender bias observed in diagnostic and healthcare systems (including as related to under-diagnosis, over-diagnosis, and misdiagnosis) is detrimental to the treatment and health of people of all genders.

The difference in diagnosis emerges at an early age, with diagnostic rates for children diverging on the basis of gender once children reach school age. These gendered differentials have been attributed to a variety of factors, including gendered socialization to internalize or externalize symptoms of distress, particularly in youth; clinician bias to perceive men as mentally healthy; gendered stereotypes regarding the types of disorders men and women are expected to experience, with emotional issues attributed to women and substance abuse issues to men; and stereotypes and allocation of resources based on, and reifying, these differences. Differential diagnosis rates are also related to differences in help-seeking or disclosure along gendered lines.

Diagnostic processes may be influenced by knowledge of a patient's sex or gender alone, and male and female patients may receive different diagnoses even when presenting the same symptoms. For instance, even with the same symptomology or scores according to diagnostic criteria, women are more likely to be diagnosed with depression than men.

Misogynistic Bias in Medicine
Misogynistic bias has impacted diagnosis and treatment of men and women alike throughout the history of psychiatry, and those disparities persist today.

Hysteria is one example of a medical diagnosis which bears a long history as a "feminine" disorder, whether associated with biological features or with "feminine" psychology or personality. For hundred of years in Western Europe, hysteria was seen as an excess of emotion and a lack of self-control, that would mostly impact women. The diagnosis was used as a form of social labeling to discourage women from venturing outside of their role, that is a tool to take control over the increasing emancipation of women.

Another instance in which such disparities emerged is in the use of lobotomies, popularized in the 1940s to treat a variety of psychiatric diagnoses including insomnia, nervousness, and more. Studies have found that US asylums disproportionately lobotomized women in spite of the fact that men made up the majority of asylum patients.

Cisheteronormative Bias in Medicine
Implicit bias in medicine also affect the way lesbian, gay, bisexual, transgender (LGBTQ+) patients, are diagnosed by mental health physicians. Due to internalized societal and medical bias, physicians are more likely to diagnosed LGBTQ+ patients with anxiety, depression and suicidality.

Gender Normativity and Bias in Medicine
It has also been observed that mental health professionals may pathologize the behaviors of individuals who do not conform to the practitioner's gender ideals. Gender ideals have been found to influence understandings of mental health and illness at the stages of diagnosis, treatment, and evaluation of symptomology or of treatment.

Violence against women
There are different type of levels of violence that can occur against women. Violence was defined by World Health Organization as "the intentional use of physical force or power, threatened or actual, against oneself, another person, or against a group of community, which either results in has a high likelihood of resulting in injury, death, psychological harm, maldevelopment, or deprivation"

Intimate partner violence / domestic violence
Intimate partner violence (IPV) is a particularly gendered issue. Data collected from the National Violence Against Women Survey (NVAWS) of women and men aged 18–65 found that women were significantly more likely than men to experience physical and sexual IPV. According to The National Domestic Violence Hotline, "From 1994 to 2010, about 4 in 5 victims of intimate partner violence were female." '''The United Nations estimates that "35 percent of women worldwide have experienced either physical and/or sexual intimate partner violence or sexual violence by a non-partner (not including sexual harassment) at some point in their lives." '''

There have been numerous studies conducted linking the experience of being a survivor of domestic violence to a number of mental health issues, including post-traumatic stress disorder, anxiety, depression, substance dependence, and suicidal attempts. Humphreys and Thiara (2003) assert that the body of existing research evidence shows a direct link between the experience of IPV and higher rates of self-harm, depression, and trauma symptoms. The NVAWS survey found that physical IPV was associated with an increased risk of depressive symptoms, substance dependence problems, and chronic mental illness.

A study conducted in 1995 of 171 women reporting a history of domestic violence and 175 reporting no history of domestic violence confirmed these hypotheses. The study found that the women with a history of domestic violence were 11.4 times more likely to suffer dissociation, 4.7 times more likely to suffer anxiety, 3 times as likely to suffer from depression, and 2.3 times more likely to have a substance abuse problem. The same study noted that several of the women interviewed stated that they only began having mental health issues when they began to experience violence in their intimate relationships.

'''Another study found that in a group of women in a psychiatric inpatient hospital ward, women who were survivors of domestic violence were twice as likely to suffer depression as those were not. All twenty of the women interviewed fit into a pattern of symptoms associated with trauma-based mental health disorders. Six of the women had attempted suicide. Moreover, the women spoke openly of a direct connection between the IPV they suffered and their resulting mental disorders. '''

In a similar study, 191 women who reported at least one event of IPV in their lifetime were tested for PTSD. 33% of the women tested positively were lifetime PTSD, and 11.4% tested positive for current PTSD.

As far as males are concerned, it is estimated that 1 in 9 men experience severe IPV. For men as well, domestic violence is correlated with a higher risk of depression and suicidal behavior.

Causes of intimate partner violence
One can identify several factors that are likely to lead to intimate partner violence:


 * Intimate partner violence depends on socio-economic status (SES). The higher SES the less likely relationships will have financial difficulties. Financially stability can decrease IPV. Women who are not economically independent are less likely to escape a violent relationship since they might feel dependent and vulnerable. Additionally, lack of resources increases the levels of stress and conflict in the household.
 * Food-insecurity at the household level is associated with increase experience of IPV. vulnerable without them. Higher SES is associated with IPV.
 * Domestic violence can also appear as a repetitive scheme. Indeed, men who witnessed their fathers using violence against their wife or children who experienced violence themselves are more likely to perpetrate inmate partner violence in their adult relationship.
 * Poverty and substance may contribute to a violent behavior, since these substances diminish the control over one's violent impulsions.
 * Lower levels of education
 * a history of exposure to child maltreatment (perpetration and experience);
 * Antisocial personality disorder
 * Community norms that privilege or ascribe higher status to men and lower status to women;
 * Low levels of women's access to paid employment.

How (IPV) impacts women's mental health
The United Nations estimates that "35 percent of women worldwide have experienced either physical and/or sexual intimate partner violence or sexual violence by a non-partner (not including sexual harassment) at some point in their lives." Women's well-being are reported to be at risk due to Intimate partner violence. Indeed, evidence shows that women who have been confronted to IPV or sexual violence report higher rates of depression, psychosis, abortion and acquiring HIV, than women who have not. "Domestic violence is associated with depression, anxiety, PTSD and substance abuse in the general population. Additionally, women who are at risk can develop suicidal thoughts, depression, PTSD and anxiety." The presence of domestic violence in their life causes psychiatric disorders amongst women survivors of domestic violence.

Another study found that in a group of women in a psychiatric inpatient hospital ward, women who were survivors of domestic violence were twice as likely to suffer depression as those were not. All twenty of the women interviewed fit into a pattern of symptoms associated with trauma-based mental health disorders. Six of the women had attempted suicide. Moreover, the women spoke openly of a direct connection between the IPV they suffered and their resulting mental disorders.

The direct psychological effects of IPV may contribute directly to the development of these disorders. In Humphreys' and Thiara's study, 60% of the women interviewed feared for their life, 69% feared for their emotional wellbeing, and 60% feared for their mental health. Some of the women discussed an undermining of their self-esteem, as well as an "overwhelming fear and erosion of their sense of safety." Johnson and Ferraro (2000) refer to this overwhelming fear as "intimate terrorism," decimating a women's sense of security and contributing to a worsening psychological state.

Humphreys and Thiara (2003) refer to these consequential mental disorders as "symptoms of abuse". That sentiment is echoed by some survivors who don't feel comfortable identifying with loaded diagnoses such as depression or PTSD.

Sexual violence
The National Coalition against Domestic Violence provides useful guidelines to distinguish between sexual violence and domestic violence. Sexual violence describes a sexually abusive behavior by a partner or non-partner that can result in rape and sexual assault. Sometimes, in abusive relationships, sexual and domestic violence can intersect. "Between 14% and 25% of women are sexually assaulted by intimate partners during their relationship."

Global estimates published by the World Health Organization indicate that about 1 in 3 (35%) of women worldwide have experienced either physical and/or sexual intimate partner violence or non-partner sexual violence in their lifetime.

Sexual violence increasingly impact adolescent girls who are subjected to forced sex, rape and sexual assault. Approximately 15 million adolescent girls (aged 15 to 19) worldwide have experienced forced sex (forced sexual intercourse or other sexual acts) at some point in their life.

How sexual violence impacts women's mental health
Sexual assault, rape and sexual abuse are likely to impact a women's mental health on a short and long-term basis. Many survivors are "mentally marked by this trauma and report flashbacks of their assault, and feelings of shame, isolation, shock, confusion, and guilt." Additionally, victims of rape or sexual assault are at a higher risk for developing PTSD, with the lifetime prevalence being 50% compared to the average prevalence of 7.8%. Sexual assault is also associated with higher rates of depression, self harm, suicide, and disordered eating.

As an example, data suggests that 30 to 80 percent of sexual assault survivors develop PTSD.

Social Media Pressures and Criticism
Social media is highly prevalent and influential among the current generation of adolescents and young adults. Approximately 90% of young adults in the United States have and use a social media platform on a regular basis. In terms of social media use and body image, boys experience social media as a higher positive influence on their body image than girls, who report social media causing more negative effects on their body image. Indeed, social media use has a connection to increased risk for eating disorders in women. Women receive greater amounts of pressure and criticism surrounding their physical appearance, making them more likely to internalize the body ideals that are glorified on social media. Social media has a substantial influence on how young adults perceive their physicality due to its appearance-focused nature. When individuals self-objectify by comparing themselves to others on social media, it can lead to increased body shame and body surveillance. In turn, these behaviors can results in an increased risk for disordered eating. The effect of social media use on self-objectification is greater in female users. Women receive greater amounts of pressure and criticism surrounding their physical appearance, making them more likely to internalize the body ideals that are glorified on social media. Consequently, women face a higher risk of developing in body dissatisfaction or unhealthy eating behaviors.

'''Furthermore, Pro-anorexia communities are widespread among social media platforms which creates an environment that encourages disordered eating behaviors, and uses primarily photos of young women to spread unhealthy messages promoting thinness. Women are more likely to be involved with pro-anorexia communities.'''