Abstract
Background
There is robust epidemiological and clinical evidence that a greater number of women than men experience depression and anxiety. This study investigated a number of socio-demographic, health and lifestyle, psychological and social factors as possible mediators for the gender difference in depression and anxiety in three cohorts (20–24, 40–44, 60–64).
Methods
Responses were from a representative, community based survey (n = 7,485) conducted in Canberra and Queanbeyan (NSW), in Australia. Depression and anxiety were measured using the self-report Goldberg Anxiety and Depression Scales. The analyses initially identified gender differences in the potential mediators, followed by univariate and multivariate mediation models.
Results
The results indicated several shared mediators for depression and anxiety across the three age groups including: childhood adversity, mastery, behavioural inhibition, ruminative style, neuroticism, physical health, physical activity, and perceived interpersonal and employment problems. There was a decrease in the number of social mediators as age increased. The multivariate models accounted for gender differences in both conditions for all age groups, except for anxiety in the 20–24 years old. This suggests further important unmeasured mediators for this age group.
Conclusions
These findings add to the literature surrounding gender differences in depression and anxiety, and provide a basis for future research exploring variation in these gender disparities over the adult lifespan.
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References
Allen NB, Barrett A, Sheeber L, Davis B (2006) Pubertal development and the emergence of the gender gap in mood disorders. In: Castle DJ, Kulkarni J, Abel KM (eds) Mood and anxiety disorders in women. Cambridge University Press, UK, pp 1–19
Andrews G, Stewart G, Morris-Yates A, Holt P, Henderson S (1990) Evidence for a general neurotic syndrome. Br J Psychiatry 157:6–12
Armstrong N, Welsman JR (2006) The physical activity patterns of European youth with reference to methods of assessment. Sports Med 36(12):1067–1086
Baddeley A, Emslie H, Nimmo-Smith I (1992) Spot the word test. Thames Valley, UK
Baron RM, Kenny DA (1986) The moderator-mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. J Pers Soc Psychol 51(6):1173–1182
Baum A, Grunberg N (1991) Gender, stress, and health. Health Psychol 10(2):80–85
Bebbington P (1996) The origins of sex differences in depressive disorder: bridging the gap. Int Rev Psychiatry 8:295–332
Bird CE (1999) Gender, household labor, and psychological distress: the impact of the amount and division of housework. J Health Soc Behav 40(1):32–45
Bruce ML, Kim KM (1992) Differences in the effects of divorce on major depression in men and women. Am J Psychiatry 149(7):914–917
Brugha TS, Cragg D (1990) The list of threatening experiences: the reliability and validity of a brief life events questionnaire. Acta Psychiatr Neurol Scand 82(1):77–81
Butler LD, Nolen-Hoeksema S (1994) Gender differences in responses to depressed mood in a college sample. Sex Roles 30:331–346
Carver CS, White TL (1994) Behavioural inhibition, behavioural activation, and affective responses to impending reward and punishment: the BIS/BAS scales. J Pers Soc Psychol 67:319–333
Christensen H, Jorm AF, Mackinnon AJ, Korten AE, Jacomb P, Henderson AS, Rodgers B (1999) Age differences in depression and anxiety symptoms: a structural equation modelling analysis of data from a general population sample. Psychol Med 29:325–339
Clark LA, Watson D (1991) Tripartite model of anxiety and depression: psychometric evidence and taxonomic implications. J Abnorm Psychol 100(3):316–336
Clark LA, Watson D, Mineka S (1994) Temperament, personality, and the mood and anxiety disorders. J Abnorm Psychol 103(1):103–116
Cohen J (1988) Statistical power analysis for the behavioural sciences. Erlbaum, USA
Cole SR, Hernan MA (2002) Fallibility in estimating direct effects. Int J Epidemiol 31:163–165
Davis MC, Matthews KA, Twamley EW (1999) Is life more difficult on Mars or Venus? A meta-analytic review of sex differences in major and minor life events. Ann Behav Med 21(1):83–97
Degenhardt L, Hall W, Lynskey M (2001) Alcohol, cannabis and tobacco use among Australians: a comparison of their associations with other drug use and use disorders, affective and anxiety disorders, and psychosis. Addiction 19(11):1603–1614
Degenhardt L, Lynskey M, Hall W (2000) Cohort trends in the age of initiation of drug use in Australia. Aust NZ J Public Health 24(4):421–426
Degenhardt L, Lynskey M, Hall W (2001) The relationship between cannabis use, depression and anxiety among Australian adults: findings from the national survey of mental health and well-being. Soc Psychiatry Psychiatr Epidemiol 36:219–227
Dunn AL, Trivedi MH, Kampert JB, Clark CG, Chambliss HO (2005) Exercise treatment for depression: efficacy and dose response. Am J Prev Med 28(1):1–8
Enders CK (2001) A primer on maximum likelihood algorithms available for use with missing data. Struct Equation Model 8:128–141
Eysenck SBG, Eysenck HJ, Barrett P (1985) A revised version of the psychoticism scale. Pers Individ Dif 6:21–29
Feingold A (1994) Gender differences in personality: a meta-analysis. Psychol Bull 116:429–456
Foot M, Koszycki D (2004) Gender differences in anxiety-related traits in patients with panic disorder. Depress Anxiety 20:123–130
Gagnon LM, Patten SB (2002) Major depression and its association with long-term medical conditions. Can J Psychiatry 47(2):149–152
Gavranidou M, Rosner R (2003) The weaker sex? Gender and post-traumatic stress disorder. Depress Anxiety 17:130–139
de Goede M, Spruijt E, Iedema J, Meeus W (1999) How do vocational and relationship stressors and identity formation affect adolescent mental health? J Adolesc Health 25:14–20
Goldberg D, Bridges K, Duncan-Jones P, Grayson D (1988) Detecting anxiety and depression in general medical settings. Br Med J 297:897–899
Gove M, Hughes W (1979) Possible causes of the apparent sex differences in physical health. Am Sociol Rev 44(1):126–146
Henderson AS (1990) Co-occurrence of affective and cognitive symptoms: the epidemiological evidence. Dement 1:119–123
Holmes GR, Offen L, Waller G (1997) See no evil, hear no evil, speak no evil: why do relatively few male victims of childhood sexual abuse receive help for abuse-related issues in adulthood? Clin Psychol Rev 17(1):69–88
Inglehart R, Norris P (2003) Rising tide: gender equality and cultural change around the world. Cambridge University Press, Cambridge
Jha P, Ranson MK, Nguyen SN, Yach D (2002) Estimates of global and regional smoking prevalence in 1995, by age and sex. J Am Public Health Assoc 92(6):1002–1006
Johnson CF (2004) Child sexual abuse. Lancet 364:462–470
Jorm AF (1987) Sex and age differences in depression: a quantitative synthesis of published research. Aust NZ J Psychiatry 21(1):46–53
Jorm AF (2000) Does old age reduce the risk of anxiety and depression? A review of epidemiological studies across the adult life span. Psychol Med 30:11–22
Jorm AF, Anstey KJ, Christensen H, Rodgers B (2004) Gender differences in cognitive abilities: the mediating role of health state and health habits. Intell 32:7–23
Jorm AF, Christensen H, Henderson S, Jacomb P, Korten AE, Rodgers B (2000) Predicting anxiety and depression from personality: is there a synergistic effect of neuroticism and extraversion? J Abnorm Psychol 109(1):145–149
Kendler KS (1996) Major depression and generalised anxiety disorder. same genes, (partly) different environments—revisited. Br J Psychiatry 30(Suppl):68–75
Kendler KS, Karkowski LM, Prescott CA (1999) Causal relationship between stressful life events and the onset of major depression. Am J Psychiatry 156:837–841
Kendler KS, Thornton LM, Gardner CO (2000) Stressful life events and previous episodes in the etiology of major depression in women: an evaluation of the “kindling” hypothesis. Am J Psychiatry 157(8):1243–1251
Kessler RC (1997) The effects of stressful life events on depression. Ann Rev Psychol 48:191–214
Kessler RC (2006) The epidemiology of depression among women. In: Keyes CLM, Goodman SH (eds) Women and depression. Cambridge University Press, New York, pp 22–37
Kessler RC, McLeod JD (1984) Sex differences in vulnerability to undesirable life events. Am Sociol Rev 49:620–631
Kessler RC, Nelson CB, McGonagle KA, Liu J, Swartz M, Blazer DG (1996) Comorbidity of DSM-III-R major depressive disorder in the general population: results from the US national comorbidity survey. Br J Psychiatry 30(Suppl):17–30
Kiecolt-Glaser JK, Newton TL (2001) Marriage and health: his and hers. Psychol Bull 127(4):472–503
Kuehner C (2003) Gender differences in unipolar depression: an update of epidemiological findings and possible explanations. Acta Psychiatr Scand 108(3):163–174
Leach LS, Christensen H, Mackinnon AJ (2008) Gender differences in the endorsement of symptoms for depression and anxiety: are gender biased items responsible? J Nerv Ment Dis 196(2):128–135
Lorant V, Croux C, Weich S, Deliege D, Mackenbach J Ansseau M (2007) Depression and socio-economic risk factors: 7-year longitudinal population study. Am J Psychiatry 190:293–298
MacKinnon D, Fairchild A, Fritz (2007) Mediation analysis. Ann Rev Psychol 58:593–614
MacKinnon D, Lockwood C, Hoffman H, West S, Sheets V (2002) A comparison of methods to test mediation and other intervening variable effects. Psychol Med 7(1):83–104
Mackinnon A, Christensen H, Jorm AF, Henderson AS, Scott R, Korten AE (1994) A latent trait analysis of an inventory designed to detect symptoms of anxiety and depression using an elderly community sample. Psychol Med 24(4):977–986
Meyer TJ, Miller ML, Metzger RL, Borkovec TD (1990) Development and validation of the Penn state worry questionnaire. Behav Res Ther 8(6):487–495
Mineka S, Watson D, Clark LA (1998) Comorbidity of anxiety and unipolar mood disorders. Ann Rev Psychol 49:377–412
Murphy JM (1973) Sociocultural change and psychiatric disorder among rural Yorubas in Nigeria. Ethos 1(2):239–262
National Health and Medical Research Council (NHMRC) (2001) Australian alcohol guidelines: health risks and benefits. NHMRC, Canberra
Nolen-Hoeksema S (1987) Sex-differences in unipolar depression—evidence and theory. Psychol Bull 101(2):259–282
Nolen-Hoeksema S (2000) The role of rumination in depressive disorders and mixed anxiety/depressive symptoms. J Abnorm Psychol 109(3):504–511
Nolen-Hoeksema S, Parker LE, Larson J (1994) Ruminative coping with depressed mood following loss. J Pers Soc Psychol 67(1):92–104
Paykel ES (1994) Life events, social support and depression. Acta Psychiatr Scand 89(377):50–58
Pearlin LI, Lieberman MA, Menaghan EG, Mullan JT (1981) The stress process. J Health Soc Behav 22(4):337–356
Pigott TA (1999) Gender differences in the epidemiology and treatment of anxiety disorders. J Clin Psychiatry 60(Suppl 18):4–15
Post RM (1992) Transduction of psychosocial stress into the neurobiology of recurrent affective disorder. Am J Psychiatry 149(8):999–1010
Preacher KJ, Hayes AF (2004) SPSS and SAS procedures for estimating indirect effects in simple mediation models. Behav Res Methods Instrum Comput 36(4):717–731
Preacher KJ, Hayes AF (2008). Asymptomatic and resampling strategies for assessing and comparing indirect effects in simple and multiple mediator models. Behav Res Methods (in press), article available at: http://www.psych.ku.edu/preacher/
Reskin BF, Padavic I (1994) Women and men at work. Pine Forge, Thousand Oaks
Rodgers B (1996) Reported parental behaviour and adult affective symptoms. Associations and moderating factors. Psychol Med 26(1):51–61
Rodgers B, Korten AE, Jorm AF, Jacomb P, Christensen H, Henderson AS (2000) Non-linear relationships in associations of depression and anxiety with alcohol use. Psychol Med 30:421–432
Rosenman S, Rodgers B (2004) Childhood adversity in an Australian population. Soc Psychiatry Psychiatr Epidemiol 39(9):695–702
Roxburgh S (2004) ‘There just aren’t enough hours in the day’: the mental health consequences of time pressure. J Health Soc Behav 45(2):115–131
Sallis J, Zakarian J, Hovell M, Hofstetter R (1996) Ethnic, socioeconomic, and sex differences in physical activity among adolescents. J Epidemiol 49(2):125–134
Samuelsson G, McCamish-Svensson C, Hagberg B, Sundstrom G, Dehin O (2005) Incidence and risk factors for depression and anxiety disorders: results from a 34-year longitudinal Swedish cohort study. Aging Ment Health 9(6):571–575
Sandanger I, Nygård JF, Sørensen T, Moum T (2004) Is women’s mental health more susceptible than men’s to the influence of surrounding stress? Soc Psychiatry Psychiatr Epidemiol 39:177–184
Saunders JB, Aasland OG, Babor TF, de la Fuente JR, Grant M (1993) Development of the alcohol use disorders identification test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption–II. Addiction 88(6):791–804
Schuster TL, Kessler RC, Aseltine RH (1990) Supportive interactions, negative interactions, and depressed mood. Am J Community Psychol 18(3):423–438
Sobel ME (1982) Asymptotic confidence intervals for indirect effects in structural equation models. In: Leinhardt S (eds) Sociological methodology. American Sociological Association, Washington, pp 290–312
Spitzer RL, Kroenke K, Williams JB, Löwe B (2006) A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med 166(10):1092–1097
Sprock J, Yoder C (1997) Women and depression: an update on the report of the APA task force. Sex Roles 36:269–303
Strangler RS, Pintz AM (1980) DSM-III: psychiatric diagnosis in a university population. Am J Psychiatry 137:937–940
Stroud CB, Davila J, Moyer A (2008) The relationship between stress and depression in first onsets versus recurrences: a meta-analytic review. J Abnorm Psychol 117(1):206–213
Vaux A (1985) Variations in social support associated with gender, ethnicity and age. J Soc Issues 41(1):89–110
Ware J, Kosinski M, Keller SD (1996) A 12-item short-form health survey: construction of scales and preliminary tests of reliability and validity. Med Care 34(3):220–233
Warner LA, Kessler RC, Hughes M, Anthony JC, Nelson CB (1995) Prevalence and correlates of drug use and dependence in the United States. Results from the national comorbidity survey. Arch Gen Psychiatry 52(3):219–229
Wechsler D (1945) A standardized memory scale for clinical use. J Psychol 19:87–95
Weiss EL, Longhurst JG, Mazure CM (1999) Childhood sexual abuse as a risk factor for depression in women: psychosocial and neurobiological correlates. Am J Psychiatry 156(6):816–828
Weissman MM, Klerman GL (1977) Sex differences and the epidemiology of depression. Arch Gen Psychiatry 34(1):98–111
Wilhelm K, Mitchell P, Slade T, Brownhill S, Andrews G (2003) Prevalence and correlates of DSM-IV major depression in an Australian national survey. J Affect Disord 75:155–162
Wilhelm K, Parker G, Hadzi-Pavlovic D (1997) Fifteen years on: evolving ideas in researching sex differences in depression. Psychol Med 27(4):875–883
Wittchen HU, Zhao S, Kessler RC, Eaton WW (1994) DSM-III-R generalized anxiety disorder in the national comorbidity survey. Arch Gen Psychiatry 51(5):355–364
Wolk S, Weissman M (1995) Women and depression: an update. Rev Psychiatry 14:227–259
Acknowledgments
Funding was provided by Program Grant no. 179805 from the national health and medical research council (NHMRC), Australia. Liana Leach is supported by NHMRC Public Health Postgraduate Research Scholarship no. S3451048. Helen Christensen is supported by NHMRC Fellowship no. 366781. Tim Windsor is supported by NHMRC Capacity Building Grant no. 418020. Peter Butterworth is supported by NHMRC Public Health (Australia) Fellowship no. 316970. We wish to thank Bryan Rodgers, Kaarin Anstey, Anthony Jorm and Perminder Sachdev (Chief Investigators for wave 1 of PATH) for their comments, as well as Trish Jacomb, Karen Maxwell and the PATH interviewers for assistance with the study.
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Leach, L.S., Christensen, H., Mackinnon, A.J. et al. Gender differences in depression and anxiety across the adult lifespan: the role of psychosocial mediators. Soc Psychiat Epidemiol 43, 983–998 (2008). https://doi.org/10.1007/s00127-008-0388-z
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DOI: https://doi.org/10.1007/s00127-008-0388-z