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Gender differences in rates of depression among undergraduates: measurement matters
Journal of Adolescence 2002, 25, 613–617 doi:10.1006/jado.2002.0508, available online at http://www.idealibrary.com on
Gender differences in rates of depression among undergraduates: measurement matters KATHRYN GRANT, PATRICIA MARSH, GINA SYNIAR, MEGAN WILLIAMS, ELISA ADDLESPERGER, MI HYON KINZLER AND SHAUN COWMAN Two studies tested for gender differences in rates of depression among undergraduates using three conceptualizations of depression (mood, syndrome, disorder). The first sample consisted of 325 non-referred undergraduate students, who completed penciland-paper measures of depressed mood, depressive syndrome and a depressive disorder analogue. The second sample consisted of 894 undergraduate students seeking counselling services, who participated in clinical intake interviews assessing depressed mood and depressive disorder. Results of analyses provide no evidence of gender differences in rates of depressed mood in either samples or of depressive syndrome in the non-referred sample. However, in both samples, gender differences in rates of depressive disorder were found, with male students more likely than female students to be depressed. r 2002 The Association for Professionals in Services for Adolescents Published by Elsevier Science Ltd. All rights reserved.
Introudction One of the most consistent findings in developmental psychopathology is that, beginning in adolescence, females report significantly higher rates of depression than males do (NolenHoeksema and Girgus, 1994). An exception has been found, however, among college students. Most studies report no evidence of gender differences in rates of depression among undergraduates (e.g. Gladstone and Koenig, 1994). With few exceptions (Stangler & Printz, 1980; Hankin et al., 1998), these studies have employed the same general methodology. They have used the Beck Depression Inventory as a measure of depression and have focused exclusively on undergraduates in non-clinical settings (i.e. Introduction to Psychology courses). In the broader literature, depression has been operationalized in different ways with findings varying as a function of the definition used (Angst and Dobler-Mikola, 1984; Compas et al., 1993). In general, operationalizations of depression may be categorized as measures of depressed mood, depressive syndrome, or depressive disorder (Compas et al., 1993). Depressed mood refers to current feelings of dysphoria, depressive syndrome to empirically derived subscales of correlated symptoms and depressive disorder to the DSM criteria for major depressive disorder (Compas et al., 1993). Recent evidence also suggests that gender differences in depression vary as a function of whether the sample examined is referred or non-referred (Compas et al., 1997). In the present studies, we tested for gender differences in depression in both a non-referred (Study 1) and a referred (Study 2) sample using three conceptualizations of depression (mood, syndrome and disorder). Reprint requests and correspondence should be addressed to: Dr. Kathryn E. Grant, Department of Psychology, DePaul University, 2219 N. Kenmore Ave., Chicago, IL 60614-3504, U.S.A. (E-mail: [email protected].) 0140-1971/02/$3500
# 2002 The Association for Professionals in Services for Adolescents Published by Elsevier Science Ltd. All rights reserved.
K. Grant et al.
614
Study 1 Method Participants. The sample consisted of 325 undergraduates (217 females) enrolled at a private commuter university in a large Midwestern city. Mean age was 20?7 years for females and 21?2 years for males. Approximately 66% of the sample were European American, 12% Latino, 10% African American, 8% Asian/Pacific Islander, 1% American Indian, and 1% ‘‘others’’.
Procedures. Survey administration was conducted in classrooms in small groups. Student responses were anonymous.
Measures. Depressed mood was assessed using a single item on the Young Adult SelfReport (YASR; Achenbach, 1997). The depressed mood item (#103) reads ‘‘I am unhappy, sad, or depressed.’’ Validity and reliability of the YASR are excellent (Achenbach, 1997). Depressive syndrome was assessed using the anxious–depressed subscale of the YASR. The anxious–depressed subscale represents an empirically derived syndrome reflective of mixed anxiety and depressive symptoms. An empirically derived measure of ‘‘pure depression’’ does not exist due to high covariation of anxious and depressive symptoms among young people (Achenbach, 1997). Participants were considered to have met the criteria for depressive syndrome if they scored in the clinical range on the anxious–depressed subscale (upper 5% of standardization sample). Depressive disorder was assessed using an analogue constructed from items on the YASR. A similar analogue, based on the Youth Self-Report (Achenbach, 1991), has been found to be a valid and reliable tool for examining rates of depressive disorder in non-clinical samples (Clarke et al., 1992; Compas, et al., 1997). The YASR analogue items for the DSM-IV (APA, 1994) criteria for major depressive disorder are as follows: (1) ‘‘I am unhappy, sad, or depressed’’, (2) ‘‘There is very little that I enjoy’’, (3) ‘‘I don’t eat as well as I should’’ or ‘‘I eat too much ‘‘, (4) ‘‘I have trouble sleeping’’ or ‘‘I sleep more than most people during day and/ or night’’, (5) ‘‘I don’t have much energy’’ or ‘‘I have trouble sitting still’’, (6) ‘‘I feel overtired’’, (7) ‘‘I feel worthless or inferior’’ or ‘‘I feel too guilty’’, (8) ‘‘I have trouble paying attention’’, (9) ‘‘I deliberately try to hurt or kill myself’’ or ‘‘I think about killing myself.’’ Participants were considered to have met the criteria for depressive disorder on the analogue measure if they endorsed the highest score (‘‘very true or often true’’) for five or more of the YASR analogue items.
Results Percentages of participants endorsing depressed mood, depressive syndrome, and depressive disorder are summarized by gender in Table 1. Results of chi-square analyses indicate no Table 1 Gender vs. three conceptualizations of depressionFresults of Study 1 (non-referred) participants Gender
N
Depressed mood (%)
Depressive syndrome (%)
Depressive disorder (%)
Males Females
108 217
13?9 8?9
13?9 9?7
8?3* 2?8
*po0?05.
Gender differences
615
significant effects for gender on depressed mood or depressive syndrome. However, males w2 (1, N ¼ 325) ¼ 5?22, po0?02 were more likely to meet the criteria for depressive disorder.
Study 2 Methods Participants. Participants consisted of 894 students (622 females) who received services at a university counselling centre at the same institution described in Study 1. Mean age was 20?8 years for females and 21?3 years for males. Approximately 70% of the referred sample were European American, 10% African American, 10% Latino, 5% Asian/Pacific Islander, and 5% ‘‘others’’.
Procedure. Intake interviews were conducted on all students seeking psychological services at the university counselling centre by a licensed clinical psychologist, a licensed clinical social worker, or a psychology doctoral candidate (supervised by a licensed clinical psychologist).
Measures. Depressed mood and depressive disorder were assessed during the intake interview and documented on a data retrieval form, which contains an extensive coded list of potential problem areas, including separate codes for depressed mood and depressive disorder symptoms.
Results Percentages of participants reporting depressed mood and depressive disorder are summarized by gender in Table 2. Chi-square analyses indicate no significant effects for gender on depressed mood. However, a significant gender difference in rates of depressive disorder emerged, with males reporting higher rates of depression w2 (1, N ¼ 894) ¼ 6?0, po0?01.
Discussion The finding that males were more likely to be depressed was unexpected. Gladstone and Koenig (1994) and Nolan and Willson (1994) have reported that undergraduate males are at heightened risk, relative to high-school males, for engaging in a ruminative response style. Rumination, in turn, has been linked with depression (Nolen-Hoeksema et al., 1999). Gladstone and Koenig (1994) argue that the reason they did not find heightened rates of depression in their male student sample was that these males received additional social support relative to peers who did not attend college. Table 2 Gender vs. two conceptualizations of depressionFresults of Study 2 (referred) participants Gender
N
Depressed mood (%)
Depressive disorder(%)
Males Females
272 622
21?3 20?9
4?0* 1?3
*po0?01.
616
K. Grant et al.
Perhaps males, like those in the present study, who attend ‘‘commuter’’ universities are at heightened risk for depressive disorder, as commuter universities may not offer the kinds of opportunities (e.g. dormitory experiences) that foster the development of social support (Sullivan and Sullivan, 1980). Prior research has indicated that commuter students report poorer social relationships and poorer mental health than residential students (e.g. Wilson et al., 1987). For example, Pascarella (1985) found that residential students’ greater social involvement on campus was predictive of positive self-image, even after controlling for preenrollment characteristics. And Sullivan and Sullivan’s (1980) longitudinal investigation found that interpersonal relationships actually improved over time for residential males relative to commuting males. Taken together, findings from prior research and the present study indicate that college attendance may lead both to rumination (perhaps due to an emphasis on reflection and introspection or an atmosphere that discourages genderstereotyped behaviour) and social support for undergraduate males; however, for some males (e.g. those who commute) social support may be less available, and these males are at heightened risk of depression. It is unclear why commuting females would be at lower risk, but perhaps the environmental context which promotes rumination in males (e.g. an atmosphere that discourages gender-stereotyped behaviour) widens the coping strategies available to college females (who are generally more prone to rumination (Nolen-Hoeksema et al., 1999)). Alternatively, prior socialization may better equip college females to develop social networks independent of institutional supports. Additional research is needed to test these hypothesized interpretations. The finding that female undergraduates were not at heightened risk of depression lends support to the primacy of social and psychological explanations for gender differences in depression emergent during adolescence. Whereas biological risk factors are likely implicated in depression for both genders, social and psychological processes may better explain gender differences in rates of depression.
References Achenbach, T. M. (1991). Manual for the youth self report. Burlington, VT: Department of Psychiatry, University of Vermont. Achenbach, T. M. (1997). Manual for the young adult self-report and young adult behavior checklist. Burlington, VT: Department of Psychiatry, University of Vermont. American Psychiatric Association (1994). Diagnostic and statistical manual of mental disorders, 4th Edn. APA: Washington, DC. Angst, J. and Dobler-Mikola, A. (1984). Do the diagnostic criteria determine the sex ratio in depression? Journal of Affective Disorders, 7, 189–198. Clarke, G. N.; Lewinsohn, P. M.; Hops, H. and Seeley, J. R. (1992). A self-and-parent-report measure of adolescent depression: the Child Behavior Checklist Depression scale (CBCL-D). Behavioral Assessment, 14, 443–463. Compas, B. E., Oppedisano, G., Connor, J. K., Gerhardt, C. A., Hinden, B. R., Achenbach, T. M. and Hammen, C. (1997). Gender differences in depressive symptoms in adolescence: comparison of national samples of clinically referred and non-referred youth. Journal of Consulting and Clinical Psychology, 65, 617–626. Compas, B. E., Ey, S. and Grant, K. E. (1993). Taxonomy, assessment, and diagnosis of depression during adolescence. Psychological Bulletin, 114, 323–344. Gladstone, T. R. G. and Koenig, L. J. (1994). Sex differences in depression across the high school to college transition. Journal of Youth and Adolescence, 23, 643–699.
Gender differences
617
Hankin, B. L., Abramson, L. Y., Moffitt, T. E., Silva, P. A., Mcgee, R. and Angell, K. E. (1998). Development of depression from preadolescence to young adulthood: emerging gender differences in a 10-year longitudinal study. Journal of Abnormal Psychology, 107, 128–140. Nolan, R. and Willson, V.L. (1994). Gender and depression in an undergraduate population. Psychological Reports, 75, 1327–1330. Nolen-Hoeksema, S. and Girgus, J. S. (1994). The emergence of gender differences in depression during adolescence. Psychological Bulletin, 115, 424–443. Nolen-Hoeksema, S., Larson, J. and Grayson, C. (1999). Explaining the gender difference in depressive symptoms. Journal of Personality and Social Psychology, 77, 1061–1072. Pascarella, E. T. (1985). The influence of on-campus living versus commuting to college on intellectual and interpersonal self-concept. Journal of College Student Personnel, 26, July, 292–299. Stangler, R. S. and Printz, A. M. (1980). DSM-III: psychiatric diagnosis in a university population. American Journal of Psychiatry, 137, 937-940. Sullivan, K. and Sullivan, A. (1980). Adolescent–parent separation. Developmental Psychology, 16, 93–104. Wilson, R. J., Anderson, S. A. and Fleming, W. M. (1987). Commuter and resident students’ personal and family adjustment. Journal of College Student Personnel, 28, 229–233.
Gender differences in rates of depression among undergraduates: measurement matters KATHRYN GRANT, PATRICIA MARSH, GINA SYNIAR, MEGAN WILLIAMS, ELISA ADDLESPERGER, MI HYON KINZLER AND SHAUN COWMAN Two studies tested for gender differences in rates of depression among undergraduates using three conceptualizations of depression (mood, syndrome, disorder). The first sample consisted of 325 non-referred undergraduate students, who completed penciland-paper measures of depressed mood, depressive syndrome and a depressive disorder analogue. The second sample consisted of 894 undergraduate students seeking counselling services, who participated in clinical intake interviews assessing depressed mood and depressive disorder. Results of analyses provide no evidence of gender differences in rates of depressed mood in either samples or of depressive syndrome in the non-referred sample. However, in both samples, gender differences in rates of depressive disorder were found, with male students more likely than female students to be depressed. r 2002 The Association for Professionals in Services for Adolescents Published by Elsevier Science Ltd. All rights reserved.
Introudction One of the most consistent findings in developmental psychopathology is that, beginning in adolescence, females report significantly higher rates of depression than males do (NolenHoeksema and Girgus, 1994). An exception has been found, however, among college students. Most studies report no evidence of gender differences in rates of depression among undergraduates (e.g. Gladstone and Koenig, 1994). With few exceptions (Stangler & Printz, 1980; Hankin et al., 1998), these studies have employed the same general methodology. They have used the Beck Depression Inventory as a measure of depression and have focused exclusively on undergraduates in non-clinical settings (i.e. Introduction to Psychology courses). In the broader literature, depression has been operationalized in different ways with findings varying as a function of the definition used (Angst and Dobler-Mikola, 1984; Compas et al., 1993). In general, operationalizations of depression may be categorized as measures of depressed mood, depressive syndrome, or depressive disorder (Compas et al., 1993). Depressed mood refers to current feelings of dysphoria, depressive syndrome to empirically derived subscales of correlated symptoms and depressive disorder to the DSM criteria for major depressive disorder (Compas et al., 1993). Recent evidence also suggests that gender differences in depression vary as a function of whether the sample examined is referred or non-referred (Compas et al., 1997). In the present studies, we tested for gender differences in depression in both a non-referred (Study 1) and a referred (Study 2) sample using three conceptualizations of depression (mood, syndrome and disorder). Reprint requests and correspondence should be addressed to: Dr. Kathryn E. Grant, Department of Psychology, DePaul University, 2219 N. Kenmore Ave., Chicago, IL 60614-3504, U.S.A. (E-mail: [email protected].) 0140-1971/02/$3500
# 2002 The Association for Professionals in Services for Adolescents Published by Elsevier Science Ltd. All rights reserved.
K. Grant et al.
614
Study 1 Method Participants. The sample consisted of 325 undergraduates (217 females) enrolled at a private commuter university in a large Midwestern city. Mean age was 20?7 years for females and 21?2 years for males. Approximately 66% of the sample were European American, 12% Latino, 10% African American, 8% Asian/Pacific Islander, 1% American Indian, and 1% ‘‘others’’.
Procedures. Survey administration was conducted in classrooms in small groups. Student responses were anonymous.
Measures. Depressed mood was assessed using a single item on the Young Adult SelfReport (YASR; Achenbach, 1997). The depressed mood item (#103) reads ‘‘I am unhappy, sad, or depressed.’’ Validity and reliability of the YASR are excellent (Achenbach, 1997). Depressive syndrome was assessed using the anxious–depressed subscale of the YASR. The anxious–depressed subscale represents an empirically derived syndrome reflective of mixed anxiety and depressive symptoms. An empirically derived measure of ‘‘pure depression’’ does not exist due to high covariation of anxious and depressive symptoms among young people (Achenbach, 1997). Participants were considered to have met the criteria for depressive syndrome if they scored in the clinical range on the anxious–depressed subscale (upper 5% of standardization sample). Depressive disorder was assessed using an analogue constructed from items on the YASR. A similar analogue, based on the Youth Self-Report (Achenbach, 1991), has been found to be a valid and reliable tool for examining rates of depressive disorder in non-clinical samples (Clarke et al., 1992; Compas, et al., 1997). The YASR analogue items for the DSM-IV (APA, 1994) criteria for major depressive disorder are as follows: (1) ‘‘I am unhappy, sad, or depressed’’, (2) ‘‘There is very little that I enjoy’’, (3) ‘‘I don’t eat as well as I should’’ or ‘‘I eat too much ‘‘, (4) ‘‘I have trouble sleeping’’ or ‘‘I sleep more than most people during day and/ or night’’, (5) ‘‘I don’t have much energy’’ or ‘‘I have trouble sitting still’’, (6) ‘‘I feel overtired’’, (7) ‘‘I feel worthless or inferior’’ or ‘‘I feel too guilty’’, (8) ‘‘I have trouble paying attention’’, (9) ‘‘I deliberately try to hurt or kill myself’’ or ‘‘I think about killing myself.’’ Participants were considered to have met the criteria for depressive disorder on the analogue measure if they endorsed the highest score (‘‘very true or often true’’) for five or more of the YASR analogue items.
Results Percentages of participants endorsing depressed mood, depressive syndrome, and depressive disorder are summarized by gender in Table 1. Results of chi-square analyses indicate no Table 1 Gender vs. three conceptualizations of depressionFresults of Study 1 (non-referred) participants Gender
N
Depressed mood (%)
Depressive syndrome (%)
Depressive disorder (%)
Males Females
108 217
13?9 8?9
13?9 9?7
8?3* 2?8
*po0?05.
Gender differences
615
significant effects for gender on depressed mood or depressive syndrome. However, males w2 (1, N ¼ 325) ¼ 5?22, po0?02 were more likely to meet the criteria for depressive disorder.
Study 2 Methods Participants. Participants consisted of 894 students (622 females) who received services at a university counselling centre at the same institution described in Study 1. Mean age was 20?8 years for females and 21?3 years for males. Approximately 70% of the referred sample were European American, 10% African American, 10% Latino, 5% Asian/Pacific Islander, and 5% ‘‘others’’.
Procedure. Intake interviews were conducted on all students seeking psychological services at the university counselling centre by a licensed clinical psychologist, a licensed clinical social worker, or a psychology doctoral candidate (supervised by a licensed clinical psychologist).
Measures. Depressed mood and depressive disorder were assessed during the intake interview and documented on a data retrieval form, which contains an extensive coded list of potential problem areas, including separate codes for depressed mood and depressive disorder symptoms.
Results Percentages of participants reporting depressed mood and depressive disorder are summarized by gender in Table 2. Chi-square analyses indicate no significant effects for gender on depressed mood. However, a significant gender difference in rates of depressive disorder emerged, with males reporting higher rates of depression w2 (1, N ¼ 894) ¼ 6?0, po0?01.
Discussion The finding that males were more likely to be depressed was unexpected. Gladstone and Koenig (1994) and Nolan and Willson (1994) have reported that undergraduate males are at heightened risk, relative to high-school males, for engaging in a ruminative response style. Rumination, in turn, has been linked with depression (Nolen-Hoeksema et al., 1999). Gladstone and Koenig (1994) argue that the reason they did not find heightened rates of depression in their male student sample was that these males received additional social support relative to peers who did not attend college. Table 2 Gender vs. two conceptualizations of depressionFresults of Study 2 (referred) participants Gender
N
Depressed mood (%)
Depressive disorder(%)
Males Females
272 622
21?3 20?9
4?0* 1?3
*po0?01.
616
K. Grant et al.
Perhaps males, like those in the present study, who attend ‘‘commuter’’ universities are at heightened risk for depressive disorder, as commuter universities may not offer the kinds of opportunities (e.g. dormitory experiences) that foster the development of social support (Sullivan and Sullivan, 1980). Prior research has indicated that commuter students report poorer social relationships and poorer mental health than residential students (e.g. Wilson et al., 1987). For example, Pascarella (1985) found that residential students’ greater social involvement on campus was predictive of positive self-image, even after controlling for preenrollment characteristics. And Sullivan and Sullivan’s (1980) longitudinal investigation found that interpersonal relationships actually improved over time for residential males relative to commuting males. Taken together, findings from prior research and the present study indicate that college attendance may lead both to rumination (perhaps due to an emphasis on reflection and introspection or an atmosphere that discourages genderstereotyped behaviour) and social support for undergraduate males; however, for some males (e.g. those who commute) social support may be less available, and these males are at heightened risk of depression. It is unclear why commuting females would be at lower risk, but perhaps the environmental context which promotes rumination in males (e.g. an atmosphere that discourages gender-stereotyped behaviour) widens the coping strategies available to college females (who are generally more prone to rumination (Nolen-Hoeksema et al., 1999)). Alternatively, prior socialization may better equip college females to develop social networks independent of institutional supports. Additional research is needed to test these hypothesized interpretations. The finding that female undergraduates were not at heightened risk of depression lends support to the primacy of social and psychological explanations for gender differences in depression emergent during adolescence. Whereas biological risk factors are likely implicated in depression for both genders, social and psychological processes may better explain gender differences in rates of depression.
References Achenbach, T. M. (1991). Manual for the youth self report. Burlington, VT: Department of Psychiatry, University of Vermont. Achenbach, T. M. (1997). Manual for the young adult self-report and young adult behavior checklist. Burlington, VT: Department of Psychiatry, University of Vermont. American Psychiatric Association (1994). Diagnostic and statistical manual of mental disorders, 4th Edn. APA: Washington, DC. Angst, J. and Dobler-Mikola, A. (1984). Do the diagnostic criteria determine the sex ratio in depression? Journal of Affective Disorders, 7, 189–198. Clarke, G. N.; Lewinsohn, P. M.; Hops, H. and Seeley, J. R. (1992). A self-and-parent-report measure of adolescent depression: the Child Behavior Checklist Depression scale (CBCL-D). Behavioral Assessment, 14, 443–463. Compas, B. E., Oppedisano, G., Connor, J. K., Gerhardt, C. A., Hinden, B. R., Achenbach, T. M. and Hammen, C. (1997). Gender differences in depressive symptoms in adolescence: comparison of national samples of clinically referred and non-referred youth. Journal of Consulting and Clinical Psychology, 65, 617–626. Compas, B. E., Ey, S. and Grant, K. E. (1993). Taxonomy, assessment, and diagnosis of depression during adolescence. Psychological Bulletin, 114, 323–344. Gladstone, T. R. G. and Koenig, L. J. (1994). Sex differences in depression across the high school to college transition. Journal of Youth and Adolescence, 23, 643–699.
Gender differences
617
Hankin, B. L., Abramson, L. Y., Moffitt, T. E., Silva, P. A., Mcgee, R. and Angell, K. E. (1998). Development of depression from preadolescence to young adulthood: emerging gender differences in a 10-year longitudinal study. Journal of Abnormal Psychology, 107, 128–140. Nolan, R. and Willson, V.L. (1994). Gender and depression in an undergraduate population. Psychological Reports, 75, 1327–1330. Nolen-Hoeksema, S. and Girgus, J. S. (1994). The emergence of gender differences in depression during adolescence. Psychological Bulletin, 115, 424–443. Nolen-Hoeksema, S., Larson, J. and Grayson, C. (1999). Explaining the gender difference in depressive symptoms. Journal of Personality and Social Psychology, 77, 1061–1072. Pascarella, E. T. (1985). The influence of on-campus living versus commuting to college on intellectual and interpersonal self-concept. Journal of College Student Personnel, 26, July, 292–299. Stangler, R. S. and Printz, A. M. (1980). DSM-III: psychiatric diagnosis in a university population. American Journal of Psychiatry, 137, 937-940. Sullivan, K. and Sullivan, A. (1980). Adolescent–parent separation. Developmental Psychology, 16, 93–104. Wilson, R. J., Anderson, S. A. and Fleming, W. M. (1987). Commuter and resident students’ personal and family adjustment. Journal of College Student Personnel, 28, 229–233.