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Behavioral Sciences
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Male Depression and Therapy
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Male Depression and Therapy

A special issue of Behavioral Sciences (ISSN 2076-328X). This special issue belongs to the section "Psychiatric, Emotional and Behavioral Disorders".

Deadline for manuscript submissions: closed (30 June 2024) | Viewed by 28725

Special Issue Editor

Dr. Andreas Walther

E-Mail Website
Guest Editor
Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland
Interests: depressive disorders; men; masculinity; traditional male role norms; gender role conflict; male specific psychotherapy; male specific pharmacotherapy; pathophysiology of depressive disorders; testosterone; steroid hormones; molecular and cellular psychiatry; healthy aging

Special Issue Information

Dear Colleagues,

It is my great pleasure to invite you to contribute an article to the Special Issue on male depression and therapy. This Special Issue will feature original research papers,  communications, and review articles. The journal Behavioral Sciences has no restrictions on the length of manuscripts, provided that the text is concise and comprehensive.

Being born male or female is one of the most distinguishing characteristics in our society and shapes how a human being is perceived, interacted with, and expected to behave. Manhood, however, has been identified as a precarious state requiring continual social proof and validation. This leads to the fact that men express psychological distress in a dissimilar way and are reluctant to seek help. The distinct biology of men compared to women, with stress physiological systems showing higher responses to psychosocial stress in men, is an additional factor that warrants consideration.

A growing field of research is concerned with the identification of differing phenotypes of depressive syndromes and disorders in men. Although for men only half the prevalence rate for depressive disorders as compared to women is observed, a two-fold higher prevalence rate of alcohol use disorders and an up to four-fold increased rate for completed suicide in men are reported. A history of depression is considered to be one of the main risk factors for both alcohol use disorders and completed suicide. Also of interest is the finding that men with a high adherence to traditional male role norms are twice as likely to die by suicide as men with a low adherence to traditional male role norms. Therefore, more and more researchers are advocating the perspective that there might exist male-typical phenotypes of depression not captured by current diagnostic criteria, suggesting a male depression related to adherence to traditional male role norms and characterized by externalizing symptomatology.

This Special Issue is therefore dedicated to men's mental health. It aims to further elucidate male-specific phenotypes of mental disorders, their relationship with gender role socialization and adherence to traditional male role norms, and the experience of gender role conflict. This involves also the aspect of help-seeking and communicating psychological distress. Likewise, contributions to the pathophysiology of depressive and associated disorders with a focus on sex differences and the unique characteristics of male patients are of interest. With regard to the advancement of personalized medicine, male-specific or male-adjusted psychotherapeutic or pharmacological therapy approaches for mental disorders will be covered.

Dr. Andreas Walther
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Behavioral Sciences is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Male Depression
  • Depressive Disorders
  • Suicide
  • Alcohol Use Disorders
  • Substance Use Disorders
  • Men
  • Boys
  • Masculinity
  • Help Seeking
  • Traditional Male Role Norms
  • Male Gender Role Conflict
  • Precarious Manhood
  • Male Specific Psychotherapy
  • Male Specific Pharmacotherapy
  • Sex Differences in the Pathophysiology of Depressive Disorders
  • Testosterone
  • Cortisol
  • Steroid Hormones
  • Stress Physiology
  • Neuroimaging
  • EEG

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Published Papers (6 papers)

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Research

16 pages, 526 KiB  
Article
Effectiveness of Group Physical Exercise in Treating Major Depressive Disorder: An Analysis of Secondary Data from an Aborted Randomized Trial
by Hossam Elgendy, Reham Shalaby, Belinda Agyapong, Deanna Lesage, Lacey Paulsen, Amy Delday, Sherianna Duiker, Shireen Surood, Yifeng Wei, Nnamdi Nkire and Vincent Israel Opoku Agyapong
Behav. Sci. 2024, 14(3), 219; https://doi.org/10.3390/bs14030219 - 8 Mar 2024
Viewed by 4366
Abstract
Background: Depression is highly prevalent and a significant cause of mortality and morbidity across the globe. Although antidepressants and/or psychotherapy are often used to treat depression, some recent studies indicate that exercise may play an important role in lowering depression symptoms among patients [...] Read more.
Background: Depression is highly prevalent and a significant cause of mortality and morbidity across the globe. Although antidepressants and/or psychotherapy are often used to treat depression, some recent studies indicate that exercise may play an important role in lowering depression symptoms among patients meeting the clinical criteria of a depressive episode. Objectives: This study aimed to evaluate the mental health and wellbeing of adult participants diagnosed with major depressive disorder (MDD) after fourteen weeks of receiving a supervised physical exercise program. Methods: In a pre-post design, the assessments were performed at baseline, seven weeks and fourteen weeks following the exercise intervention program using facilitated self-reported psychometric scales. The Beck Depression Inventory (BDI-2) and Clinical Outcomes in Routine Evaluation—Outcome Measure (CORE-OM) were used to assess depression. The short form of the International Physical Activity Questionnaire (IPAQ) was used for the self-reporting of participants’ physical activity. Results: At the beginning of the study, the baseline total mean scores and standard deviations for the BDI-2, CORE-OM, and IPAQ in both genders did not differ significantly (p-value > 0.05). Patients showed significant improvement in all assessment scales after completing fourteen weeks of the physical exercise program. Based on the BDI-2, the baseline score dropped from 31.25 (indicating moderate to severe depression) to 14.25 (indicating mild to minimal depression), with a p-value of <0.001. The CORE-OM total mean score was reduced from 1.91 to 0.98 with a significant p-value < 0.005 indicating effective clinical improvement in depression symptoms. The IPAQ total MET-minutes/week mean score increased from 1713.22 to 4367.62, indicating an improvement in the participants’ weekly P.E. intake; however, the change was not statistically significant (p = 0.07). Conclusions: Exercise treatment is linked with considerable therapeutic improvement in patients with MDD, particularly when exercise is sustained over time. The BDI-2 and CORE-OM total scores significantly decreased after the fourteen-week P.E. programme, indicating a change from moderate and severe depression to minimal and mild depression. Our findings offer insightful information to primary care doctors and psychiatrists, indicating that prescribing exercise to depressed patients may be a helpful adjunctive therapy. Full article
(This article belongs to the Special Issue Male Depression and Therapy)
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14 pages, 1052 KiB  
Article
Defense-Oriented Psychoanalytic Psychotherapy as a Tailored Treatment for Boys: Neurobiological Underpinnings to Male-Specific Response Tested in Regulation-Focused Psychotherapy for Children
by Timothy Rice, Tracy A. Prout, Andreas Walther and Leon Hoffman
Behav. Sci. 2022, 12(8), 248; https://doi.org/10.3390/bs12080248 - 22 Jul 2022
Cited by 4 | Viewed by 2091
Abstract
This paper presents defense-oriented psychoanalytic psychotherapy as a tailored treatment for boys through a neurophysiological hypothesis. Male central nervous system development is reviewed, with a focus on the development of the emotion regulation system. The organizational effects of pre- and post-natal androgens delay [...] Read more.
This paper presents defense-oriented psychoanalytic psychotherapy as a tailored treatment for boys through a neurophysiological hypothesis. Male central nervous system development is reviewed, with a focus on the development of the emotion regulation system. The organizational effects of pre- and post-natal androgens delay central nervous system development in males relative to females, following a caudal to rostral phylogenetic framework. Ventromedial prefrontal structures mature at an earlier developmental age than dorsolateral prefrontal structures, creating less of a gender gap in the available underlying neural architecture for responsivity to targeted therapeutic intervention. The hypothesized operation of defense analysis upon ventromedial prefrontal cortical structures and corticolimbic connectivity therefore positions boys to benefit from psychotherapy equally as girls. In this study, we explored gender differences in presentation and response to a short-term, manualized defense-oriented psychoanalytic psychotherapy named regulation-focused psychotherapy for children. In a sample size of 43 school-aged children, consisting of 32 boys and 11 girls, with oppositional defiant disorder, we found no statistically significant differences in participant characteristics upon entry nor in treatment response, as measured by changes in scores on the Oppositional Defiant Disorder Rating Scale, the oppositional defiant problems subscale of the Child Behavior Checklist, the suppression and reappraisal subscales of the Emotion Regulation Questionnaire for Children and Adolescents, and the lability and negativity subscale of the Emotion Regulation Checklist. The findings were comparable with the gendered findings of preexisting studies of play therapy, where boys and girls improve equally, but not of behaviorally predominant psychotherapy, where girls appear to have superior responses. Our findings suggest that the treatment as a general play therapy, but with a focus on the implicit emotion regulation system, was successful in meeting boys’ gendered treatment needs. Conclusions are drawn with implications for further study. Full article
(This article belongs to the Special Issue Male Depression and Therapy)
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18 pages, 1842 KiB  
Article
Gender Differences in Attachment Anxiety and Avoidance and Their Association with Psychotherapy Use—Examining Students from a German University
by Rainer Weber, Lukas Eggenberger, Christoph Stosch and Andreas Walther
Behav. Sci. 2022, 12(7), 204; https://doi.org/10.3390/bs12070204 - 22 Jun 2022
Cited by 13 | Viewed by 4384
Abstract
Attachment anxiety and avoidance might explain gender differences in psychotherapy use, which is generally lower in men. In addition, university students are a particularly vulnerable group for mental health problems, and understanding psychotherapy use, especially among mentally distressed male students, is pivotal. A [...] Read more.
Attachment anxiety and avoidance might explain gender differences in psychotherapy use, which is generally lower in men. In addition, university students are a particularly vulnerable group for mental health problems, and understanding psychotherapy use, especially among mentally distressed male students, is pivotal. A total of 4894 students completed an online survey answering questions regarding psychotherapy use and completing the PHQ-D identifying psychological syndromes. In addition, the ECR-RD12 was used to measure attachment anxiety and avoidance. Significant gender differences for attachment anxiety and avoidance emerged, showing higher attachment anxiety in female students and higher attachment avoidance in male students. Male students used psychotherapy significantly less than female students. Male students’ attachment anxiety and avoidance predicted psychotherapy use, while for female students, only attachment anxiety emerged as a significant predictor. Attachment anxiety is positively associated with psychotherapy use, and lower attachment anxiety in men may explain lower psychotherapy use in male students. Full article
(This article belongs to the Special Issue Male Depression and Therapy)
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19 pages, 2079 KiB  
Article
Examining the Role of Traditional Masculinity and Depression in Men’s Risk for Contracting COVID-19
by Andreas Walther, Lukas Eggenberger, Jessica Grub, John S. Ogrodniczuk, Zac E. Seidler, Simon M. Rice, David Kealy, John L. Oliffe and Ulrike Ehlert
Behav. Sci. 2022, 12(3), 80; https://doi.org/10.3390/bs12030080 - 16 Mar 2022
Cited by 6 | Viewed by 4272
Abstract
In the light of the COVID-19 pandemic and claims that traditional masculinity may put some men at increased risk for infection, research reporting men’s health behaviors is critically important. Traditional masculine norms such as self-reliance and toughness are associated with a lower likelihood [...] Read more.
In the light of the COVID-19 pandemic and claims that traditional masculinity may put some men at increased risk for infection, research reporting men’s health behaviors is critically important. Traditional masculine norms such as self-reliance and toughness are associated with a lower likelihood to vaccinate or follow safety restrictions. Furthermore, infection risk and traditional masculinity should be investigated in a differentiated manner including gender role orientation, underlying traditional masculine ideologies and male gender role conflict. In this pre-registered online survey conducted during March/April 2021 in German-speaking countries in Europe, 490 men completed questionnaires regarding contracting COVID-19 as confirmed by a validated test, fear of COVID-19 (FCV-19S), and experience of psychological burden due to COVID-19. In addition, depression symptomatology was assessed by using prototypical internalizing and male-typical externalizing depression symptoms. Furthermore, self-identified masculine gender orientation, endorsement of traditional masculinity ideologies, and gender role conflict were measured. A total of 6.9% of men (n = 34) reported having contracted COVID-19 since the beginning of the pandemic. Group comparisons revealed that men who had contracted COVID-19 exhibited higher overall traditional masculine ideology and gender role conflict. Logistic regression controlling for confounders (age, income, education, and sexual orientation) indicated that only depression symptoms are independently associated with the risk of having contracted COVID-19. While prototypical depression symptoms were negatively associated with the risk of having contracted COVID-19, male-typical externalizing depression symptoms were positively associated with the risk of contracting COVID-19. For traditional masculinity, no robust association for an increased risk of contracting COVID-19 could be established, while higher male-typical externalizing depression symptoms were associated with an increased risk of contracting COVID-19. Full article
(This article belongs to the Special Issue Male Depression and Therapy)
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9 pages, 971 KiB  
Article
Job Satisfaction and Psychological Distress among Help-Seeking Men: Does Meaning in Life Play a Role?
by Aiden A. P. Simard, Zac E. Seidler, John L. Oliffe, Simon M. Rice, David Kealy, Andreas Walther and John S. Ogrodniczuk
Behav. Sci. 2022, 12(3), 58; https://doi.org/10.3390/bs12030058 - 22 Feb 2022
Cited by 14 | Viewed by 6249
Abstract
Men’s low job satisfaction has been shown to be associated with greater symptoms of psychological distress. Meaning in life may be an important factor in this relationship, but its role as a mediator has not been reported. The present study investigated meaning in [...] Read more.
Men’s low job satisfaction has been shown to be associated with greater symptoms of psychological distress. Meaning in life may be an important factor in this relationship, but its role as a mediator has not been reported. The present study investigated meaning in life as a mediator in the relationship between job satisfaction and psychological distress among men. A total of 229 employed Canadian men participated in a cross-sectional survey, completing measures of depression and anxiety symptoms, anger severity, job satisfaction, and the presence of meaning in life. Zero-order correlations were calculated, and regression with mediation analyses were conducted; two models were tested: one for anxiety/depression symptoms and one for anger, as the dependent variables. Both mediation models emerged as significant, revealing a significant mediating effect for job satisfaction on the symptoms of psychological distress (anxiety/depression symptoms, anger) through meaning in life, even while controlling for salient confounding variables including COVID-related impacts. Lower job satisfaction was associated with less meaning in life, which in turn was associated with more symptoms of depression, anxiety, and anger. The findings highlight the importance of job satisfaction in the promotion of a sense of meaning in life among men, leading to improved psychological well-being both inside and outside of the workplace. Full article
(This article belongs to the Special Issue Male Depression and Therapy)
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21 pages, 2578 KiB  
Article
Men’s Psychotherapy Use, Male Role Norms, and Male-Typical Depression Symptoms: Examining 716 Men and Women Experiencing Psychological Distress
by Lukas Eggenberger, Callia Fordschmid, Claudio Ludwig, Seraina Weber, Jessica Grub, Nikola Komlenac and Andreas Walther
Behav. Sci. 2021, 11(6), 83; https://doi.org/10.3390/bs11060083 - 2 Jun 2021
Cited by 24 | Viewed by 5795
Abstract
Men as compared to women are half as often affected by depressive and anxiety disorders and seek significantly less help for mental health issues than women. Adherence to traditional male role norms (AtTMRN) may hinder men from describing prototypical depression symptoms and from [...] Read more.
Men as compared to women are half as often affected by depressive and anxiety disorders and seek significantly less help for mental health issues than women. Adherence to traditional male role norms (AtTMRN) may hinder men from describing prototypical depression symptoms and from seeking psychotherapy. The current study compared whether AtTMRN, gender role identity, or the experience of prototypical or male-typical externalizing mental health symptoms were associated with psychotherapy use in men and women. In an anonymous online survey, 716 participants (37% men) reporting to currently experience psychological distress were examined. Information was obtained on psychotherapy use, depression and anxiety symptoms, gender role identity, and traditional male role norms. Although experiencing similar levels of depression, men compared to women showed a reduction in psychotherapy use by 29%. Masculine role identity was directly associated with reduced psychotherapy use in men (β = −0.41, p = 0.029), whereas AtTMRN was not (men: β = −0.04, p = 0.818; women: β = −0.25, p = 0.064). Higher externalizing depression symptomatology (β = −0.68, p = 0.005), but not prototypical depression symptomatology (β = −0.02, p = 0.499), was associated with reduced psychotherapy use in men but not women (p > 0.05). Interactions revealed that men, but not women, with high AtTMRN use psychotherapy only when exhibiting elevated symptom levels. The results corroborate previous reports showing reduced psychotherapy use in men as compared to women and identify elevated masculine role identity and male-typical externalizing depression symptomatology as direct factors associated with reduced psychotherapy use in psychologically distressed men. AtTMRN interacts with mental health symptoms to predict psychotherapy use, indicating that men with high AtTMRN only use psychotherapy when exhibiting high symptomatology. Full article
(This article belongs to the Special Issue Male Depression and Therapy)
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