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Chapter 13

PSYC 3480 Chapter 13: PSYC 3480 Women’s Psychology – Chapter 13

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PSYC 3480

PSYC 3480 Women’s Psychology – Chapter 13 Mental Health  Overall, rates of mental illness are almost identical for men and women. o Women have higher rates of eating disorders, depression and anxiety disorders o Men are more likely to have impulse control, antisocial and substance abuse disorders. Factors Promoting Mental Health Social Support  Receiving and giving social support play an important role in maintaining good physical and mental health and helping people cope with stressful events o Especially strong for women – girls more likely than boys to seek social support following stressful events  Women who feel more loved and supported by their friends, relatives and children are at less risk for major depression  For men, level of social support is less strongly related to the risk of depression Tend and Befriend  Women use social support as a coping aid more than men  Taylor – proposed that women often respond to stress by tending to themselves and their children and by forming ties with others  Men are more likely to show aggression or escape – fight or flight  What stimulates these different behaviors in males and females? o Hormonal differences are partly the problem – Taylor o Eagly – points out that gender different could result from cultural conditioning that prepares females for the role of caregiver and nurturer Optimism: “The Power of Positive Thinking”  An optimistic outlook – the expectation that good rather than bad things will happen – has been linked to a variety of positive mental and physical health outcomes, including longer life  Pessimism is associated with poorer health outcomes and higher mortality  Optimists are more likely to deal actively with problems  Optimism appears to protect women from some of the health risks associated with depression Mental Health in Childhood and Adolescence  Girls show fewer adjustment problems in childhood, but girls are more likely than boys to first manifest psychological difficulties during adolescence – stress increases  The pattern of stress girls encounter may leave them more vulnerable to emotional disorders than do those experienced by boys Internalizing Disorders in Girls  Adjustment problems more common in girls and women like depression, anxiety and social withdrawal, are labeled internalizing problems o They are harder to detect and are more often overlooked than the externalizing problems shown by men and boys: aggression, antisocial etc.  Early socialization of girls and boys into gender typed behaviors may be responsible for these differences in the expression of distress Externalizing Disorders in Girls  Boys are more likely than girls to show externalizing behaviors – ADHD  Girls with externalizing disorders are rarely studied because of the notion that these are “male” problems.  Girls who show externalizing problems exhibit deficits in social, emotional and communication skills and elevated rates of substance use, anxiety and risky sexual behavior.  These girls are more likely to have difficulty as adults.  Studies in Sweden, Canada and US show that girls with these problems have higher rates of educational failure, juvenile crime, substance abuse, mental health problems, pregnancy and poor parenting skills in adulthood. Eating Disorders Types of Eating Disorders  There are three major types: anorexia nervosa, bulimia nervosa and binge eating disorder. Anorexia Nervosa  Refusal to maintain a minimal normal body weight (defined as 85% of ideal weight), intense fear of gaining weight, a distorted body image (feeling fat even when too thin), and amenorrhea (lack of menstruation) in females  They diet, fast and exercise excessively to lose weight; they may lose 25% of their original body weight; many share self starvation tips and ‘thinspiration’ messages on pro-ana Websites  Dramatic weight loss can cause osteoporosis, fertility problems, hormone abnormalities, dangerously low BP and damage to vital organs  They have greater risk of death from all causes and suicide  Girls and women account for more than 95% of cases of it  Its incidence is increasing among women of color and poor women  Can become anorexic at any age, but mostly occurs in adolescence; increasing number of girls as young as 6 have been diagnosed  Growing number of women in midlife and beyond are developing and continuing to have it  Midlife trigger may be the 10-15 pound weight gain during menopause; fear of aging, losing a spouse, dealing with a troubled child or having a child leave for college can set it off  Young women with physical disabilities also have an elevated risk of developing symptoms of eating disorders Bulimia Nervosa  Recurrent episodes of uncontrolled binge eating, followed by purging activities aimed at controlling body weight  Purging activities – self induced vomiting, exercise, extreme dieting and fasting, abuse of laxatives, diuretics or enemas  Seem to be driven by an intense fear of weight gain and a distorted perception of body size similarto anorexics  Unlike anorexics, bulimics often maintain normal weight; can cause gastrointestinal problems as well as tooth decay because of gastric acid in vomit  May result in imbalance of electrolytes, the chemicals necessary for normal functioning heart  Young women account for more than 90% of the cases of bulimia Binge Eating Disorder  Characterized by recurrent binge eating in the absence of compensatory weight control efforts  Most common eating disorder, has a later onset and is associated with obesity  Female to male ratio is still 3:1 Causes of Eating Disorders Biological Factors  Identical twin is much more likely than a fraternal twin to develop an eating disorder if her co-twin also has the disorder.  Could also reflect identical twins’ highly similar social and cultural environments.  Another biological consideration is that anorexics have disturbances in their levels of serotonin; these chemical imbalances may result from the eating disorder rather than cause it. Psychological Factors  Low self esteem, high levels of anxiety, depression, perfectionism, conscientiousness, competitiveness, OCD, difficulty in separating from parents, strong need for approval of others etc. can all put women at risk for eating disorders  May also reflect family problems o Parents of anorexics – overly nurturant and overprotective and place emphasis on achievement and appearance o Parents of bulimics – critical and controlling, overprotective and low in nurturance and support  Another risk factor is sexual or physical abuse Cultural Factors  Some view eating disorders as attempts to attain the reed-thin ideal of beauty that has been socially constructed  In NA, the effect of cultural pressures to be thin is perhaps seen most vividly among girls and young women who are involved in sports  Female athlete triad – the combination of disordered eating accompanied by amenorrhea and premature bone loss, or osteoporosis o Prevalence of this appears to have grown with girls’ participation in dance and performance sports like diving, skating, cheerleading etc. Treatment of Eating Disorders  Difficult to cure; cognitive behavioral therapy, which helps to manage behavior and the way they think, seems to be the most effective for bulimia and BED; antidepressants also used  Family therapy shows promise in the treatment of anorexia in adolescents; cognitive behavioral therapy may be helpful in improving outcomes and preventing relapse  Antidepressants sometimes help prevent relapse once the anorexic client returns to normal; not effective in reversing anorexic symptoms  Anorexia is resistant to a wide range of interventions; typically, fewer than half of the clients fully recover  Treatment for bulimia is more successful; about 3 fourths diagnosed show full recovery 20 years later, while 5% still have the disorder BED has more favorable prognosis than anorexia or bulimia, with a recovery rate of 80% five years after treatment and a low relapse rate Substance Use and Abuse Alcohol Incidence  Females are less likely than males to use alcohol and to be heavy drinkers; about 8-10% of women and 15-20% of men will develop alcohol problems  Telescoping – while women’s alcoholism starts later than men’s, it progresses more quickly  White women have higher rates of alcohol use than women in other ethnic groups; followed by native American women, Blacks, and Latinas; Asian American have the lowest  Problem drinking in young women has been increasing at an alarming rate in the US and abroad o US college women are now almost as likely as college men to engage in binge drinking – having 5 drinks in a row for men or 4 in a row for women at least once in the last 2 weeks  Heavy drinking prevalent among sorority women and fraternity men and others whose peers drink heavily; female and male high-schoolers are equally likely to drink and females are almost as likely to binge drink  Explanation – increase in alcohol advertising targeting teen girls. Health Consequences  Women have more body fat, less water and less of the enzyme that breaks down alcohol than men – have higher levels of alcohol in their blood even when they consume the same amount  As women age, they have greater physiological susceptibility to alcohol’s effect and experience impairment or intoxication after fewer drinks  Another consequence is that women develop cirrhosis of the liver, hepatitis, heart disease and brain damage at lower levels of alcohol intake than men  Prolonged heavy drinking also increases the risk of breast cancer, osteoporosis and infertility  Drinking during pregnancy can lead to fetal alcohol syndrome (FAS) – disorder characterized by mental retardation, growth deficiencies, facial deformities, and social, emotional, learning and behavioral problems  Even light drinkers risk having children with fetal alcohol effect (FAE) – milder but still serious form of FAS Risk Factors  Children of alcoholic parents or siblings have increased rates of alcoholism; genetic factors play a strong role for daughters and sons  Adolescents whose parents and peers consume alcohol more likely to start drinking at an early age  Divorced and single women more likely than married or widowed to drink heavily and to have alcohol related problems  Women who are depressed and anxious report stressful life events such as physical or sexual abuse – more likely to be heavy drinkers Treatment  Double standard of drinking – heavy drinking in men is often expected and seen as normal, whereas heavy drinking in women is strongly criticized  As a result – women tend to hide or deny alcohol use, making them less likely to seek help and to be more seriously ill before the disease is diagnosed  Physicians less likely to counsel female patients than male patients on alcohol or drug use  Alcohol problems in older women often mistaken for other aging conditions and are missed  Twelve step treatment programs like AA have been criticized for being based on research with alcoholic men; other programs like Women for Sobriety, focus on the special issues and needs of women with drinking problems – shown success in treating Illegal Substances Incidence  Use of marijuana, cocaine, heroin, hallucinogens, and steroids varies by gender and ethnic group  Among women, use is highest among North Americans, the White, Latina, Black and Asian  Males generally have higher rates of illegal drug use; tend to use them more heavily than females  Reason for gender gap – illegal drug use by women is less acceptable in society th th  Recently, 8 and 10 grade girls have shown higher rates of drug use than males for some drugs  Some teen girl athletes are moving away from preoccupation with thinness toward a lean, more muscular look – reverse anorexia o Steroids for women may interfere with their ability to bear children  Individuals who use illegal substances tend to use more than one and also abuse alcohol  In girls and women, the problem is compounded because they are more likely than men to both use and misuse prescription drugs Treatment  Women in drug abuse treatment programs have different needs than men  Successful program depends on meeting these different needs Anxiety Disorders and Depression  More than 1 in 4 Americans will have an anxiety disorder in their lifetime and nearly 1 in 5 will develop major depression – women are at greater risk for both. Anxiety Disorders  Anxiety disorder; irrational, excessive and persists over several months; most occur 2
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