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Adolescent Onset of the Gender Difference in Lifetime Rates of Major Depression: A Theoretical Model
Abstract
Prepubescent boys are, if anything, more likely than girls to be depressed. During adolescence, however, a dramatic shift occurs: between the ages of 11 and 13 years, this trend in depression rates is reversed. By 15 years of age, females are approximately twice as likely as males to have experienced an episode of depression, and this gender gap persists for the next 35 to 40 years. We offer a theoretical framework that addresses the timing of this phenomenon. First, we discuss the social and hormonal mechanisms that stimulate affiliative needs for females at puberty. Next, we describe how heightened affiliative need can interact with adolescent transition difficulties to create a depressogenic diathesis as at-risk females reach puberty. This gender-linked vulnerability explains why adolescent females are more likely than males to become depressed when faced with negative life events and, particularly, life events with interpersonal consequences.
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“There now is consensus that the gender difference in depression has a multifactorial etiology”
From Gender Differences in Depression in Representative National Samples: Meta-Analyses of Diagnoses and Symptoms (2017) · cites this paper as Cyranowski et al., 2000
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ResultGou, Y., Wu, N., Xia, J., Liu, Y., Yang, H., Wang, H., Yan, T., & Luo, D. (2022) · Frontiers in Public Health · doi:10.3389/fpubh.2022.893280 · Cited by 19
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“Sex was entered as a confounding variable in view of evidence indicating sex differences in adolescent mental health [60, 61].”
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“…of significant gender differences in this mediating pathway was somewhat non expected, because in accordance with the vulnerability-stress model (Cyranowski et al., 2000) we originally hypothesized that in the presence of low levels of social support adolescent girls would face higher risks for…”
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Wheaton, B., & Montazer, S. (2017) · Cambridge University Press eBooks · doi:10.1017/9781316471289.013 · Cited by 24
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“In addition, many studies also fit in with a general notion on gender-specific social orientations, which states that men are more status-oriented, whereas women are more affection-oriented (e.g., Cross and Madson 1997; Cyranowski et al. 2000).”
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Erözkan, A., Karakaş, Y., Ata, S., & Ayberk, A. (2011) · Social Behavior and Personality An International Journal · doi:10.2224/sbp.2011.39.4.451 · Cited by 15
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Essau, C. (2009) · doi:10.1093/med:psych/9780199226504.001.0001 · Cited by 18
“"'&1 ~ c :0 Cyranowski et al. (2000) presented the so-called model of 'correlated consequences' to (JJ 00 *~.”
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“Men are about half as likely as women to experience a lifetime episode of major depression [5].”
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“For example, the higher global prevalence of depression among women compared to men is well-documented (65 – 67).”
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“than males to become depressed when faced with negative life events (Cyranowski et al., 2000).”
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“2012) and that the prevalence rates of depression were higher in female than male population (Cyranowski et al. 2000).”
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“This phenomenon of the onset of gender gap of depressive symptoms in adolescence has also been reported in Canada, Great Britain, and the United States (Cyranowski et al., 2000;Wade et al., 2002).”
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“in adolescence to interpersonal events is argued to arise out of both hormonal changes, such as increased levels of oxytocin, and greater sociocultural pressures on adolescent females to seek out emotional closeness in affliative connections (Cyranowski et al., 2000).”
BackgroundMental Health and HIV Risk Among African American Adolescents
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Género, Adversidad Familiar y Síntomas Emocionales en Preadolescentes
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“Girls exhibit a stronger relationship orientation and greater attachment needs during adolescence and are more likely to be troubled by negative interpersonal events than boys (Cyranowski et al., 2000).”
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“There was a stable prevalence of depression inmales from the age of 13 years, while the prevalence of depression in females increases yearly and is about twice as high as that of males (7, 8).”
BackgroundAdverse life experiences and mental health of adolescents in Ghana: a gendered analysis
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“…example, the gender invariance in the relationship between mental health outcomes and ALEs partly negate the previous suggestion of low psychopathology threshold for internalizing behaviours among females, compared with males (Cyranowski et al., 2000; Harkness et al., 2010; Kendler et al., 2006).”
ResultYoungstrom, E. A., Young, A. S., Eck, K. V., Stepanova, E. A., Langfus, J. A., Carlson, G. A., & Findling, R. L. (2021) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374416.2021.1929251 · Cited by 17
“(Cyranowski et al., 2000), with more KSADS diagnoses of depression and dysthymia, and anxiety disorders, and significantly less bipolar and CD, and lower rates of”
BackgroundInfluentialStudy Protocol: Transitions in Adolescent Girls (TAG)
Barendse, M. E. A., Vijayakumar, N., Byrne, M. L., Flannery, J., Cheng, T. W., Flournoy, J. C., Nelson, B. W., Cosme, D., Mobasser, A., Chavez, S., et al. (2020) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2019.01018 · Cited by 18
“The study focuses on female adolescents, because of the vast differences between the sexes in pubertal processes, as well as the increased prevalence of internalizing disorders in female adolescents (11).”
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Zur Lebenszeitprävalenz Affektiver Störungen im Jugendalter
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“According to Cyranowski et al. (2000), women are about twice as likely as men to experience a depressive episode, and differ from men with regard to the clinical presentation of depressive symptoms and the way depression develops.”
BackgroundBenedetto, L. D., Pinto, M., Ieritano, V., Lisci, F. M., Monti, L., Marconi, E., Chieffo, D. P. R., Montanari, S., Kotzalidis, G. D., Sani, G., et al. (2025) · Journal of Clinical Medicine · doi:10.3390/jcm14062030 · Cited by 12
“This suggests that cognitive functioning may influence the ability to plan ahead and resist immediate urges, further highlighting the complex interplay between cognitive capacity, impulsivity, and emotional regulation [66].”
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“Social and biological factors might play a pivotal role in age-related treatment with psychotropic medications because adolescence is a development period characterized by pronounced biological and social changes [14].”
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“and equally associated with negative comments from others, thereby supporting the suggestion that girls are generally more influenced by interpersonal relationships than boys [23].”
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“Another model by Cyranowski et al. (2000) postulates a difficult adolescent transition as being causally”
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“A number of studies have shown that women have higher prevalence of depression versus men [56, 61]; however, the mechanism remains unclear.”
BackgroundAcne and its association with internalizing problems
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Elevated Serum IL-2 Levels are Associated With Major Depressive Disorder: A Case-Control Study
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“Depression is far more prevalent in women than men([42,43]) and is the leading cause of disability worldwide.”
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Metadata
- Authors
- Cyranowski, J. M., Frank, E., Young, E., & Shear, M. K.
- Affiliations
- University of Pittsburgh Medical Center (US)
- Venue
- Archives of General Psychiatry
- Publisher
- American Medical Association (AMA)
- Published
- 2000-01-01
- Volume
- 57
- Issue
- 1
- Pages
- 21
- ISSN
- 0003-990X (ISSN-L)
- OpenAlex
- W2025113055
- Cited by
- 1,276
- References
- 0
- Citations by year
- 2026: 32 · 2025: 44 · 2024: 57 · 2023: 51 · 2022: 69 · 2021: 72 · 2020: 77 · 2019: 49 · 2018: 43 · 2017: 83 · 2016: 44 · 2015: 72 · 2014: 51 · 2013: 53 · 2012: 53
- FWCI
- 30.35
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of General Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Mental Health (MH-18269, T32MH018269)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Keywords
- adolescent depression, gender differences, major depressive disorder, puberty, endocrine effects, adolescent transition, diathesis
- MeSH terms
- Adolescent, Adult, Age Factors, Depressive Disorder, Humans, Interpersonal Relations, Life Change Events, Models, Psychological, Puberty, Risk Factors, Sex Factors, Socialization, Age of Onset, Sex Distribution
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