The role of internalizing and externalizing liability factors in accounting for gender differences in the prevalence of common psychopathological syndromes
Abstract
Background: We hypothesized that gender differences in average levels on the internalizing and externalizing factors that account for co-morbidity among common psychopathological syndromes in both men and women account for gender differences in the prevalence of specific syndromes. Method: The latent structure of 11 syndromes was examined in a middle-aged (mean age=52.66 years, s.d .=5.82) sample of 2992 (37% men) members of the community-based Minnesota Twin Registry (MTR) assessed using 10 scales of the Psychiatric Diagnostic Screening Questionnaire (PDSQ) and an adult antisocial behavior scale. Confirmatory factorial invariance models were applied to a best-fitting, internalizing–externalizing model. Results: A ‘strong gender invariance model’ fit best, indicating that gender differences in the means of individual syndromes were well accounted for by gender differences in mean levels of internalizing and externalizing. Women exhibited higher mean levels of internalizing ( d =0.23) and lower mean levels of externalizing ( d =−0.52) than men. Conclusions: These findings suggest that risk factors for common mental disorders exhibiting gender differences may influence prevalence at the latent factor level. Future research may benefit from focusing on both the latent factor and individual syndrome levels in explaining gender differences in psychopathology.
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Other internalizing disorders, such as bulimia nervosa or another anxiety disorder, may appear alongside anxiety.
“Therefore, other internalizing disorders, such as bulimia nervosa or another anxiety disorder, may appear alongside anxiety.37,43”
From Factors associated with gender and sex differences in anxiety prevalence and comorbidity: A systematic review (2022) · cites this paper as [43]
The most common comorbid anxiety disorders and/or symptoms in men are substance abuse, ADHD, and intermittent explosive disorder.
“the most common comorbid anxiety disorders and/or symptoms in men are substance abuse, attention deficit hyperactivity disorder (ADHD), and intermittent explosive disorder.35,43,47”
From Factors associated with gender and sex differences in anxiety prevalence and comorbidity: A systematic review (2022) · cites this paper as [43]
This overrepresentation was probably because ASD and ADHD are diagnosed more often in boys than girls.
“This was likely due to the fact that ASD and ADHD are more frequently diagnosed in boys than in girls.53”
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- Authors
- Kramer, M. D., Krueger, R. F., & Hicks, B. M.
- Affiliations
- University of Minnesota (US)
- Corresponding author
- Kramer, Mark D.
- Krueger, Robert F.
- Venue
- Psychological Medicine
- Publisher
- Cambridge University Press (CUP)
- Published
- 2007-09-25
- Volume
- 38
- Issue
- 1
- Pages
- 51-61
- ISSN
- 0033-2917 (ISSN-L)
- 1469-8978
- OpenAlex
- W1967724567
- Cited by
- 190
- References
- 56
- Citations by year
- 2026: 10 · 2025: 11 · 2024: 4 · 2023: 6 · 2022: 14 · 2021: 12 · 2020: 10 · 2019: 11 · 2018: 11 · 2017: 12 · 2016: 15 · 2015: 19 · 2014: 6 · 2013: 7 · 2012: 13
- FWCI
- 8.96
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychological Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research 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
- Keywords
- gender differences, psychopathology prevalence, psychiatric syndromes, comorbidities, antisocial behavior, middle-aged adults, Minnesota Twin Registry, latent factor structure, psychiatric risk factors
- MeSH terms
- Adult, Aged, Antisocial Personality Disorder, Anxiety Disorders, Mental Disorders, Major Depressive Disorder, Diseases in Twins, Female, Humans, Male, Middle Aged, Minnesota, Models, Psychological, Psychiatric Status Rating Scales, Risk Factors, Sex Factors, Syndrome, Models, Statistical, Comorbidity, Prevalence, Substance-Related Disorders, Genetic Predisposition to Disease
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