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Explaining the gender difference in depressive symptoms.
Abstract
It was hypothesized that women are more vulnerable to depressive symptoms than men because they are more likely to experience chronic negative circumstances (or strain), to have a low sense of mastery, and to engage in ruminative coping. The hypotheses were tested in a 2-wave study of approximately 1,100 community-based adults who were 25 to 75 years old. Chronic strain, low mastery, and rumination were each more common in women than in men and mediated the gender difference in depressive symptoms. Rumination amplified the effects of mastery and, to some extent, chronic strain on depressive symptoms. In addition, chronic strain and rumination had reciprocal effects on each other over time, and low mastery also contributed to more rumination. Finally, depressive symptoms contributed to more rumination and less mastery over time.
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“Studies suggest that women may be more likely to experience many risk factors that increase—or indicate the presence of—thwarted belongingness and perceived burdensomeness, including major depression (i.e., females are approximately twice as likely as males to suffer from Major Depression; Nolen-Hoeksema, Larson, & Grayson, 1999).”
From The interpersonal theory of suicide. (2010) · cites this paper as Nolen-Hoeksema, Larson, & Grayson, 1999
In the citing paper
“Mastery, a person’s perception of the degree of control they have in their lives, was measured using Pearlin’s 7-item Mastery Scale (Cronbach’s alpha = 0.84).”
From Longitudinal impacts of an online safety and health intervention for women experiencing intimate partner violence: randomized controlled trial (2020) · cites this paper as [50]
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“This gender difference in depressive symptoms appears to emerge in early adolescence and then remains throughout the adult life span ( Kessler et al., 1993; Nolen-Hoeksema & Girgus, 1994).”
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“In turn, a number of laboratory and field studies have shown that people who engage in rumination when distressed show longer and more severe periods of depressive symptoms and are more likely to develop full depressive disorders than those who do not engage in rumination (Alloy & Abramson, 1997; Nolen-Hoeksema & Morr…”
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“Paralleling previous findings from nonclinical longitudinal studies with shorter follow-ups (e.g., Abela et al., 2002; Hong, 2007; Nolen-Hoeksema et al., 1999; Nolen-Hoeksema & Morrow, 1991; Sarin et al., 2005), ruminative coping predicted higher depressive symptoms over the short- and subsequent long-term interval in…”
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“Second, Treynor et al. (2003) reanalyzed the data from Nolen-Hoeksema et al. (1999) and after removing 12 potentially dysphoric contaminated items (based on overlap with Beck Depression Inventory items; BDI, Beck et al. 1961) conducted factor analyses of the ten remaining rumination items and identified two five-item…”
MethodGender differences in rates of depression among undergraduates: measurement matters.
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BackgroundMen, women, and their outcome in psychotherapy
Ogrodniczuk, J. S. (2006) · Psychotherapy Research · doi:10.1080/10503300600590702 · Cited by 73
“For women, this may involve a greater focus on external problem solving to counter a ruminative response style that amplifies vulnerability to depression (Nolen-Hoeksema et al., 1999).”
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“It is known that women tend to ruminate more during periods of stress[10].”
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“If the worst health of women is due to biological factors (sex) or social factors (gender), or to the interaction between them, is a question that goes beyond the objective of this study (Nolen-Hoeksema et al., 1999).”
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“2001), in the context of depression, girls generally experience more risk factors than do boys, such as ruminating in response to depressed mood, engaging in passive coping strategies, and experiencing stressful life events (Hankin et al. 1998; Jose and Brown 2008; Nolen-Hoeksema et al. 1999).”
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“The RRS is a 22-item self-report for assessing ruminative coping responses to depressed mood [36].”
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“In addition, results from three prospective studies indicated that rumination specifically predicts increases in binge eating, bulimic symptoms, binge drinking and drug use over time (Nolen-Hoeksema & Harrell, 2002 ; Nolen-Hoeksema, Larson, & Grayson, 1999 ; Nolen-Hoeksema, Stice, Wade, & Bohon, 2007 ).”
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“More specific examples are body dissatisfaction, with its relevance for eating disorders (Keeton et al., 1990; Silberstein et al., 1988; Stice, 1994), and rumination, a type of coping when distressed that seriously contributes to depression (Nolen-Hoeksema et al., 1999).”
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Breakup Distress and Loss of Intimacy in University Students
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“Those authors noted that this difference might be related to different cognitive styles and greater chronic stress in women [20].”
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“Teenage girls show increased vulnerability to anxiety disorders and depression compared to boys [20,21].”
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The impact of mineralocorticoid receptor ISO/VAL genotype (rs5522) and stress on reward learning
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“Only females were recruited because differences in HPA axis system function as well as behavioral responses to stress are theorized to contribute to the twofold rate of depression found in women relative to men (Nolen-Hoeksema et al. 1999; Young & Korszun 2010).”
BackgroundYing, Y.-W., Lee, P., & Tsai, J. L. (2007) · International Journal of Intercultural Relations · doi:10.1016/j.ijintrel.2007.01.001 · Cited by 67
“Furthermore, research has demonstrated that, compared to men, women ruminate over problems more and feel less able to control their lives, resulting in higher levels of depressive symptoms ( Nolen-Hoeksema, Larson, & Grayson, 1999 ).”
Maladaptive Rumination as a Transdiagnostic Mediator of Vulnerability and Outcome in Psychopathology
Luca, M. (2019) · Journal of Clinical Medicine · doi:10.3390/jcm8030314 · Cited by 83
“However, it seems that people with a low sense of mastery over life events are more prone to brooding [32].”
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Abela, J. R., Parkinson, C., Stolow, D., & Starrs, C. (2009) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374410902851630 · Cited by 65
“For example, Nolen-Hoeksema, Larson, and Grayson (1999) found there to be an interaction between a ruminative response style and chronic stress in predicting higher levels of depressive symptoms.”
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“90) with total scores on the full Rumination Scale in an adult sample (Nolen-Hoeksema et al., 1999).”
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Cognition as predictor of current and follow-up depressive symptoms in the general population
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“A consistent finding in epidemiological research is that women are at least twice as likely as men to suffer from a unipolar depression (50, 51) and in non-clinical samples, women tend to score higher on depression scales (52, 53).”
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Preparing for problems: A measure of mental anticipatory processes
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“Ruminative thinking has been shown to predict depressive symptoms in longitudinal studies (e.g., Nolen-Hoeksema et al., 1999) and even diagnostic depressive disorders (Nolen-Hoeksema, 2000).”
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“For example, during depressed states, women are more likely to ruminate, whereas men are more likely to distract themselves.([25]) Given that rumination has been shown to influence the appraisal of the past, present, and future,([26,27]) it is likely to lead to distorted perceptions of events, including those that aro…”
Fear of Intimacy in Women: Relationship between Attachment Styles and Depressive Symptoms
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“Women also differ in response and adaptation to stress, and adolescent girls have been shown to focus more internally on stressful emotions and mental distress [21].”
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Cardiovascular Disease and Psychiatric Comorbidity: The Potential Role of Perseverative Cognition
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“Also, while women are at greater overall risk for depression, studies show that the risk is greater only for women high in trait rumination [19].”
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“Differences in rates of depression between men and women may largely be attributed to social, psychological, and environmental factors [3–6].”
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“Empirical evidence has supported the view that rumination prolongs depressed mood, even when controlling for initial levels of depression (e.g., Nolen-Hoeksema, Morrow, & Fredrickson, 1993), and studies have also suggested that tendency to ruminate predicts episodes of major depression over time, again even after cont…”
BackgroundFord-Gilboe, M., Varcoe, C., Scott-Storey, K., Wuest, J., Case, J., Currie, L. M., Glass, N., Hodgins, M., MacMillan, H., Perrin, N., et al. (2017) · BMC Public Health · doi:10.1186/s12889-017-4143-9 · Cited by 61
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“Past research employing the rumination subscale of the RSQ in a community samples of adults has demonstrated high internal consistency and test–retest reliability and has yielded mean rumination scores ranging from 37.38 (SD = 9.5) to 39.64 (SD = 10.03) in men and 40.02 (SD = 10.66) to 42.01 (SD = 10.64) in women ( No…”
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“Nolen-Hoeksema, Larson, and Grayson (1999) suggested that the tendency of young women to ruminate constitutes a vulnerability factor for depression.”
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Gender-related explanatory models of depression: A critical evaluation of medical articles
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Sense of Mastery, Social Support, and Health in Elderly Canadians
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“Prospective longitudinal studies revealed that engaging in rumination when distressed increases the risk to develop depressive disorders and may prolong periods of depression (Just and Alloy, 1997; Nolan et al., 1998; Kuehner and Weber, 1999; NolenHoeksema and Davis, 1999; Nolen-Hoeksema et al., 1999).”
Association of sleep duration and risk of mental disorder: a systematic review and meta-analysis
Zhang, J., He, M., Wang, X., Jiang, H., Huang, J., & Liang, S. (2023) · Sleep And Breathing · doi:10.1007/s11325-023-02905-1 · Cited by 71
“Females also respond and adapt differently to stress. dolescent girls tend to be more concerned with stressful emotions and mental distress [96].”
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Who Turns Green with Envy? Conceptual and Empirical Perspectives on Dispositional Envy
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“Moreover, this connection might be due to an increase in self-focused attention (Silvia & Duval, 2001), as this form of selfawareness has been shown to be linked to social comparison orientation and negative affect (Nolen-Hoeksema et al., 1999; White et al., 2006).”
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“Generally, women are more likely to engage in rumination, or passively focusing on one’s symptoms of distress and on their possible causes and consequences [55], amplifying chronic strain [56].”
BackgroundSpirituality and Depressive Symptoms in a Racially Diverse US Sample of Community-Dwelling Adults
Mofidi, M., Devellis, R., Blazer, D. G., Devellis, B., Panter, A., & Jordan, J. (2006) · Journal of Nervous and Mental Disease · doi:10.1097/01.nmd.0000243825.14449.de · Cited by 57
“On the basis of the differential demographic influences on spirituality (e.g., Shahabi et al., 2002) and depressive symptoms (e.g., Nolen-Hoeksema et al., 1999), we explored whether the relationship between spiritual experiences and depressive symptoms manifests itself differently across gen*Health…”
BackgroundKœrner, S. S., Wallace, S., Lehman, S. J., Lee, S.-A., & Escalante, K. A. (2004) · Journal of Family Psychology · doi:10.1037/0893-3200.18.1.46 · Cited by 56
Do Somatic Complaints Predict Subsequent Symptoms of Depression?
Terre, L., Poston, W. C. C., Foreyt, J., & Jeor, S. S. S. (2003) · Psychotherapy and Psychosomatics · doi:10.1159/000071897 · Cited by 57
Gender Differences in Depressive Symptoms Among Older Korean American Immigrants
Jang, Y., Kim, G., & Chiriboga, D. (2011) · Social Work in Public Health · doi:10.1080/10911350902987003 · Cited by 56
“According to gender-role and feminist theories, limited social power and status among women may contribute to their higher rates of depression (Nolen-Hoeksema et al., 1999).”
BackgroundResultSmallwood, J., Obonsawin, M. C., Baracaia, S. F., Reid, H., O’Connor, R. C., & Heim, D. (2003) · Imagination Cognition and Personality · doi:10.2190/2n80-avm3-4a23-leaj · Cited by 50
“06) indicating a relatively higher frequency of females in the high dysphoria condition [37].”
Sex and age differences in the antidepressant-like effect of fluoxetine in the forced swim test
Fernández‐Guasti, A., Olivares-Nazario, M., Reyes, R., & Martı́nez-Mota, L. (2016) · Pharmacology Biochemistry and Behavior · doi:10.1016/j.pbb.2016.01.011 · Cited by 57
“., et al., Sex and age difference .doi.org/10.1016/j.pbb.2016.0 symptom profile (American Medical Association Council on Scientific Affairs, 2006; Goodwin and Gotlib, 2004; Nolen-Hoeksema et al., 1999; Silverstein, 2002).”
InfluentialThe association between physical activity and depressive symptoms in young women: A review
Azar, D., Ball, K., Salmon, J., & Cleland, V. J. (2008) · Mental health and physical activity · doi:10.1016/j.mhpa.2008.09.004 · Cited by 49
Differences in men's and women's responses to short-term group psychotherapy
Ogrodniczuk, J. S., Piper, W., & Joyce, A. (2004) · Psychotherapy Research · doi:10.1093/ptr/kph019 · Cited by 55
Zhen, R., & Zhou, X. (2021) · Journal of Traumatic Stress · doi:10.1002/jts.22720 · Cited by 68
Anniko, M. K., Boersma, K., van Wijk, N. P. L., Byrne, D. G., & Tillfors, M. (2018) · Scandinavian Journal of Child and Adolescent Psychiatry and Psychology · doi:10.21307/sjcapp-2018-001 · Cited by 58
Birditt, K. S., Hartnett, C., Fingerman, K., Zarit, S., & Antonucci, T. (2015) · Journal of Marriage and Family · doi:10.1111/jomf.12203 · Cited by 54
The Effects of Decision-Making Style and Cognitive Thought Patterns on Negative Career Thoughts
Paivandy, S. L., Bullock, E. E., Reardon, R., & Kelly, F. (2008) · Journal of Career Assessment · doi:10.1177/1069072708318904 · Cited by 54
“More recent studies have demonstrated how this depressive thought pattern can impair problem-solving and decision-making abilities, such as the ability to make a career decision (Lyubomirsky, Tucker, Caldwell, & Berg, 1999; Nolen-Hoeksema et al., 1999; Ward et al., 2003).”
BackgroundAutonomy-Connectedness and Gender
Bekker, M., & van Assen, M. (2008) · Sex Roles · doi:10.1007/s11199-008-9447-x · Cited by 54
“For example, Bar-Tal et al. (2006) found, in an Israelian sample, identical levels of “perceived control” in men and women, in contrast to reports in terms of “mastery versus helplessness” by, for example, Nolen-Hoeksema et al. (1999).”
ResultThyme, K. E., Sundin, E., Ståhlberg, G., Lindstrom, B., Eklöf, H., & Wiberg, B. (2007) · Psychoanalytic Psychotherapy · doi:10.1080/02668730701535610 · Cited by 53
“Many studies have shown that there are clear gender differences in prevalence as well as frequency and intensity of depression (Nolen-Hoeksema et al. 1999).”
BackgroundFeldner, M. T., Leen‐Feldner, E. W., Zvolensky, M. J., & Lejuez, C. W. (2005) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/j.jbtep.2005.06.002 · Cited by 58
Lockard, A. J., Hayes, J. A., Neff, K. D., & Locke, B. D. (2014) · Journal of College Counseling · doi:10.1002/j.2161-1882.2014.00061.x · Cited by 58
Wiener, C. D., Rassier, G. T., Kaster, M. P., Jansen, K., Pinheiro, R. T., Klamt, F., Magalhães, P. V. D. S., Kapczinski, F. P., Ghisleni, G., & da Silva, R. A. (2013) · European Psychiatry · doi:10.1016/j.eurpsy.2013.05.006 · Cited by 56
“Biological and psychosocial factors have been postulated to explain these differences [35].”
BackgroundTHE COST OF THE MUSE: POETS DIE YOUNG
Kaufman, J. (2003) · Death Studies · doi:10.1080/713842357 · Cited by 53
Ricarte, J. J., Bravo, B. N., Latorre, J. M., Ros, L., & Watkins, E. R. (2016) · The Spanish Journal of Psychology · doi:10.1017/sjp.2016.46 · Cited by 50
Metadata
- Authors
- Nolen-Hoeksema, S., Larson, J., & Grayson, C.
- Venue
- Journal of Personality and Social Psychology
- Published
- 1999
- Volume
- 77
- Issue
- 5
- Pages
- 1061-1072
- ISSN
- 0022-3514 (ISSN-L)
- 1939-1315
- OpenAlex
- W2083186275
- Cited by
- 1,543
- References
- 0
- Citations by year
- 2026: 20 · 2025: 38 · 2024: 41 · 2023: 65 · 2022: 74 · 2021: 52 · 2020: 103 · 2019: 45 · 2018: 64 · 2017: 99 · 2016: 81 · 2015: 71 · 2014: 70 · 2013: 55 · 2012: 62
- FWCI
- 28.68
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Personality and Social Psychology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Mental Health (MH51817, R01MH051817)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
- Social Sciences › Gender Studies › Gender Roles and Identity Studies
- Keywords
- gender differences, depressive symptoms, rumination, chronic strain, sense of mastery, mediation, reciprocal effects, coping
- MeSH terms
- Adaptation, Psychological, Adult, Aged, California, Depression, Female, Gender Identity, Humans, Interview, Psychological, Male, Middle Aged, Models, Psychological, Negativism, Population Surveillance, Psychiatric Status Rating Scales, Sex Factors, Socioeconomic Factors, Stress, Psychological, Thinking, Sex Distribution
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