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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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Cites
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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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Items 401–500 of 1,019
Marshall, T. C., Bejanyan, K., & Ferenczi, N. (2013) · PLoS ONE · doi:10.1371/journal.pone.0075161 · Cited by 56
“Furthermore, we included the five general reflection items of the Ruminative Responses Scale [51], also adapted to measure breakup-specific reflection (e.g., ‘‘How often did you analyse your personality to try to understand why you felt the way you did about your former relationship?’’).”
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“Females are, for instance, much more likely to become depressed than males (Nolen-Hoeksema et al. 1999) but tend to experience a more benign form of PD with a later onset than males (Haaxma et al.”
BackgroundWisco, B. E., & Nolen–Hoeksema, S. (2008) · Elsevier eBooks · doi:10.1016/b978-0-08-045078-0.00010-1 · Cited by 44
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“We included only women in this study both given findings that depressive phenotypes differ between men and women (Nolen-Hoeksema et al., 1999) and to reduce error variance and improve the statistical sensitivity of our design.”
ResultMandelli, L., Nearchou, F., Vaiopoulos, C., Stefanis, C. N., Vitoratou, S., Serretti, A., & Stefanis, N. C. (2014) · Psychiatry Research · doi:10.1016/j.psychres.2014.11.001 · Cited by 53
“These findings are in line with the established notion that poor social support increases the risk for MD and depressive symptoms, particularly in women exposed to stressful life events (Goodwin and Gotlib, 2004; Nolen-Hoeksema et al., 1999).”
BackgroundResultUnwanted Pursuit Behavior After Breakup: Occurrence, Risk Factors, and Gender Differences
de Smet, O., Uzieblo, K., Loeys, T., Buysse, A., & Onraedt, T. (2015) · Journal of Family Violence · doi:10.1007/s10896-015-9687-9 · Cited by 51
Approaching dysphoric mood: State-effects of mindfulness meditation on frontal brain asymmetry
Keune, P. M., Bostanov, V., Hautzinger, M., & Kotchoubey, B. (2013) · Biological Psychology · doi:10.1016/j.biopsycho.2013.01.016 · Cited by 50
Abela, J. R. Z., Hankin, B. L., Sheshko, D. M., Fishman, M. B., & Stolow, D. (2011) · Research on Child and Adolescent Psychopathology · doi:10.1007/s10802-011-9563-x · Cited by 58
“Preliminary studies show that higher levels of rumination interact with increased levels of stress to predict elevated levels of depressive symptoms in adult samples (Nolen-Hoeksema et al. 1999) and prospectively in adolescent samples (Abela and Hankin 2011; Hankin 2009; for exception see Abela et al.”
Meaning Reconstruction in the Context of Religious Coping: Rebuilding the Shattered Assumptive World
Matthews, L. T., & Marwit, S. J. (2006) · OMEGA - Journal of Death and Dying · doi:10.2190/dkmm-b7kq-6mpd-ljna · Cited by 44
Depression in children and adolescents: Does gender make a difference?
Weller, E. B., Kloos, A. L., Kang, J. Y., & Weller, R. A. (2006) · Current Psychiatry Reports · doi:10.1007/s11920-006-0007-1 · Cited by 50
“Early exposure to these may lead to increased depression in adolescent females [27, 37 ].”
BackgroundZeng, W., Wu, X., Xu, Y., Wu, J., Zeng, Y., Shao, J., Huang, D., & Zhu, Z. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.684354 · Cited by 64
“Under negative cognitive conditions, they are more likely to produce intrusive ruminations, which can exacerbate negative emotions or depression (Nolen-Hoeksema et al., 1999) or posttraumatic stress disorder (Zhou and Wu, 2016).”
Background“Female Preponderance” of Depression in Non-clinical Populations: A Meta-Analytic Study
Wang, K., Lu, H., Cheung, E. F. C., Neumann, D. L., Shum, D., & Chan, R. C. K. (2016) · Frontiers in Psychology · doi:10.3389/fpsyg.2016.01398 · Cited by 57
“While results of several large-scale studies seem to suggest a higher level of depressive symptoms in females than males in the general population (Nolen-Hoeksema et al., 1999; Koivumaa-Honkanen et al., 2004; Aalto et al., 2012; Lopez Molina et al., 2014), consistent results are not always reported…”
Roelofs, J., Huibers, M., Peeters, F., Arntz, A., & van Os, J. (2009) · Cognitive Therapy and Research · doi:10.1007/s10608-009-9244-z · Cited by 50
“According to Nolen-Hoeksema’s response styles theory (Nolen-Hoeksema 1987, 1990, 1991; Nolen-Hoeksema et al. 1999), engaging in ruminative responses amplifies depressive symptoms and extends negative mood, while distraction dampens the symptoms.”
MethodBoursier, V., Musetti, A., Gioia, F., Flayelle, M., Billieux, J., & Schimmenti, A. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.599859 · Cited by 48
“These results thus enter in resonance with previous data showing women’s higher propensity to experience negative affect and low sense of mastery in negative circumstances, thus engaging in abstract and dysfunctional ruminative coping (66), and that female gender constitutes a risk factor for anxiety during the COVID1…”
ResultAng, S., & Malhotra, R. (2016) · Social Science & Medicine · doi:10.1016/j.socscimed.2016.02.019 · Cited by 56
The Door That Leads Into Madness: Eastern European Poets and Mental Illness
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A Writing Intervention for Negative Body Image
Earnhardt, J. L., Martz, D. M., Ballard, M. E., & Curtin, L. (2002) · Journal of College Student Psychotherapy · doi:10.1300/j035v17n01_04 · Cited by 41
“Nolen-Hoeksema, Larson, and Grayson (1999) describe the common relationship between rumination and depression, both of which are seen more frequently in women (Kessler et al., 1994; Nolen-Hoeksema, 1990; 1995; Weissman & Klerman, 1977).”
BackgroundImpact of parent–child relationship and sex on trajectories of children internalizing symptoms
Wu, C. Y., & Lee, T. S. (2019) · Journal of Affective Disorders · doi:10.1016/j.jad.2019.09.016 · Cited by 51
Diotaiuti, P., Girelli, L., Mancone, S., Corrado, S., Valente, G., & Cavicchiolo, E. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.941313 · Cited by 55
van Harmelen, A., Blakemore, S., Goodyer, I. M., & Kievit, R. (2020) · Adversity and Resilience Science · doi:10.1007/s42844-020-00027-1 · Cited by 73
Sweating the small stuff: how different types of hassles result in the experience of stress
McIntyre, K. P., Korn, J. H., & Matsuo, H. (2008) · Stress and Health · doi:10.1002/smi.1190 · Cited by 48
“Differences between males’ and females’ experience of stress due to hassles may be caused by several factors, including differences in coping strategies (Stone & Neale, 1984), emotional reactions to stressors (Almeida & Kessler, 1998), perceived control over stressors ( Nolen-Hoeksema, Larson, & Grayson, 1999 ) and ru…”
BackgroundFox, H. C., & Sinha, R. (2014) · Advances in pharmacology · doi:10.1016/b978-0-12-420118-7.00006-8 · Cited by 46
Grazzani, I., Agliati, A., Cavioni, V., Conte, E., Gandellini, S., Spagnolo, M. L., Ornaghi, V., Rossi, F. M., Cefai, C., Bartolo, P. A., et al. (2022) · Frontiers in Psychology · doi:10.3389/fpsyg.2022.801761 · Cited by 72
Polanco-Roman, L. A., Gomez, J., Miranda, R., & Jeglic, E. L. (2016) · Cognitive Therapy and Research · doi:10.1007/s10608-016-9782-0 · Cited by 55
“The Ruminative Responses scale of the Response Styles Questionnaire (RSQ; Nolen-Hoeksema et al. 1999) is a widely used assessment of rumination, or the degree to which individuals think about the causes, meanings and consequences of their negative mood.”
BackgroundMethodInfluentialKinser, P. A., & Lyon, D. (2014) · Brain and Behavior · doi:10.1002/brb3.249 · Cited by 53
“…in particular, such as temperament, inherited and epigenetic changes and dysregulated stress response systems (Nolen-Hoeksema and Girgus 1994; Nolen-Hoeksema et al. 1999; Davidson et al. 2002; Hammen 2005; Nolen-Hoeksema 2006; Halbreich and Kahn 2007; Deecher et al. 2008; Gotlib and Hammen…”
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Espinosa, F., Romero, N., & Sánchez-López, Á. (2022) · International Journal of Cognitive Therapy · doi:10.1007/s41811-022-00133-1 · Cited by 62
“Thus, a greater tendency to ruminate in girls has been postulated as a possible explanation to gender differ‐ ences found for depression symptoms, emerging during adolescence, and persisting across adulthood (Gomez‐Baya et al., 2017; Nolen‐Hoeksema et al., 1999; Ottaviani et al., 2016; Shors et al., 2017).”
BackgroundNasso, S., Vanderhasselt, M., Demeyer, I., & Raedt, R. D. (2018) · Emotion · doi:10.1037/emo0000448 · Cited by 66
The role of parental psychopathology and personality in adolescent non-suicidal self-injury
Gromatsky, M. A., Waszczuk, M. A., Perlman, G., Salis, K. L., Klein, D. N., & Kotov, R. (2016) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2016.10.013 · Cited by 66
Barnett, M. D., & Flores, J. (2016) · Personality and Individual Differences · doi:10.1016/j.paid.2016.03.026 · Cited by 51
Symptoms of Depression and Related Factors among Spanish University Students
Vázquez, F., & Blanco, V. (2006) · Psychological Reports · doi:10.2466/pr0.99.2.583-590 · Cited by 46
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More prevalent and more severe: gender differences of depressive symptoms in Chinese adolescents
Sun, Y., Zhong, Y., Sun, W., Chu, L., Long, J., & Fan, X. W. (2023) · Frontiers in Public Health · doi:10.3389/fpubh.2023.1167234 · Cited by 43
“Negative attributional strategies contribute to the development of helplessness and symptoms of depression (41), and as mentioned earlier, females face more stress as well as differences in coping styles directly linked to gender (42), including negative or biased outlooks (43).”
BackgroundSex and age‐related anxiety in a community sample of Norwegian adolescents
Leikanger, E., Ingul, J. M., & Larsson, B. S. (2011) · Scandinavian Journal of Psychology · doi:10.1111/j.1467-9450.2011.00915.x · Cited by 50
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“…research suggests that, compared with boys, girls report greater jealousy (Parker et al. 2005), depression (Hart and Thompson 1996), and rumination (Broderick 1998; Nolen-Hoeksema et al. 1999; Rose 2002; Schwartz and Koenig 1996), we anticipate that girls will be higher than boys in these areas.”
BackgroundMaladaptive coping strategies in patients with bruxism compared to non-bruxing controls
Schneider, C., Schaefer, R., Ommerborn, M., Giraki, M., Goertz, A., Raab, W., & Franz, M. (2007) · International Journal of Behavioral Medicine · doi:10.1007/bf03003001 · Cited by 45
“This is according to previous findings, demonstrating that women have more negative coping strategies than men (Weyers et al., 2005), and, respectively, that men show more problemorienting coping than women (Endler & Parker, 1990; Nolen-Hoeksema, Grayson, & Larson, 1999 ).”
ResultGender Differences in Law Enforcement Officer Stress and Coping Strategies
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“Researchers have determined that men and women experience stress in different ways, and that women are more likely to report higher levels of stress (Matud, 2004) as well as report more chronic stress than men (McDonough & Walters, 2001; Nolen-Hoeksema et al., 1999; Turner et al., 1995).”
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“It is known that women are more likely to have mild forms of anxiety and depression (Kendler et al., 2007; Nolen-Hoeksema et al., 1999).”
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September 11th related stress and trauma in New Yorkers
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“Ruminative coping has been shown to be associated with depressive symptoms (Nolen-Hoeksema et al., 1999).”
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Neurobiological Foundations of Behavioral Addictions
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How do Rumination and Social Problem Solving Intensify Depression? A Longitudinal Study
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“studies have similarly shown depressive symptoms to be significant positive predictors of subsequent rumination (Nolen-Hoeksema et al. 1999; Hasegawa et al. 2015a).”
ResultMache, S., Danzer, G., Klapp, B. F., & Groneberg, D. A. (2013) · Langenbeck s Archives of Surgery · doi:10.1007/s00423-012-1044-3 · Cited by 48
“Nolen-Hoeksema found that women tend to complain more often about their symptoms than men [44].”
BackgroundThe mental health gender-gap in urban India: patterns and narratives.
Das, J., Das, R., & Das, V. (2012) · Social Science & Medicine (1967) · doi:10.1016/j.socscimed.2012.06.018 · Cited by 43
Cognitive Vulnerabilities, Negative Life Events, and Depressive Symptoms in Young Adolescents
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“Nolen-Hoeksema et al. (1999) found that people who were more prone to ruminate reported more chronic strain over time.”
Perceived Physical Appearance Mediates the Rumination and Bulimic Symptom Link in Adolescent Girls
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“Girls begin to experience dysphoria and depression at higher rates than boys around adolescence (Hankin et al, 1998 ) and begin to engage more frequently in rumination (Nolen-Hoeksema, Larson, & Grayson, 1999 ).”
BackgroundEMPATHY, SELF-AFFIRMATION, AND FORGIVENESS: THE MODERATING ROLES OF GENDER AND ENTITLEMENT
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“One possibility is that reflecting on offenses might lead women into negative rumination (Nolen-Hoeksema et al., 1999).”
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“For example, Nolen-Hoeksema, Larson, and Grayson (1999) argued that the indirect effect from chronic strain to depressive symptoms, with rumination process as the mediator, would be stronger in women than in men.”
BackgroundSelective attention to stressful distracters: effects of neuroticism and gender
Osorio, L. C., Cohen, M., Escobar, S. E., Salkowski-Bartlett, A., & Compton, R. J. (2003) · Personality and Individual Differences · doi:10.1016/s0191-8869(02)00074-0 · Cited by 39
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“The fact that women are more likely to ruminate when in dysphoric states could explain why they are twice as likely as men to be depressed ( Ingram, Cruet, Johnson, & Wisnicki, 1988 ; Nolen-Hoeksema, Larson, & Grayson, 1999 ; Nolen-Hoeksema & Morrow, 1991 ; Nolen-Hoeksema et al, 1994 ; Wood, Saltzberg, Neale, Stone, &…”
BackgroundGender Differences in Grief Reactions following the Death of a Parent
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Feedback Models for Gambling Control: The Use and Efficacy of Online Responsible Gambling Tools
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Human Neurobiological Approaches to Hedonically Motivated Behaviors
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Davis, C., & Mason, A. E. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108632591.023 · Cited by 42
Attention Bias Test Differentiates Anxiety and Depression in Sheep
Monk, J. E., Belson, S., Colditz, I., & Lee, C. (2018) · Frontiers in Behavioral Neuroscience · doi:10.3389/fnbeh.2018.00246 · Cited by 40
State-level women’s status and psychiatric disorders among US women
McLaughlin, K., Xuan, Z.-M., Subramanian, S., & Koenen, K. (2010) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-010-0286-z · Cited by 40
“A wide range of individual-level factors have been posited to underlie these gender differences, ranging from sex differences in biological factors, including sex hormone changes during puberty [12, 13], to psychological factors including self-efficacy, stress reactivity, emotion regulation, and coping styles [12, 14,…”
BackgroundLachlan, K. A., Spence, P. R., & Nelson, L. D. (2010) · Communication Research Reports · doi:10.1080/08824090903293601 · Cited by 44
“Nolen-Hoeksema (2001; see also Nolen-Hoeksema & Girgus, 1994 ; Nolen-Hoeksema, Larson, & Grayson, 1999 ) further argued that gender differences in depressive tendencies can, to a certain degree, be accounted for by gender differences in rumination tendencies (Treynor, Gonzalez, & Nolen-Hoeksema, 2003 ).”
BackgroundDual-Task Attention Deficits in Dysphoric Mood
Rokke, P. D., Arnell, K. M., Koch, M. D., & Andrews, J. T. (2002) · Journal of Abnormal Psychology · doi:10.1037/0021-843x.111.2.370 · Cited by 40
“In addition, functional attention may be reduced by the frequent presence of self-absorbed thought, impaired distractor inhibition, or failure to initiate organizational strategies that promote the efficient use of available cognitive resources (Ellis & Ashbrook, 1988; Hertel & Rude, 1991; Ingram, 1990; Nolen-Hoeksema…”
BackgroundDoes rumination mediate the relationship between mindfulness and depressive relapse?
Kearns, N. P., Shawyer, F., Brooker, J. E., Graham, A. L., Enticott, J. C., Martin, P. R., & Meadows, G. N. (2016) · Psychology and Psychotherapy: Theory, Research and Practice · doi:10.1111/papt.12064 · Cited by 39
Calvete, E., Orue, I., & Hankin, B. L. (2015) · Journal of Social and Clinical Psychology · doi:10.1521/jscp.2015.34.3.203 · Cited by 39
Does Repetitive Negative Thinking Influence Alcohol Use? A Systematic Review of the Literature
Devynck, F., Rousseau, A., & Romo, L. (2019) · Frontiers in Psychology · doi:10.3389/fpsyg.2019.01482 · Cited by 46
“No studies included in this review have examined this issue, whereas literature on depression strongly showed that rumination was more linked to depression in women than in men (Nolen-Hoeksema, 1987; Nolen-Hoeksema et al., 1999).”
BackgroundDeb, S., McGirr, K., & Sun, J.-D. (2016) · Journal of religion and health · doi:10.1007/s10943-016-0207-x · Cited by 39
“Women are also more likely than men to experience repeated negative situations over which they have little control (Nolen-Hoeksema et al. 1999), and they are more likely than men to be aware of their emotions and may turn toward spiritual avenues more than males to vent emotional burdens.”
BackgroundRetractedFurther Evidence for the Role of Psychosocial Factors in Depression Chronicity
Nolen-Hoeksema, S. (2006) · Clinical Psychology Science and Practice · doi:10.1093/clipsy.7.2.224 · Cited by 39
Self-citationRumination and Distraction Among Chronic Depressives in Treatment: A Structural Equation Analysis
Arnow, B. A., Spangler, D. L., Klein, D. N., & Burns, D. D. (2004) · Cognitive Therapy and Research · doi:10.1023/b:cotr.0000016931.37807.ab · Cited by 38
“One difference between the studies that may account for the discrepant findings is that Nolen-Hoeksema et al. (1999) sampled from the community, whereas ours was a chronically depressed clinical sample in treatment.”
BackgroundResultInfluentialSchulte, E. M., Schiestl, E. T., & Gearhardt, A. N. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108632591.035 · Cited by 43
Murn, L. T., & Steele, M. R. (2019) · Counselling Psychology Quarterly · doi:10.1080/09515070.2019.1605334 · Cited by 53
Correlates of Depression in First-Year College Students
Villatte, A., Marcotte, D., & Potvin, A. (2017) · Canadian Journal of Higher Education · doi:10.47678/cjhe.v47i1.186429 · Cited by 45
Hill, R. M., Mellick, W., Temple, J. R., & Sharp, C. (2016) · Journal of Affective Disorders · doi:10.1016/j.jad.2016.09.007 · Cited by 38
Ruminative subtypes and impulsivity in risk for suicidal behavior
Valderrama, J., Miranda, R., & Jeglic, E. L. (2016) · Psychiatry Research · doi:10.1016/j.psychres.2016.01.008 · Cited by 43
“Rumination Rumination was assessed via the brooding and reflection subscales of the Ruminative Responses Scale (RRS; Nolen-Hoeksema et al., 1999).”
Integrated review of the social and psychological gender differences in depression
Boughton, S. G., & Street, H. (2007) · Australian Psychologist · doi:10.1080/00050060601139770 · Cited by 34
Alpizar, D., Plunkett, S. W., & Whaling, K. M. (2017) · doi:10.1037/lat0000087 · Cited by 38
The Impact of Gender on Antidepressants
Sramek, J. J., & Cutler, N. R. (2011) · Current topics in behavioral neurosciences · doi:10.1007/7854_2010_118 · Cited by 48
Fukukawa, Y., Nakashima, C., Tsuboi, S., Niino, N., Ando, F., Kosugi, S., & Shimokata, H. (2004) · The Journals of Gerontology Series B · doi:10.1093/geronb/59.1.p19 · Cited by 36
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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