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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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“Indeed, women’s limited perception of control has been discussed as a factor contributing to gender differences in depression (Nolen-Hoeksema et al. 1999).”
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“Whereas the existence of gender differences in depressive symptoms is well established (Nolan-Hoeksema et al., 1999), most studies from medical settings have failed to reveal significant gender differences regarding depressive symptoms according to the Hospital Anxiety and Depression Scale (Herrmann, 1997).”
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Diwan, S., Jonnalagadda, S., & Gupta, R. (2004) · doi:10.1177/0733464804270584 · Cited by 24
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“…of several large-scale studies, including evidence from the WLS, suggest a higher level of depressive symptoms in females than males in the general population (Aalto et al., 2012; KoivumaaHonkanen et al., 2004, Lopez Molina et al., 2014, MacLean and Hauser, 2000, Nolen-Hoeksema et al., 1999).”
Understanding associations between rumination and inflammation: A scoping review
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“Many reasons have been given for the higher rate of major depression in women, but none seems to fully explain it (Nolen-Hoeksema et al., 1999; Cahill, 2005; Altemus, 2006; Nes et al., 2007; Pohl et al., 2007).”
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“Nonetheless, previous studies have found that women tend to ruminate more than men, a finding that has been linked to gender differences in depressive symptoms (Nolen-Hoeksema et al., 1999).”
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“This coping strategy has been found to account for gender differences in depression ( Nolen-Hoeksema et al. 1999 ).”
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“This is probably because women are more likely to experience strain, to have a low sense of mastery, and to engage in ruminative coping [37].”
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Negative mood mind wandering and unsafe driving in young male drivers
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Gender Differences in Coping, Depression, and Anxiety in Patients with Non-Metastatic Lung Cancer
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“The use of a coping style is a reaction to stress and represents a focal parameter that directly contributes to the pathogenesis of depression and anxiety amongst women.(61,62) Although coping approaches that belong to the avoidant category – in handling stressful circumstances with secondary appearance of depression/…”
BackgroundHodges, T. E., Lee, G. Y., Noh, S. H., & Galea, L. A. M. (2022) · Neurobiology of Stress · doi:10.1016/j.ynstr.2022.100458 · Cited by 21
“Cognitive symptoms of MDD such as negative cognitive bias (the perception of ambiguous stimuli as negative) and rumination (repetitive negative thinking) are more common in females than in males (Kornstein et al., 2000; Mansour et al., 2006; Nolen-Hoeksema et al., 1999; Silverstein, 1999).”
Investigating COVID‐19 stress and coping: Substance use and behavioural disengagement
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“While men use substances more to cope with stress, anxiety symptoms are more common in women (Nolen-Hoeksema et al., 1999).”
BackgroundInfluentialLu, W., Pai, M., Scholes, S., & Xue, B. (2021) · Journal of Affective Disorders · doi:10.1016/j.jad.2021.07.012 · Cited by 22
“Gender differences also exist in terms of coping, with women relying on emotion-focused coping that includes ruminating whereas men employ problem-focused strategies (Nolen-Hoeksema, Larson, and Grayson 1999).”
Umegaki, Y., Nakagawa, A., Watkins, E. R., & Mullan, E. (2021) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2021.01.003 · Cited by 20
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“First, the stress and strain hypotheses posit that women experience greater stress and strain over their lives that, in turn, causes greater symptom reports (Nolen-Hoeksema et al., 1999), consistent with minority stress models.”
BackgroundMillon, E. M., Chang, H. Y. M., & Shors, T. J. (2018) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2018.00311 · Cited by 26
“Rumination is considered a risk factor for depression, in part because women tend to ruminate more than men do and are more often diagnosed with depression (75, 76).”
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“– Ruminative Response Scale (RRS) [51, 52].”
InfluentialWisco, B. E., Gilbert, K., & Marroquín, B. M. (2014) · Journal of Experimental Psychopathology · doi:10.5127/jep.038213 · Cited by 26
Rumination, gender, and depressive symptoms associated with caregiving strain in bipolar disorder
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“Both depression (9) and ruminative style (10, 11) are more prevalent among women than among men.”
BackgroundResultPerceived Control and Emotional Status in Abusive College Student Relationships
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“A common difficulty in interpreting data from samples at high risk for dysphoria is that women are more likely to report dysphoria than men (Nolen-Hoeksema et al., 1999).”
BackgroundPublic health context of women's mental health research
Blehar, M. C. (2003) · Psychiatric Clinics of North America · doi:10.1016/s0193-953x(03)00039-x · Cited by 22
“There is evidence that women respond more than men to stressful life events with a cognitive style that prolongs negative emotions and increases risk for depression [18].”
BackgroundChurch Attendance in the United States
Chaves, M. A., & Stephens, L. (2003) · Cambridge University Press eBooks · doi:10.1017/cbo9780511807961.007 · Cited by 30
Donato, K. M., León-Pérez, G., Wallston, K. A., & Kripalani, S. (2018) · Journal of Health and Social Behavior · doi:10.1177/0022146518789362 · Cited by 22
“For studies addressing gendered effects of familial roles, see Waite (1995); Cross and Madson (1997); Bird (1999); Nolen-Hoeksema, Larson, and Grayson (1999); and Kiecolt-Glaser and Newton (2001).”
BackgroundWu, Y., Bai, Y., Liu, X., Xu, W., & Liu, Y. (2025) · Cyberpsychology Behavior and Social Networking · doi:10.1089/cyber.2024.0442 · Cited by 23
“73 Short-form video platforms consist of other people ’ s carefully curated “ ideal ” lives, and female adolescents negatively compare themselves with others and focus more on the information that threatens their self-worth.”
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“Healthy young adults tend to self-report RRS scores of approximately 42–44, women with sexual violence history tend to report RRS scores of approximately 54, and depressed individuals tend to report RRS scores of approximately 60 (Millon et al., 2018; Nolen-Hoeksema et al., 1999; Shors et al., 2017).”
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“Differences between Suicide Ideators and Non-Ideators (assessed at 6- month follow up) on Study Measures Group Current Suicide Ideators Non-Ideators (n = 13) (n = 37) Measures M (SD) p d ETI ETI Total 1 11.31 (4.53) 10.78 (4.85) 0.74 0.11 RRS Brooding 2* 14.92 (3.95) 12.16 (3.80) 0.05 0.71 Reflection 2* 14.08 (3.35) 1…”
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“, perceived lower mastery over life events, increased chronic stress; [76]), as well as other empirical evidence that rumination tends to influence affect, cognition, and behavior primarily for females [15,77,78].”
BackgroundExemplification effects: responses to perceptions of risk
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“…because this research also argues that women are more likely than men to experience these ruminative patterns when exposed to a risk, and to use rumination as a coping strategy when presented with distressing information (Nolen-Hoeksema and Girgus 1994; Nolen-Hoeksema, Larson, and Grayson 1999).”
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“Women are more prone to depression and this could be explained by gender roles and norms attached to those roles [3].”
BackgroundDepressive Symptoms After Trauma: Is Self-Esteem a Mediating Factor?
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“…relationship between life events and depression (i.e., negative self-schemas, Beck, 1967, 1976; attribution style, Metalsky et al, 1993; rumination, Nolen-Hoeksema and Morrow, 1991; rumination and social support, Nolen-Hoeksema and Davis, 1999; rumination and mastery, Nolen-Hoeksema et al, 1999).”
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“Investigation of the model’s equivalence for gender was done in the context of observed gender differences for most of the constructs in the model: women report more stressors, more rumination, less mastery, higher levels of depressive symptoms (Nolen-Hoeksema et al., 1999), and more social support as compared to men.”
Mood and Sex of Participant in Perception of Happy Faces
Killgore, W. D. S., & Cupp, D. W. (2002) · Perceptual and Motor Skills · doi:10.2466/pms.2002.95.1.279 · Cited by 19
“In particular, depressed women tend to use more verbal processing strategies and are more Uely to ruminate, whereas men tend to rely on distraction and physical activity to cope with feelings of depression (31, 32).”
BackgroundResultSexism and antisemitism as experienced by canadian jewish women: Results of a national study
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Self-citationSex Steroid Hormones in Depressive Disorders as a Basis for New Potential Treatment Strategies
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Bao, C., Lv, J., Chen, J., Wei, G.-Z., Liu, N., Wang, Y., Ding, Z., Liu, W., Li, X., Cao, H., et al. (2022) · Ecotoxicology and Environmental Safety · doi:10.1016/j.ecoenv.2022.113313 · Cited by 23
Neural correlates of mindful emotion regulation in high and low ruminators
Rosenbaum, D., Kroczek, A., Hudak, J., Rubel, J. A., Maier, M. J., Sorg, T., Weisbender, L., Goldau, L., Mennin, D. S., Fresco, D. M., et al. (2020) · Scientific Reports · doi:10.1038/s41598-020-71952-5 · Cited by 22
Zhen, R., Quan, L.-J., & Zhou, X. (2020) · Journal of Health Psychology · doi:10.1177/1359105318763505 · Cited by 18
“Other studies have found that female sex is a risk factor of PTSD (e.g. Brewin, 2005; Brewin et al., 2000) and depression (e.g. Litofsky and Resnick, 2009), due to a tendency to engage in rumination when distressed (e.g. Nolen-Hoeksema et al., 1999).”
BackgroundMediators of gender effects on depression among cardiovascular disease patients in Palestine
Allabadi, H., Probst-Hensch, N. M., Alkaiyat, A. S., Haj‐Yahia, S., Schindler, C., Kwiatkowski, M., & Zemp, E. (2019) · BMC Psychiatry · doi:10.1186/s12888-019-2267-4 · Cited by 17
Understanding depressive symptoms through psychological traits and physiological stress reactivity
Määttänen, I., Martikainen, J., Henttonen, P., Väliaho, J., Thibault, M., & Palomäki, J. (2019) · Cogent Psychology · doi:10.1080/23311908.2019.1575654 · Cited by 18
Rivera, E. A., Sullivan, C. M., Zeoli, A. M., & Bybee, D. I. (2016) · Journal of Interpersonal Violence · doi:10.1177/0886260516629391 · Cited by 30
Frandsen, L. S., Villumsen, L. B., Hjorth, C. F., Nielsen, B. J., Ullits, L. R., Torp-Pedersen, C. T., Bøggild, H., & Overgaard, C. (2016) · BMC Psychiatry · doi:10.1186/s12888-016-0893-7 · Cited by 17
“This is in line with studies showing that women more often report depressive symptoms compared to men [45–47] and thus also relevant to our study, that focuses on mental health, where depressive symptoms are a part of [4].”
ResultCristea, I., Matu, S., Tatar, A. S., & David, D. (2013) · Anxiety, Stress, & Coping · doi:10.1080/10615806.2012.725469 · Cited by 18
Trait Rumination Is Associated with Enhanced Recollection of Negative Words
Kuo, J. R., Edge, I., Ramel, W., Edge, M. D., Drabant, E. M., Dayton, W. M., & Gross, J. (2011) · Cognitive Therapy and Research · doi:10.1007/s10608-011-9430-7 · Cited by 18
“Women were targeted because they are twice as likely as men to develop affective disorders and because they are more likely than men to display ruminative tendencies (Nolen-Hoeksema et al. 1999).”
한국판 반추적 반응 척도(K-RRS)의 확인적 요인분석
김, 소., 권, 정., 양, 은., 김, 지., 유, 범., & 이, 동. (2010) · doi:10.15842/kjcp.2010.29.1.001001 · Cited by 18
Gendering late-life depression? The coping process in a group of elderly men
Jensen, H. V., Munk, K. P., & Madsen, S. A. (2010) · Nordic Psychology · doi:10.1027/1901-2276/a000011 · Cited by 18
The Impact of Ruminative Processing on the Development of Intrusive Memories
Williams, A. D., & Moulds, M. L. (2007) · Behaviour Change · doi:10.1375/bech.24.2.55 · Cited by 18
The Sociology of Religion in Late Modernity
Dillon, M. (2003) · Cambridge University Press eBooks · doi:10.1017/cbo9780511807961.001 · Cited by 21
Grant, K. E., Finkelstein, J.-A. S., & Lyons, A. L. (2003) · American Journal of Community Psychology · doi:10.1023/a:1023034906393 · Cited by 18
“of others, to value interpersonal relationships, and to avoid conflict (Char & McDermott, 1987; Gilligan 1982; Jones & Costin, 1995; Jordan, Kaplan, Miller, Stiver, & Surrey, 1991; Nolen-Hoeksema & Girgus, 1994; Nolen-Hoeksema, Larson, & Grayson, 1999 ).”
Religion and the New Immigrants
Ebaugh, H. R. (2003) · Cambridge University Press eBooks · doi:10.1017/cbo9780511807961.017 · Cited by 205
Bętkowska-Korpała, B., Pastuszak-Draxler, A., Olszewska-Turek, K., Sikora-Zych, K., Epa, R., & Starowicz-Filip, A. (2022) · BMC Medical Education · doi:10.1186/s12909-022-03432-5 · Cited by 17
How personality affects reaction. A mental health behavioral insight review during the Pandemic
Mourelatos, E. (2021) · Current Psychology · doi:10.1007/s12144-021-02425-9 · Cited by 27
The acute effects of alcohol on state rumination in the laboratory
Mollaahmetoğlu, Ö. M., Palmer, E., Maschauer, E. L., Nolan, M. C., Stevens, T., Carlyle, M., Hardy, L., Watkins, E. R., & Morgan, C. J. A. (2021) · Psychopharmacology · doi:10.1007/s00213-021-05802-1 · Cited by 21
“This is in line with the Response Style Theory account of rumination (NolenHoeksema 2000; Nolen-Hoeksema et al. 1999) and with previous literature demonstrating that rumination amplifies existing negative affective states such as depression, anxiety, sad or angry mood; however it does not impact…”
ResultRabelo, V. C., Holland, K. J., & Cortina, L. M. (2019) · Psychology of Violence · doi:10.1037/vio0000166 · Cited by 17
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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