Cited by 1,474Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesChild and Adolescent Psychosocial and Emotional DevelopmentStress Responses and Cortisol

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Gender Differences in Depression

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Nolen-Hoeksema, Susan·2001·Current Directions in Psychological Science

DOI 10.1111/1467-8721.00142

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Abstract

From early adolescence through adulthood, women are twice as likely as men to experience depression. Many different explanations for this gender difference in depression have been offered, but none seems to fully explain it. Recent research has focused on gender differences in stress responses, and in exposure to certain stressors. I review this research and describe how gender differences in stress experiences and stress reactivity may interact to create women's greater vulnerability to depression.

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“Others have suggested that depression serves as an increase risk factor for sexual abuse in male and female, an indication that individuals with depressive symptoms are more likely to be forced into unwanted sexual activity (Nolen-Hoeksema, 2001).”
Background
Cultural Perspectives on Aging and Well-Being: A Comparison of Japan and the U.S.
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“Nonetheless, we also predicted that women in both cultures would report higher levels of negative affect compared to men, thus extending prior research, including international studies, on women and depressive symptoms (Nolen-Hoeksema, 2001).”
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“Women have twice as high an incidence of anxiety-like symptoms than men (Nolen-Hoeksema, 2001; Bekker and van Mens-Verhulst, 2007).”
Background
A Longitudinal Rejection Sensitivity Model of Depression and Aggression: Unique Roles of Anxiety, Anger, Blame, Withdrawal and Retribution
Zimmer‐Gembeck, M. J., Nesdale, D., Webb, H. J., Khatibi, M., & Downey, G. (2016) · Research on Child and Adolescent Psychopathology · doi:10.1007/s10802-016-0127-y · Cited by 159
“Beh = behavior Nolen-Hoeksema 2001; Rose and Rudolph 2006; ZimmerGembeck and Skinner 2008, 2011), rather than providing avenues for positive coping responses.”
Background
Psychological injury in victims of child sexual abuse: a meta-analytic review
Amado, B. G., Arce, R., & Herraiz, A. (2015) · Psychosocial Intervention · doi:10.1016/j.psi.2015.03.002 · Cited by 140
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“T hi s ar tic le is in te nd ed so le ly fo r th e pe rs on al us e of th e in di vi du al us er an d is no t to be di ss em in at ed br oa dl y. more likely to engage in rumination than males (for reviews, see Nolen-Hoeksema & Hilt, 2009; Rood et al., 2009).”
Social inequality in the prevalence of depressive disorders
Andersen, I., Thielen, K., Nygaard, E., & Diderichsen, F. (2009) · Journal of Epidemiology & Community Health · doi:10.1136/jech.2008.082719 · Cited by 136
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Background
A Test of the Tripartite Model of Anxiety and Depression in Elementary and High School Boys and Girls
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Result
Acute stress selectively reduces reward sensitivity
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“First, the study included only female participants due to sex differences in psychological and hormonal responses to stress (e.g., women demonstrate a more pronounced stress response than men; Nolen-Hoeksema and Hilt, 2009).”
Background
Betrayal trauma and gender differences in posttraumatic stress
Tang, S. S. S., & Freyd, J. J. (2012) · Psychological Trauma Theory Research Practice and Policy · doi:10.1037/a0025765 · Cited by 130
“As with PTSD and anxiety, gender differences in rates of depression begin to emerge in early adolescence (Hankin, Abramson, Moffitt, Silva, & McGee, 1998; Nolen–Hoeksema, 1990).”
Background
Social Media Use, Social Media Stress, and Sleep: Examining Cross-Sectional and Longitudinal Relationships in Adolescents
van der Schuur, W. A., Baumgartner, S. E., & Sumter, S. R. (2018) · Health Communication · doi:10.1080/10410236.2017.1422101 · Cited by 145
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“A combination of biological (e.g., hormones), psychological, and social factors (e.g., lack of control or power) are likely responsible for this difference (Nolen-Hoeksema, 2001; WHO, 2002).”
Background
Increased prevalence of depression in South Korea from 2002 to 2013
Kim, G. E., Jo, M., & Shin, Y. (2020) · Scientific Reports · doi:10.1038/s41598-020-74119-4 · Cited by 132
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Background
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“These differences may, in part, be related to environmental considerations, for example, sociocultural roles and psychological attributes [48] or hormonal factors [49].”
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“We used an alpha level of .05 for all statistical tests.”
MethodResult
Testing a Hierarchical Model of Neuroticism and Its Cognitive Facets: Latent Structure and Prospective Prediction of First Onsets of Anxiety and Unipolar Mood Disorders During 3 Years in Late Adolescence
Zinbarg, R. E., Mineka, S., Bobova, L., Craske, M. G., Vrshek-Schallhorn, S., Griffith, J. W., Wolitzky-Taylor, K., Waters, A. M., Sumner, J. A., & Anand, D. (2016) · Clinical Psychological Science · doi:10.1177/2167702615618162 · Cited by 123
“Gender is another variable related to risk for internalizing disorders with females at greater risk for UMDs (e.g., Nolen-Hoeksema & Hilt, 2009) and many ADs (e.g., Craske, 2003).”
Background
Childhood Social Withdrawal, Interpersonal Impairment, and Young Adult Depression: A Mediational Model
Katz, S. J., Conway, C., Hammen, C. L., Brennan, P. A., & Najman, J. M. (2011) · Research on Child and Adolescent Psychopathology · doi:10.1007/s10802-011-9537-z · Cited by 140
“Theorists have also posited other explanations for this gender difference, including biological factors and gender differences in coping styles ( Nolen-Hoeksema 2001 ).”
Background
The Relationship Between Latino Adolescents’ Perceptions of Discrimination, Neighborhood Risk, and Parenting on Self-Esteem and Depressive Symptoms
Behnke, A., Plunkett, S. W., Sands, T., & Bámaca‐Colbert, M. Y. (2010) · Journal of Cross-Cultural Psychology · doi:10.1177/0022022110383424 · Cited by 150
“…plethora of studies have attempted to explain the emergence of these gendered differences by exploring a number of psychosocial risk factors among European American and African American populations (e.g., Grant, Lyons, Finkelstein, Conway, & Reynolds, 2004; Nolen-Hoeksema, 2001; Rudolph, 2002).”
Background
Memory for emotional and neutral information: Gender and individual differences in emotional sensitivity
Bloise, S. M., & Johnson, M. K. (2007) · Memory · doi:10.1080/09658210701204456 · Cited by 123
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“…et al., 2005; Collignon et al., 2010), there is also evidence pointing to women’s increased vulnerability Frontiers in Psychology | www.frontiersin.org 13 December 2017 | Volume 8 | Article 1867 to affective disturbances (Nolen-Hoeksema, 2001; Kessler, 2003; Bekker and van Mens-Verhulst, 2007).”
Background
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Psychological distress in spouses of men treated for early‐stage prostate carcinoma
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Relational victimization, loneliness and depressive symptoms: Indirect associations via self and peer reports of rejection sensitivity
Zimmer-Gembeck, M. J., Trevaskis, S., Nesdale, D., & Downey, G. A. (2014) · Journal of Youth and Adolescence · doi:10.1007/s10964-013-9993-6 · Cited by 120
“Such changes include the development of more complex conceptions of the self, which can be positive or negative and begin to stabilize (Harter 2012), which may be linked to rejection sensitivity and may be one reason that depressive symptoms escalate and become more stable into adolescence (Nolen-Hoeksema 2001; Sincla…”
Background
Associations Between Childhood Learning Disabilities and Adult-Age Mental Health Problems, Lack of Education, and Unemployment
Aro, T. I., Eklund, K., Eloranta, A., Närhi, V. M., Korhonen, E., & Ahonen, T. P. S. (2018) · Journal of Learning Disabilities · doi:10.1177/0022219418775118 · Cited by 121
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“This is a relevant consideration when designing experiments for testing the efficacy of antidepressant compounds, and as women are twice as likely as men to experience depression (Nolen-Hoeksema, 2001) testing drug efficacy in both male and female preclinical models may be pertinent to potential therapeutic approaches.”
Cognitive Hypnotherapy for Depression: An Empirical Investigation
Alladin, A., & Alibhai, A. (2007) · International Journal of Clinical and Experimental Hypnosis · doi:10.1080/00207140601177897 · Cited by 145
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“these women more vulnerable to depression, particularly when they are confronted with stress (Nolen-Hoeksema, 2001).”
BackgroundInfluential
Prevalence and predictors of depression among hemodialysis patients: a prospective follow-up study
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“Moreover, the generalizability of the sample is limited such that future studies should include men as sex and gender differences have been found in relation to HRV [72], insomnia [73], and depression [74].”
Background
Stress and the Development of Cognitive Vulnerabilities to Depression Explain Sex Differences in Depressive Symptoms During Adolescence
Hamilton, J. L., Stange, J. P., Abramson, L. Y., & Alloy, L. B. (2015) · Clinical Psychological Science · doi:10.1177/2167702614545479 · Cited by 115
“Consistent with several prior studies (e.g., Mezulis et al., 2010; Nolen-Hoeksema, 2001), adolescent boys reported significantly more negative cognitive styles than girls at Time 1, whereas girls and boys reported comparable levels of negative cognitive styles by Time 3, which suggests that girls may exhibit more nega…”
Result
Psychosocial and Cultural Contributions to Depression in Women: Considerations for Women Midlife and Beyond
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“…account for any systematic gender differences in well-being outcomes—for example, that women are more likely to suffer depressive symptoms (e.g., Nolen-Hoeksema, 2001) and that relationship quality more strongly predicts married women’s happiness (Proulx, Helms, & Buehler, 2007;…”
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Background
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McIndoo, C. C., File, A. A., Preddy, T., Clark, C. G., & Hopko, D. R. (2016) · Behaviour Research and Therapy · doi:10.1016/j.brat.2015.12.012 · Cited by 111
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“We restricted our sampling to young adolescent girls to avoid the confound of sex differences on brain structure and depression vulnerability (Nolen-Hoeksema & Hilt, 2010) and because of previous findings indicating that the average age for first onset of adolescent depression is 15 years…”
Method
Leadership and Adolescent Girls: A Qualitative Study of Leadership Development
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Urban environment, physical inactivity and unhealthy dietary habits correlate to depression among elderly living in eastern Mediterranean islands: The MEDIS (MEDiterranean ISlands elderly) study
Mamplekou, E., Bountziouka, V. P., Ψαλτοπούλου, Θ., Zeimbekis, A., Tsakoundakis, N., Papaerakleous, N., Gotsis, E., Metallinos, G., Pounis, G., Polychronopoulos, E., et al. (2010) · The journal of nutrition health & aging · doi:10.1007/s12603-010-0091-0 · Cited by 108
Coping with depression and vulnerability to mania: A factor analytic study of the Nolen‐Hoeksema (1991) Response Styles Questionnaire
Knowles, R. J., Tai, S., Christensen, I. P., & Bentall, R. P. (2005) · British Journal of Clinical Psychology · doi:10.1348/014466504x20062 · Cited by 116
A qualitative investigation of depression in men.
Chuick, C. D., Greenfeld, J. M., Greenberg, S. T., Shepard, S. J., Cochran, S. V., & Haley, J. T. (2009) · Psychology of Men & Masculinity · doi:10.1037/a0016672 · Cited by 108
The moderator role of emotion regulation ability in the link between stress and well-being
Extremera, N., & Rey, L. (2015) · Frontiers in Psychology · doi:10.3389/fpsyg.2015.01632 · Cited by 132
Teaching about race/ethnicity and racism matters: An examination of how perceived ethnic racial socialization processes are associated with depression symptoms.
Liu, L. L., & Lau, A. S. (2013) · Cultural Diversity & Ethnic Minority Psychology · doi:10.1037/a0033447 · Cited by 122
The Evolution of Culturally-Variable Sex Differences: Men and Women Are Not Always Different, but When They Are…It Appears Not to Result from Patriarchy or Sex Role Socialization
Schmitt, D. P. (2014) · Evolutionary psychology · doi:10.1007/978-3-319-09384-0_11 · Cited by 111
From Child Welfare to Juvenile Justice
Goodkind, S. A., Shook, J. J., Kim, K. H., Pohlig, R. T., & Herring, D. J. (2012) · Youth Violence and Juvenile Justice · doi:10.1177/1541204012463409 · Cited by 114
“medication use is higher among boys than girls in the placement sample, when we know that girls generally have higher rates of depression (Nolen-Hoeksema, 2001).”
Background
Feasibility, Acceptability, and Effects of Gentle Hatha Yoga for Women With Major Depression: Findings From a Randomized Controlled Mixed-Methods Study
Kinser, P. A., Bourguignon, C. M., Whaley, D. E., Hauenstein, E. J., & Taylor, A. G. (2013) · Archives of Psychiatric Nursing · doi:10.1016/j.apnu.2013.01.003 · Cited by 114
“Many women with depression express frustration about the usual care, citing reasons such as inadequate symptom management, unacceptable side effects, and inadequate methods for coping (Kessler et al., 2003; Lafrance & Stoppard, 2006; S. Nolen-Hoeksema & Hilt, 2009).”
Method
Brief Report: Inter-Relationship between Emotion Regulation, Intolerance of Uncertainty, Anxiety, and Depression in Youth with Autism Spectrum Disorder
Cai, R. Y., Richdale, A. L., Dissanayake, C., & Uljarević, M. (2018) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-017-3318-7 · Cited by 107
“2011; Nolen-Hoeksema 2001).”
Gender Differences in Adolescents’ Daily Interpersonal Events and Well-Being
Flook, L. (2011) · Child Development · doi:10.1111/j.1467-8624.2010.01521.x · Cited by 104
Gender Differences in the Effects of Strain on the Delinquency of South Korean Youth
Morash, M., & Moon, B. (2007) · Youth & Society · doi:10.1177/0044118x06287861 · Cited by 104
Regret resolution, aging, and adapting to loss.
Torges, C. M., Stewart, A. J., & Nolen–Hoeksema, S. (2008) · Psychology and Aging · doi:10.1037/0882-7974.23.1.169 · Cited by 106
Self-citation
Family functioning, resilience, and depression among North Korean refugees
Nam, B., Kim, J. Y., DeVylder, J., & Song, A. (2016) · Psychiatry Research · doi:10.1016/j.psychres.2016.08.063 · Cited by 101
“(Nolen-Hoeksema, 2001; Sarmiento and Cardemil, 2009).”
Trait emotional intelligence and problematic online behaviors among adolescents: The mediating role of mindfulness, rumination, and depression
Kircaburun, K., Griffiths, M. D., & Billieux, J. (2019) · Personality and Individual Differences · doi:10.1016/j.paid.2018.11.024 · Cited by 100
The risk and protective factors associated with depression and anxiety in a national sample of Irish adolescents
Dooley, B., Fitzgerald, A., & Giollabhui, N. M. (2015) · Irish Journal of Psychological Medicine · doi:10.1017/ipm.2014.83 · Cited by 99
“Likewise, females in the present study were found to be at a greater risk for depression and anxiety in line with previous research (Lewinson et al. 1998; Nolen-Hoeksema, 2001; Twenge & Nolen-Hoeksema, 2002; Kessler et al. 2012).”
Result
I Bask in Dreams of Suicide: Mental Illness, Poetry, and Women
Kaufman, J., & Baer, J. W. (2002) · Review of General Psychology · doi:10.1037/1089-2680.6.3.271 · Cited by 91
Sleep Duration and Depressive Symptoms: A Gene-Environment Interaction
Watson, N. F., Harden, K. P., Buchwald, D., Vitiello, M. V., Pack, A. I., Strachan, E. D., & Goldberg, J. H. (2014) · SLEEP · doi:10.5665/sleep.3412 · Cited by 97
Escaping reality through videogames is linked to an implicit preference for virtual over real-life stimuli.
Deleuze, J., Maurage, P., Schimmenti, A., Nuyens, F., Melzer, A., & Billieux, J. (2019) · Journal of Affective Disorders · doi:10.1016/j.jad.2018.11.078 · Cited by 88
The Neuropsychology of Anxiety
McNaughton, N., & Gray, J. A. (2024) · doi:10.1093/oso/9780198843313.001.0001 · Cited by 99
Epidemiology of major depressive disorder in iran: a systematic review and meta-analysis.
Sadeghirad, B., Haghdoost, A. A., Amin‐Esmaeili, M., Ananloo, E. S., Ghaeli, P., Rahimi‐Movaghar, A., Talebian, E., Pourkhandani, A., Noorbala, A. A., & Barooti, E. (2010) · Europe PMC (PubMed Central) · Cited by 98
Mapping the interplay among cognitive biases, emotion regulation, and depressive symptoms
Everaert, J., Grahek, I., Duyck, W., Buelens, J., Van den Bergh, N., & Koster, E. H. W. (2017) · Cognition and Emotion · doi:10.1080/02699931.2016.1144561 · Cited by 96
“Given the gender differences in ER (e.g. Nolen-Hoeksema & Hilt, 2009), future research could investigate potential gender differences in the interplay between cognitive biases and ER difficulties.5”
Background
Network analysis of depressive symptoms in Hong Kong residents during the COVID-19 pandemic
Cheung, T. C. C., Jin, Y., Lam, S. C., Su, Z., Hall, B. J., Xiang, Y., Suen, L. K. P., Chan, S., Ho, H., Lam, H. K. B., et al. (2021) · Translational Psychiatry · doi:10.1038/s41398-021-01543-z · Cited by 100
Interpersonal Predictors of Stress Generation
Eberhart, N. K., & Hammen, C. L. (2009) · Personality and Social Psychology Bulletin · doi:10.1177/0146167208329857 · Cited by 102
A social cure in the community: A mixed‐method exploration of the role of social identity in the experiences and well‐being of community volunteers
Bowe, M., Gray, D., Stevenson, C., McNamara, N., Wakefield, J. R. H., Këllezi, B., Wilson, I., Cleveland, M., Mair, E., Halder, M., et al. (2020) · European Journal of Social Psychology · doi:10.1002/ejsp.2706 · Cited by 113
Social networks and risk for depressive symptoms in a national sample of sexual minority youth
Hatzenbuehler, M. L., McLaughlin, K. A., & Xuan, Z. (2012) · Social Science & Medicine · doi:10.1016/j.socscimed.2012.05.030 · Cited by 95
Rising rates of depression in today's society: Consideration of the roles of effort-based rewards and enhanced resilience in day-to-day functioning
Lambert, K. G. (2005) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2005.09.002 · Cited by 98
Mental Health Outcomes for Youth Living in Refugee Camps: A Review
Vossoughi, N., Jackson, Y., Gusler, S., & Stone, K. J. (2016) · Trauma Violence & Abuse · doi:10.1177/1524838016673602 · Cited by 94
“…more aggression than girls (Card, Stucky, Sawalani, & Little, 2008; Irshad & Bano, 2004), Western studies also commonly find that girls experience more internalizing symptoms, such as depression, than boys (Nolen-Hoeksema, 2001), which was not found among the populations covered in this review.”
Background
The Adolescent Mattering Experience: Gender Variations in Perceived Mattering, Anxiety, and Depression
Dixon, A. L., Scheidegger, C., & McWhirter, J. J. (2009) · Journal of Counseling & Development · doi:10.1002/j.1556-6678.2009.tb00111.x · Cited by 94
Adolescent Depressive Symptomatology and Young Adult Educational Attainment: An Examination of Gender Differences
Needham, B. L. (2009) · Journal of Adolescent Health · doi:10.1016/j.jadohealth.2008.12.015 · Cited by 94
Gender and stress: Differential psychophysiological reactivity to stress reexposure in the laboratory
Schmaus, B. J., Laubmeier, K. K., Boquiren, V. M., Herzer, M., & Zakowski, S. G. (2008) · International Journal of Psychophysiology · doi:10.1016/j.ijpsycho.2008.03.006 · Cited by 93
Depressive symptoms: how do adolescents compare with adults?
Wight, R. G., Sepúlveda, J. E., & Aneshensel, C. S. (2004) · Journal of Adolescent Health · doi:10.1016/j.jadohealth.2003.05.003 · Cited by 93
Connecting the self to traumatic and positive events: links to identity and well-being
Merrill, N. A., Waters, T. E. A., & Fıvush, R. (2015) · Memory · doi:10.1080/09658211.2015.1104358 · Cited by 93
“Females generally showed higher levels of distress, consistent with the literature on gender differences in mental health (Nolen-Hoeksema, 2001).”
Result

Authors: Nolen-Hoeksema, S.
Affiliations: Department of Psychology, University of Michigan, Ann Arbor, Michigan
Venue: Current Directions in Psychological Science
Publisher: SAGE Publications
Published: 2001-10
Volume: 10
Issue: 5
Pages: 173-176
ISSN: 0963-7214 (ISSN-L)
1467-8721
DOI: 10.1111/1467-8721.00142
OpenAlex: W2114965225
Cited by: 1,474
References: 16
Citations by year: 2026: 34 · 2025: 59 · 2024: 94 · 2023: 42 · 2022: 40 · 2021: 73 · 2020: 88 · 2019: 69 · 2018: 88 · 2017: 102 · 2016: 97 · 2015: 89 · 2014: 102 · 2013: 83 · 2012: 73
FWCI: 19.51
Type: journal article
Language: en
Open access: green
hdl.handle.net
Licence: journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
Locations: Current Directions in Psychological Science (publishedVersion)
Deep Blue (University of Michigan) (submittedVersion)
Topics: Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
Keywords: gender differences, depression, women, stress response, stress reactivity, stressors, depression vulnerability, adolescence, adulthood

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