Autonomy-connectedness mediates sex differences in symptoms of psychopathology
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OBJECTIVES: This study aimed to examine if autonomy-connectedness, capacity for self-governance under the condition of connectedness, would mediate sex differences in symptoms of various mental disorders (depression, anxiety, eating disorders, antisocial personality disorder). METHOD: Participants (N = 5,525) from a representative community sample in the Netherlands filled out questionnaires regarding the variables under study. RESULTS: Autonomy-connectedness (self-awareness, SA; sensitivity to others, SO; capacity for managing new situations, CMNS) fully mediated the sex differences in depression and anxiety, and partly in eating disorder -(drive for thinness, bulimia, and body dissatisfaction) and anti-social personality disorder characteristics. The mediations followed the expected sex-specific patterns. SO related positively to the internalizing disorder indices, and negatively to the anti-social personality disorder. SA related negatively to all disorder indices; and CMNS to all internalizing disorder indices, but positively to the anti-social personality disorder. CONCLUSION: Treatment of depression, anxiety, but also eating disorders and the antisocial personality disorder may benefit from a stronger focus on autonomy strengthening.
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Externalizing disorders are more commonly reported in men.
“In contrast, externalizing disorders, where distress is outwardly expressed through impulsive or aggressive behavior, are more commonly reported in men (8).”
From Where Sex Meets Gender: How Sex and Gender Come Together to Cause Sex Differences in Mental Illness (2022) · cites this paper as [8]
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Autonomy deficits as vulnerability for anxiety: evidence from two laboratory-based studies
Kunst, L. E., Maas, J., van Assen, M. A. L. M., der Heijden, W. V., & Bekker, M. H. J. (2019) · Anxiety Stress & Coping · doi:10.1080/10615806.2019.1580697 · Cited by 15 · see citing works
Maas, J., Laceulle, O. M., & Bekker, M. H. J. (2018) · Psychological Trauma Theory Research Practice and Policy · doi:10.1037/tra0000412 · Cited by 13 · see citing works
Sex/Gender Differences in Depression and Anxiety Disorders
Park, H. Y. (2024) · Springer eBooks · doi:10.1007/978-981-97-0130-8_21 · Cited by 10 · see citing works
Labots-Vogelesang, M. S., Andringa, R. K., Teunissen, D. A. M., & Lagro‐Janssen, A. L. M. (2023) · European Journal of General Practice · doi:10.1080/13814788.2023.2166033 · Cited by 9 · see citing works
Kunst, L. E., Maas, J., van Balkom, A. J. L. M., van Assen, M. A. L. M., Kouwenhoven, B., & Bekker, M. H. J. (2021) · Depression and Anxiety · doi:10.1002/da.23231 · Cited by 7 · see citing works
Development and validation of the Autonomy Scale Amsterdam
Bergamin, J., Hoven, M., van Holst, R. J., Bockting, C., Denys, D. A. J. P., Nevicka, B., & Luigjes, J. (2024) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2024.152466 · Cited by 6 · see citing works
Chen, C., Dai, C., Richardson, G. B., & Chen, W. (2021) · Measurement and Evaluation in Counseling and Development · doi:10.1080/07481756.2021.1998781 · Cited by 4 · see citing works
Kunst, L. E., Bekker, M. H. J., Maas, J., van Assen, M. A. L. M., Duijndam, S., & Riem, M. M. E. (2021) · International Journal of Psychophysiology · doi:10.1016/j.ijpsycho.2021.10.013 · Cited by 3 · see citing works
A Reconsideration of Premorbid Factors in Conversion Disorders
Stroink, L. (2023) · Psychology and Psychotherapy Research Study · doi:10.31031/pprs.2023.07.000655 · Cited by 2 · see citing works
Moleiro, C., Marto, L., Santos, J. M., & Ratinho, I. (2019) · Portugese Journal of Social Sciences · doi:10.1386/pjss_00004_1 · Cited by 2 · see citing works
Kunst, L. E., van Assen, M. A. L. M., Clouth, F. J., Hunt, C. J., Abbott, M. J., Maas, J., & Bekker, M. H. J. (2025) · Cognitive Therapy and Research · doi:10.1007/s10608-025-10604-2 · Cited by 1 · see citing works
Lagro‐Janssen, A. L. M., & Teunissen, D. A. M. (2019) · Praktische huisartsgeneeskunde · doi:10.1007/978-90-368-2409-5_5
Lagro‐Janssen, T. (2021) · Bohn Stafleu van Loghum eBooks · doi:10.1007/978-90-368-2707-2_26
Gendersensitieve huisartsgeneeskunde
Lagro‐Janssen, T., & Teunissen, D. A. M. (2021) · Bohn Stafleu van Loghum eBooks · doi:10.1007/978-90-368-2707-2_1
Tienen, C. V., Mathijssen-Struijs, N., Torrado, M. V., Bodde, N. M. G., de Lima, C. B., & van den Broek, A. H. S. (2024) · Psychology · doi:10.4236/psych.2024.156055
The Importance of Existential Questions in Patients with a Depressive Disorder: A Pilot Study
Mavrogiorgou, P., Paffrath, V. P., & Juckel, G. (2025) · Psychopathology · doi:10.1159/000548702
Bosman, N., Maas, J., van Assen, M. A. L. M., Simeunovic-Ostojic, M., & Bekker, M. H. J. (2026) · JMIR Research Protocols · doi:10.2196/87349
Jones, B., Topham, G. L., Vennum, A., Durtschi, J. A., & Kremer, K. P. (2025) · Family Relations · doi:10.1111/fare.70119
- Authors
- Bekker, M. H. J., & van Assen, M. A. L. M.
- Affiliations
- Tilburg University (NL)
- Corresponding author
- Bekker, Marrie H. J.
- ORCID
- Bekker, Marrie H. J.
- Venue
- PLoS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2017-08-03
- Volume
- 12
- Issue
- 8
- Pages
- e0181626
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC5542470
- OpenAlex
- W2743489066
- Cited by
- 23
- References
- 115
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 3 · 2023: 2 · 2022: 1 · 2021: 5 · 2020: 1 · 2019: 3 · 2018: 3 · 2015: 1
- FWCI
- 2.49
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- PLoS ONE (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- Research portal (Tilburg University) (publishedVersion, other-oa)
- PubMed (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Utrecht University Repository (Utrecht University) (submittedVersion, other-oa)
- 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 › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Keywords
- sex differences, psychopathology, depression, anxiety, eating disorders, antisocial personality disorder, self-awareness, sensitivity to others, mediation, internalizing disorders, bulimia nervosa, body dissatisfaction, drive for thinness
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Mental Disorders, Female, Humans, Male, Middle Aged, Psychopathology, Surveys and Questionnaires, Sex Characteristics, Young Adult
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