Longitudinal sex differences of externalising and internalising depression symptom trajectories : Implications for assessment of depression in men from an online study

Journal article


Rice, Simon M., Fallon, Barry J., Aucote, Helen M., Möller-Leimkühler, AnneMaria, Treeby, Matt S. and Amminger, G. Paul. (2015). Longitudinal sex differences of externalising and internalising depression symptom trajectories : Implications for assessment of depression in men from an online study. International Journal of Social Psychiatry. 61(3), pp. 236-240. https://doi.org/10.1177/0020764014540149
AuthorsRice, Simon M., Fallon, Barry J., Aucote, Helen M., Möller-Leimkühler, AnneMaria, Treeby, Matt S. and Amminger, G. Paul
Abstract

Background:
Clinical reports indicate that men tend to engage in a range of externalising behaviours in response to negative emotional states. Such externalising behaviours have been theorised to reflect a male sub-type of depression that is inconsistent with current diagnostic criteria, resulting in impeded detection and treatment rates of depressed men.

Aims:
In addressing previous study design limitations, this article presents self-report longitudinal data for the multidimensional Male Depression Risk Scale (MDRS-22) against ratings of diagnostic criteria for major depressive disorder as assessed by the Patient Health Questionnaire–Depression Module (PHQ-9). Longitudinal psychometric properties of the MDRS-22 are reported and symptom trajectories described.

Method:
A sample of 233 adults (males = 125; 54%) completed measures of externalising and prototypic depression symptoms at Time 1, and again at Time 2 (15 weeks later). Psychometric properties were examined and within-subjects analyses undertaken.

Results:
The MDRS-22 demonstrated stable internal consistency and test–retest correlations equivalent to those observed for the PHQ-9. Both prototypic and externalising depression symptoms increased with experiences of recent negative life events. Marked gender differences were observed. Males experiencing ≥ 2 stressful negative life events reported significantly higher MDRS-22 scores at both Time 1 and Time 2 relative to comparable females.

Conclusion:
Findings contribute to the validity of the MDRS-22 as a measure of externalising depression symptoms. Results suggest that while both males and females experience externalising depression symptoms, these symptoms may be particularly elevated for men following experiences of negative life events. Findings suggest that externalising symptoms may be a special feature of depression for men. Given the problematic nature of such externalising symptoms (e.g. excessive substance use, aggression, risk-taking), their clinical assessment appears warranted.

Keywordsdepression; externalising symptoms; psychometric; sex differences; men
Year2015
JournalInternational Journal of Social Psychiatry
Journal citation61 (3), pp. 236-240
PublisherSAGE Publications
ISSN0020-7640
Digital Object Identifier (DOI)https://doi.org/10.1177/0020764014540149
Scopus EID2-s2.0-84929174140
Page range236-240
FunderAustralian Postgraduate Award, Australian Goverment
Publisher's version
License
All rights reserved
File Access Level
Controlled
Output statusPublished
Publication dates
Online29 Jun 2014
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