Conceptualizing men: A transdiagnostic model of male distress

Article · March 2012with12 Reads
DOI: 10.1111/j.2044-8341.2011.02017.x · Source: PubMed
This review aims to produce a comprehensive, parsimonious, and empirically based model of male psychological distress from the perspective of cognitive behaviour therapy (CBT) that may apply in the majority of clinical situations involving men in Britain and possibly elsewhere. This paper reviews studies that pertain to male psychological distress. Studies are selected via examination of the literatures around men's psychological health. Criteria for inclusion of studies are direct and indirect relevance to male distress. Studies are examined on the basis of their possible contribution to a comprehensive yet critical model of male functioning, and are grouped according to their neurological, developmental, and cultural origins. The review suggests that certain factors inform the psychological presentation of males across disorders, and can help predict therapy-interfering behaviours and outcomes. A transdiagnostic model of male distress emerges from existing data and theory containing the hypothesized reflection abandonment mechanism (RAM) that helps account for characteristic male externalizing and therapy-interfering behaviours. Existing data and theory can be synthesized to produce a cognitive behavioural model of male distress that adds value to case conceptualizations regardless of the disorder involved, and has predictive value regarding men's access to and engagement with psychological services.
  • [Show abstract] [Hide abstract] ABSTRACT: Since the introduction of specified diagnostic criteria for mental disorders in the 1970s, there has been a rapid expansion in the number of large-scale mental health surveys providing population estimates of the combined prevalence of common mental disorders (most commonly involving mood, anxiety and substance use disorders). In this study we undertake a systematic review and meta-analysis of this literature. We applied an optimized search strategy across the Medline, PsycINFO, EMBASE and PubMed databases, supplemented by hand searching to identify relevant surveys. We identified 174 surveys across 63 countries providing period prevalence estimates (155 surveys) and lifetime prevalence estimates (85 surveys). Random effects meta-analysis was undertaken on logit-transformed prevalence rates to calculate pooled prevalence estimates, stratified according to methodological and substantive groupings. Pooling across all studies, approximately 1 in 5 respondents (17.6%, 95% confidence interval:16.3-18.9%) were identified as meeting criteria for a common mental disorder during the 12-months preceding assessment; 29.2% (25.9-32.6%) of respondents were identified as having experienced a common mental disorder at some time during their lifetimes. A consistent gender effect in the prevalence of common mental disorder was evident; women having higher rates of mood (7.3%:4.0%) and anxiety (8.7%:4.3%) disorders during the previous 12 months and men having higher rates of substance use disorders (2.0%:7.5%), with a similar pattern for lifetime prevalence. There was also evidence of consistent regional variation in the prevalence of common mental disorder. Countries within North and South East Asia in particular displayed consistently lower one-year and lifetime prevalence estimates than other regions. One-year prevalence rates were also low among Sub-Saharan-Africa, whereas English speaking counties returned the highest lifetime prevalence estimates. Despite a substantial degree of inter-survey heterogeneity in the meta-analysis, the findings confirm that common mental disorders are highly prevalent globally, affecting people across all regions of the world. This research provides an important resource for modelling population needs based on global regional estimates of mental disorder. The reasons for regional variation in mental disorder require further investigation.
    Article · Mar 2014
  • [Show abstract] [Hide abstract] ABSTRACT: If the principal function of health services is to keep people alive and well, then the disproportionately high male suicide rate alone suggests that the needs of men are not being optimally served. Picking up on the theme set out by Linda Morison and colleagues in the previous article of this special feature, it is argued that health services for men can be improved if gender awareness is incorporated into their design, promotion, and implementation.
    Article · Jun 2014