Evaluation of Male-Specific Psychoeducation for Major Depressive Disorder Compared to Cognitive Behavioral Therapy Psychoeducation: A Randomized Controlled Investigation in Mentally Distressed Men

Background: Research suggests that male-specific psychotherapy approaches for major depressive disorder (MDD) that consider traditional masculinity ideologies (TMI) and their impact on men’s MDD may achieve improved treatment efficacy and reduced therapy dropout. However, to date, randomized controlled studies examining male-specific psychotherapy for MDD or specific therapy aspects remain lacking. Aim: To evaluate a male-specific psychoeducation for MDD in a randomized controlled investigation. Methods: An anonymous online study on men’s mental health examined 152 self-reporting mentally distressed cisgender men (Mage = 25.5 ± 9.1) from German-speaking countries of Europe. After completing baseline assessments of state self-esteem, state shame, positive/negative affect, depressive symptoms, and endorsement of TMI, men were randomly assigned to read either a male-specific (n = 78) or a cognitive behavioral therapy oriented (CBT; n = 74) psychoeducation text for MDD. Subsequently, participants rated its usefulness and completed follow-up assessments. Results: Men in the male-specific psychoeducation condition showed a decrease in shame and negative affect as compared to men in the CBT-based psychoeducation condition. Furthermore, in the male-specific psychoeducation condition an increase in prototypical depression symptoms was identified as compared to the CBT-based psychoeducation condition, whereas male-typical externalizing depression symptoms tended to decrease, although not statistically significant. The psychoeducation condition overall had no influence on TMI. Conclusion: Male-specific psychoeducation for MDD targeting TMI may help depressed men feel less ashamed about their MDD and experience less negative affect about their condition than CBT-based psychoeducation. Furthermore, male-specific psychoeducation for MDD may elicit a shift from detrimental male-typical externalizing depression symptoms to more prototypical depression symptoms, which warrants further investigations in future studies

Precarious Manhood Beliefs Are Positively Associated with Erectile Dysfunction in Cisgender Men

The notions that manhood is hard to attain, easy to lose, and needs to be proven via public action constitute precarious manhood beliefs (PMB). PMB is a new concept and it remains unclear whether and how PMB relate to erectile dysfunction (ED) in cisgender men. The ability to achieve an erection remains considered as a cornerstone of masculinity and sexual performance can be conceived as a proof of one’s masculinity. In this context, ED can be received as sexual failure and a threat to a man’s masculinity and sense of adequacy. For these reasons, the hypothesis that PMB are associated with ED warranted empirical testing. In an anonymous online survey focusing on men’s mental health conducted in German-speaking countries of Europe, 507 cisgender men (M$_{age}$ = 44.2, SD$_{age}$ = 15.2) completed measures on PMB, sexual function, self-stigma, social desirability, and conformity to traditional masculinity ideology (TMI). Multilinear regression analysis with stepwise introduction of relevant covariates evaluated potential associations between PMB and ED. Of a 507 cisgendered male sample, 63.1% reported an increased risk for ED based on previously established cutoff points. Elevated levels of PMB endorsement among the men predicted reduced sexual and erectile function in all models, even when accounting for relevant control variables such as age, education, self-stigma, social desirability, or conformity to TMI. Group comparisons revealed that the men suffering from ED showed higher levels of PMB endorsement but not self-stigma nor TMI relative to men without ED. PMB are significantly associated with ED. While determining causality will require further study, our results may support the hypothesis that higher levels of PMB endorsement may lead to increased tension to perform sexually, resulting in increased psychological pressure and a higher risk to develop ED

The Gendered Nature of AI: Men and Masculinities Through the Lens of ChatGPT and GPT4

Because artificial intelligence powered language models such as the GPT series have most certainly come to stay and will permanently change the way individuals all over the world access information and form opinions, there is a need to highlight potential risks for the understanding and perception of men and masculinities. It is important to understand whether ChatGPT or its following versions such as GPT4 are biased – and if so, in which direction and to which degree. In the specific research field on men and masculinities, it seems paramount to understand the grounds upon which these language models respond to seemingly simple questions such as "What is a man?" or "What is masculine?". In the following, we provide interactions with ChatGPT and GPT4 where we asked such questions, in an effort to better understand the quality and potential biases of the answers from ChatGPT and GPT4. We then critically reflect on the output by ChatGPT, compare it to the output by GPT4 and draw conclusions for future actions

Statistical Uncertainty in Quantitative Neutron Radiography

We demonstrate a novel procedure to calibrate neutron detection systems commonly used in standard neutron radiography. This calibration allows determining the uncertainties due to Poisson-like neutron counting statistics for each individual pixel of a radiographic image. The obtained statistical errors are necessary in order to perform a correct quantitative analysis. This fast and convenient method is applied to data measured at the cold neutron radiography facility ICON at the Paul Scherrer Institute. Moreover, from the results the effective neutron flux at the beam line is determined

Thoughts about dropping out of studies as warning sign for suicidal ideation and mental health problems in male university students

Despite increasing rates for suicidal ideation in university students, male students remain reluctant in reporting such thoughts. It is thus paramount to establish more easily detectable risk factors for male students. The present study examines study dropout thoughts as potential low-treshold risk factor as well as gender-differences in established risk patterns. A total of N = 4894 German university students (24.6% men) completed a cross-sectional online survey on their mental health at the University of Cologne. In addition to sociodemographic and questions related to university studies (e.g., dropping out of studies), the Patient Health Questionnaire D (PHQ-D) was used to assess psychological syndromes (any psychological syndrome, depressive syndrome, alcohol syndrome), life stressors and suicidal ideation. Study dropout thoughts were more prevalent among male students, while being associated with increased suicidal ideation for both genders assessed. For all outcomes, significant gender-differences were observed with financial stress and a recent bad experience being risk factors for suicidal ideation in men but not women. Relationship problems, problems at work and current psychotherapy use were positively associated with suicidal ideation in women but not in men. Thus, study dropout thoughts were associated with suicidal ideation in university students and there were male-specific risk patterns for suicidal ideation and associated mental health problems. Consequently, male university students reporting study dropout thoughts or financial stress should be screened for suicidality and mental health problems. Future prevention measures in the University context should consider study dropout thoughts and male-specific risk-patterns to increase the chances to detect male student’s suicidality and to improve the effectiveness of suicide prevention programs for men

Psychotherapists' endorsement of traditional masculinity ideologies and their assessment of gender differences in the treatment of depressive disorders

Background: Psychotherapists differ in treatment success depending on the patient’s gender, suggesting men to be a challenging patient group for many psychotherapists. On the patient’s side, traditional masculinity ideologies (TMI) have been linked to differing symptom presentation in depression, reduced psychotherapy use, poorer therapy engagement and increased risk for psychotherapy dropout. However, the association between therapists’ endorsement of TMI and their assessment of gender differences in the treatment of depressive disorders has never been investigated. Methods: A total of 438 therapists (psychological psychotherapists or psychiatrists) from Switzerland, Germany and Austria completed an online questionnaire about their endorsement of TMI and their perceived differences in psychotherapy success in female and male depression patients. Results: Most therapists indicated no difference in their perceived treatment success for depression therapy with men and women (n=283, 65%). However, the vast majority of the 155(35%) psychotherapists who reported a difference in treatment success disfavored men (n=118,27%) as compared to women (n=37, 8%). Psychotherapists who disfavored men also showed higher endorsement of TMI as compared to psychotherapists who reported no perceived gender-differences in psychotherapy success. Conclusion: Our results suggest that there might be a group of psychotherapists (high in TMI)that perceive men with depression as harder to treat than female depression patients. Previous findings on therapist effects suggest that this bias could negatively influence psychotherapy outcomes in male patients. Clinicians should recognize that endorsing TMI may bias their perception of treatment success, potentially disadvantaging male depression patients

Gender Differences in Attachment Anxiety and Avoidance and Their Association with Psychotherapy Use—Examining Students from a German University

Attachment anxiety and avoidance might explain gender differences in psychotherapy use, which is generally lower in men. In addition, university students are a particularly vulnerable group for mental health problems, and understanding psychotherapy use, especially among mentally distressed male students, is pivotal. A total of 4894 students completed an online survey answering questions regarding psychotherapy use and completing the PHQ-D identifying psychological syndromes. In addition, the ECR-RD12 was used to measure attachment anxiety and avoidance. Significant gender differences for attachment anxiety and avoidance emerged, showing higher attachment anxiety in female students and higher attachment avoidance in male students. Male students used psychotherapy significantly less than female students. Male students’ attachment anxiety and avoidance predicted psychotherapy use, while for female students, only attachment anxiety emerged as a significant predictor. Attachment anxiety is positively associated with psychotherapy use, and lower attachment anxiety in men may explain lower psychotherapy use in male students

How do traditional masculinity ideologies and emotional competence relate to aggression and physical domestic violence in cisgender men?

BackgroundMen are disproportionately often perpetrators of physical domestic violence (DV). Gender role constructs, such as traditional masculinity ideologies (TMI), are broadly accepted as an explanation for this effect. Emotional competence further constitutes an important role in TMI and the prevention of DV. However, the interactions between these constructs remains unclear.ObjectiveThe present study aims to investigate associations of TMI with aggression, DV perpetration, and emotional competence, while also examining emotional competence as a potential moderator.MethodA sample of 428 cisgender men (M$_{age}$ = 43.9 ± 15.3) from German-speaking countries in Europe completed an anonymous online survey that assessed TMI, aggression, and DV perpetration as well as alexithymia, emotion regulation, and self-compassion as indicators of emotional competence.ResultsStrong TMI were associated with high levels of aggression and overall reduced emotional competence, as reflected by high levels of alexithymia, frequent use of expressive suppression, and low levels of self-compassion. Strong conformity to TMI was associated with a higher likelihood for DV perpetration when considering relevant sociodemographic covariates. Moderation analyses revealed that expressive suppression buffered the association between TMI and DV perpetration.ConclusionMen with strong TMI report high levels of aggression and impaired emotional competence. While strong conformity to TMI was associated with more frequent perpetration of DV, higher expressive suppression seems to buffer the association between TMI and DV perpetration. The present study highlights the importance of addressing gender ideologies when working on aggression, DV perpetration and emotional competence in men

Men's Psychotherapy Use, Male Role Norms, and Male-Typical Depression Symptoms: Examining 716 Men and Women Experiencing Psychological Distress

Men as compared to women are half as often affected by depressive and anxiety disorders and seek significantly less help for mental health issues than women. Adherence to traditional male role norms (AtTMRN) may hinder men from describing prototypical depression symptoms and from seeking psychotherapy. The current study compared whether AtTMRN, gender role identity, or the experience of prototypical or male-typical externalizing mental health symptoms were associated with psychotherapy use in men and women. In an anonymous online survey, 716 participants (37% men) reporting to currently experience psychological distress were examined. Information was obtained on psychotherapy use, depression and anxiety symptoms, gender role identity, and traditional male role norms. Although experiencing similar levels of depression, men compared to women showed a reduction in psychotherapy use by 29%. Masculine role identity was directly associated with reduced psychotherapy use in men (β = -0.41, p = 0.029), whereas AtTMRN was not (men: β = -0.04, p = 0.818; women: β = -0.25, p = 0.064). Higher externalizing depression symptomatology (β = -0.68, p = 0.005), but not prototypical depression symptomatology (β = -0.02, p = 0.499), was associated with reduced psychotherapy use in men but not women (p > 0.05). Interactions revealed that men, but not women, with high AtTMRN use psychotherapy only when exhibiting elevated symptom levels. The results corroborate previous reports showing reduced psychotherapy use in men as compared to women and identify elevated masculine role identity and male-typical externalizing depression symptomatology as direct factors associated with reduced psychotherapy use in psychologically distressed men. AtTMRN interacts with mental health symptoms to predict psychotherapy use, indicating that men with high AtTMRN only use psychotherapy when exhibiting high symptomatology

Thoughts about dropping out of studies as warning sign for suicidal ideation and mental health problems in male university students

Despite increasing rates for suicidal ideation in university students, male students remain reluctant in reporting such thoughts. It is thus paramount to establish more easily detectable risk factors for male students. The present study examines study dropout thoughts as potential low-treshold risk factor as well as gender-differences in established risk patterns. A total of N = 4894 German university students (24.6% men) completed a cross-sectional online survey on their mental health at the University of Cologne. In addition to sociodemographic and questions related to university studies (e.g., dropping out of studies), the Patient Health Questionnaire D (PHQ-D) was used to assess psychological syndromes (any psychological syndrome, depressive syndrome, alcohol syndrome), life stressors and suicidal ideation. Study dropout thoughts were more prevalent among male students, while being associated with increased suicidal ideation for both genders assessed. For all outcomes, significant gender-differences were observed with financial stress and a recent bad experience being risk factors for suicidal ideation in men but not women. Relationship problems, problems at work and current psychotherapy use were positively associated with suicidal ideation in women but not in men. Thus, study dropout thoughts were associated with suicidal ideation in university students and there were male-specific risk patterns for suicidal ideation and associated mental health problems. Consequently, male university students reporting study dropout thoughts or financial stress should be screened for suicidality and mental health problems. Future prevention measures in the University context should consider study dropout thoughts and male-specific risk-patterns to increase the chances to detect male student’s suicidality and to improve the effectiveness of suicide prevention programs for men