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

A elaboração de mapas mentais: estudo da influência da Avenida Brasil no desenvolvimento urbano da cidade de Passo Fundo/RS

A Avenida Brasil pode ser representada de várias formas, uma delas é a característica de ser um eixo central com “ponto de partida e de chegada”, da cidade de Passo Fundo, no Estado do Rio Grande do Sul. O desenho do seu trajeto representa uma grande avenida com topografia suave e ondulada.  Os seus canteiros trazem à memória, a cada trecho percorrido, uma linearidade da via pela qual a cidade é observada em suas formas, em suas cores, em seus movimentos, em suas sensações e luzes. Metodologicamente, buscou-se representar de maneira perceptiva o espaço analisado, que servirá como uma ferramenta de apoio na estruturação do território e no desenvolvimento urbano, dessa forma, servindo de base para urbanistas, geógrafos, arquitetos e gestores. Os resultados mostraram que a Avenida Brasil torna-se um forte elemento de análise, podendo caracterizá-la como eixo ordenador da cidade de Passo Fundo/RS. Palavras-chave: Percepção Ambiental, Planejamento Urbano, Ambiente Geográfico

Male depression risk, psychological distress, and psychotherapy uptake: Validation of the German version of the male depression risk scale

Background Screening for depressive disorders in men may be complicated by traditional male role norms. The Male Depression Risk Scale (MDRS) was developed to aid screening for depression in men adhering to traditional male role norms and to facilitate identification of depression in men in general and to promote treatment uptake. Aims Validation of a German version of the MDRS and examination of its potential to predict clinical characteristics. Methods In an anonymous online survey comprising of 1605 participants (male: N = 671; 42%), information was obtained on psychological distress, diagnosed psychological disorders, psychotherapy and psychopharmacological treatment. Additional measures included a German version of the MDRS as further mental-health-related constructs. Results The German version of the MDRS showed good validity and reliability. The previously identified 6-factor structure could be replicated for the German version. Compared to the Patient Health Questionnaire 9, the MDRS showed similar detection performance in identifying men who self-reported psychological distress, psychological disorders, depression, psychotherapy usage, or usage of psychopharmacological therapy. Conclusions The German version of the MDRS shows good psychometric validity and represents a valid screening instrument for the identification of psychological distress specifically in men

Status loss due to COVID-19, traditional masculinity, and their association with recent suicide attempts and suicidal ideation

The COVID-19 pandemic is causing extensive job loss leading to a loss of social status in many men. Endorsement of traditional masculinity ideology may render some men particularly sensitive to status loss and thereby to an increased risk for suicidality. In this anonymous online survey conducted in German-speaking European countries, 490 men completed questionnaires regarding loss of social status due to the COVID-19 pandemic, past-month and lifetime suicide attempt and suicidal ideation. Furthermore, endorsement of traditional masculinity ideology and prototypical and male-typical externalizing depression symptoms were measured. Out of a total of 490 men, 14.7% of men reported experiencing status loss due to the pandemic. These men were more than four times as likely to have attempted suicide in the past month (OR = 4.48, 95% CI [1.72, 11.67]) and more than twice as likely to report suicidal ideation during the past 2 weeks (OR = 2.47, 95% CI [1.42, 4.28]), than men not reporting status loss. Status loss, but not endorsement of traditional masculinity ideology, was associated with suicide outcomes. However, when male-typical externalizing depression symptoms and prototypical depression symptoms were included in the models, they exhibited the only direct associations with suicide outcomes (e.g., for past-month suicide attempt: male-typical externalizing depression symptoms OR = 2.18, 95% CI [1.31, 3.62], prototypical depression symptoms OR = 2.41, 95% CI [1.13, 5.12]). A significant interaction between status loss and endorsement of traditional masculinity ideology further suggests an enhancing moderating effect of traditional masculinity on the relationship between status loss and past-month suicide attempts (OR = 3.27, 95% CI [1.16, 9.27]). Status loss due to the COVID-19 pandemic emerges as risk factor for suicide in men. Men who experience status loss due to the COVID-19 pandemic while concomitantly exhibiting strong endorsement of traditional masculinity ideology have an additional increased risk of suicide

Psychosocial factors promoting resilience during the menopausal transition

Despite significant biological, psychological, and social challenges in the perimenopause, most women report an overall positive well-being and appear to be resilient to potentially negative effects of this life phase. The objective of this study was to detect psychosocial variables which contribute to resilience in a sample of perimenopausal women. A total of 135 healthy perimenopausal women aged 40-56 years completed a battery of validated psychosocial questionnaires including variables related to resilience, well-being, and mental health. First, using exploratory factor analysis, we examined which of the assessed variables related to resilience can be assigned to a common factor. Second, linear regression analyses were performed to investigate whether a common resilience factor predicts well-being and mental health in the examined sample of women. Optimism (LOT-R-O), emotional stability (BFI-K-N), emotion regulation (ERQ), self-compassion (SCS-D), and self-esteem (RSES) in perimenopausal women can be allocated to a single resilience-associated factor. Regression analyses revealed that this factor is related to higher life satisfaction (SWLS; β = .39, p < .001, adj. R$^{2}$ = .20), lower perceived stress (PSS-10; β = - .55, p < .001, adj. R$^{2}$ = .30), lower psychological distress (BSI-18; β = - .49, p < .001, adj. R$^{2}$ = .22), better general psychological health (GHQ-12; β = - .49, p < .001, adj. R$^{2}$ = .22), milder menopausal complaints (MRS II; β = - .41, p < .001, adj. R$^{2}$ = .18), and lower depressive symptoms (ADS-L; β = - .32, p < .001, adj. R$^{2}$ = .26). The α levels were adjusted for multiple testing. Our findings confirm that several psychosocial variables (optimism, emotional stability, emotion regulation, self-compassion, and self-esteem) can be allocated to one common resilience-associated factor. This resilience factor is strongly related to women's well-being as well as mental health in perimenopause

Steroid Hormone Secretion Over the Course of the Perimenopause: Findings From the Swiss Perimenopause Study

Background: Perimenopause is characterized by a decline in the steroid hormones, estradiol, and progesterone. By contrast, the steroid hormone cortisol, a marker of the hypothalamic-pituitary-adrenal (HPA) axis, increases. Recent longitudinal studies reported fluctuations in steroid hormone levels during perimenopause, and even increases in estradiol levels. To understand these confounding results, it is necessary to conduct a longitudinal, highly standardized assessment of steroid hormone secretion patterns in perimenopausal women. Methods: This longitudinal study investigated 127 perimenopausal women aged 40-56 years for 13 months. Estradiol, progesterone, and cortisol were assessed using saliva samples, which were collected for two (during months 2 and 12 for estradiol and progesterone) or three (during months 2, 7, and 12 for cortisol) non-consecutive months over the course of the study. A total of 14 saliva samples per participant were analyzed to investigate the courses of estradiol and progesterone. Cortisol awakening response and fluctuations of cortisol throughout the day were measured using a total of 11 saliva samples per participant (on awakening, +30 min, +60 min, at 12:00 p.m., and before going to bed) for months 2, 7, and 12. Results: Multilevel analyses revealed variance in intercept and slope across participants for estradiol [intercept: SD = 5.16 (95% CI: 4.28, 6.21), slope: SD = 0.50 (95% CI: 0.39, 0.64)], progesterone [intercept: SD = 34.77 (95% CI: 25.55, 47.31), slope: SD = 4.17 (95% CI: 2.91, 5.99)], and cortisol (intercept: SD = 0.18 (95% CI: 0.14, 0.23), slope: SD = 0.02 (95% CI: 0.01, 0.02)]. Time predicted cortisol levels [b = -0.02, t (979) = -6.63, p < 0.0001]. Perimenopausal status (early vs. late) did not predict estradiol [b = -0.36, t (1608) = -0.84, p = 0.400], progesterone [b = -4.55, t (1723) = -0.87, p = 0.385], or cortisol [b = 0.01, t (1124) = 0.61, p = 0.542] scores over time. Discussion: Our results are consistent with previous findings emphasizing highly individual fluctuations of estradiol and progesterone levels during perimenopause. However, our findings do not suggest a continuous decline during the observed transition phase, implying relatively stable periods of fluctuating hormone levels. Furthermore, given the lack of significant group differences, it may not be necessary to differentiate between early and late perimenopause from the standpoint of hormonal progression. Keywords: hormone fluctuations; menopausal transition; perimenopause; sex steroids; steroid hormones

Prior depression affects the experience of the perimenopause - findings from the Swiss Perimenopause Study

BACKGROUND: There is a prevalence peak of depression in the perimenopause, with this reproductive phase being considered a window of vulnerability due to major biopsychosocial changes. Depression has been associated with physical and psychosocial impairment. Prior depression has been shown to be a risk factor for the development of several somatic and mental diseases. We assume that women with prior depression will exhibit increased burdensome symptoms in the perimenopause compared to women without prior depression. METHODS: A total of 135 perimenopausal women aged 40-56 years participated in the longitudinal Swiss Perimenopause Study. For the purpose of this investigation, a cross-sectional design was chosen. A wide range of validated psychosocial questionnaires were used to compare women with and without prior depression regarding their experience of the perimenopause. Findings were statistically adjusted for multiple testing. RESULTS: Women with prior depression showed significantly more depressive symptoms (U = 1215.5, p < .01), more menopausal symptoms (U = 1395.0, p < .01), and more sleep disturbances (U = 1583.5, p < .05) than women without prior depression. Moreover, women with a history of depression reported lower subjective mental health (U = 1573.0, p <  05) and felt more isolated (U = 1524.0, p < .05) than those without prior depression. LIMITATIONS: Self-report data may affect the results. Furthermore, due to the cross-sectional design, causality cannot be inferred. CONCLUSIONS: Prior depression affects women's experience of the perimenopause. Women with prior depression exhibit significantly more negative health outcomes in the perimenopause than those without prior depression

Andromind Self-Test (AST)

The primary aim of the anonymous online study is to facilitate a self-assessment of individual mental well-being through a specialized self-test hosted on the Andromind.ch platform. This platform is a dedicated online resource specifically designed to promote and support men's mental health, providing vital tools and resources tailored to their unique needs. Unlike other self-tests commonly available for depression screening, the self-test on Andromind.ch is uniquely focused on men. It incorporates male-specific instruments, such as the Male Depression Risk Scale, to capture the symptom profiles typically seen in men. These tools have been calibrated to recognize and assess symptoms that may manifest differently in men, offering a more accurate and relevant insight into male mental health. A significant objective of this study is to offer men who may be under mental strain an opportunity to gain a comprehensive understanding of their own mental health condition. Those who utilize the self-test on the Andromind.ch webpage will receive feedback on a wide array of symptoms. This information can then be used as a solid foundation for deciding whether to seek therapy or not and help them identify possible points of contact or resources to support their mental health. The self-test explores various facets of mental health. Alongside the traditional areas such as depression, anxiety, trauma, suicidality, and alcohol or drug use, it also delves into aspects of mental health like aggression and violence, and sexual function. This comprehensive approach ensures that the feedback provided to the individuals covers a broad spectrum of their current situation, allowing for a nuanced understanding of their mental health status. While providing invaluable personal insights to individuals, this study also serves a broader purpose. The anonymous data generated from the self-tests will be collected and analyzed to gain further information about the stress profiles commonly seen in men. This data serves as a crucial resource for advancing our understanding of male mental health. It allows researchers to further examine the connections between societal gender roles and the stigma often associated with mental health issues in men, paving the way for more effective strategies and interventions in the future. Therefore, the data consists of cross-sectional questionnaire data

Estradiol and progesterone as resilience markers? – Findings from the Swiss Perimenopause Study

While resilience seems to be associated with a variety of biological markers, studies assessing such correlates in women during the perimenopause are lacking. The perimenopause constitutes a phase of major biopsychosocial changes, during which the sex hormones estradiol (E2) and progesterone (P4) eventually decrease significantly. The aim of this study was to examine the extent to which the declining levels of E2 and P4 serve as resilience markers in perimenopausal women. In 129 healthy perimenopausal women aged 40–56 years, saliva samples were collected on every fourth day over a period of four weeks in order to investigate E2 and P4 levels. All participants completed psychosocial questionnaires including variables related to resilience, well-being, and mental health. Perimenopausal status was determined using the Stages of Reproductive Aging Workshop (STRAW) criteria. The results indicate that P4 is linked to psychosocial resilience. More precisely, women with higher P4 levels seem to be more resilient than women with lower P4 levels, irrespective of the perimenopausal status. No such relation was found for E2 levels. Further analyses revealed that women with higher P4 levels experience significantly higher life satisfaction, lower perceived stress, and lower depressive symptoms than women with lower P4 levels. Accordingly, P4 can be considered as a biological marker of resilience in perimenopause

Biopsychosocial predictors of depressive symptoms in the perimenopause-findings from the Swiss Perimenopause Study

OBJECTIVE: The perimenopause is associated with increased hormone fluctuations and an elevated risk of depression. A number of predictors of depressive symptoms in the menopausal transition have previously been suggested. The purpose of this study was to investigate a set of biopsychosocial predictors of depressive symptoms in perimenopausal women. METHODS: This cross-sectional study, investigating 114 perimenopausal women (according to the STRAW criteria) aged 40-56 years, was conducted within the scope of the Swiss Perimenopause Study. Multiple regression analyses were performed to identify the most accurate model predicting perimenopausal depressive symptoms. Depressive symptoms were assessed with the German version of the Center of Epidemiologic Studies Depression Scale (CES-D). Validated questionnaires were used to examine psychophysiological complaints, stress, self-esteem, self-compassion, body image, and social support. Estradiol (E2) and progesterone (P4) were assessed through saliva samples, and follicle-stimulating hormone and luteinizing hormone were determined through dried blood spot samples. Seven saliva samples per participant were used to investigate absolute levels and fluctuations of sex steroids. All other variables were measured once. RESULTS: Multiple regression analyses revealed that E2 fluctuations (β=0.15, P = 0.015), history of depression (β=0.14, P = 0.033), menopausal symptoms (β=0.47, P < 0.0001), perceived stress (β=0.17, P = 0.014), body image (β= -0.25, P = 0.014) and self-esteem (β=-0.35, P < 0.0001) were predictive of perimenopausal depressive symptoms (R2 = 0.60). P4 fluctuations and absolute levels of hypothalamic-pituitary-gonadal hormone were not statistically significant. CONCLUSIONS: E2 fluctuations were shown to be predictive of depressive symptoms in the perimenopause. Moreover, the presence of burdensome complaints and chronic stress as well as a poor self-evaluation seem to promote depressive symptoms in perimenopausal women