Cognitive emotion regulation strategies and depressive symptoms: differences between males and females

Abstract

The present study focuses on comparability of men and women in (a) the extent to which they use specific cognitive emotion regulation strategies in response to the experience of life stress and (b) the extent to which the use of these strategies is related to the reporting of depressive symptoms. In a general population sample of 251 males and 379 females, data were obtained on symptoms of depression and the use of nine cognitive emotion regulation strategies. Significant differences were found in the strategies Rumination, Catastrophizing and Positive refocusing: women reported to use these strategies more often than men. However, no differences were found in the extent to which specific cognitive strategies were related to the reporting of depressive symptomatology. In both groups, higher extents of reporting self-blame, rumination and/or catastrophizing as strategies were strongly related to higher depression scores, whereas higher extents of using positive reappraisal were related to lower depression scores.

Introduction

It is widely acknowledged that women are about twice as likely as men to suffer from clinically relevant symptoms of depression (e.g. Nolen-Hoeksema, 1987). The processes underlying these pervasive differences, however, are still poorly understood. Several biological and psychosocial explanations have been proposed to account for the sex differences in depression (Ingram et al., 1998, Weissman & Klerman, 1977). A first explanation refers to the possibility that sex differences in depression might be artifacts of other differences between men and women, such as differences in socioeconomic status or level of education or differences in the extent to which they acknowledge and seek help for their depression. A second explanation suggests that women’s greater vulnerability to depression might be the result of biological characteristics unique to women, for example by hormonal or genetic predispositions. Epidemiological studies, however, did not find much support for these two models (Ingram et al., 1998, Nolen-Hoeksema, 1987). A third explanation refers to the hypothesis that women might be more likely than men to encounter negative life events, and that these negative life events in their turn are related to the onset of depression. Although evidence indeed has been found that women might be more likely to encounter life events factors that may trigger depression, past research has also shown that, without including other factors, the experience of life events alone is not enough to adequately account for the large differential rates of depression in women as compared with men (Ingram et al., 1998). A fourth explanation refers to the influence of individual vulnerability factors, as expressed by personality characteristics. Although it has been shown that stable personality traits, such as neuroticism and attributional styles characterized by globality, stability and internality are involved in the vulnerability to depression, there is insufficient support for the notion that they contribute to the increased risk to females by a direct mechanism (Piccinelli & Wilkinson, 2000).

A fifth explanation focuses on the ways people cope with stressful experiences. There is accumulating empirical evidence for the hypothesis that the higher rates of depressive symptoms in women might be related to their less effective ways of coping. Empirical studies consistently suggest the global conclusion that women in general tend to rely on passive and emotion-focused coping strategies to a greater extent than men (Thoits, 1995, Vingerhoets & Van Heck, 1990). An important direction for empirical investigations therefore pertains to the question of whether specific coping strategies are related to the higher rates of depression in women. The concept of coping, however, is a broad conceptual rubric encompassing behavioral as well as cognitive regulatory processes. It has been argued that although all kinds of coping are important and should be examined, attempts should be made to describe aspects of the construct, while cognitive and behavioral aspects should be clearly distinguished (Gross, 1999, Garnefski et al., 2001). The present study will therefore exclusively focus on differences in the use of specific cognitive coping strategies between men and women and their relationship with depressive symptomatology.

Previous studies have shown that cognitive coping strategies such as ruminating, self-blame and catastrophizing are positively related to depression and/or other measures of mental ill-health, while strategies such as positive reappraisal are negatively related (Anderson et al., 1994, Sullivan et al., 1995, Carver et al., 1989, Garnefski et al., 2001). Nolen-Hoeksema (1991) has shown that women in general have more ruminative response styles than men, i.e. are more likely than men to amplify their moods by ruminating about their depressed states. It may be argued, that, regardless of the initial source of a depressive episode (biological or psychological) the more ruminative responses of women may form a risk factor for severe and prolonged periods of distress (Nolen-Hoeksema, 1987). Ruminative responses may interfere with effective problem solving, because they may make negative cognitions more accessible and because they may interfere with the initiation of positive behaviors (Nolen-Hoeksema, 1991). No information is available on the extent to which men and women differ in the use of the other cognitive strategies.

On the basis of the research on ruminative responses, only conclusions can be drawn about the general ruminative style of responding and not about the content of cognitions. Although ruminative response styles as such may help to explain why women are more likely to become (severely) depressed than men, they carry only global recommendations for interventions, i.e. that interventions for depressed women should be ones that help to distract them from their mood and increase activity (Nolen-Hoeksema, 1987). Distraction, however, is not the perfect coping strategy either, as not dealing with one’s feelings may lead to externalizing disorders such as alcoholism and violent behavior (Fivush & Buckner, 2000). To create opportunities for a more targeted tailoring of treatment and preventive measures, focus of study should also include the content of cognitions or cognitive coping strategies by means of which men and women regulate their emotions. Whereas the relationship between cognitive coping strategies and emotional well-being is already implicit in psychological treatments such as thought stopping, self-instructional training and other cognitive approaches (Beck, 1976, Ellis, 1962, Wells & Matthews, 1994), empirical research into these issues should help to make these premises of cognitive therapies more explicit. Questions should be asked such as: if it is true that women are more likely than men to show depressed mood, and that a depressed mood in its turn is positively related to catastrophizing and negatively to positive reappraisal, is it also true, then, that women are more likely to report catastrophizing and less likely to report positive reappraisal as a cognitive strategy than men? The identification of cognitive coping strategies that are used to a greater extent by women than by men may provide specific information by which to explain women’s greater vulnerability to depression.

Another question that is even more important than the question whether men and women differ in the extent to which they report different cognitive coping strategies is the question whether the same or other cognitive coping strategies are responsible for depression in men and women. Although it might be true that women are more inclined to ‘catastrophize’ than men, it still also might be true that ‘catastrophizing’ in men is related to the reporting of depressive symptoms in a comparable way, just as it may be argued that although women may encounter more life events than men, still the experience of life events in men might be related to depression in the same way as in women. The answer to the question whether the same cognitive coping variables that are predictive of depression in women are also predictive of depression in men may provide important clues for content of intervention in both groups.

The present paper will focus on these issues by comparing men and women from a general population sample regarding (a) the extent to which various cognitive emotion regulation strategies are used in response to the experience of life stress; and (b) the relationship between the use of these strategies and reporting of depressive symptomatology.