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, 121 (1), 282-8

An Invariant Dimensional Liability Model of Gender Differences in Mental Disorder Prevalence: Evidence From a National Sample

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An Invariant Dimensional Liability Model of Gender Differences in Mental Disorder Prevalence: Evidence From a National Sample

Nicholas R Eaton et al. J Abnorm Psychol.

Abstract

Epidemiological studies of categorical mental disorders consistently report that gender differences exist in many disorder prevalence rates and that disorders are often comorbid. Can a dimensional multivariate liability model be developed to clarify how gender impacts diverse, comorbid mental disorders? We pursued this possibility in the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC; N = 43,093). Gender differences in prevalence were systematic such that women showed higher rates of mood and anxiety disorders, and men showed higher rates of antisocial personality and substance use disorders. We next investigated patterns of disorder comorbidity and found that a dimensional internalizing-externalizing liability model fit the data well, where internalizing is characterized by mood and anxiety disorders, and externalizing is characterized by antisocial personality and substance use disorders. This model was gender invariant, indicating that observed gender differences in prevalence rates originate from women and men's different average standings on latent internalizing and externalizing liability dimensions. As hypothesized, women showed a higher mean level of internalizing, while men showed a higher mean level of externalizing. We discuss implications of these findings for understanding gender differences in psychopathology and for classification and intervention.

Conflict of interest statement

Declarations of interest: None.

Figures

Figure 1
Figure 1
The constrained (gender invariant) model in women and men using lifetime diagnoses. Note. Values are standardized factor loadings (all significant p < .001). Values before slash and bolded are for women; values after slash are for men. Values differ slightly across gender due to standardization. MDD: major depressive disorder. Dysth: dysthymic disorder. GAD: generalized anxiety disorder. Panic: panic disorder. Social: social phobia. Spec: specific phobia. ASPD: antisocial PD. Nic: nicotine dependence. Alc: alcohol dependence. Marij: marijuana dependence. Drug: other drug dependence. Arrows without numbers indicate unique variances, including error.

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