Research reportWork and family roles and the association with depressive and anxiety disorders: Differences between men and women☆
Introduction
In modern societies, the prevalence of depression and anxiety disorders is highest among people in their midlife, during their reproductive years. The prevalence is also consistently higher among women compared to men (Alonso et al., 2004, Bebbington et al., 1998, Bijl et al., 1998, Kessler et al., 2003). The aspects of the social environment may contribute to the gender difference in the risk of depression and anxiety disorders (Maier et al., 1999, Piccinelli and Wilkinson, 2000). Social roles, such as working in a paid job, being a partner, parenthood, and the combination of these roles might have a part in this. Concerning their mental health, men probably profit more from certain social roles than women.
Working can be advantageous as well as disadvantageous for the mental health (Stansfeld et al., 1999, Siegrist, 1996, Karasek and Theorell, 1990, Iacovides et al., 2003). In general, working people have a better mental health compared to people who are not working (Alonso et al., 2004). Having a job provides a meaningful daytime program, increases the social economic status, and provides possibilities of self-realization (Sieber, 1974). On the other hand, the job demands can be a source of stress, resulting in mental health problems (Karasek and Theorell, 1990, Maslach et al., 2001, Virtanen et al., 2006, Plaisier et al., 2007). Besides having a job or not, also the amount of working hours may play a role in the association of work with mental health. Compared to part-time jobs, full-time work usually provides more money and better careers. Nevertheless, working many hours may overburden someone and therefore may have a negative impact on mental health. Particularly in the case of combining social roles, such as work combined with childcare, scarcity of time and energy might be a cause of stress. Because generally women have more childcare tasks than men, more hours of paid work may increase the risk for stress among those with children. Furthermore, women on average have a poorer quality of work compared to men: less job control, a lower occupational level, and lower salaries (Crompton and Harris, 1998, Fagan and Burchell, 2002, Plaisier et al., 2007). Therefore, among women employment may have a less favourable impact on mental health than among men.
Family roles, such as being a partner or a parent may also be associated with mental health. Being a partner is associated with a positive effect on mental health (Horwitz et al., 1996, Helbig et al., 2006). The partner is one of the most important sources of daily emotional support (Wade & Kendler, 2000). Some studies have found gender differences in the effect of spousal support on mental health, e.g. Schwarzer and Guiterrez-Dona (2005) showed that men profit more from spousal support compared to women. In addition, the parent role, and its effect on mental health may differ for men and women. Helbig et al. (2006) found an association of parenthood with lower rates of particularly depressive disorders that was stronger among men than among women. Although men's participation in domestic work increased during the last decennia, in couples with children women generally spend more time on domestic work such as child care compared to their husbands (Barnett et al., 1994, Sullivan, 2000). This may also depend on the age of their children; younger kids need more care, and therefore make a larger appeal to time and physical energy of parents. On the other hand, teenagers and adolescents may demand more of parents in a psychological way. A probable other aspect of parenthood is the age at which the transition into parenthood took place. In particular, women who gave birth to their first child at a relatively older age may have had more possibilities to develop a professional career compared to younger mothers (Blossfeld & Huinink, 1991) and may therefore be in a more favourable position than younger mothers.
In addition to an effect of a certain social role, the combination of social roles may have an influence on mental health. According to the role accumulation theory, having more social roles may be associated with better mental health among both genders. An adequate combination of more social roles may provide energy (Sieber, 1974, Nordenmark, 2002) and having more social roles provide possibilities to compensate the negative experiences in one role by better experiences in other roles (Thoits, 1983). On the other hand, according to the role–strain theory, some combinations of social roles may be particularly stressful, such as being a working parent without support from a partner (Cairney et al., 2003).
In this paper, data of NEMESIS (Netherlands Mental Health Survey and Incidence Study) will be used to describe the associations of work and family roles with depression and anxiety disorders among men and women in the age of 25 through 55 years. With this study, associations of social roles (employee, partner, and parent) and role characteristics with the presence of depression and anxiety disorders will be explored, and it will examine to what extent social roles contribute to the explanation of gender differences in the prevalence of these disorders. Studies that examine the (gender differences in) associations of social roles with diagnoses of depressive and anxiety disorders measured by the CIDI interview (Robins et al., 1988) in a large community sample are scarce. The first hypothesis of this study is that all three social roles will be positively associated to better mental health, but stronger among men compared to women. The second hypothesis is that having more social roles is better for one's mental health, but a particular role combinations, such as being a parent without a partner, are disadvantageous for the mental health. Finally, we hypothesize that gender differences in the association of social roles with mental health can contribute to the explanation of the female preponderance of depression and anxiety disorders.
Section snippets
Research population
The Netherlands Mental Health Survey and Incidence Study (NEMESIS) is an epidemiological study in the Dutch general population to determine the prevalence of psychiatric disorders. A representative sample of adults, aged 18–64 years, was interviewed by intensively trained and monitored interviewers in 1996 (n = 7076), (Bijl et al., 1998). Psychiatric disorders were measured using a computerized version of the Composite International Diagnostic Interview (CIDI, version 1.1). The CIDI is a
Sample description
Table 1 shows a significantly higher 12-month prevalence of depression and anxiety disorders in women (16.3%) than in men (8.8%, χ2 = 48.99, p < 0.001). In this sample, 483 persons had an anxiety or depressive disorder from whom 242 (50%) had a prevalent anxiety disorder, 136 persons (28%) had a prevalent depressive disorder and 105 persons (22%) had both. Men were higher educated and had fewer chronic diseases. The proportion of men and women living with a partner did not differ. Women were more
Conclusion
The present study examined the associations of work and family roles with the prevalence of depression and anxiety disorders, and whether these social roles could explain the female preponderance in the prevalence of depression and anxiety disorders. Concerning their mental health, we expected that men may profit more from certain social roles than women. This was particularly supported by the results regarding the work role. Both having a job and working full-time were associated with a lower
Acknowledgements
Netherlands Mental Health Survey and Incidence Study is being conducted by the Netherlands Institute of Mental Health and Addiction (Trimbos-instituut) in Utrecht. Financial support has been received from the Netherlands Ministry of Health, Welfare and Sport. Funding for data analysis was provided by Sterpunt Arbeid, VU University in Amsterdam.
References (41)
Combining a job and children: contrasting the health of married and divorced women in the Netherlands
Soc. Sci. Med.
(2002)- et al.
The relationship between job stress, burnout and clinical depression
J. Affect. Disord.
(2003) - et al.
Gender differences in the prevalence of depression: a survey in primary care
J. Affect. Disord.
(1999) Women's employment, marriage, motherhood and mortality: a test of the multiple role and role accumulation hypotheses
Soc. Sci. Med.
(1995)- et al.
The contribution of working conditions and social support to the onset of depressive and anxiety disorders among male and female employees
Soc. Sci. Med.
(2007) - et al.
Anxiety and depression in the working population using de HAD Scale. Psychometrics, prevalence and relationships with psychosocial work characteristics
Soc. Psychiatry Psychiatr. Epidemiol.
(2004) - et al.
Prevalence of mental disorders in Europe: results from the European Study of the Epidemiology of Mental Disorders (ESEMeD) project
Acta. Psychiatr. Scand. Suppl.
(2004) - et al.
Gender and the relationship between parent role quality and psychological distress: a study of men and women in dual-earner couples
J. Fam. Issues
(1994) - et al.
The influence of age and sex on the prevalence of depressive conditions: report from the National Survey of Psychiatric Morbidity
Psychol. Med.
(1998) - et al.
Prevalence of psychiatric disorder in the general population: results of the Netherlands Mental Health Survey and Incidence Study (NEMESIS)
Soc. Psychiatry Psychiatr. Epidemiol.
(1998)
Human capital investments or norms of role transition? How women's schooling and career affect the process of family formation
Am. J. Sociol.
Do anxiety and depression have a common pathophysiological mechanism?
Acta Psychiatr. Scand., Suppl.
Stress, social support and depression in single and married mothers
Soc.Psychiatry Psychiatr. Epidemiol.
Explaining women's employment patterns: ‘orientations to work’ revisited
Br.J.Sociol.
A critical examination of the demand–control–support model from a work psychological perspective
Int.J. Stress Manag.
Burnout and engagement at work as a function of demands and control
Scand.J Work Environ. & Health
Gender, Jobs and Working Conditions in the European Union
Is parenthood associated with mental health? Findings form an epidemiological community survey
Soc. Psychiatry Psychiatr. Epidemiol.
Historical overview of the relationship between anxiety disorders and affective disorders
Depress. Anxiety
Becoming married and mental health: a longitudinal study of a cohort of young adults
J. Marriage Fam.
Cited by (76)
Moving around with an anxiety disorder
2024, Transportation Research Part F: Traffic Psychology and BehaviourThe role of labor market inequalities in explaining the gender gap in depression risk among older US adults
2023, Social Science and MedicineChanges in parents' mental health related to child out-of-home care placements: A Swedish national register study
2023, Child Abuse and NeglectDo work-family initiatives improve employee mental health? Longitudinal evidence from a nationally representative cohort
2022, Journal of Affective DisordersCitation Excerpt :Hypothesis 3b: Actual usage of work-family initiatives improves employee mental health by increasing their job satisfaction and leisure time satisfaction. Fourth, men and women have divergent roles in paid and unpaid labor and are segmented by occupations (Plaisier et al., 2008; Wang, 2019), so the mental health benefits of work-family initiatives may also differ by genders. Specifically, women users of work-family initiatives would experience a significant improvement in their mental health because they are persistently taxed by work-family conflict.
Stress, depression, mental illness, and men’s health
2019, Effects of Lifestyle on Men’s HealthGender career divide and women's disadvantage in depressive symptoms and physical limitations in France
2017, SSM - Population Health
- ☆
Role of Funding Source: Netherlands Ministry of Health, Welfare and Sport and Sterpunt Arbeid of VU University had no further role in study design, in the collection, analysis and interpretation of data and in the writing of the paper as well as in the decision to submit the paper for publication.
Contributors: Inger Plaisier, MA: Conception and design, analyses and interpretation of data, drafting and revising the paper.
Jeanne G.M. de Bruijn, Ph.D.: Supervision, conception and design of the paper.
Johannes H. Smit, Ph.D.: Supervision, conception and design, and revising the paper critically for the methodological and theoretical content.
Ron de Graaf, Ph.D: Revising the paper critically for both methodological and theoretical content.
Margreet ten Have, Ph.D.: Revising the paper critically for both methodological and theoretical content.
Richard van Dyck, M.D., Ph.D.: Supervision, conception and design, and revising the paper critically for the methodological and theoretical content.
Aartjan T. F. Beekman, M.D. Ph.D.: Conception and design and revising the paper for important intellectual content.
Brenda W. J. H. Penninx, Ph.D.: Supervision, conception and design, advice for data-analyses, interpretation of data and final approval of the version to be published.
Conflict of interest: None of the authors or the institutions they work for has any conflict of interest related to the topic of this paper.