Feminine Sex Roles and Depression in Middle-Aged Women

University of Central Florida STARS

Retrospective Theses and Dissertations

Fall 1979

Feminine Sex Roles and Depression in Middle-aged Women

Emily Gaines Tinsley University of Central Florida

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STARS Citation Tinsley, Emily Gaines, "Feminine Sex Roles and Depression in Middle-aged Women" (1979). Retrospective Theses and Dissertations. 452. https://stars.library.ucf.edu/rtd/452 FEMININE SEX ROLES AND DEPRESSION IN MIDDLE-AGED WOMEN

EMILY GAINES TIMSLEY B. A. , Uni versi ty of Central Florida, 1976

THESIS submitted in partial ful fi1 lment of the requirements for the degree of Master of Science: Clinical Psychology in the Graduate Studies Program of the College of Social Sciences of the University of Central Florida at Orlando, Florida

Fall Quarter 1979 Abstract

The preponderance of females in the depressed population is a well established fact. Various hypotheses for this fact are reviewed and the hypothesis that females accepting the feminine role will be more 1ikely to become depressed during their middle years than a more androgenous woman is submitted. To support this hypothesis a study was designed utilizing a

Clinical group consisting of females, 35 to 50 experiencing depression and undergoing treatment for depression at one of three mental health centers and a Non-clinical group consisting of women, same age group, not experlence depression and who had never undergone treatment for depression. Each subject was asked to complete a questionnaire to measure depression and femininity.

Results of this study support the hypothesis that depression in middle-aged fe~clales is related to the degree of their acceptance of the tradi tional feminine role. Depression as defined and measured by Beck's

Depression Inventory was positively correlated with femi ninity as measured by Bern's Sex-Rol e Inventory. The Pearson correlation coeffi - cient for these two measures was .62 (p<.001), indicating that 38% of the variance in depression scores can be accounted for by the sex-role vari abl e. TABLE OF CONTENTS EsE ACKNOWLEDGEMENTS ...... iii LIST OF TABLES ......

Preponderance of females in depressive role ... POSSIBLE ETIOLOGY OF FEMALE DEPRESSION .. .. . Menopause ...... Other endocri nologi cal s tudi es ...... Stress ...... Help-seeking attitude ...... Genetics ...... Psychodynami c ...... Psychoanalytic ...... Social factors ...... Soci ety i n twins i ti on ...... Society ' s expectati ons ...... Marriage role ...... Feminine role ...... If I. METHOD ...... Subjects ...... Millteria1 s ...... Procedure ...... IV . RESULTS ...... Pearson correlation coefficient ...... Post-hoc analysis ...... V . DISCUSSION ...... APPENDIX A CONSENT FORM GIVEN TO SUBJECTS .... APPENDIX B QUESTIONNAIRE ...... APPENDIX C RAW DATA ...... REFERENCE NOTE ...... REFERENCES ...... ACKNOWLEDGMENTS

I wish to thank Dr. Sandra Guest for guiding me into the present study and for keeping me at it. I wish to thank Dr, Jack McGui re for his understanding, encouragement and direction. My appreciatlon goes to Betty Goyings and Dr. Bruce Hertz for their aid in securing subjects. I also wish to thank Elaine Harris for her assistance in the statistical and computer analysis of the data. LIST OF TABLES AND' FIGURES

page

2 Sex Ratios in Suicide Attempts ...... 4 3 Sex Ratios in Depression: Comnunity Surveys . . 9 4 HeritabilityofAffectiveDisorders ...... 10

5 Model for Negative Reactions during . ' Cl imacterium ...... 14 6 Means with Standard Deviations for Cl i nlcal and Mon-cli nical groups . . . . - - . 26

Figure

1 Raw scores of subjects on BSRI and Beck's Depression Inventory ...... 27 Femf nine Sex Roles and

Depressi on in Middl e-Aged Women

In a recent publication Klennan (1979) notes that depression is the nation's most comnly reported psychological disorder and that possibly the Age of ~e~ress'ionhas replaced the Age of Anxiety of the 50's. - De- pression is highlighted in the entire publ icati on. Arieti (1979) states that depression-prone people spend their lives attempting in vain to please a speci-fic dominant other, or to achieve an ever-elusive goal. Farber (1979) maintains that his current patients do not declare their distress to be marital tension, job security or generation conflict, but that they are depressed. Farber states "Is it any wonder that sufferers are glad to fling aside the particularity, the messy concreteness bf their private torments and enlist in the ranks of depression, where the only forced marching will be back and forth to the pharmacist?" (pq 64). Another article in the same publ ication by Scarf (1979) points out women are found to be depressed at two to five times the male rate and growing because of the demands and contradictions of being feminine. It is a well establtshed fact that there is a sex difference in the epidemiology of depression. Weissman and Klerman (1977) have summarized the findings of twenty-nine studies of sex ratios in treated cases of depression and fifteen studies of sex ratios in suicide attempts (see

Tables 1 and 2) which show the preponderance of females. Ratios in the two tables vary from culture to culture and from nation to nation, but almost without exception, the females show higher rates of depress-ion. Table 1 .-Sex Rat~osin Depression: Treated Cases

~Md~Sox RaUcn (Fernah-Mak) United States Baltimore 2:l (psychoneurosts, inckrding depresston and manic-depressrve) Boston, Marked increase in young females with 1945,1955.1965 - diagnosis of depressive reaction Pittsfield, Mess, 2.4:l (patients treated with 1946- 1968 electroconvulsive therapy) New York State, 1.7:l 1949-- -- Massaohuastts, 251 (all depressives) 1957-1 958 Ohio, First admissions: 1958-1 961 1.9:1 (wh~te) 2.7: 1 (nonwhite) Madison. WEs. Increase in depression for women over decade 19%19&s (patients referred for psychological testing) Monroe County, New York, 2.1 :1 (affective psychosis) 1960 United Stam. Outpatient admissions: 1961 1.4:l (psychotic depression) 1.2:1 (manic depression) 1-8: 1 (invotutional psychosis) 1.6:l (depressive reacttons) Manrw County, New York, 1.6:1 (prevalence) 1961-1962 1.3:l (inctdsnce) New Havsn, Conn. 3:l (all depressions) 1966 United Stat-, .Qdmissions to all psychiatric facilittes: 1970 2.1 :1 (all depressive disorders) Outside United States Amsterdam. 2.3:l (Ashkenaz~mJews) 1916-1940 2.4:l (Gentiles) Gaustad, Norway, Lifetime risk of first admission: 1926- 1955 1.37:l (1 926-1935) 1.36:l (1946-1950) i.33:i ii951-1955j Buckinghamshire, England. 1.8:l (1931-1933)

1965-1 971 First admissions of manic-depressives; involutional mekncholir and affective psychosis

1OYLI 6 1869 1871 Chnade 1.8:l 1.7:l ?.8:1 1.7:l Crechodervekia 2.1:l 2.1:l Denmark 2.4:l 1.9:l 1.81 1.8:l Fidahd* 1:l 1.3:l France 1 7.1 1.6:l NWP~ 1.2:1 121 0.9:l 1.5:l Poland* 1 4:l 1.4:l 1.4:l Sweden5 1.R1 1.8:l 53wifm~* 1.6:1 1 3'1 1.4:l England -adWaW 1 9.1 1 9:1 I .$:I New z*zul0nd 1.5.1 2.2:l 1.8:l -. ------,,..--.- --4 ---.-r ---- Table 1.-ax Ratios In Depression: Treated Cases (cont) Place and Tlme Sex Ratto$ (hmd.-Male) Madras rcnd Madwai, India, 0.2:t 1961-1963 Tokyo and Taiwan, Women have more depressive symptoms 1983-1 9$4 Madurai. India. 0.56:1 (endogenous depression) 1964-1 $66 Bulawatys, Rhodes~a, 1.1:l (N = 76) 1965-1967 Baghdad, Iraq, 1.l:l 1966- 1967 Honduras, 1-6: t (admissions) 1967 6.7:1 (outpatients) New Delhi, 0.55: 1 1960 Jerulaam. 2.1 :1 (affective disorders) 1969- 1972 Papua, New Guinea. 0.4: 1 (based on a few cases) 1970-1 973 Denmark. 1.9.1 (first admissions for manic 1973 depression) Bangkdc. Thailand 1.3.1(Far East Orientals) (time not indicated) 0.8:; (Occidentals) ------. - . -- .- -. --- London, 21 1947- 1 949 Scania, Sweden. 1 8:1 (Lifet~meprevalence of 1947, 1957 severe depresston) England and Wales, 1.6:l (1952) 1 952, 1960 1.7'1 (1 960) Aarhus County, Denmark. 2: 1 (endogenous depresston) 1958 4: 1 (psychogenrc drpresslon) 3:1 (deprecrsive neurosis) Salford, England, 1.9:1 (Depressive psychoas) 1 959-1 963 Dakar. Gutnea. 0.5.1 1960-1 961

Table 2 - Sex Ratios in Suicide Attempts

Sex Ratio Place and t isno (FamabMa16) Unttsd States Sex Ratb New York. - Place and Time (FemaloMala) 1 960 3: 1 Victoria. Window Rock. Ariz. 1W3 1.3:l 1968 2: 1 St Louis, 1 968- 1 989 2: 1 8 risbans, Provi&ence, RI, 1 965- 1 966 2.5:l 1968 3: 1 Southern Tasmania, New Haven. Conn, 1968-1969 2.5:1 1970 2: 1 Melbourne. Israel Israel, Great Erita~n 1 962- 1963 Gtasgow, Scotland. 1960-1962 Sheffield, England. India 1960-1 961 1.7.1 New Delhi. Edinburgh, 2 1 (1 962) 1967-1 969 1962. 1967 1 6 (1967) Table 2 - Sex Ratios in Suicide Attempts (cont) Place and Time Sex Ratio Place and Time Sex Ratio (Femle-Male) (~emale-Ma1 e)

Leicester, England. Madurai, 1961 2.4:1 1 964 0.@:1 London, Poland 1 963 2.1:1 Krakow, 1.S:1 (1.980) 1960-1 969 O.&1 (1 962) Bristol, England, 1.0:1 (I946) 1964- 1965 2: 1 1.21 (1967) Shropshire, Montgomery- 0.8:l (1969) shire, England, Pornania. 1965- 1 966 2.3:l 1970 1.1:l Brighton, England. Audraiia 1967 2:1 Western Australia. Newcastleupon-Tyne, England. 1961 2: 1 1962-1964, 1999-1969 2.5:1 Northeast Tasmania, Glasgow, Scotland, 19$?-1963 1.7:l 1970 1.4:1

The hypothesis for the greater number of females suffering from depression ranges from the menopausal theory to a theory of genetic trans- mission in which the X chrorno;ome plays a part. After a brief summary of various hypotheses, evidence pointing to the hypothesi s that females with more femi nine characteri s tics are more prone to middl e-aded depression than their more androgenous counterparts wi11 be cited and a study to prove this hypothesis will be described. Results of the study will be displayed and discussed.

Menopause

The menopause was once a scapegoat for depression in middle-aged females. In a study by Neugarten (1973), a group of 100 women, aged

45 to 55 were studied. A third of the women were still menstrating regularly, a third were in a transitional period and the remaining .. third had not menstrated for at least two years. The presence or absence of the menstral cycle was unimportant in the psychological states of the women. In this study, the three groups seemed more alike than dl fferent. Only 12 of the 10a Here unable to see any positive value

in the menopause. Three-fourths mentioned elimi nation of fear of

pregnancy and the bather of menstruation and some mentioned better sex relations wlth their husbands. According to this study, menopause did not contrtbute to depression.

For her i'ecint book, Harris (1976) intervi-ewed over 300 mf ddle- * aged females from all parts of America, and from many djfferent. soci o-economic and cul tural 1eve1 s and concl udes : The fact that the change of life marks the end of fert4l ity did not sadden even one of the wanen with whm I spoke. "Pregnancy and childbearing are iron taskmasters" one woman told me. "All my 1 ife I ' ve had the feeling that my body was for sow other use than my own. Now, at last, it belongs to me." (p. 198)

Ifthe menopause were relevant to an increase in depressive i1 lness, the years from 45 - 54 would show a sharp increase in the number of females in the depressed population; however a recent study in England, Wales and America of first admission rates for depressive psychoses

showed a consistent increase with aging but no peak in the decade

45-54 (Slater & Cowie, 1971), A study of white American females attempt-

ing suicide from 1958 to 1960 showed an increase with aging but no peak. The actual figures wgre 45 - 54, 6.7 per 100,000; 55 - 64, 6.6 per 100,000; 65 - 74, 6.1 per 100,000 -- a monotonous similarity (Dublin, 1963).

An unpublished article by Weissman (1979), concludes with: A review of the epidemiologic and clinical studies failed to find support for the valldi t.y of f involutional melancholia as a d.f$tinct diagnostic entity. Research findSngs do not support an increased prevalence of depression around the menopausal years, Nor is support found for a distinct symptom picture, an absence of previous epi sades or an absence of 1i fe stress precipi - tants in depression occurring in the menopausal period. (p. 7)

Other endocri no1dad ea1 ' s tudi es . Other endocrinological studi es wi11 be mentioned briefly, however no studies correlating the state of depression with the female endocrine system, us ing modern endocri no1ogi cal methods of sens iti ve quantitative hormonal assays have been found.

There is a good indication that postpartum depression my be ex- plained by the endocrine system (unless the cognitive fact of antici- pation during pregnancy and a 1et-down after the attention is lessened is the cause. ) Medical records of a1 1 women in Cincinnati who were inpatients in the psychiatric service between the ages of 14 and 44 for two years were studied. Depression was found to be at lowest risk during pregnancy and at highest risk during the postpartum period

(Paffenberger & McCabe, 1966).

It is be1 ieved that brain catechol ami nergic activity is reduced in depressive illness. Brain catecholamines appear to play a major role in the hypothalamic regulation of 1uteni zing hormone (LH) secret- ion so it might be expected that plasma LH concentration in women who are depressed would be reduced compared to that of normal woman. A study by Sachar (1975) supports this theory. The subjects were postmenopausal females, 13 in the normal group and 12 in the depressed group. Mean plasma LH concentration of the depressed patients was 33 percent less than that of the normal subjects. Half of the depressed females had mean LH levels lower than the lowest found among the normal s . Stress

Is it that women are under greater stress than men, and are therefore at greater risk for depression? Until recently there has been very 1 ittle literature relating stress to depression but there has been developed a simple -quantitative scale for assessing the amount of stress in different life events which has been used in clinical studies (Holmes

81 Rahe, 1967). Patlents were asked to judge the degree to which various

1ife events were upsetting and it was observed that women do. not per- cei ve events as more stressful than men (~aykelet a1 . , 1971 ). Another study investigating the relationship between actual or perceived stress among patients in both psychiatric settings and normal populations re- * vealed that women did not report more stressful life events than men (Uhl enhuth & Paykel , 1973), Hel p-seeki ng attitude - It has been hypothesized that women go to the doctor more so ,perhaps they feel freer to seek he1 p for depression. A 25-year study of

over 200 telephone company employees in New York corroborates the fact

that women do go to the doctor more frequently. The health care

system, day hours, make it easier for women to seek help than for men who work during most of the doctor's office hours. Also it may be that the sick role is interpreted by men as a sign of weakness. On

the other hand ,. he1 p-seeking patterns a1 one cannot account for the

preponderance of depressed women. In a cormuni ty survey where there

has been no treatment in psychiatric clinics or by physicians, women

even here were seen to predominate in the depressive role. Table 3

\ il lustrates this comnuni ty survey (Weissman & Klennan, 1977).

~&&j.--~sx Differences in Depression: Community Surveys

Pfaw (R#( Tha $ex Ratlor (Female-Male) United States Brooklyn and Queens. NY, Women were more depressed 1 960 Baltimore. l.&l (Includes wtves of blue collar 1960 workers only) Northern Florida, 181 1 988- -- Carroll County. Maryland. Women were more nervous, helpless. anxious - 1m - New Haven, Conn, 2; 1 (surcidal feelings) 1969 St Louis, No srgnificant sex differences in depres- 1 968- 1969 ston cn bereaved spouse NwYork City, More reterrals for minor d8prtts~tonin %year period female employees in one company Outside United Statma lcetand , 1 .6:1 (all depressions) 1910-1957 Samso, Qenm~k, 3.5:1 (all depressions) 1 960 Ghiraz, Iran. 3.6:l fN = 23) 1 964 Luchnow, India. 2: 1 1969-1971

Herfordshire. England. 2.4:1 1 949- 1954 Agra. India 1.6.1 (manic depression) (time not indicated) Aarnus County, Chmrnack, l.6:1 (man~cdspresslan) 1 960-1 964 3.8:1 (psychogentc depressionJ 2.9: 1 (neurotic depress~on) Genetics

Many studies investigating the role of heridity in the affective disorders have been conducted . Gers hon , Dunner and Goodwi n (1971 )

reviewing the literature in this area find that family history studies '

reveal a consi stently high 1 ifetime prevalence in first degree re1ati ves

(parents, sibl inus and chi 1dren) of patients wi th affecti ve di sorder as

compared with the general population. There is always the possibility

that living with the depressed person causes the depression in the first degree relative rather than any biological factor. However, if

the envir~narentis the cause it is difficult to explain the difference in concordance rates between monozygoti c twins and dizygotic twins in view of the data that parents commonly misidentify MZ twins and DZ twins and in view of the high concordance of abilities and personality traits in twins even when reared apart (Scarr, 1966). A collation of case reports in the literature of affective disorder in 12 MZ twin pairs reared apart indicates the high concordance rate is maintained even though the environmental conditions are different (Price, 1968).

Heritabi 1 ity of affective disorders is ref1ected in the table below (Table 4) compiled by Gershon, Dunn and Goodwi n (1971 ) .

Table 4 - Heritability of Affective Disorders

Investigator Monozygoti c .Monozygotic Dizygotic Dl zygoti c Pairs % Concord. Pairs % Concord.

Luxenberger (1930) 4 75.0 13 0 Rosanoff (1935) 23 69.6 67 16.4 Kal lmann (1954) 27 92.6 55 23.6 Sl ater (1953) 7 57.1 7 7 23.5 Da Fonesca (1959) 21 71.4 39 38.5 Harvald & Hauge (1965) 70 50.0 39 2.6

If indeed a genetic factor is implicated in depression and females are in the preoponderance, the possible explanation is that depression may be 1 inked to the X chromosome. Weissman and Klerman (1977), pursue the linkage of the X ch~omosomeand state:

A rare X-linked recessive trait will seldom appear in the parents of children of an affected male, but will always be found in both the father and all sons of an affected female. A rare X-linked dominant trait will usually appear in the mother and all of the daughters of an affected male and will occur in at least one parent and at least half of the children of an affected female. The exact frequencies with which f irst-degree re1ati ves are affected is also a function of the allele frequency in the population and of the mating pattern. Based on the assumptions of random mating and an X-1 inked dominant trait, Slater and CwSe calculated that for every affected male siblfng of an affected female there would be three affected female siblings. (p. 104) Studies of the X linkage have been confusing but there is good evidence that the X linkage operates in bipolar depression but does not operate in the unipolar depression (Perris, 1971). Psychodynamic The classic psychodynamic theory of depression emphasizes that individuals prone to depression were characterized by early childhood deprivation, excessive guilt and a tendency to turn hostility against themselves. Jacobson, Fasinan and DiMascio conducted a study on childhood deprivation and its .relationship to adult depression (1975). Their subjects consisted of 347 depressed inpatient women, 114 depressed outpatient women and 198 normal women. A1 1 subjects were caucasian. They did not find loss by death of either parent during the subject's chi1dhood to be significant. With regard to parental separation, there was a significant difference between. the three groups with the normal women least often having experienced a separation of their parents during childhood. The most remarkable finding was the difference in chi ldrearing experiences. The inpatients showed more severe deprivation in their childhood than the outpatients or normals. The normals endured less rejection and overprotection and more affec- tion in their childhood than either patient group. A surprising find1 ng was that the nornal subjects had depriving and punitive expeserlences more often (but not as severe) as that experienced by the patient groups. In a British study by Brown and Harris (1978), aver 500 women were interviewed in Carnbrldge, a suburb of London, and the loss of a mother before the age of 11 was found to be a significant factor in depression. Perhaps the fact that so few subjects in the American study had lost a parent by death nay have failed to reveal the significance in the American study by Jacobson et a1 . (1975). Psychoanalytic The psychoanalytic theory by Freud that a1 1 females are characterized by narcissism, masochism, 1ow sel f-esteem, dependency and inhibited hostility as a consequence of the young girl 's special re- solution of her Oedipal complex and penis envy has been extensively criticized, most recently byMf1let.(1970). Even though the psychoanalytic theory has been widely accepted by clinicians, empirical evidence for its support has been meager. Soci a1 factors . Soci ety in transition

A study by Dowty (1972) addressed the question, which style of life is most rewarding for the woman in middle 1ife -- that of a traditional woman whose children are a1 1 about her, or that of a modern woman who can choose career, family or both. Five ethnic groups were represented in the study, a1 1 living in Israel. They represented traditional to modern on a continuum: Israeli Muslim Arabs; Persian; Turkish; North Afrlcan Jews and European Jews. They had similar traditions but differed to the extent to which they had retained or repudiated the traditions. Some of the women wwe homebound with many children and subordinate to the male. Some had nearly equal rights, higher educational level, fewer controls and a smaller family. The groups differed in regard to their perception and evaluation of the middle 1ife for the woman. The most successfully adjusted were the modern women of European background. They welcomed the cessation of fertility and saw their life changing for the better. Next to the European women were the Arab women of the most tradi ti onal , ma1 e-dominated group. The least we1 1 adjusted were the transitional group who had not yet adapted to modernity but could not look forward to the role of matriarch. Thus both the traditional and the liberated woman adapted better in a psychological sense to midlife changes than the woman who was neither. Gove and Tudor (1973) note' that communities that are extremely close knit, traditional and family oriented and cul tural ly is01ated have lower rates of mental i 1lness in general, with women having even lower rates than men. Brown and Harris (1978) found the same to be true of the women in a London suburb as compared to women in an isolated communal group in Ireland. As' our society becomes more mobile and families more fragmented, women become more depressed. Women are more nutrient than men and when the extended family existed, if the husband were busy with his career and the children left home, the female had other female com- panions for support. Wi11 iams (1977) consi deri ng the psycho1 agy of women reasons :

" . . . depressions are artifacts of culture, not a fateful concomitant of aging tissues and ebbing hormones endogenous to the woman.' (p. 365) 'vlilliams (1977) posits the following model for negative reactions during the climacterium (Table 5): Model for negative reactions during climacteriurn The society: The woman : Socialized girls to wife-mpther Aspires to wife-mother role as role. u1timate fulfi 1 lment. Youth oriented, values f emal es Self-esteem based on sexual as sex objects. attractiveness and maintenance of youthful beauty. Denies or discourages other or Leaves job in first pregnacy. No addi ti onal roles for women. career involvement of her own. Promotes and supports husband's career. Chi1d-centered, nuclear farni ly. Dedi cated mother. Chi 1dren are her primary concern.

Values passivity, humil ity and Subjugates her own needs to family's. self-sacrifice in women. Puts self-interest last.

Values masculine, competitive Identifies vicari ously with achieve- model of achi evement . ments of husband and child. Male-oriented. Women seen as Sees self and other women as inferior. inferior. Ready to blame self, feel gui 1ty . Transitional. Both traditional Matriarchal role not available. Has and modern life styles in neither desire nor necessary skills evi dence. for "1i berated" role.

Double standard of aging for Fears aging with its loss of status, men and women. lone1iness and isolation.

Society's expectations

Rich (1972) points out that our mental health picture begins with our definition of our behavior itself. She says we are classified by ourselves and by our society on the basis of: . . . a male ethic of mental health, based on the invisible assumptions of patriarchal society . . . the psychiatric definition of a "heal thy" woman is assumed to differ from a "heal thy" man by being "more submissive, less independent, less egpressive, less competitive, more excitable in rninov crises, more easily hurt, more emotional , mre sijncai ted about appearance, less objective . . . a bias steam-ironed into women's lives by early training, education, intensive social pressure and when necessary, punishment. (p. 1) Rich's opinion is bourne out by studies testing the prevalence of clearly defined sex-role s terotypes for women. Broverman , Broverman , Clarkson, Rosenkratr and Vogel (1970) sent sex role questionnaires to col 1ege students and mental heal th professionals. Subjects were asked to identify characteristics that describe a mentally heal thy male, a mental ly heal thy female and a mental ly heal thy adult (sex unspecified). More posi ti-vely valued characteristics such as competence, rationality and assertiveness, were ascribed to males than to females. Broverman et a1. state:

In effect, clinicians are suggesting that heal thy women differ from heal thy men by being more submissive, less independent, 1 ess adverturous , 1ess objective, more easily infl.uenced, less aggressive, less competitive, more exci table in mlnar crises , more emotional , more concei ted about their appearance and having their feelings more easily hurt. (p. 4) Broverman et a1 . descri be the di1 emma of the traditional woman : Acceptance of an adjustment notion of health, then places women in the confl ictual position of having to decide whether to exhibit those positive characteristics con- sidered desirable for men and adults, and thus have their "femininity" questioned, that is be deviant in terms of being a woman; or to behave in the prescribed feminine manner, accept second-cl ass adult status, and possibly live a lie to boot. (p. 6) Marri age role Gove (1972); in exam1 ning the preponderance of femal es in the

depressive role feels it is the marriage role that is accountable. We cites 17 studies which found the ratio of mental disorder in married women to married men ranging. . from a low of 1.02 to a high of 2.78. On the other hand, he cited 11 studies in which single men have higher rates of mental disorder than slngle females and 17 studies showing that divorced and widowed men have higher rates of mental disorder than divorced and widowed females, He concludes that the data suggests that the role expl.anation accounts for the difference between the sexes.

Femi nine role

Bart (1971 ) relates the depressive syndrome in the middle age to noxious aspects of women's social ization and women's role, particularly to the centralI ty of mothering to women' s perception of self. One of the most comprehensive studies of depression and th.e middle-aged femal e was conducted by Bart in 1971. She used three kinds of data in the study: anthropological, epidemiological and interviews with projective tests.

She conducted cross-cultural studies of 30 societies using the Human Rel- ations Area Files, and intensively studied six cultures using the original anthropological monographs. After she completed this cross-cul tural study of the roles available to women after childbearing ceases, she examined the records of 533 women between the ages of 40 and 49 who were in hospitals for depressive disorders. She used five hospitals, ranging from an upper-class private hospital to the two state hospitals that served people from Los Angeles county. She compared these women to women who had other functional , nonorgani c diagnoses . Five methods were used to overcome diagnostic biases. First, the sample was drawn from five hospi tal s. Second "neuroti c depressives" 'were merged with "invol utional" and "manic depressives" since the .upper class hospital would call patients "neurotic depressives" while the other hospitals would use. the other di3gnos.e~.[a suspicion that was bourne out). Third, a symptom'check ffst-was used'in.theanalysis ofdata and she

found that depressed pat9mts dtffetcered signif icant1 y from those given

other di agnoses. Fourth, case . histories of women were dlstri buted to th.e psychiatric resfdents at the teaching hospital for "bl lnd" di agnoses. [The woman was called Jewish in half the cases and Presbyterian in the other half. 1 Fifth, 39.MMPI profiles were obtained at one hospital and given to a psychologist at another hospital to diagnose "bl ind. " Bart then conducted 20 intensive interviews at two hospitals to 0btai.n infomation unavailable from the patients' records. She gave them a projective test - a test consisting of sixteen pictures showing women at df fferent stages in their life cycle and in different roles. She did not read their charts unti 1 after the interviews so as not to have her percepti.on affected by psychiatrists' or. social workers' eval ua tions . This study revealed that menopause was not the culprit, as has been di.scussed earlier in this paper, but the lack of important roles

and loss of self-esteem. In societies where 'the woman's status was enhanced with increasing age, depression did not occur. In two societies where the culture was simi lar to that of Western countries, the effects were similar to that experienced by middle-aged women in our

society. . Also those hospital ized were more likely to have suffered a recent maternal role loss. The study also revealed that housewives had a higher rate of depression than working women when children left. Jewish women had the highest rate of depression, Anglos iecond and blacks the lowest.

\ In the black culture there ic frequently an extension of the mother role by caring for her daughter's or ather relative's children. Also the black woman has been more likely to have been employed outside the home while her children were growing up and may have avoided the intense involvement with her children that the Jewish mothers experienced. Bart says: . . . my data show that it is the women who assume the traditional feminine role -- who are housewives, who stay married to their husbands, who are not overtly aggressive, in short who "buy" the traditional norms - who respond with depression when their chi 1dren leave. Even the MMPI masculine-feminine scores for women

a at one hospital were ope-half a standard deviation more feminine than the mean. These findings are consistent with Cohen's theory bf depression; he considers depression, in contrast to schi zophrenia, an "illness" found among people too closely integrated into the culture. (p. 142)

Katkin, Sasmore and Tan (1965) examined depressed patients and a control group of nonpsychiatric subjects from the comnuni ty. The results of the study demonstrated that depressives adhered -excessively to traditional family ideology. In other words, the depressed females con- formed to the traditional feminine role.

A study of 172 affluent married women, 35 to '55, revealed that their depression was aggravated by social and family changes, notably their loss of the mother role when children left the home, a problem aptly named the empty-nest syndrome. As women live longer and as the amount of time needed to run a household decreases, it i s expected that this problem wi11 increase (Goodman & Goodman, 1972).

It seems that depression occurs as much as a result of the loss of the maternal-role as the loss of the child from the home. This premise is shared by Becker (1962) who ascribes depression to a loss of meaningful ego integrity and identity and self-esteem due to the loss of a meaningful role activfty. These middle-aged females, so to speak, are on stage without a scrl pt. Careers that are meaningful need years of preparation and there yeam have gone into homemaking and chi'ld rearing for the tradt tlonal feminine woman. One depressed hamemaker .interviewed. for this study was going through a difficult tIme with her 14 year old son. She said he had berated her for her lack of accomplishment in life. "Igraduated near the tap of my college class and had many good job opportunities but I thought mothering him was more important than carving a career. I don't have a career, and it seems I don't have a good son either."

Harris (1976) after examining the 1ive: of the women she had

interviewed for her book, speaks along this line: If our needs for love were channeled into preoccupation with children, our needs for work and achievement directed. toward the maintenance of our horns, what about all those other yearnings, desfres -- recognition, challenge, ad- venture, power? Sorting through the answers I got to my questions, I sensed that samehow they were simply turned away, he1 d in abeyance. The pattern was simply to find expression in self-renunciation and I heard it a hundred ways. . . Some wmn spoke about feeling guilty when they faiTed to find cmpletion in their devotion to their families. . . And a recurring theme was this one: "Sometimes when I become dissatisfied and restless, I would tell myself that I couldn't, take time for what I wanted now, but that someday the children would be grown and I would be able to do all those things I wanted to. What those vague "things" were was never spelled out for us, but they never seemed to merit serious attention from psychologists, sociologist or educators who so strongly reinforced our selection of the "womanly role", nor indeed were we ever given any hints that after a lifetime spent on deferring our needs and wishes to the service of others, we were not properly equipped to take upon ourselves the privilege and responsibility for our own sef f-expression. (p. 66) 20 Friedan (1963) a1 so emphasizes the peri1's. of the tradi tional feminine role, writing: The fact rmains that the girl who wastes her college years with acquf ri ng serious interes ts and wastes her early years marking time until she finds a man gambles with the possibilitfes of an identity of her own . . . It is not that easy for a woman who has defined herself wholly as wife and,.mother far ten to fifteen years to find a new identity at thirty-five, or forty, or fifty. (p. 365) Friedan also found that those women who had made a serious comitmentment outside the "feminine" role of housekeeping and chi ldren seemed most able to a1 low their husbands and children to pursue their own activities. Those whose only outlet was through their family nagged and overprotected and for all their good intentions were less able than their freer counterparts to be good wives and mothers. Freedman (1963) conducted a study of Vassar graduates and reveals:

The women who, twenty years later, were most troubling to the psychologi st were the most conventional ly feminine - the ones who were not interested, even in college, in

anything except finding a husband. (p. '878) * - Maslow studied 130 women of college education between 20 and 28 and found, contrary to what one might expect from psychoanalytical theories and conventional images of femini ty, that the more "domi nant" the woman, the greater her enjoyment of sexuality. These women were more free to be themselves and this seemed 1inked with a greater free- dom to give themselves in love. In an odd paradox, the dominant woman seemed to feel no need to dominate. These women were not in the usual sense "feminine" but they enjoyed sexual fulfillment to a much higher degree than the conventional ly feminine woman in the same study. (Mas1ow, 1939).

With so many studies and so much 1 iterature indi cati ng the feminine 21 role 1 tself may affect depression in the middle-aged female, the present study was undertaken to determine if females who were depressed would score higher in feminine characteristics on the BSRI (Bern's Sex-Role Inventory) than a normal group of women who were not experiencing depressi on and who had never undergone treatment for depression. Method Subjects Subjects were two groups of women between the ages of 35 and 50. The first group, called the Clinical Group, was composed of women who went through i ntake procedures and/or were bei ng counseled at the Northeast Orange Mental Health Center, the Seminole County Mental Health Center and the Orlando Regional Mental Health Center between the dates of July 23, 1979 and August 3, 1979 with the diagnosis of depression. The second group, called the Non-Cl inical Group, was composed of students at the University of Central Florida, personnel from the Northeast Orange Mental Heal th Center and members of St. Andrews Presbyterian Church. The criteria for the Non-Clinical Group is that they have not undergone psychiatric treatment or counseling and fa11 within the prescribed ages. Materials -- --- The questionnaire was a comb1 nation of Bern's Sex-Rol e Inventory and Beck 's Depression Inventory. Bern's Sex-Role Inventory (BSRI) was created by Sandra $ems at Stanford Universi ty and pub1 ished i n Archives of General Psychiatry in 1961. From a list of 200 male characteristics, 20 that were thought to be the most indicative of males were chosen by judqes. The judges consisted of both rnales and females. The same procedure was used to choose feminine characteri s tics . A1 so incl uded in the inventory is a Social Desirability Scale of 20 items which is completely neutral with respect to sex, to provide a neutral context for the Masculinity and Femi ninity Scales ., Ma1 e personal ity characteristics qua1 ifi ed for the inventory if they were independently judged by both males and females to be significantly (pe.05) more desirable for a man than for a woman.

The female characteri stics were simi1 arly chosen. Test-retes t re1i a- '

bi1 i ty on the instrument proved to be highly re1iable. (Masculine Scale

r = .90; Feminity Scale r = .90; Androgeny Scale r = -93; Social De- sirability Scale r = .89). The scale used to determine depth of depression of clients, Beck's

Depression Inventory, was primarily c-1i ni cal ly derived. Aaron T. Beck,

in the course of psychoanalytic psychotherapy of depressed patients, made systematic observations and records of characteri stic attitudes and symptoms that appeared to be specific for depressed patients. He con- structed an inventory of 21 categories of symptoms and attitudes. Each category describes a specific behavioral manifestation of depression

and consists of graded series of 4 to 5 self-evaluative statements. Two sample groups of depressed patients were than given the inventory (one group, 226 patients; the second, 183 patients) over a 7-month period starting June 1959. The patients were seen either directly before or after the administration of the inventory by a psychiatrist who

interviewed him and rated him on a Cpoint scale for depth of depression. Four experienced psychiatrists participated in the diagnostic study.

The degree of agreement in the rating on the scale and by the psychiatrist was within 1 degree on the 4-point scale in 97% of the cases.

Re1 iability of the inventory was evaluated for internal consistency

by analyzing 200 consecutive cases with the use of Krusal-Wal lis Non-

parametric Analysis of Variance by Ranks. It was shown that a1 1 categories showed significant ralationship to the total score for the

inventory. Test-retest method was administered to 38 different patients

at two different times with an interval of between 2 to 6 weeks. It was found that changes in the score on the inventory tended to para1lel changes in the clinical state of the patient. Validity of the test was

determined by means of the Mann-Whi tney U Test to appraise the power of

depression inventory to discrirni nate between speci fic depth of depres- . sion categories. It was found that a1 1 differences between adjacent categories were signif i cant. Thus studies of the internal consistency

and stability of the instrument indicate a high degree of reliability. Procedure The questionnaire was given to intake personnel and counselors at the three mental health centers. The intake person or counselor, after

having determined that the patient was between the ages of 35 and 50,

and was suffering from depression, asked her if she would take part

in the study. If she was aggr'eable to so doing, she was asked to

sign the letter attached (Appe!dix A) giving permission for the use

of her questionnaire. She was asked if she wished feedback from the

study, and if she replied in the affirmative, her name and mailing address were noted on a separate list of those wishing feedback. She

was then given the questionnaire and asked to complete it (Appendix B).

The women in the Non-Cl inical Group were asked to take part in the study by various persons. Those at the University of Central Florida were contacted during Psychology classes by their instructor. Those at the Northeast Orange Mental Health Center were contacted during a staff meeting by the' Exetutive Director of the Center. Those at

St. Andrews Presbyterian Church were contacted by their class teacher during a church school session. Those who were wi1 ling to take part in the study were asked to sign the letter of permission (Appendix A) and return it to the person contacting them. Those who signed the letter and returned it were given the questionnaire (Appendix 8) and asked to complete it. They were asked if they wished feedback from the study, and if they replied in the affirmative, their names and addresses were noted on a separate list of those wishing feedback. Results

Results of the study support the hypothesis that depression in middle-aged females is related to their degree of acceptance of the traditional femi nine role. For a1 1 subjects, depression (as measured by Beck's Depression Inventory) was posi tively correlated with feminl nity (as defined and measured by Bern's Sex-rol e Inventory). The

Pearson correlation coefficient for these two measures was r = .62 p < .001. A one way ANOVA across a11 samples on Beck's Depression Inventory scores revealed a significant main effect CF- (4,33) = 11.29, c .001.1 A post hoc analysis using Duncan's Mu1 tiple Range procedure revealed that the Non-cl inical samples had significantly lower depression scores than the Clinical samples (all ~'s< .05). In addi tion the 25 Northeast Orange Clinical sample had significantly higher depression scores than the Semi no1e Cl inical sampl e (g < .05).

An ANOVA based on Bern's Sex-role Inventory scores across a1 1 Clinical and Non-clinical samples also revealed a main effect [F (4,33) = 11 .29, E < .001 .I A Duncan's post hoc analysi s revealed that the Northeast Orange ~7 inical sample had a significantly higher feminism score (i.e. more traditional feminine values) than all other samples, both Clinical and Non-clinical . The Seminole Cli'nical sample, a1though not significantly different from the three Non-cl inical samples, had the second highest score in feminism (See Table 6). Figure 1 is a Scatter plot showing the relationship between Bern's Sex-role Inventory for each subject in the Clinical and Non-clinical samples. Inspection of this figure reveals that while 100% of the Non-clinical subjects (n- = 24) had depression scores that were s 16,

95% (n- = 14) of the Clinical subjects had depression scores 2 18. Similarly, Figure 1 reveals that whSl e 29% (fi = 7) of the Non-clinical group had sex-role scores in the masculine range of the BSRI, no Clinical subject had a score in the masculine range. ~llof the Non- clinical subjects scored s 20 on the feminism scale; 73% of the Clinical subjects (n- = 11) had scores > 20. Diseussi on

The results of this study support the hypothesis that depression in the middle-aged female is related to their degree of acceptance of the traditional feminine role. Depression and femini ty showed a positive, significant correlation of .62, indicating that 38% of the variance in these women s depression scores can be accounted for by the sex-role variable. More simply, it appears that middle-aged females who get depressed tend to subscribe to a more traditional feminine role and the degree of their depression is significantly related to their degree of acceptance of the feminine role. This correlation is apparent from an inspection of Table 6 and Figure 1.

Table 6 - Means with Standard Deviations for Clinical and Non-cl ini cal groups Beck's Depression Bern's Sex-role Actual Inventory Score Inventory Score BSRI Non-cl inical (+ 25 points) Score

Sample #I

Uni versi ty of ' Central Ft orida Means (No. in sample=14) S.D. Sample #2 Northeast Orange Mental Health Means (No. in sampled) S.D. Sample #3 St. Andrews Presbyterian Church Means (NO. in sample=$) S.D.

Clinical

Sample #4 Semi no1 e Mental Health Center Means (No. in sample=5) SOD. Sample #5 Northeast Orange Mental Health Means (No. in sample=8) S.D. 65 Bem's Sex-Role Inventory Score 60

x = Non-Cl ini cal 25 subjects 20 o = Clinical subjects

5 10 15 20 25 30 35 40 45 50 Beck' s Depression Inventory Score Figure 1. Raw scores of subjects on BSRI and Beck's Depression Inventory Further inspection of Figure 1 reveal s that, interestingly, a1 1 except one of the Clinical group scored higher than 16 on the Beck's Depression Inventory and only one of the Non-cl inical women scored as high as 16. Looking at the scores on the BSRI reveals that not one woman in the Clinical group scored in the masculine range; 29%

i (n = 7) of the Non-clinical group scored in the masculine range. 73% (n = 11) of the Clinical group scored higher in the feminine traits than the highest of the Non-cl inical group. The fact that the Northeast Orange Clinical group scored higher in depression than the Seminole group suggests a possible sampling bias indicating that Northeast Orange deals with a more severely depressed population than the Semi no1e Mental Heal th Center. Thi s trend may be a result of the difference in the two areas. Winter Park in which Northeast Orange is located, is a more settled area and there is much wealth in this community. Those coming into Northeast Orange are of a low socio-economic class and would feel their deprivation more severely than those in the Seminole area which is relatively new and composed mostly of working-class people. In either area the passive, retiri ng , tradi tional ly femi nine woman would have more diff icul ty in making new friends and opening new avenues of experience in her middle years than a more androgenous woman. The Northeast Orange Clinical group is significantly higher in femini ty than the three Non-clinical groups. The Seminole Clinical group is not significantly more feminine than the f on-cl inical groups but is 9.35 points higher than even the women in the highly feminine Non-clinical church group (E = 43.60 - vs. & = 34.25). The high feminine score of the St. Andrews church women in comparison with the other Nan-el inical groups (x- = 34.25 vs. = 26.22, 26.17) may be due in part to the small number in the sample (n = 4). Another possibility is that since this sample is comprised. of church women they inay subscribe to a more traditionally feminine role but not

' become depressed because they draw their support from the church. The church in question has a small congregation and members enjoy close, warm relationships and possibly rewards a woman for her conformity. The present study suggests that society 's training and expectati ons of the woman, i. e. fitting her into a "feminine" role to fulfill the needs and desires of others, teaching her to be nonassertive and to find her happiness through 1iving vicariously through important others . leaves her more vulnerable to depression in her middle years as her

children leave home and she feels no longer young and attractive to her husband. In many cases the husband is going through his own crises and does not gfve her the support she needs. As indications of the undesi rable consequences of following the traditional femi nine role evolve from studies and from literature, perhaps society will modify child training practices. It is up to human beings to select the type of child training that leads into productive and mentally heal thy

adults. MacCoby and Jack1 in (1974) express this as follows:

It is by no means obvious that attempts to foster sex- typed behavior (as traditional ly defined) in boys and girls serve to make them better men and women. Indeed, in some spheres of adult life, such attempts appear to be positively handicapping. (P- 373) A suggestion for further study would be the younger woman between

the ages of 20 and 35, as there are indications .that it is the younger 30 woman who is becoming mi at an ever-grrowing rate (Klerman, 1979). Are the depressed fm dm younger age group more feminine than t hei r nondepressed counteyparts? A1 so i t woul d be in teres ti ng to sea how feminine characteristice vary during therapy for the depressed woman. Do the ones who improve become more androgenous?

b6 UNIVERSITY OF CENTRAL FLORIDA

DEPARTMENT OF PSYCHOLOGY

OR LANDO, FLOR IDA 328 16 (305) 275-22 16 Summer 1 9 7 9

You are being asked to complete a questionnaire. This paper will become part of a study of women's personality traits and attitudes that will be published as a Master's Thesis at the

University of Central Florida by Emily G. Tinsley.

You will remain anonymous and will not be identified in any way in this study.

By signing below, you signjfy that you have been advised of this fact and that you agree to let the questionnaire become part of the study.

Signature

Date Appendix 8: Questionnaire Pick out the one statement in the group which best describes the way you feel TODAY, that is RIGHT NONOW. Circle the number beside the statement you have chosen. If ieveral statements in the group seem to apply equa,l ly we1 1 , circle each one. Be sure to read a1 1 the statements in the group before maki ng your choi ce: A. 0 I do not feel sad 1 I feel blue or sad 2a 1 am blue or sad all the time and I can't snap out of it 2b I am so sad or unhappy that it is quite painful 3 1 am so sad or unhappy that I can't stand it

Be 0 I am not particulary pessimistic or discouraged about the future 1 I feel discouraged about the future 2a I feel that I have nothing to look forward to 2b I feel that I won' t ever get over my troubles 3 1 feel that the future is hopeless and that things cannot improve C. 0 I do not feel like a failure 1 I feel that I have failed more than the average person 2a I feel I have accompl ished very 1i ttle that is worthwhile or that means anything 2b As I look back on my life all I can see is a lot of failure 3 I feel I am a complete failure as a person (parent, spouse) D . 0 I am not particularly dissatisfied 1 I feel bored most of the time 2a I don't enjoy things the way I used to 2b I don't get satisfaction out of anything any more 3 I am dissatisfied with everything E. 0 I don't feel particularly guilty 1 I feel bad or unworthy a good part of the time 2a I feel quite guilty 2b I feel bad or unworthy practically a1 1 the time now 3 1 feel as though I am very bad or worthless F. 0 I don't feel I am being punished 1 I have a feeling that something bad may happen to me 2 1 feel I am being punished or wi11 be punished 3a I feel I deserve to be punished 3b I want to be punished Appendi x B (Con tinued)

G. 0 I don't feel dtsappointed in myself la I am disappointed in nlysel f lb I don't like nyself 2 I am di.sgusted wl th myself 3 I hate mysel f H . 0 I don' t feel I am worse than anybody else 1 I am crf tical of myself for my weaknesses or mistakes 2 I blame myself for my faults 3 I blame myself for everything that happens

0 I don't cry any more than usual 1 I cry more than I used to 2 I cry all the time now. I can't stop it 3 I used to be able to cry but now I can't cry at all even though I want to 3 .

0 I don' t have any thoughts of harming myself a 1 I have thoughts of harming myself but I would not carry them out 2a I feel I would be better off dead 2b I feel my family would be better off if I were dead 3a I have definite plans about committing suicide 3b I would kill myself if I could

K. 0 I am no more irritated now than I ever am 1 I get annoyed or irritated more easily than I used to 2 I feel irritated all the time 3 1 don't get irritated at all at thlnqs that used to irritate me L. 0 I have not lost interest in other people 1 I am less interested in other people now than I used to be 2 I have lost all my interest in other people and don't care about them at all M. 0 I make decisions about as well as ever 1 I try to put off making decisions 2 I have great difficulty in making decisions 3 I can't make any decisions at all anymore N. 0 I don't feel I look any worse than I used to 1 I am worried that I am looking old or unattractive 2 I feel that there are permanent changes in my appearance and Appendix 0 (continued) N . (Conti nued) they make me look'unattractive 3 I feel that I am ugly or repulsive looking 0. 0 I can work as we1 1 as, before la It takes extra effort to get started doing something lb I don't wo~kas well as I used to 2 1 have to push myself very hard to do anything 3 1 can't doaany work at all

I can sleep as well as usual I wake up more tired in the morning than I used to Iwake up 2-3 hours earlier than usual and find it hard to get back to sleep I wake up early every day and can t get more than 5 hours sleep

I don' t get any more tired than usual I get tired more easily than I used to I get tired from doing anything I get too tired to do anything

My appetite is not worse than usual My appetite is not as good as it used to be My appetite is much worse now I have no appetite at all s. 0 I haven't lost much weight, if any, 'lately 1 I have lost more than 5 pounds 2 I have lost mare than 10 pounds 3 I have lost more than 15 pounds T. 0 I am no more concerned about my health than usual 1 I am concerned about aches and pains or upset stomach or cons tipati on 2 I am so concerned with how I feel or what I feel that it is hard to think of much else 3 I am completely absorbed in what I feel

U. 0 I have not noticed any recent change in m.y interest in sex 1 I am less interest in sex than I used to be 2 I am much. less interest in sex now 3 I have lost interest in sex completely Appendix B (Continued)

Below you wi11 be shown a large number of personality characteristics. I would 1i ke you to use those characteristics in order to describe yourself. That is, I would like you to indicate on a scale from 1 to 7 how true of you these various characteristics are. Please do not leave any characteristic unmarked. Example: sly Mark a 1 if it is NEYER OR ALMOST NEVER TRUE that you are sly. Mark a 2 if 1t is USUALLY NOT TRUE that you are sly. Mark a 3 if it 5 s SOMETIMES BUT INFREQUENTLY TRUE. that you are sly. Mark a 4 if.i t'is OCCASIONALLY TRUE that you are sly. Mark a 5 if it is OFTEN TRUE that you are sly. Mark a 6 if it is USUALLY TRUE that you are sly. Mark a 7 if it is ALWAYS OR ALMOST ALWAYS TRUE that you are sly.

Thus if you feel that it is sometimes but infrequently true that you are "sly", never or almost never true that you are "ma1 icious" , alwa s or almost always true that you are "irresponsible" and often true+ t at you are carefree, then you would rate these characteristics as follows: Irresponsible 7 Carefree 5 Self reliant - Re1 iabl e Likable Yielding - Ana 1 vttear - Mascul ine He1 pful sympathetic Warm - Defends own Jeal-- ous. -.- - Sol emn be1 ief - Has leadership Willing to Cheerful - abi 1i ty take stand Moody Sensitive tothe Tender

Independent needs of others ' ~riendly Shy Truthful Aggressi ve Consc7 entious Willing tr Gullible Athl etic take risk - Affections Unders tandi Acts as leader Theatri cal - Secreti ve - Child1ike Assertive Makes decisions Adapta ble ~latterabla- easily Indivi duali'stic Happy Compassionate Does not use har5 Strong Per- Sincere -- - - 1anguage sonal ity - Self-sufficient Unsympatheti c Loya 1 Eager to soothe Com~etitive - Unpredi ctable hurt feel ings ~oveschi 1 dren ~orceful Concei ted Tactful Femi nine - Domi nant ~mbitiour Solf spoken Gentle Conventional Appendlx C: Raw Data

Subject No. Origln Beck ' s Depression Bern's Sex-Rol e . ., lfiventory Score Inventory Score CLINICAL GROUP: #I Orlando Reglogal Mental

Center ' #2 Seminole Mental Heal th Center #3 1B

#7 Northeast Orange Mental Heal th Center #8 II Appendi x C (Continued) NON-CLINICAL GROUP: Beck's BSRI #I University af Central Fla. -1

#I 5 Personnel at Northeast Orange Mental Health Center #16 It

#21 St. Andrews Presbyterian Church members #22 It Reference Note

1 . Wei ssman, M. M. Th'emyth of invol utional melancholia. Manuscript submitted for pob~ication, 1979. References

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