Gender Differences in Depression: Biological, Affective, Cognitive, and Sociocultural Factors.

The odds ratio (OR) for gender differences in major depression is 1.95, averaged meta-analytically over all ages and nations. The gender difference appears by age 12, OR = 2.37, and peaks at OR = 3.02 for ages 13-15. Using the ABC (affective, biological, cognitive) model as a framework within a vulnerability-stress approach, we consider the evidence for biological vulnerabilities (genes, pubertal hormones, and pubertal timing), affective vulnerabilities (temperament), and cognitive vulnerabilities (negative cognitive style, objectified body consciousness, and rumination). The impact of stress is central to the vulnerability-stress model, and we review evidence on gender differences in stress exposure, emphasizing gender differences in sex-related traumas such as child sexual abuse and rape. Finally, we examine sociocultural factors that may contribute to the gender difference, including the media and gender inequality. An implication for research methods is that single-gender designs should be questioned. Regarding clinical implications, the vulnerabilities and stressors identified in this review should contribute to personalized interventions with depressed individuals, especially depressed women.