Ruth L Firmin1,2, Aieyat B Zalzala3, Jay A Hamm4, Lauren Luther5,6, Paul H Lysaker7,8. 1. Department of Psychiatry and Human Behavior, Brown University Medical School, Providence, Rhode Island, USA. 2. Department of Psychiatry, Rhode Island Hospital, Providence, Rhode Island, USA. 3. Department of Psychiatry, The Institute of the Living at Hartford Hospital, Hartford, Connecticut, USA. 4. Midtown Community Mental Health Center, Eskenazi Hospital, Indianapolis, Indiana, USA. 5. Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA. 6. Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA. 7. Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, USA. 8. Roudebush VA Medical Center, Indianapolis, Indiana, USA.
Abstract
PURPOSE: Psychosis disrupts how persons experience themselves and their lives. Despite knowledge that gender differences have been noted in presentation and course of psychosis symptoms, little is known about differences in how men and women experience these disruptions. METHOD: The narratives of 26 men and 27 women diagnosed with psychosis, matched on age, education, and race, of the impact of psychosis on one's life, were compared. Using secondary data from semi-structured interviews, themes were identified using inductive, phenomenological qualitative analyses. RESULTS: Women and men discussed psychosis-related interruptions to the roles and relationships that shape their identity. Both genders discussed the impact of psychosis on their sense of self, work, and relationships. Nuanced gender differences emerged, informing unique areas of challenge related to (1) parenting and loss of parenting roles, (2) work and loss or changes in work trajectories, (3) isolation and strain on interpersonal relationships, and (4) manifestations of stigma. CONCLUSIONS: Psychosis may disrupt distinct aspects of life for men and women. Each gender faces the intersection of socially informed expectations that impact one's experiences of stigma, expectations of others, and manifestations of losses felt in one's role and sense of identity. Findings inform important considerations for therapy and other services. PRACTITIONER POINTS: Gender-based socialized expectations, losses, and challenges that accompany psychosis are important areas for therapeutic consideration. Current treatments may neglect challenges that are more commonly experienced by women with psychosis.
PURPOSE:Psychosis disrupts how persons experience themselves and their lives. Despite knowledge that gender differences have been noted in presentation and course of psychosis symptoms, little is known about differences in how men and women experience these disruptions. METHOD: The narratives of 26 men and 27 women diagnosed with psychosis, matched on age, education, and race, of the impact of psychosis on one's life, were compared. Using secondary data from semi-structured interviews, themes were identified using inductive, phenomenological qualitative analyses. RESULTS:Women and men discussed psychosis-related interruptions to the roles and relationships that shape their identity. Both genders discussed the impact of psychosis on their sense of self, work, and relationships. Nuanced gender differences emerged, informing unique areas of challenge related to (1) parenting and loss of parenting roles, (2) work and loss or changes in work trajectories, (3) isolation and strain on interpersonal relationships, and (4) manifestations of stigma. CONCLUSIONS:Psychosis may disrupt distinct aspects of life for men and women. Each gender faces the intersection of socially informed expectations that impact one's experiences of stigma, expectations of others, and manifestations of losses felt in one's role and sense of identity. Findings inform important considerations for therapy and other services. PRACTITIONER POINTS: Gender-based socialized expectations, losses, and challenges that accompany psychosis are important areas for therapeutic consideration. Current treatments may neglect challenges that are more commonly experienced by women with psychosis.