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PubMed2002

The experience of schizophrenia: what's gender got to do with it? A critical review of the current status of research on schizophrenia.

The role of gender in schizophrenia is explored, and literature on gender and schizophrenia is critically reviewed. The importance of investigating gender differences in schizophrenia is underscored by the lack of sufficient research in this area to date and the comparative neglect of sociocultural issues during the "decade of the brain." The importance of incorporating gender factors into research analysis is demonstrated via an interdisciplinary discussion that involves psychiatric, anthropological, and sociological theory. Methodological and measurement issues in gender-based research are considered. Selected directions for future research initiatives that expand beyond a dichotomous comparison of "male" and "female" sex differences to examine the role of gender along a continuum as a sociocultural influence on schizophrenia onset, illness presentation, and treatment are presented.

Culture↗
PubMed2003

What influences medical students to pursue careers in obstetrics and gynecology?

OBJECTIVES: The purpose of this study was to identify factors that influence medical students to choose of obstetrics/gynecology as a career specialty. STUDY DESIGN: A Web-based survey of medical students was conducted that included demographics, desire to enter the obstetrics and gynecology specialty, factors that influence selection of the obstetrics and gynecology specialty, perceptions about the obstetrics and gynecology specialty, and incidents of encouragement and discouragement toward entering the obstetrics and gynecology specialty. Analysis included parametric and nonparametric testing. RESULTS: Fifty-one percent of the students (n=205) returned the survey: 131 women (64%) and 72 men (35%); 2 respondents did not specify gender. Various factors influenced a medical student to pursue a career in obstetrics and gynecology, which revealed some specific areas of significant difference between genders, particularly in relation to lifestyle issues and practice trends. CONCLUSIONS: This study amplifies the importance of understanding the role of student gender when exploring the obstetrics and gynecology specialty as a career choice. Appreciating factors that influence decisions to enter the obstetrics and gynecology specialty provides opportunities to impact the experiences and decisions of students toward considering the obstetrics and gynecology specialty as a career choice.

Career Choice↗
PubMed1996

Women with bipolar illness: clinical and research issues.

OBJECTIVE: The purpose of this article is to review the literature concerning gender differences in the course of bipolar illness and discuss issues relevant to the treatment of women with the illness. METHOD: The literature concerning the following topics is reviewed: gender differences in the course of bipolar illness; effects of the female reproductive cycle on the course of bipolar illness; special considerations in the treatment of bipolar women (focusing on the hypothalamic-pituitary-gonadal and hypothalamic-pituitary-thyroid axes); and hypotheses to explain the greater prevalence of rapid cycling among bipolar women than among bipolar men. RESULTS: Data clearly indicate that rapid cycling is more common among bipolar women. Data also suggest that bipolar women may have more depressive episodes (and fewer manic episodes) and may be more likely to suffer from mixed (as opposed to pure) mania than bipolar men. While it is clear that bipolar women are at high risk for postpartum episodes, the effects of other reproductive system events (i.e., puberty, menstrual cycle, pregnancy, menopause, use of oral contraceptives or hormone replacement therapy) on the course or treatment of bipolar illness have received little systematic study. It is unclear whether women are at higher risk than men for developing lithium-induced hypothyroidism. Higher rates of hypothyroidism, greater use of antidepressants, and gonadal steroid effects are possible explanations for the greater prevalence of rapid cycling among bipolar women. CONCLUSIONS: Gender differences in bipolar illness and the effects of the female reproductive system on the course and treatment of the illness deserve more study. The importance of a longitudinal approach to these questions is emphasized.

Adult↗
PubMed2002

Ethical issues in gynecology: adolescent confidentiality, provider conscience and abortion, and patient choice of provider gender.

All medical specialists struggle with problems that cannot be solved with medical knowledge alone. The field of gynecology is not unique in medicine for the presence of ethical dilemmas, but the nature of the dilemmas are unique. Gynecologists commonly confront complex ethical questions in their practices that can be answered only through thoughtful consideration of the values, interests, rights, goals, and obligations of those involved. In this paper, three ethical issues that commonly arise in the practice of gynecology are presented: adolescent confidentiality regarding reproductive health services, physician conscience and provision of abortion services, and the question of accommodating patient choice of provider gender. Each topic is introduced with a case vignette followed by an analysis of the issues involved and recommendations for resolution.

Abortion, Induced↗
PubMedDate not supplied

Reliability of laterality effects in a dichotic listening task with nonverbal material.

The present study examined the reliability of a dichotic listening task using nonverbal stimuli. Twenty undergraduate students (all right-handed native English speakers) had to report whether they had heard a target emotion. The task used English words (bower, dower, power, tower) pronounced with an angry, happy, neutral, or sad emotional tone. Results showed a relatively high level of test-retest reliability for the laterality effect. In addition, a significant gender by ear of presentation interaction was obtained. The interaction reflected the fact that a strong left ear advantage was found in females but not in males. The findings indicate that the task used here should be considered a reliable means to assess the lateralization of emotions. Issues concerning the relation between gender and laterality are addressed in the discussion.

Dichotic Listening Tests↗
PubMed2006

Osteoarthritis of the hip and knee: sex and gender differences.

Osteoarthritis of the hip and knee is a leading cause of functional disability and compromised quality of life in older patients and a significant public health issue. Emerging research shows sex and gender differences in osteoarthritis which, to date, may not be appreciated by the orthopedic community. This article discusses sex and gender differences in osteoarthritis with a focus on disease involving the hip and knee. Understanding what we know (and do not know) about sex and gender differences in this disorder is critical to improving quality of care for our patients.

Anterior Cruciate Ligament Injuries↗
PubMed1995

Anxiety disorders in women.

Existing research indicates that anxiety disorders are three times as common in women as in men. Yet true gender-based research is still in its infancy. The author discusses key areas affecting the occurrence of anxiety disorders in women, including medical conditions, epidemiological and diagnostic perspectives, work and the reproductive cycle, trauma (including abuse), and marriage and the family. She notes that future research is likely to produce rapid change and reevaluation in many of these core issues. She concludes that both genders will benefit because evaluation and treatment can truly be tailored to the specific needs of each individual man or woman.

Anti-Anxiety Agents↗
PubMed1996

Adolescent attitudes about rape.

A very significant problem in society is adolescent rape victimization and the growing number of adolescent perpetrators. This paper examines adolescent attitudes about rape in order to develop curricular materials. It is found that adolescents exhibit conservative attitudes about gender roles, general rape myths, and victim issues.

Adolescent↗
PubMed2003

Why are women diagnosed borderline more than men?

DSM-IV-TR states that borderline personality disorder (BPD) is "diagnosed predominantly (about 75%) in females." A 3:1 female to male gender ratio is quite pronounced for a mental disorder and, consequently, has led to speculation about its cause and to some empirical research. The essential question is whether the higher rate of BPD observed in women is a result of a sampling or diagnostic bias, or is it a reflection of biological or sociocultural differences between women and men? Data to address these issues are reviewed. The differential gender prevalence of BPD in clinical settings appears to be largely a function of sampling bias. True prevalence by gender is unknown. The modest empirical support for diagnostic biases of various kinds would not account for a wide difference in prevalence between the genders. Biological and sociocultural factors provide potentially illuminating hypotheses, should the true prevalence of BPD differ by gender.

Antisocial Personality Disorder↗
PubMed2002

Areas of brain activation in males and females during viewing of erotic film excerpts.

Various lines of evidence indicate that men generally experience greater sexual arousal (SA) to erotic stimuli than women. Yet, little is known regarding the neurobiological processes underlying such a gender difference. To investigate this issue, functional magnetic resonance imaging was used to compare the neural correlates of SA in 20 male and 20 female subjects. Brain activity was measured while male and female subjects were viewing erotic film excerpts. Results showed that the level of perceived SA was significantly higher in male than in female subjects. When compared to viewing emotionally neutral film excerpts, viewing erotic film excerpts was associated, for both genders, with bilateral blood oxygen level dependent (BOLD) signal increases in the anterior cingulate, medial prefrontal, orbitofrontal, insular, and occipitotemporal cortices, as well as in the amygdala and the ventral striatum. Only for the group of male subjects was there evidence of a significant activation of the thalamus and hypothalamus, a sexually dimorphic area of the brain known to play a pivotal role in physiological arousal and sexual behavior. When directly compared between genders, hypothalamic activation was found to be significantly greater in male subjects. Furthermore, for male subjects only, the magnitude of hypothalamic activation was positively correlated with reported levels of SA. These findings reveal the existence of similarities and dissimilarities in the way the brain of both genders responds to erotic stimuli. They further suggest that the greater SA generally experienced by men, when viewing erotica, may be related to the functional gender difference found here with respect to the hypothalamus.

Adult↗
PubMed1996

Older adults and healthy lifestyle issues: results of a community study.

AIM: To discover sources of information about, levels of understanding of, and degrees of commitment to a healthy lifestyle on the part of elderly people in the community as a preliminary to mounting health promotion and education initiatives. METHOD: In 1992 500 people aged 60 and over were surveyed anonymously using a 33 item questionnaire. This sought information on a wide range of health and lifestyle issues in older age. The material in this paper refers to only four of the questions asked, namely those relating to sources of, knowledge of, and interest in information on health and ageing. RESULTS: Doctors were perceived to be the most important sources of health information (89% of respondents rating them as "very" or "moderately" important). Relatives/friends and books/magazines were the next most important sources (56 and 55% respectively). High levels of misinformation about lifestyle issues were revealed. Whilst 85+% of respondents answered correctly that smoking was deleterious and strong social ties advantageous to good health in old age there was confusion about causes of osteoporosis, use of vitamins, likelihood of developing dementia and even the importance of exercise. This has implications for the content of health promotion programmes. Contrary to previously published research, we found no correlation between educational or socioeconomic status or gender, and knowledge about health issues and healthy lifestyles. CONCLUSION: Studies of this type clearly have the ability to provide a range of information which ought to be available to those responsible for the planning of health promotion and education initiatives for older adults.

Aged↗
PubMed1998

Should alcohol consumption measures be adjusted for gender differences?

Because of biological differences between men and women, the same quantity of alcohol consumed over the same time period produces higher blood alcohol levels (BALs) in women than in men. Some alcohol researchers have proposed that quantity and volume measures of alcohol consumption (e.g. usual number of drinks per drinking day and overall amount of alcohol consumed) should be adjusted to reflect these biological differences. To date, no standard adjustment for biological gender differences has been adopted. In this paper, we review the literature on biological and behavioral differences related to alcohol consumption and effects and discuss the implications of these differences in terms of adjusting alcohol consumption measures. Our review suggests that adjusting measures of alcohol consumption to compensate for biological sex differences is most appropriate for research or policy applications involving the short and long-term physiological effects of alcohol in contexts where gender differences in how alcohol is consumed can be assumed to be minimal. In other circumstances, non-biological gender differences relating to alcohol use, such as pace of drinking, may moderate the relationship between alcohol consumption and biological gender differences, making an adjustment less defensible. We also identify areas where more knowledge is needed not only to address the issue of adjusting alcohol measures for gender differences but also to understand better the relationship between alcohol consumption and effects.

Alcohol Drinking↗
PubMed2003

Medical student awareness of sexual health is poor.

The aim of the study was to assess sexual health knowledge of medical students. Participants from the student population of an English Medical School (University of Bristol) were asked to fill in a questionnaire on the Internet about sexual health issues. The number of correct responses to each question was analysed according to participants' gender and medical school year. While certain issues relating to sexually transmitted infections, contraception and confidentiality in HIV testing were well understood, there was poor knowledge about the failure rate of condoms, abortion rates and prevalence of chlamydia. Women knew more about the contraceptive pill than men. Although increased years of medical training had some benefit in improving the accuracy of knowledge, this effect was surprisingly small. Most medical students have inaccurate factual knowledge about certain important sexual health issues. We consider this to reflect poorly on sexual health awareness in young people in general. There is need for greater sexual health education for future doctors and for the general public.

Attitude of Health Personnel↗
PubMed1997

Physicians' gender and clinical opinions of reproductive health matters.

The purpose of this study was to investigate the effect of physicians' gender when sex-specific conditions are being treated in a country where almost half of the physicians are women. Five Finnish surveys originally conducted for other purposes were reanalyzed. Two surveys examined physicians' and medical students' views about hormone therapy during and after menopause, one survey examined medical students' attitudes about medicines, one survey examined physicians' obstetric practices, and one examined contraceptive counselling. All the surveys showed more similarities than differences in the clinical decision-making of women and men physicians. In opinions about menopause the physician's medical specialty was more important than gender. Physicians' obstetrical practices were also similar in five cases out of six, but in one situation where medical factors were not a deciding issue, women physicians acted differently. These results suggest that socialization into the medical profession makes physicians' practices more alike and diminishes gender differences.

Attitude of Health Personnel↗
PubMed2006

Developmental endocrine influences on gender identity: implications for management of disorders of sex development.

When a baby is born, the first medical pronouncement is usually, "It's a boy," or "It's a girl." In most cases, this pronouncement is based simply upon the appearance of the child's external genitalia. Due to variations in the process of sexual differentiation, sometimes the gender that should be assigned is not apparent from inspection of the external genitalia, either because they are "ambiguous" or because their appearance is not congruent with the internal anatomy. Decisions must be made not only about the most appropriate gender to assign the infant but also about the medical and rearing practices that will facilitate optimal psychological development and quality of life for the affected individual. This article will review the approach to managing gender disorders that has evolved since the 1950s. Three issues are identified as central to current shifts that are occurring in the management of these disorders: (a) increased understanding of the biological substrates of gender identity; (b) questions regarding the indications for irreversible cosmetic genital surgeries as a means of reinforcing gender assignments in infancy, and (c) ethical issues pertaining to informed consent and who is entitled to give it, particularly with regard to surgical gender reassignments in infancy. In keeping with the neuropsychiatry theme of this issue, the focus of this article is on prenatal sexual differentiation of the brain as it pertains to the question of psychosexual neutrality at birth.

17-Hydroxysteroid Dehydrogenases↗
PubMed1998

Gender differences in the schooling experiences of adolescents in low-income countries: the case of Kenya.

Although a growing proportion of young people is spending some time in school between puberty and marriage, little research on education in developing countries has been focused on adolescent issues. This article examines the school environment in Kenya and the ways it can help or hinder adolescents. Gender differences are considered with a view toward illuminating some factors that may present particular obstacles or opportunities for girls. Using both qualitative and quantitative data, 36 primary schools in rural areas in three districts of Kenya are studied. These schools are chosen to reflect the spectrum of school quality in the country. The focus in this study is on primary schools because the majority of adolescents in school attend primary school. In these schools, where considerable variation in performance and parental educational status is found, disorganization coexists with strict punishment, minimal comforts are lacking, learning materials are scare, learning is by rote, and sex education is not provided. In the primary-school-leaving exam, girls' performance is poorer than that of boys. Teachers' attitudes and behavior reveal lower expectations for adolescent girls, traditional assumptions about gender roles, and a double standard about sexual activity.

Adolescent↗
PubMed1998

Treatment needs of women with alcohol and other drug problems: experiences and views of Australian treatment personnel.

One hundred treatment personnel completed a structured interview as part of an Australian national study of the treatment needs of women with alcohol and other drug problems. The aim of the survey was to ascertain personnel's experiences of, and beliefs about providing services to women. Respondents had a broad range of qualifications and experience, and were generally supportive of provision of gender-sensitive services to women. The interview addressed a number of issues, including: barriers to treatment access, ability to provide gender-sensitive services, appropriateness of women-only services, and addressing sexual abuse issues. It is concluded that while many agencies attempted to provide appropriate services for women, many experienced difficulties, such as a lack of resources and funding. There is a continuing need for research into the best method of service delivery for women.

Journal Article↗