Mental Health 491adjust to their sexual orientation, fewer dif-
ferences may be found. Among adults, the
difference in mental health problems between
sexual minorities and heterosexuals is less
clear. It also is not clear whether the differ-
ence is larger for males or females. One study
of mood disorders (anxiety and depression)
indicated that the difference between gay
men and heterosexual men is larger than the
difference between lesbians and heterosexual
women (Bostwick et al., 2010), whereas two
other studies found just the opposite (Bybee
et al., 2009; Cochran et al., 2007).
There are several reasons why sex-
ual minorities have elevated mental health
problems compared to heterosexuals. One
is the impact of discrimination. A second,
and related, reason is lack of social support
(Spencer & Patrick, 2009). Finally, sexual mi-
norities may internalize society’s negative at-
titudes toward them. One study showed that
explicit measures of antigay attitudes were
not related to mental health problems among
sexual minorities, but implicit attitudes were
(Hatzenbuehler et al., 2009). Over a 10-day
period, stigma-related stress was associated
with more distress but only among sexual mi-
norities who held implicit antigay attitudes.TAKE HOME POINTS
■ Females are more likely than males to report depres-
sive symptoms as well as major depressive disorder.
■ Sex differences persist across a variety of cultures but
are not observed in some homogenous populations,
such as college students and the widowed.
■ The sex difference in depression is related to the onset
of depression—not recurrence.
■ There are elevated rates of mental health problems
among sexual minorities.episode of depression experienced a recur-
rence (Wainwright & Surtees, 2002). Thus
among those without a history of depression,
women are more likely than men to become
depressed at any given point in time, but no
evidence indicates that depression is more
likely to recur among women than men
among those with a history of depression.
There is a higher prevalence of some
mental health problems among gay and les-
bian people compared to heterosexuals. A
meta-analytic review of the literature showed
that sexual minorities have more anxiety,
depression, and substance abuse problems
than heterosexuals (Meyer, 2003). More re-
cent studies have confirmed these findings
(Coker, Austin, & Schuster, 2010). However,
a majority of studies in this area focus on
younger samples—adolescents and college
students. Because adults have more time toAge67CDI Score128910117 8 9 10 11 12 13 14 15 16 17Boys
GirlsFIGURE 13.2 CDI (depression) scores for
girls and boys. Prior to age 13, boys have slightly
higher scores than girls. After age 13, females’
rates of depression substantially increase lead-
ing to a sex difference in depression that persists
across the lifespan.
Source: Twenge and Nolen-Hoeksema (2002).M13_HELG0185_04_SE_C13.indd 491 6/21/11 12:55 PM