508 Chapter 13men experienced more trauma than women
(Tolin & Foa, 2006). This sex difference de-
pended greatly on the nature of the trauma.
Whereas women were 6 times as likely as men
to report adult sexual assault and 2.5 times as
likely as men to report child sexual assault,
men were 3.5 times as likely to experience
combat/war/terrorism and over 1.5 times as
likely to experience nonsexual assault.
Just as we distinguished between major
depressive disorder and depressive symptoms,
we can also distinguish between traumatic
life events (e.g., sexual assault, disaster) and
stressful life events (e.g., job loss, divorce, re-
lationship problems, financial difficulties).
A meta-analytic review of the literature on sex
differences in stressful life events showed that
across 119 studies there was a small tendency
for females to report more stressful events
than males (d=+.12; Davis, Matthews, &
Twamley, 1999). The size of this effect is ex-
tremely small, and a number of variables in-
fluenced the size of the relation. One factor
that influenced the effect size was how stress
was measured. Researchers who study stress-
ful life events typically ask respondents to in-
dicate whether an event happened and/or to
rate the level of stress associated with an event.
That is, ratings are made ofstress exposureand
stress impact. When these two kinds of ratings
were distinguished from one another in the
meta-analysis, the sex difference in exposure
was smaller than the sex difference in impact
(d=+.08 vs.d=+.18). Thus, women may ap-
praise stressors as more severe than men, but
women and men do not necessarily experience
a different number of stressors. The age of the
sample also influenced the size of the relation.
The sex difference in stress was larger among
adolescent samples compared to children and
adult samples, supporting Nolen-Hoeksema’s
(1994) claim that adolescent females face more
stress than adolescent males.1975), one more recent study showed a sex
difference (Sethi & Nolen-Hoeksema, 1997),
and one did not (Flory et al., 2000). However,
even if there is not an overall sex difference in
private self-consciousness, there could be a
sex difference in the tendency to react to envi-
ronmental events by engaging in private self-
consciousness. That is, private self-consciousness
could be an interactive theory of depres-
sion. In an experience sampling study where
women and men were beeped periodically via
palm pilots, private self-consciousness was
more strongly associated with negative affect
after negative social interactions for women
than men (Flory et al., 2000).
Other research has shown that women
may be more vulnerable than men to situational
cues that evoke private self-consciousness. A
meta-analysis of self-report studies of private
self-consciousness and mirror manipulations
to induce private self-consciousness showed
that the link of private self-consciousness to
negative affect and self-blame was stronger
for women than men (Fejfar & Hoyle, 2000).
In sum, the tendency to engage in private
self-consciousness provides an explanation
for sex differences in depression, partly due
to its overlap with rumination. It is also an
interactive theory of depression because it
predicts that women are more likely than
men to respond to certain cues by becoming
introspective.Stressful Life Events
One reason that women may be more de-
pressed than men is that women experience
more traumatic or stressful life events. Al-
though women suffer higher rates of post-
traumatic stress disorder than men (Olff et al.,
2007), this does not mean that women face
more trauma than men. A meta-analysis of
sex differences in traumatic events found thatM13_HELG0185_04_SE_C13.indd 508 6/21/11 12:55 PM