The Psychology of Gender 4th Edition

Mental Health 525

previously who had put the health care needs

of her husband before her own. A common

theme that ran throughout the course of my

interviews with these 20 women was that

their concern with taking care of others and

putting others’ needs first had adverse conse-

quences for their own health. Some of these

women undoubtedly had difficulty with re-

covery because they continued to take care of

others at the expense of taking care of them-

selves. However, a few women did view their

heart attack as a wake-up call—a chance to

shift their priorities and put themselves first.

There are a variety of aspects of the

female gender role that have implica-

tions for adjustment to chronic illness (see

Figure 13.11). One issue is the extent to

which the illness interferes with caregiving.

If the caregiver role is central to one’s iden-

tity and a chronic illness undermines this

role, the person will have difficulty adjust-

ing to the illness. This is the issue that con-

cerned many of the women cardiac patients

I first interviewed. When taking care of one-

self detracts from taking care of others, these

women may neglect their own health. One

study of cardiac patients showed that women

were more likely than men to resume house-

hold responsibilities after they were dis-

charged from the hospital (Rose et al., 1996).

The conflict between receiving as-

sistance and providing assistance to oth-

ers may be especially difficult for women

who are highly invested in the caregiving

role, such as those who score high on un-

mitigated communion. Unmitigated com-

munion has been linked to poor adjustment

to chronic illnesses such as heart disease

(Helgeson, 1993; Fritz, 2000), breast cancer

(Helgeson, 2003), diabetes (Helgeson & Fritz,

1996), and irritable bowel syndrome (Voci &

Cramer, 2009). One reason for this relation

is that these women neglect their own health

are more likely than adolescent females to

use exercise as a way to control their illness

(Williams, 2000). In general, male adoles-

cents with chronic illness are more likely to

perceive they can control their illness than

female adolescents (Williams, 2000). To the

extent that control is possible and control be-

haviors are helpful in regulating the illness,

this perspective is a healthy one. Agency is

an aspect of the male gender role that may

reflect this problem-solving orientation.

Agency has been linked to positive adjust-

ment to chronic illnesses, such as heart dis-

ease (Helgeson, 1993; Fritz, 2000; Helgeson &

Mickelson, 2000), prostate cancer (Helgeson &

Lepore, 1997, 2004), and irritable bowel syn-

drome (Voci & Cramer, 2009). However, the

“chronic” aspect of chronic illness suggests

control efforts will be limited in their effects.

This aspect of illness could be frustrating to

men who focus on control.

Thus the male gender role has links to

both successful and problematic adjustment

to chronic illness. To the extent the illness

threatens masculinity, recovery will be diffi-

cult. To the extent it can be used to aid re-

covery, masculinity will be helpful.

Female Gender Role

When I first started interviewing cardiac pa-

tients over 20 years ago, I wondered if the

female cardiac patient would have the same

“Type A” characteristics as the male car-

diac patient—impatience and hostility. The

first 20 women I interviewed created quite

a different picture of the woman with heart

disease. Two of these 20 women had been

admitted to the hospital for heart attacks

the day after their husbands were admitted

for potential heart problems. Interestingly,

in each case, the husband did not sustain

a heart attack, but the wife did. The most

noteworthy case was the woman I described

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