Lack of leadership confidence relates to problem drinking in women: gender identity, heavy episodic drinking and alcohol use disorders in Swedish women.
OBJECTIVE
The aim of this study was to analyse in women the association between four dimensions of gender identity, heavy episodic drinking (HED) and alcohol use disorders (AUD), taking into account age, personality, psychiatric co-morbidity and level of education.


METHODS
An initial screening of alcohol consumption was followed by a structured psychiatric interview in a sample of women drawn from the Gothenburg population and women attending primary care, maternity and hospital services (n = 930). Gender identity was assessed using the Masculinity-Femininity Questionnaire (M/F-Q) (items grouped into four dimensions: leadership, caring, self-assertiveness and emotionality). The Karolinska Scale of Personality was administered. Clinical psychiatric diagnoses according to DSM were made in face-to-face interviews. HED was defined as consumption of at least 60 g of ethanol on a single day at least once a month.


RESULTS
Women who scored low on the leadership dimension were twice as likely to have AUD [age-adjusted odds1.98 (95% confidence interval 1.30-3.01)] compared to those with medium scores. These odds ratios were significant after adjustment for personality [2.21 (1.35-3.63)], psychiatric disorders [2.09 (1.25-3.47)] and level of education [1.95 (1.17-3.26)]. Low scores on the leadership dimension were associated with HED [1.55 (0.98-2.44)] after adjustment for age, personality, psychiatric disorders and level of education. High scores on leadership were not significantly associated with AUD or HED after these adjustments. The odds ratios for those who scored low on caring were non-significant throughout the analyses of associations with both AUD and HED. A similar pattern was found for the self-assertiveness dimension. Low emotionality was associated with decreased odds for AUD [0.42 (0.25-0.70)] and HED [0.66 (0.44-0.99)], and increased odds for AUD [2.14 (1.38-3.31)] and HED [2.33 (1.58-3.44)], after adjusting for age. These associations became non-significant after adjustment for personality and remained so after psychiatric disorders and level of education were added to the models.


CONCLUSIONS
Of the four gender identity dimensions, only low scores on leadership remained significantly associated with AUD and HED after adjustment for age and personality. Clinical work could focus on the development of leadership abilities in women scoring low on these items to improve the ability.
Hensing
Gunnel
G
Department of Public Health and Community Medicine, The Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden. gunnel.hensing@socmed.gu.se
Spak
Fredrik
F
D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000453:epidemiology / Q000523:psychology; D019973:Alcohol-Related Disorders / Q000453:epidemiology* / Q000523:psychology; D015331:Cohort Studies; D000431:Ethanol / Q000506:poisoning*; D005260:Female; D005783:Gender Identity; D006801:Humans; D007857:Leadership; D008137:Longitudinal Studies; D008875:Middle Aged; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology; D016387:Women's Health
D000431:Ethanol