title: An invariant dimensional liability model of gender differences in mental disorder prevalence: evidence from a national sample.
abstract: Epidemiological studies of categorical mental disorders consistently report that gender differences exist in many disorder prevalence rates and that disorders are often comorbid. Can a dimensional multivariate liability model be developed to clarify how gender impacts diverse, comorbid mental disorders? We pursued this possibility in the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC; N = 43,093). Gender differences in prevalence were systematic such that women showed higher rates of mood and anxiety disorders, and men showed higher rates of antisocial personality and substance use disorders. We next investigated patterns of disorder comorbidity and found that a dimensional internalizing-externalizing liability model fit the data well, where internalizing is characterized by mood and anxiety disorders, and externalizing is characterized by antisocial personality and substance use disorders. This model was gender invariant, indicating that observed gender differences in prevalence rates originate from women and men's different average standings on latent internalizing and externalizing liability dimensions. As hypothesized, women showed a higher mean level of internalizing, while men showed a higher mean level of externalizing. We discuss implications of these findings for understanding gender differences in psychopathology and for classification and intervention.
authors.affiliation: Department of Psychology, University of Minnesota, 75 East River Road, Minneapolis, MN 55455, USA. nreaton@gmail.com
authors.forename: Nicholas R
authors.initials: NR
authors.lastname: Eaton
authors.forename: Katherine M
authors.initials: KM
authors.lastname: Keyes
authors.forename: Robert F
authors.initials: RF
authors.lastname: Krueger
authors.forename: Steve
authors.initials: S
authors.lastname: Balsis
authors.forename: Andrew E
authors.initials: AE
authors.lastname: Skodol
authors.forename: Kristian E
authors.initials: KE
authors.lastname: Markon
authors.forename: Bridget F
authors.initials: BF
authors.lastname: Grant
authors.forename: Deborah S
authors.initials: DS
authors.lastname: Hasin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D015897:Comorbidity; D005260:Female; D006801:Humans; D007389:Internal-External Control; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000523:psychology; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D012737:Sex Factors; D014481:United States / Q000453:epidemiology; D055815:Young Adult