ABSTRACT
We began this chapter by reviewing the historical and cultural perceptions and biases of mental illness that have existed over time, especially toward women. Although many changes have taken place and others have been initiated, we should ask what progress has actually been made in the treatment of mental disorders. However, the exploration of women’s health and well being, as well as gender differences in mental disorders, has become far more of a focus in the United States over recent years.
Depression, considered the leading cause of disability among women today, is a significantly gendered 445disorder. Although gender has long been recognized as a critical variable in depression, it has not been rigorously studied. We have been involved in bringing the issue of sex and gender bias in depression to the forefront of research (Gorman and Rabinowitz, 2004; Sechzer et al., 1994). Other groups have also studied gender in various aspects of depression and have made important contributions to the progress in this area. Now that the National Institute of Health has mandated that both women and men be studied in disorders affecting both genders and data be compared and analyzed separately, we can look forward to more data about the earlier recognition and appropriate treatment, both medical and psychotherapeutic, of women and men with this disorder.
Previously considered upper middle class disorders, anorexia and bulimia are now affecting women at all socioeconomic levels and across race and ethnicity. Additionally, we are beginning to see men with eating disorders. The death rates from eating disorders, especially anorexia, have doubled in the last twenty years and are now one of the highest reported for any mental disorder. We have also made progress in evaluating many of the psychological and cultural factors that are highly associated with the onset of anorexia and bulimia.
The question of which therapies are appropriate for women, including women of different ethnic and racial groups, has also begun to be studied. More data is needed to evaluate the outcomes of these therapies, compare them to more “standard” therapies, and to consider the possible benefits of integrating facets of these therapies with traditional therapies.
Finally, psychology has begun to focus on diversity, poverty, and stresses of migration. Psychology has increasingly come to recognize the importance of knowledge by therapists about the different racial and ethnic cultures that compose an impressive proportion of the U.S. population.
