Gender role strain, core schemas, and psychotic experiences in ethnically diverse women: A role for sex‐ and gender‐based analysis in psychosis research?

Abstract

Negative ‐self and ‐others core schemas have been implicated in the development and maintenance of psychotic experiences. One component of the self‐system is gender‐role strain (GRS; perceived discrepancy between actual self and gender‐role norms). Although the role of gender in the formation of core schemas has been underscored in social and developmental psychology literatures, GRS has not been investigated in relation to psychosis. We examined whether it might be associated with negative schemas and psychotic experiences in women consistent with the trend toward sex‐ and gender‐based analysis (SGBA) in health research. Forty‐four women with a schizophrenia spectrum disorder diagnosis and 48 female nonclinical participants completed a series of questionnaires measuring GRS, femininity ideology, core schemas, childhood trauma, and implicit femininity stereotypes (The Gender Stereotype Implicit Association Test). Half the total sample comprised women with minority‐ethnic status. Women in the psychosis group reported higher levels of GRS than comparison participants. Differences in endorsement of femininity ideology between the two groups narrowly missed significance with a trend toward greater femininity ideology in the psychosis group and significantly greater endorsement of the sexual purity domain for minority‐ethnic women. There was no difference in implicit femininity stereotypes. Analyses suggested that the relationship between GRS and symptoms was mediated by negative ‐self and ‐others schemas. Childhood sexual trauma, though higher for women with psychosis, was associated with gender‐role strain in the nonclinical sample only. Findings warrant further investigation with larger samples. SGBA has the potential to fill gaps in our current knowledge with regard to psychosis theory, research, and practice.

Feminine sexuality, religiousness and psychotic distress: Tracing a pattern

“…It contributes more generally to the flourishing literature linking systemic inequalities and injustices with psychotic experiences (Bentall et al, 2014), and particularly to feminist literature examining the role of patriarchy, including mental health discourses and practices, in generating and regulating women's distress (Marecek & Gavey, 2013;Marecek & Lafrance, 2021). More specifically, it expands recent research on intersectionality (Haarmans et al, 2018), adding culture and religion to the examination of gendered and racialized aspects of women's psychotic experiences. This has obvious clinical implications, highlighting the importance of adopting a psychosocial approach to understanding and managing psychosis, and more specifically of paying attention to the particularities of the sociocultural context of women's distress in order to support them in their recovery.…”

Girl's and women's experiences of seeking mental health support for symptoms associated with psychosis. A narrative review

“…Research typically characterises 'adverse life experiences' as being isolated occurrences, such as an attack, neglect, or bereavement. However, it is important to note that abuse also occurs systemically and over the long-term, particularly for women (Haarmans et al, 2018), such as the consistent oppression of women within a patriarchal society (McCarthy-Jones et al, 2015).…”

“…Similarly, Haarmans et al (2018) suggests people from disadvantaged positions in society are more susceptible to developing symptoms associated with psychosis, such as voice-hearing. These disadvantages can include social inequality and discrimination, which women often face.…”

How psychosis interrupts the lives of women and men differently: a qualitative comparison

“…Important gender differences have also been noted in factors that contribute to the development of psychosis‐related symptoms, such as child abuse and subsequent coping strategies (Barker‐Collo & Read, 2011) and early experiences with psychosis (Thorup et al, 2007). Gender differences also appear to impact factors that influence one’s experience of symptoms, including social schemas (Haarmans, McKenzie, Kidd, & Bentall, 2018). Socially mediated manifestations of symptoms have also been observed.…”