Sex-specific Relationship Between Stress Coping Strategies and All-cause Mortality: Japan Multi-Institutional Collaborative Cohort Study

Abstract

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Mental Health Status before and during the COVID-19 Pandemic in Patients First Visiting a Psychosomatic Internal Medicine Clinic in Tokyo, Japan

“…It is suggested that men are psychologically distressed. Cultural and social environments are different among males and females (e.g., life events, gender role norms at home, job positions, and/or salary gaps) [19]. Male stress responses may predominantly involve the traditional "fight and flight" reaction, whereas female stress responses may be better characterized by "tend and befriend", involving nurturing activities and the creation of social networks [18].…”

“…In addition, women have various coping strategies and use them more frequently than men [34]. Women reportedly tend to focus on emotional coping [19] and mobilize greater social support during periods of stress [34]. In contrast, men prefer coping styles that can be practiced by themselves rather than relying on others.…”

“…In contrast, men prefer coping styles that can be practiced by themselves rather than relying on others. This could be why men rarely share their feelings under stress and are more likely to use alcohol, tobacco, or drugs than women [19]. Another reason for the sex difference in traditional Japanese women, Yamatonadeshiko, is their tendency to be patient, which is generally perceived as appealing by the society [29].…”

“…The first coronavirus disease (COVID- 19) infection in Japan was confirmed on 16 January 2020. The World Health Organization declared the virus a pandemic on 11 March 2020, and the Japanese government first declared a state of emergency on 7 April 2020 [1].…”

“…Kudielka reported [18] that expressing anger is considered shameful in the Japanese culture and that men found it difficult to express anger, especially in public. Cultural and social environments have been different for men and women (e.g., life events, gender role norms at home and job positions and/or salary gaps, and biological sex differences also led to sex differences in stress reaction) [19].…”