Gender Bias in Diagnosing Personality Disorders
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Ever since Freud, more women than men sought
therapy. Consequently, terms like "hysteria' are intimately connected to
female physiology and alleged female psychology. The DSM (Diagnostic and
Statistical Manual, the bible of the psychiatric profession) expressly
professes gender bias: personality disorders such as Borderline and Histrionic
are supposed to be more common among women. but the DSM is rather even-handed:
other personality disorders (e.g., the Narcissistic and Antisocial as well as
the Schizotypal, Obsessive-Compulsive, Schizoid, and Paranoid) are more
prevalent among men.
Why this gender disparity? There are a few possible answers:
Maybe personality disorders are not objective clinical entities, but
culture-bound syndromes. In other words, perhaps they reflect biases and value
judgments. Some patriarchal societies are also narcissistic. They emphasize
qualities such as individualism and ambition, often identified with virility.
Hence the preponderance of pathological narcissism among men. Women, on the
other hand, are widely believed to be emotionally labile and clinging. This is
why most Borderlines and Dependents are females.
Upbringing and environment, the process of socialization and cultural mores all
play an important role in the pathogenesis of personality disorders. These
views are not fringe: serious scholars (e.g., Kaplan and Pantony, 1991) claim
that the mental health profession is inherently sexist.
(continued below)
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Then again, genetics may be is at work. Men
and women do differ genetically. This may account for the variability of the
occurrence of specific personality disorders in men and women.
Some of the diagnostic criteria are ambiguous or even considered
"normal" by the majority of the population. Histrionics
"consistently use physical appearance to draw attention to self."
Well, who doesn't in Western society? Why when a woman clings to a man it is
labeled "codependence", but when a man relies on a woman to maintain
his home, take care of his children, choose his attire, and prop his ego it is
"companionship" (Walker, 1994)?
The less structured the interview and the more fuzzy the diagnostic criteria,
the more the diagnostician relies on stereotypes (Widiger, 1998).
Quotes from the Literature
"Specifically, past research suggests that exploitive
tendencies and open displays of feelings of entitlement will be less integral
to narcissism for females than for males. For females such displays may carry a
greater possibility of negative social sanctions because they would violate
stereotypical gender-role expectancies for women, who are expected to engage in
such positive social behavior as being tender, compassionate, warm,
sympathetic, sensitive, and understanding.
In females, Exploitiveness/Entitlement is less well-integrated with the other
components of narcissism as measured by the Narcissistic Personality Inventory
(NPI) - Leadership/Authority, Self-absorption/Self-admiration, and
Superiority/Arrogance- than in males - though 'male and female narcissists in
general showed striking similarities in the manner in which most of the facets
of narcissism were integrated with each other'."
Gender differences in the structure of narcissism: a multi-sample
analysis of the narcissistic personality inventory - Brian T. Tschanz, Carolyn
C. Morf, Charles W. Turner - Sex Roles: A Journal of Research - Issue: May,
1998
"Women leaders are evaluated negatively if they exercise their authority
and are perceived as autocratic."
Eagly, A. H., Makhijani, M. G., & Klonsky, B. G. (1992). Gender
and the evaluation of leaders: A meta-analysis. Psychological Bulletin, 111,
3-22, and ...
Butler, D., & Gels, F. L. (1990). Nonverbal affect responses to male and
female leaders: Implications for leadership evaluations. Journal of Personality
and Social Psychology, 58, 48-59.
"Competent women must also appear to be sociable and likable in order to
influence men - men must only appear to be competent to achieve the same
results with both genders."
Carli, L. L., Lafleur, S. J., & Loeber, C. C. (1995). Nonverbal behavior,
gender, and influence. Journal of Personality and Social Psychology, 68,
1030-1041.
Gender and the Narcissist - click HERE!
Homosexual and Transsexual Narcissists - click HERE!
Sex and Gender - click HERE!
Many additional Frequently Asked Questions (FAQs) about Personality Disorders - click HERE!
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