Warum entscheiden sich Männer für Geheimhaltung und gegen Offenlegung einer depressiven Erkrankung? Eine qualitative Studie

Zusammenfassung

Ziel der Studie Diese qualitative Studie untersucht aus Sicht von Männern mit Depression, aus welchen Gründen und in welchen Situationen sie die depressive Erkrankung geheim halten.

Methodik Fünf Fokusgruppen mit 16 Männern wurden inhaltsanalytisch ausgewertet.

Ergebnisse Es wurden vier Motive für Geheimhaltung herausgearbeitet: 1. Berufliche Kontinuität sicherstellen, 2. Akzeptanz und soziale Zugehörigkeit sichern, 3. Kontrolle über soziale Identität gewinnen, 4. Belastungen des privaten Umfelds vermeiden. Stereotype traditioneller Männlichkeit werden im Allgemeinen abgelehnt, bilden jedoch im Arbeitskontext einen Referenzrahmen für beruflichen Erfolg.

Schlussfolgerung Die Ergebnisse verweisen auf die Präsenz von Normen traditioneller Männlichkeit insbesondere im Arbeitskontext sowie auf Öffentliches Stigma und Selbststigma von Männern mit Depression. Betroffene könnten von Maßnahmen profitieren, die der öffentlichen Stigmatisierung von psychischen Erkrankungen im Arbeitsumfeld entgegenwirken.

Abstract

Objective The qualitative study aims to explore reasons and occations for concealment in male participants with depression.

Methods Five focus groups with 16 men were analysed via Qualitative Content Analysis.

Results Four motives of concealment have been explored: 1. continuity of professional career, 2. Ensure acceptance and social belonging, 3. control over social identity, 4. avoiding loads of personal environment. Participants differentiate from stereotypes of hegemonic male gender norms. However, participants connect to hegemonic male gender norms when attributing professional success with vigour and assertiveness.

Conclusion Results confirm the presence of hegemonic male gender norms particularly on the job. As a consequence, men with depressiopn replicate self- and social stigma if they fail to comply with hegemonic male gender roles. Workplace interventions that react to discrimination of mental health problems may be beneficial for men with depression.

Schlüsselwörter

Depression - Offenlegung - Geheimhaltung - Qualitative Studie - Mentale Männergesundheit

Keywords

Depression - Disclosure - Concealment - Qualitative Research - Men`s Mental Health

• Literatur

• 1 Johnson JL, Oliffe JL, Kelly MT. et al. Men's discourses of help-seeking in the context of depression. Sociol Health Illn 2012; 34: 345-361
• 2 Möller-Leimkühler AM. Männer und Depression: geschlechtsspezifisches Hilfesuchverhalten. Fortschr Neurol Psychiatr 2000; 68: 489-495
• 3 Connell RW, Messerschmidt JW. Hegemonic Masculinity. Gender & Society 2005; 19: 829-859
• 4 Möller-Leimkühler AM. Barriers to help-seeking by men: a review of sociocultural and clinical literature with particular reference to depression. J Affect Disord 2002; 71: 1-9
• 5 McKenzie SK, Oliffe JL, Black A. et al. Men's Experiences of Mental Illness Stigma Across the Lifespan: A Scoping Review. Am J Mens Health 2022; 16 15579883221074789
• 6 Staiger T, Stiawa M, Mueller-Stierlin AS. et al. Masculinity and Help-Seeking Among Men With Depression: A Qualitative Study. Front Psychiatry 2020; 11: 599039
• 7 Chaudoir SR, Fisher JD. The disclosure processes model: understanding disclosure decision making and postdisclosure outcomes among people living with a concealable stigmatized identity. Psychol Bull 2010; 136: 236-256
• 8 Camacho G, Reinka MA, Quinn DM. Disclosure and concealment of stigmatized identities. Curr Opin Psychol 2020; 31: 28-32
• 9 Wright A, Jorm AF, Mackinnon AJ. Labeling of mental disorders and stigma in young people. Soc Sci Med 2011; 73: 498-506
• 10 Mayer L, Corrigan PW, Eisheuer D. et al. Attitudes towards disclosing a mental illness: impact on quality of life and recovery. Soc Psychiatry Psychiatr Epidemiol 2022; 57: 363-374
• 11 Corrigan PW, Rao D. On the self-stigma of mental illness: stages, disclosure, and strategies for change. Can J Psychiatry. Revue canadienne de psychiatrie 2012; 57: 464-469
• 12 Bril-Barniv S, Moran GS, Naaman A. et al. A Qualitative Study Examining Experiences and Dilemmas in Concealment and Disclosure of People Living With Serious Mental Illness. Qual Health Res 2017; 27: 573-583
• 13 Rodriguez RR, Kelly AE. Health Effects of Disclosing Secrets to Imagined Accepting Versus Nonaccepting Confidants. J Soc Clin Psychol 2006; 25: 1023-1047
• 14 Goffman E. Stigma. Über Techniken der Bewältigung beschädigter Identität. Bd. 140. suhrkamp taschenbuch wissenschaft. 25. Aufl. Frankfurt am Main: Suhrkamp; 2020
• 15 Pachankis JE. The psychological implications of concealing a stigma: a cognitive-affective-behavioral model. Psychol Bull 2007; 133: 328-345
• 16 Quinn DM. When Stigma Is Concealable: The Costs and Benefits for Health. In: Major B, Dovidio JF, Link BG, eds. The Oxford handbook of stigma, discrimination, and health. Oxford handbooks online. New York, NY: Oxford University Press; 2018: 287-299
• 17 Quinn DM, Williams MK, Quintana F. et al. Examining effects of anticipated stigma, centrality, salience, internalization, and outness on psychological distress for people with concealable stigmatized identities. PLoS ONE 2014; 9: e96977
• 18 Quinn DM, Weisz BM, Lawner EK. Impact of active concealment of stigmatized identities on physical and psychological quality of life. Soc Sci Med 2017; 192: 14-17
• 19 van Beukering IE, Bakker M, Corrigan PW. et al. Expectations of Mental Illness Disclosure Outcomes in the Work Context: A Cross-Sectional Study Among Dutch Workers. J Occup Rehabil 2022;
• 20 Follmer KB, Jones KS. Navigating Depression at Work: Identity Management Strategies Along the Disclosure Continuum. Group & Organization Management 2022; 47: 963-1007
• 21 Yoshimura Y, Bakolis I, Henderson C. Psychiatric diagnosis and other predictors of experienced and anticipated workplace discrimination and concealment of mental illness among mental health service users in England. Soc Psychiatry Psychiatr Epidemiol 2018; 53: 1099-1109
• 22 Brouwers EPM, Joosen MCW, van Zelst C. et al. To Disclose or Not to Disclose: A Multi-stakeholder Focus Group Study on Mental Health Issues in the Work Environment. J Occup Rehabil 2020; 30: 84-92
• 23 Chaudoir SR, Fisher JD. The disclosure processes model: understanding disclosure decision making and postdisclosure outcomes among people living with a concealable stigmatized identity. Psychol Bull 2010; 136: 236-256
• 24 Krumm S, Checchia C, Koesters M. et al. Men's Views on Depression: A Systematic Review and Metasynthesis of Qualitative Research. Psychopathology 2017; 50: 107-124
• 25 Staiger T, Stiawa M, Mueller-Stierlin AS. et al. Depression und Männlichkeit: Krankheitstheorien und Bewältigung – Eine biografisch-narrative Studie. Psychiat Prax 2020; 47: 65-70
• 26 Kuckartz U. Qualitative Inhaltsanalyse. Methoden, Praxis, Computerunterstützung. Grundlagentexte Methoden. 2. Aufl. Weinheim: Beltz Juventa; 2014
• 27 Follmer KB, Jones KS. Stereotype content and social distancing from employees with mental illness: The moderating roles of gender and social dominance orientation. J Appl Soc Psychol 2017; 47: 492-504