Adolescent Gender Differences In Psychotropic Treatment Experience

Purpose: This study compares male and female adolescent experience of psychotropic treatment. In particular, how do male and female adolescents make sense of psychiatric medications, how do they manage their illnesses, and are their stigma experiences similar? Minimal research has been conducted on adolescent experience of stigma (Hinshaw, 2007) and there is a significant research gap investigating adolescent medication management (Floersch, 2003). Research has shown that male adolescents report more negative attitudes towards mental illness than females (Komiya, Good & Sherrod, 2000; Leong & Zachar, 1999). Moreover, studies show that male adolescents are reluctant to receive help from others as it signifies vulnerability and weakness (Griffin-Pierson, 1988). In contrast, females more readily seek psychiatric help (Leong & Zachar, 1999). However, few empirical studies have been conducted comparing male and female experiences of psychiatric medication use.

Methods: A narrative descriptive, qualitative study design was implemented that focused on a thematic and structural analysis (Reissman 2008). Ten males and ten females, ages 12-17, demographically and clinically matched, who currently met DSM-IV criteria for a psychiatric illness and who were currently prescribed psychiatric medication were eligible to participate in the NIMH funded, IRB approved study. A semi-structured interview was conducted, making inquiries into their respective illness, medication, stigma, and management experiences. Using the constant comparative method, themes were first identified. Second, using structural analysis techniques, the illness/medication management plots that males and females mobilized to make sense of the themes were also identified.

Results: Reported themes included: 1) males used general terms, such as up, down, or balanced to describe emotions, whereas females were more willing to express their emotions using terms such as depressed or happy; 2) males felt more pressure to succeed in academics, sports and work, whereas females wanted the medication to help them earn higher grades; 3) males worried about peers discovering their illness, whereas females were more open. The dominant plot by which males organized their illness/management experience was a dependency plot, which kept mothers managing daily medication use. Females, on the other hand, utilized plots of self-care and therefore less dependency on mothers for medication management.

Discussion: This study provides descriptive data about gender differences in the subjective experience of adolescent psychotropic treatment. Findings are consistent with the conceptual literature. First, females appear to be less stigmatized as they were open about their use of medications; they were also more willing to manage their illness than males. Since males tended not to self-manage their use of medications, their reliance on mothers poses questions about use of psychiatric medications when males transition to college or leave home. Second, males' stigmatized response to use of medications and mental illness suggests a more complicated help seeking behavior than for females, suggesting that males perceive medication as a weakness and not as a strengthening of their self-care behaviors (Florell & Swerdik, 2000). A possible implication is that male adolescent psychiatric medication use may have unintended psychological “side-effects” that more negatively influence autonomy development than their female counterparts.