As this year wraps up, we are excited to reflect on our work and share a list of our Top 10 publications generated from the RMS cluster from 2023! 

Authors: JL Oliffe, MT Kelly, N Gao, J Mootz, ZE Seidler, SM Rice

Journal: Social Science & Medicine

Abstract: Shifts in gender roles, identities and relations since the 1980s are continuing to influence masculinities within intimate partner relationships. Forefront in men's contemporary heterosexual relationships have been calls for gender equality and gender equity as a means to promoting the mental health and well-being of partners and their families. Most previous research has focused on a pathologized role of men in relationships (e.g., intimate partner violence). Little is known about how men perceive intimate partner relationships using a strength-based perspective. The current photovoice study addressed the research question, ‘What are the connections between masculinities and men's heterosexual intimate partner relationships?’ to highlight young men's (19-43 years-old) experiences of, and perspectives about their intimate partner relationships. Drawing from individual Zoom interviews with 92 heterosexual, cisgender men from 14 countries, we abductively derived three masculine typologies: 1) neo-traditionalist, 2) egalitarian and 3) progressive. Twenty-two (24%) participants embodied neo-traditionalist masculinities characterized by reliance's on traditional masculine norms that assign domesticities as feminine and prize masculine breadwinner and protector roles. Half of the participants (50%, n = 46) purposefully distanced themselves from traditional masculine norms to engage egalitarian masculinities. These men idealized equal (50-50) contributions and reciprocity wherein counts were often used to evaluate each partner's relative efforts and contributions to the relationship. Progressive masculinities were evident in 26% (n = 24) of participants who focused on fairness and social justice, checking their own privilege to justly operate within the relationship, and more broadly in society. The three typologies are grounded in men's heterosexual intimate partner gender relations, and advance masculinity frameworks to guide future health-research, policy and practice. In addition, there are opportunities for men's mental health promotion by prompting readers' reflexivity to thoughtfully consider what they idealize, and where they map in relation to the masculine typologies featured in the current article.

Link: https://www.sciencedirect.com/science/article/pii/S0277953623005002

Authors: JS Ogrodniczuk, JL Oliffe, D Kealy, ZE Seidler, P Sharp, SM Rice

Journal: Nature Mental Health

Introduction: Silence can have deadly consequences for mental health in men and should not be ignored. The World Health Organization reports that men account for roughly 7 out of every 10 suicide deaths, with male suicide rates being persistently high across most parts of the globe. This is a mulish trend that has persisted for decades despite prevention efforts. In Canada, for example, suicide is the second leading cause of death among men under the age of 50. Similarly, in Australia, suicide is the leading cause of death for men aged 15–44. Despite the chronically high loss of men’s lives to suicide, the issue is most often referred to as a “silent crisis” or “silent epidemic”, positioning male suicide as something that occurs in the dark corners of society. Although the tragedy of male suicide is deserving of the recent increase in public recognition and attention it has received, it is but one of the aspects of men’s mental illness that are surrounded by silence. Ironically, there is a risk that the dialogue around men’s suicidality may inadvertently silence consideration of other mental health issues in men with seemingly less drastic outcomes.

Link: https://www.nature.com/articles/s44220-023-00093-1.epdf?sharing_token=Ume1fi-8I2z6RqZ4HtMETtRgN0jAjWel9jnR3ZoTv0MI0Y72dQz5TjcQiQUHAmvvFLL9W-8KhznbgvNJqAs6sLufT6cAdoStRhumOFO7Lr5HDAjASPL8obOEpiZT9gdrHEamlIQZzuB8BEo5FYed0s7mUX4gVDfyHgnWI0CYatY%3D

Authors: D Kealy, GB Chartier, A Walther, SM Rice, ZE Seidler, JL Oliffe, JS Ogrodniczuk

Journal: The Journal of Nervous and Mental Disease

Abstract: The Psychic Pain Scale (PPS) measures a form of mental pain involving overwhelming negative affect and loss of self-control. Understanding psychic pain among men is needed to advance efforts for preventing male suicide. The present study examined the factor structure and psychosocial correlates of the PPS among 621 online help-seeking men. Confirmatory factor analysis indicated a higher-order factor comprising affect deluge and loss of control factors. Psychic pain evinced significant associations with general psychological distress, r = 0.64; perceived social support, r = −0.43; social connectedness, r = −0.55; and suicidal ideation, r = 0.65 (all p’s < 0.001)—the latter three remained significant after controlling for general distress. Psychic pain also mediated the association between social disconnection and suicidal ideation (standardized indirect effect = −0.14 [−0.21, −0.09]), after controlling for social support and distress. Findings support the PPS as a promising measure for investigating psychic pain among men and indicate psychic pain as a link between social disconnection and suicidal ideation.

Link: https://journals.lww.com/jonmd/abstract/2023/09000/psychic_pain_among_men__factor_structure,.1.aspx

Authors: FE Darroch, JL Oliffe, GG Montaner, JM Webb

Journal: Men and Masculinities

Abstract: To better understand the needs of fathers who experience health inequities, we individually interviewed fathers, mothers, and service providers about their perspectives of supports for men in Vancouver’s Downtown Eastside, one of the most disadvantaged groups in Canada. Using a gender lens, thematic analysis of transcribed interviews with three cohorts revealed the following themes: “we need a He-way”: Fathers arguing for men-friendly services; “I had to do all the hard work”: Mothers identifying relational impacts of fathers’ barriers to services; “there is nothing out there for them”: Service providers acknowledging the lack of father-focused programs. Findings highlight the need for, and challenges to creating accessible, gender specific, father focused programs and services to best support men and families within the complex contexts of experiencing significant health inequities. This work illustrates how gender-based analyses can guide strategies for health promotion programs that will ultimately support fathers, mothers, and their families.

Link: https://journals.sagepub.com/doi/full/10.1177/1097184X221149984

Authors: A Walther, U Ehlert, M Schneeberger, L Eggenberger, C Flückiger, N Komlenac, A Heald, T Rice, SS Palm, ZE Seidler, J Ogrodniczuk, JL Oliffe, SM Rice, D Kealy, R Weber, D Zimmermann.

Journal: Frontiers in Psychiatry

Background: Treatment of major depressive disorder (MDD) in men is complicated by the endorsement of traditional masculinity ideologies (TMI) often leading to reluctance toward psychotherapy, therapy interfering processes, or premature termination. In addition, it has been shown that men with MDD have a significantly increased risk of being hypogonadal (e.g., total testosterone levels <12.1 nmoL/L). Therefore, it is recommended to examine depressed men with regard to their testosterone status and if hypogonadism is present to combine psychotherapy with testosterone treatment (TT).

Aim: This project aims to evaluate a male-specific psychotherapeutic program (MSPP) for MDD in depressed eugonadal and hypogonadal men receiving testosterone in comparison to a standard cognitive behavioral therapy (CBT) for MDD and a Waitlist.

Methods: The study presents a 2×3 factorial study design. In total, 144 men aged between 25 and 50 will be stratified by testosterone status (eugonadal/hypogonadal) and then randomized into one of the three conditions (MSPP, CBT, or Waitlist). Additionally, a healthy control group of 100 men will be recruited, which will undergo only baseline assessments. Both standardized psychotherapy programs will encompass 18 sessions delivered in a weekly manner. Aligned with the TT-related medical visits of the 72 hypogonadal men, all participants will be followed up with clinical assessments and bio sampling at weeks 0, 6, 15, 24, and 36.

Expected Results: Compared to Waitlist control groups, treatment groups are expected to be more effective and efficacious (depression score reduction of ≥50%) at week 24 and at the follow-up at week 36. The MSPP is expected to show higher effectiveness and efficacy for depressive symptoms and higher acceptability (lower dropout rate) as compared to CBT.

Discussion: This study represents the first attempt to test a male-specific psychotherapy for MDD in a single-setting compared to standard CBT and a Waitlist control condition using randomized clinical trial methodology. In addition, the potential positive adjunct effect of psychotherapy to TT in reducing depressive burden and improving quality of life in hypogonadal depressed men represents a neglected research area and might introduce new hypogonadism screening procedures in depressed men and combined treatment approaches for depressed men suffering from hypogonadism. Limitations are the rigorous inclusion and exclusion criteria, which limit the generalizability of the study results to first episode treatment naïve depressed men.

Link: https://www.frontiersin.org/articles/10.3389/fpsyt.2023.1129386/full

Authors: ZE Seidler, MJ Wilson, R Benakovic, A Mackinnon, JL Oliffe, JS Ogrodniczuk, D Kealy, J Owen, J Pirkis, C Mihalopoulos, LK Le, SM Rice

Journal: American Psychologist

Abstract: Improved engagement of men in psychotherapy is an essential element in improving male health outcomes. This trial examined whether the Men in Mind intervention improved practitioners’ self-rated clinical competencies to engage and respond to male clients in therapy. A parallel, single-blind, wait-list randomized controlled trial was conducted with Australian-based mental health practitioners, currently administering psychotherapy to males, fluent in English, and not currently completing their undergraduate degree. Participants were randomly assigned 1:1, through variable-sized blocks stratified by gender, to either the intervention (Men in Mind) or wait-list control. Men in Mind was offered as a self-led 6-week, five-module online program to upskill practitioners to engage and respond to male clients. The primary outcome was self-reported competency in engaging men in psychotherapy, measured by the Engaging Men in Therapy Scale (EMITS) at 6 weeks. All analyses were by intention-to-treat. Between January 16 and March 17, 2022, 587 participants were randomly assigned to the intervention (n = 300) or wait-list control (n = 287). In total, 492 (84%) participants completed the primary endpoint assessment at 6 weeks. Men in Mind demonstrated a large effect of improved EMITS scores compared to the control group (d = 2.63, 95% CI [2.39, 2.87], p < .001). Men in Mind was effective at increasing mental health practitioners’ self-reported efficacy to work with men, which is potentially a key change mechanism in their ability to improve health outcomes for male clients. A limitation of the trial was the use of a bespoke, self-reported primary outcome, while a strength was the gender-responsive intervention design.

Link: https://psycnet.apa.org/fulltext/2024-28138-001.html

Authors: SK McKenzie, MT Kelly, E Cooney, JL Oliffe

Journal: SSM - Qualitative Research in Health

Abstract: Anxiety disorders are one of the most commonly diagnosed mental illnesses amongst men. Despite this, research exploring men's lived experiences of anxiety is sparse. The current photovoice study offers key insights to the understandings of nineteen New Zealand based men aged 24-62 who live with anxiety disorders. Using reflexive thematic analysis to analyse individual in-depth photo-elicitation interviews, two overarching themes were inductively derived: 1) Experiencing and embodying anxiety wherein men's internalized anxiety was characterised as an amorphous and unpredictable entity which could render them powerless, isolated and trapped; 2) Managing uncertainties in which men employed several strategies to control their anxiety amid an array of challenging circumstances. Discussed within a masculinities framework, the findings reveal complex lived experiences embedded in men's social worlds and gendered practices. Findings indicate the need to develop targeted interventions for men experiencing anxiety.

Link: https://www.sciencedirect.com/science/article/pii/S2667321523001403?via%3Dihub

Authors: P Sharp, JL Oliffe, D Kealy, SM Rice, ZE Seidler, J Ogrodniczuk 

Journal: Early Intervention in Psychiatry

Aim: Social support and resilient coping can aid mental health. The aim of this study was to examine age effects of social support on men's resilient coping for psychological distress.

Methods: The sample consisted of 434 help-seeking Canadian men who completed standardized measures. Regression analyses tested a moderated moderation model, controlling for COVID-19 pandemic impact.

Results: Greater resilient coping was associated with lower psychological distress and this relationship was moderated by social support. Higher levels of social support had a significant positive effect on men's resilient coping for psychological distress. Findings indicated that younger men (18–24 years) were most positively buffered by social support.

Conclusions: Social support appears to be particularly important for young men's coping response to psychological distress. This is an important finding in the context of the COVID-19 pandemic, where social support networks have been challenged. Community-based and clinical programs and initiatives that proactively target young men's development of social connections and robust supportive networks, while bolstering their individual resilient coping skills, are likely to provide protections from psychological distress.

Link: https://onlinelibrary.wiley.com/doi/10.1111/eip.13371

Authors: K Fisher, SM Rice, JL Oliffe, K King, ZE Seidler

Journal: Sociology of Health & Illness

Abstract: Anxiety is the most prevalent mental disorder experienced by young men, and when untreated, is predictive of co-morbid mental health challenges and suicide. Despite the rising prevalence, there is a conspicuous absence of qualitative research to distil and theorise young men’s anxiety. Twenty-five young Australian men (15–25 years), who had been diagnosed with an anxiety disorder or self-reported anxiety symptoms, took part in individual semi-structured interviews. Interviews were transcribed verbatim and analysed using a constructivist grounded theory approach. A three-process grounded theory (Resisting-Reckoning-Responding; Triple R Anxiety Model) depicted young men’s experiences of anxiety, gilded and guided by their masculine socialisation. Initially, young men noticed somatic symptoms (i.e., headaches, nausea and myalgia) but did not connect these symptoms to anxiety. Avoiding anxiety (e.g., denying, distracting) proved unhelpful in the longer term and as symptoms diffused, a subsequent process of reckoning anxiety (i.e., meaning making) ensued. As young men gained insight to the life limiting bounds of their anxiety, some were prompted towards actions of acceptance, seeking help proactively and employing strength-based adaptive coping strategies. This theoretical conceptualisation of young men’s anxiety has the capacity to enhance identification and treatment efforts, improving young men’s mental health outcomes across the lifespan.

Link: https://onlinelibrary.wiley.com/doi/10.1111/1467-9566.13641

Authors: T Goodyear, JL Oliffe, N Parent, C Mniszak, E Jenkins, R Knight

Journal: Harm Reduction Journal

Background: Alcohol consumption is common among young men and occurs in many contexts. The sexualized substance use literature has generated some insight into the role of alcohol alongside other substances in the context of sex, though there remain opportunities for targeted and context-sensitive studies to examine the sexual practices and outcomes associated with alcohol, specifically.

Link: https://harmreductionjournal.biomedcentral.com/articles/10.1186/s12954-023-00835-5

Thanks for reading! Please follow our Men's Health Research Program at UBC Twitter account to follow along RMS with their activities. We hope you have a happy holiday and new year! @MensHealthUBC