Psychiatric Diagnoses and Traditional Masculinity Ideologies: Evidence from 317 Structured Clinical Interviews for DSM-5

Background: Conformity to traditional masculinity ideologies (TMIs) has consistently been linked to increased psychopathology. However, little is known about the association with formal psychiatric diagnoses.Method: Cross-sectional data from a randomized controlled trial were analyzed. A total of 317 men (mean age = 31.8, SD = 7.2) completed an online questionnaire assessing conformity to TMIs and underwent the Structured Clinical Interview for DSM-5 (SCID-5) in person. Participants had been pre-screened for depressive symptoms as part of the larger trial. Inclusion criteria were male sex and gender, age between 25 and 50 years, sufficient German-language skills, and no current or past psychopharmacological or psychological treatment.Results: Overall, 200 participants (64.7%) met the criteria for at least one psychiatric diagnosis. Logistic regression analyses revealed that higher conformity to TMIs was associated with increased odds of receiving any psychiatric diagnosis (OR=1.04, 95% CI [1.02, 1.05]), particularly depressive disorders (OR=1.03, 95% CI [1.01, 1.04]) and substance-related and addictive disorders (OR=1.03, 95% CI [1.01, 1.05]). No significant associations were found for attention-deficit/hyperactivity disorder or anxiety disorders. Exploratory analyses suggested a significant association between conformity to TMIs and personality disorders, and an initially significant association with sleep-wake disorders that did not survive correction for multiple testing.Conclusion: Higher conformity to TMIs is associated with an increased risk of fulfilling the criteria for a psychiatric diagnosis, especially depressive and substance-related disorders. As such, the study highlights the clinical relevance of including TMIs in the assessment and treatment of men suffering from mental disorders.