Men are less likely than women to seek help for mental health support yet are more likely to die by suicide (WHO, 2020). These differences are hypothesised to be related to a range of biopsychosocial factors, which are further compounded by the challenges in detecting mental health conditions due to psychological assessments often relying on open disclosure of symptoms and emotional reflection, things that some men find difficult.
At NovoPsych, we want to ensure that clinicians can access a toolkit of specialised measures to support the identification of psychopathology in males. We’ve provided an introduction and summary of a range of related measures below, which we hope you’ll find helpful in your practice.
To familiarise yourself with these assessments, we’d recommend self-administering them before you give them to a real client. All NovoPsych subscriptions include access to these measures. We hope you find them useful!
Yours sincerely,
Ben
The Male Depression Risk Scale (MDRS-22) is a self-report instrument that can be used to identify adult men’s risk of depression, with a focus on externalising signs and symptoms (i.e., aggression & drug use; Rice et al., 2013).
The MDRS-22 comprises six subscales categorised into internalising and externalising symptoms.
The advantage of choosing the MDRS-22 over a gender-neutral depression rating scale is that it specially measures factors associated with depression and suicidality in men and emphasises maladaptive coping strategies. It can be a helpful choice for use with men who exhibit signs of alexithymia, have low psychological literacy or who are reluctant to acknowledge or express emotions.
The MDRS-22 can be helpful for use with men in your clinical practice as a screening tool, for monitoring risk factors and for monitoring the progression of treatment.
The Toronto Alexithymia Scale (TAS) is a 20-item self-report questionnaire that measures difficulty in identifying and describing feelings (Bagby et al., 1994). The TAS can be a particularly helpful screening tool for males, who have been observed to score significantly higher on alexithymia than females (Levant et al., 2006, 2009).
Investigations have found TAS scores to be associated with psychopathology symptoms and poor well-being (Taylor et al., 1999). Using the TAS, alexithymia was found to be prevalent in depressive, anxiety, adjustment, somatoform and eating disorders (Leweke et al., 2012).
The TAS can be useful in clinical practice as a tool for screening, formulation with clients or as a predictor of therapy outcomes (Bagby et al., 1994; Kauhanen et al., 1992). As a predictor, the TAS can provide an early indication of potential future roadblocks in therapy. For example, people high on alexithymia are more likely to leave therapy prematurely (Sommerfeld, 2023). The TAS can also help clinicians identify which clients would benefit from emotional insight as a specific target for treatment.
The Empathy Quotient – 40 item version (EQ-40) is a self-report tool that measures empathy in adults aged 18 years and older (Baron-Kohen & Wheelwright, 2004). Three subscales are included:
Percentiles are based on normative EQ-40 data specific to the client’s gender, providing clinicians with helpful gender-specific comparative information about the client’s level of empathy. On average, women have significantly higher levels of empathy compared with men.
In clinical practice, the EQ-40 is a valuable resource for understanding the complex interplay of empathy and social functioning. Empathy is an important component of social cognition and plays a significant role in interpersonal relationships, mental health and overall well-being (Decety & Ickes, 2009). Low empathy is a transdiagnostic signal of possible interpersonal difficulties and has been associated with diverse populations, such as Autism, ADHD and some personality disorders (Dinsdale & Crepi, 2013; Groen et al., 2018; Michaels et al., 2014; Rum & Perry, 2020; Schwenk et al., 2011; Turner et al., 2019).
The Buss and Perry Aggression Questionnaire (BPAQ) is a 29-item self-report instrument designed as a comprehensive measure of aggression in adults (18+) (Buss & Perry, 1992). The BPAQ divides aggression into four related but distinct factors reflected in the subscales below:
When interpreting the BPAQ, clinicians should consider that prominent gender differences in scores have been observed, with evidence found for men being higher in general and women being higher in relation to hormonal cycles (Archer & Webb, 2006; Ritter, 2003).
The BPAQ can be used in clinical practice to identify aggression-related issues important to formulation and as an impartial method of approaching the subject of aggression. It is also useful for monitoring treatment progress and evaluating the effectiveness of a particular treatment approach.
Sex and gender differences in prevalence rates of mental health conditions have been consistently demonstrated by research. For example, internalizing disorders are observed to be more common in females while externalizing disorders are more common in males (Eaton et al., 2012).
Increasingly, sex/gender variations in the clinical presentations and symptom profiles within mental health conditions are documented. Sex and gender differences in the expression of psychopathology have been demonstrated across mental health conditions, including depression (Winkler et al., 2004), posttraumatic psychopathology (Kofman et al., 2024), and psychosis (Irving et al., 2021), for example. Being able to assess for these differences in symptom expression can help with diagnostic accuracy, formulation and the development of tailored treatment plans to address psychopathology effectively in each client.
We hope that the above measures will help you assess sex/gender psychopathological differences in the symptoms experienced by your clients and also provide valuable insights that go beyond just diagnosis and treatment planning in your clinical practice.
If you know any professionals that might be interested in these scales, please forward them this email! We’re constantly adding assessments to the NovoPsych test library. To view over 150 of the current psychometric tools available you can visit our website: https://NovoPsych.
Warm regards,
Dr Ben Buchanan
Psychologist
NovoPsych Co-founder
[email protected]
LinkedIn