Gender, marital status, and psychiatric disorder, an examination of social causation versus social selection explanations for the gender-specific benefits of marriage for mental health

A meta-analysis of results from previous research combined with event history modeling of retrospective life calendars was employed to examine the differential benefits of marriage experienced by men compared to women in terms of their emotional and mental health. A meta-analysis was employed to quantify the consistency of the association between gender, marital status and mental disorder and to examine the effect of design factors on the variation in the gender specific effect of marriage on mental health found in previous research. Event history modeling enabled the separation of social causation processes from social selection processes, two contrasting explanations for gender and marital status differences in mental health. Thus, it was used to examine the gender specific causal impact of marriage on mental health as well as the gender specific selection effects of mental health on marital status. Results of the meta-analysis indicated that men's differential marital gains consistently declined over time in community based studies, becoming zero by 1990. Moreover, the gender specific effect of marriage that differentially benefited men was less likely to be observed among male prevalent measures of mental health including alcohol and drug related disorders and personality disorders. Contrary to the differential utilization argument, there was no evidence of the gender specific effect of marriage in studies based on treatment statistics, where parameters consistently approximated zero values since 1933. Event history models for the social causation effect of marriage on the risk of mental illness provided no support for the sex-role argument that higher rates of mental illness among married women are a function of marital role differences that differentially benefit men. Contrary to this argument, the only evidence of a gender specific effect of marriage indicated that women, not men, differentially benefit from marriage. Following marriage, women were only one-third as likely to experience a substance disorder compared to men. There was also evidence the beneficial impact of marriage on reducing the risk of substance disorder increased over time and was stronger among younger birth cohorts. Event history models for social selection into marriage based on mental health status provided no support for the argument that higher rates of mental illness among married women are a function of selection processes that differentially reduce the probability of marriage for men with a mental disorder. In contrast, the results indicated that women, not men, are differentially excluded from marriage following onset of a psychiatric disorder. The results highlight the importance of considering gender specific indicators of mental health problems as well as aggregate mental health measures. More importantly, the results indicate the importance of a life course and an historical perspective in research arch on socio-demographic differences in mental health. Life course trends explained the gender specific effect of marriage that differentially benefited men for a psychiatric diagnosis and suppressed the gender specific effect of a psychiatric diagnosis that differentially excluded women from marriage. Generation differences suppressed the gender specific effect of marriage that differentially reduced women's risk for a substance disorder and explained the main beneficial effect of marriage on reducing the probability of a psychiatric diagnosis and a psychological disorder. It was not until the life course differences in marital timing and disorder onset, and differences across birth generations, were controlled, that women's differential benefits from marriage and women's differential selection from marriage appeared.