Abstract
The following study examined a single case of a young Hispanic man suffering from distorted body image and dysfunctional schemas about himself as a man exacerbated by hair loss. He reported anxiety and depression related symptoms affecting his daily life functioning. Treatment considered for this case was centered on Cognitive Behavioral Therapy (CBT) with some guidelines suggested by a review of literature on gender role theory. During the course of treatment, other techniques based on mindfulness were included to target anxiety related symptoms including: breathing exercises, yoga, and guided imagery. In addition, an imaginary exposure technique was conducted to further address patient symptomatology. To guide treatment, measures related to masculinity were used like the Male Role Norms Inventory (MRNI-SF), and the Health Behavior Inventory-20 (HBI-20) to assess preventive and risk behaviors. A genogram was also used to explore family history and family dynamics. Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI) were used as clinical measures for baseline, post and follow up treatment. Masculinity issues, family dynamics and clinical outcomes are discussed.
References
Barber, K. (2008). The well-coiffed man: Class, race, heterosexual masculinity in the hair salon. Gender & Society, 22, 455-476. doi:10.1177/0891243208321168.
Beck, A., & Steer, R. (1993). Beck Anxiety Inventory Manual. San Antonio, TX: Psychological Corporation.
Beck, A., Steer, R., & Brown, G. (1996). Beck Depression Inventory-Second Edition Manual. San Antonio, TX: The Psychological Corporation.
Bem, S. (1981). Gender scheme theory: A cognitive account of sex typing. Psychological Review, 88(4), 354-364.
Brooks, G. R. (1998). A new psychotherapy for traditional men. San Francisco: Jossey-Bass.
Burlew, L., & Shurts, W. M. (2013). Men and body image: Current issues and consoling implications. Journal of Counseling & Development, 91, 428-435. doi:10.1002/j.1556-6676.2013.00114.x
Carpenter, K., & Addis, M. (2000). Alexithymia, gender and responses to depressive symptoms. Sex Roles, 9(43), 629-644.
Centers for Disease Control and Prevention. (2011). Health United States, 2011: With special feature on socioeconomic status and health. Retrieved from: http://www.cdc.gov/nchs/data/hus/hus11.pdf
Centers for Disease Control and Prevention. (2013). Health, United States, 2013: With special feature on prescription drugs. Retrieved from: http://www.cdc.gov/nchs/data/hus/hus13.pdf
Connell, R. W. (2005). Masculinities (2nd ed.). Los Angeles, CA: Cambridge Polity Press.
Coull, G., & Morris, P. G. (2011). The clinical effectiveness of CBT-based guided self-help interventions for anxiety and depressive disorders: A systematic review. Psychological Medicine, 11, 2239-2252. doi:10.1017/S0033291711000900.
Courtenay, W. (2011). Behavioral factors associated with disease, injury and death among men. In W. Courtenay (Ed.), Dying to be men. Psychosocial, environmental and biobehavioral directions in promoting health of men and boys. (pp. 43107) New York: Routledge.
Courtenay, W. H., McCreary, D. R. & Merighi, J. R. (2002). Gender and ethnic differences in health beliefs and behaviors. Journal of Health Psychology, 7, 219231. doi:10.1177/1359105302007003216.
Didonna, F. (2009). Clinical handbook of mindfulness. New York: Springer.
DiMauro, J., Domingues, J., Fernandez, G., & Tolin, D. (2013). Long-term effectiveness of CBT for anxiety disorders in an adult outpatient clinic sample: A follow-up study. Behavior Research and Therapy, 2, 82-86. doi:10.1016/j.brat.2012.10.003.
Dorr, N., Brosschot, J., Sollers, J., & Thayer, J. (2007). Damned if you do, damned if you don‘t: The differential effect of expression and inhibition of anger on cardiovascular recovery in Black and White males. International Journal of Psychophysiology, 66, 125-134. doi:10.1016/j.ijpsycho.2007.03.022
Englar-Carlson, M., & Stevens, M. (2006). In the room with men: A casebook of therapeutic change. Washington, DC: American Psychological Association.
Hays, P., & Iwamasa, G. (2006). Culturally responsive cognitive-behavioral therapy assessment, practice and supervision. Washington, DC: American Psychological Association.
Kabat-Zinn, J. (2013). Full catastrophe living: Using the wisdom of your body and mind to face stress, pain, and illness. New York: Bantam Books.
Katz, D., & Toner, B. (2013). A systematic review of gender differences in the effectiveness of mindfulness-based treatments for substance use disorder. Mindfulness, 4, 318-331. doi:10.1007/s12671-012-0132-3.
Keyes, K. M., Martins, S. S., Hatzenbuehler, M. L., Blanco, C., Bates, L. M., & Hasin, D. S. (2011). Mental health service utilization for psychiatric disorders among Latinos living in the United States: The role of ethnic subgroup, ethnic identity and language/social preferences. Soc. Psychiat. Psychiatr. Epidemiol., 47, 383-394. doi:10.1007/s00127-010-0323-y.
Kochanek, K., Arias, E., & Anderson, R. (2013). How did cause of contribute to racial differences in life expectancy in the United States in 2010? Retrieved from: http://www.cdc.gov/nchs/data/databriefs/db125.pdf
Korhonen, A. (2010). Strange things out of hair: Baldness and masculinity in early modern England. Sixteen Century Journal, 41(2), 371-391.
Levant, R. F., Wimer, D. J., & Williams, C. M. (2011). An evaluation of the psychometric properties of the Health Behavior Inventory-20 (HBI-20) and its relationships to masculinity and attitudes towards seeking psychological help among college men. Psychology of Men and Masculinity, 12, 26-41. doi:http://dx.doi.org/10.1037/a0021014
Levant, R. F., Hall, R. J., & Rankin. T. J. (2012). Male Role Norms Inventory-Short Form (MRNI-SF): Development, confirmatory factor analytic investigation of structure, and measurement invariance across gender. Journal of Counseling Psychology, 60, 228-238. doi:http://dx.doi .org/10.1037/a0031545
Lincoln, T., Ziegler, M., Mehl, S., Kesting, M. L., Lullmann, E., Westermann, S., & Winfried, R. (2012). Moving from efficacy to effectiveness in cognitive behavioral therapy for psychosis: A randomized clinical practice trial. Journal of Consulting and Clinical Psychology, 4, 674-686. doi:10.1037/a0028665.
Lupis, S., Lerman, M., & Wolf, J. (2014). Anger responses to psychosocial stress predict heart rate and cortisol stress responses in men but not women. Psychoneuroendocrinology, 49, 84-95. doi:http://dx.doi.org/10.1016/j.psyneuen.2014.07.004
Mannes, A. (2012). Shorn scalps and perceptions of male dominance. Social Psychological and Personality Science, 2, 198-205. doi:10.1177/1948550612449490.
Mansfield, A., Addis, M., & Mahalik, J. (2003). "Why won‘t he go to the doctor?" The Psychology of Men‘s Help Seeking, 2, 93-109. doi:10.3149/jmh.0202.93.
McGoldrick, M., Gerson, R., & Shellenberger, S. (1999). Genograms: Assessment and Intervention (2nd ed.) New York: W.W. Norton & Company.
Mussap, A. (2008). Masculine gender role stress and the pursuit of masculinity. International Journal of Men‘s Health, 7, 72-89. doi:10.3149/jmh.0701.72
Neudeck, P., & Wittchen, H.U. (2012). Exposure therapy: Rethinking the model-refining the method. New York: Springer.
O‘Dea, J., & Abraham, S. (2002). Eating and exercise disorders in young college men. Journal of American College of Health, 50(6), 273-278.
Ogden, P., Minton, K., & Pain, C. (2006). Trauma and the body: A sensorimotor approach to psychotherapy. New York: Norton.
Olavarría, J. (2009). La investigación sobre Masculinidades en América Latina. In: J. Toro-Alfonso. (Eds.) (pp. 315-344) Lo masculino en evidencia. Investigaciones sobre la masculinidad. San Juan, P.R.: Publicaciones Puertorriqueñas.
O‘Neil, J. M., Good, G. G., & Holmes, S. (1995). Fifteen years of theory and research on men‘s gender role conflict: New paradigms for empirical research. In R. F. Levant & W. S. Pollack (Eds.), A new psychology of men (pp.164-206). New York, N.Y.: Basic Books.
Ousley, L., Cordero, E., & White, S. (2008). Eating disorders and body image of undergraduate men. Journal of American College Health, 56(6), 617-622.
Pleck, J. H. (1995). The gender role strain paradigm: An update. In R. F. Levant & W. S. Pollack (Eds.), A new psychology of men (pp.11-32). New York: N.Y. Basic Books.
Primack, J. M., Addis, M. E., Syzdek, M., & Miller, I. W. (2010). The men‘s stress workshop: A gender-sensitive treatment for depressed men. Cognitive and Behavioral Practice, 17(1), 77-87.
Ricciardelly, R. (2011). Masculinity, consumerism, and appearance: A look at men‘s hair. Canadian Review of Sociology, 48(2), 181-201.
Siegel, D. (1999). The developing mind. New York: Guilford.
Spendelow, J. (2015). Cognitive-behavioral treatment of depression in men: Tailoring treatment and directions for future research. American Journal of Men‘s Health, 2, 94-102. doi:10.1177/1557988314529790.
Stevens, M. (2006). Paul‘s journey to find calmness: From sweet to tears. In M. Englar-Carlson & M. Stevens (Eds.), In the room with men: A casebook of therapeutic change (pp.51-68). Washington, DC: American Psychological Association.
Suicide Prevention Resource Center. (2013). Suicide among racial/ethnic populations in the U.S. Retrieved from: http://www.sprc.org/sites/sprc.org/files/library/Hispanics%20Sheet%20Aug%2028%202013%20Final.pdf
Toro-Alfonso, J. (2009). La investigación sobre masculinidades. In J. Toro-Alfonso. (Ed.), Lo masculino en evidencia: Investigaciones sobre la masculinidad (pp.13-33). San Juan, PR: Publicaciones Puertorriqueñas.
Toro-Alfonso, J. (2012). Como el diablo a la cruz: Los hombres y la terapia psicológica. Revista Psicólogos, 2(6), 4-11.
Wagley, N., Rybarczyk, B., Nay, W., Danish, S., & Lund, H. (2012). Effectiveness of abbreviated CBT for insomnia in psychiatric outpatients‘ sleep and depression outcomes. Journal of Clinical Psychology, 10, 1043-1055. doi:10.1002/jclp.21927
Derechos de autor: La Revista Griot no reserva los derechos de publicación de los artículos. Los autores podrán distribuir su propio material en cualquier otro medio, siempre y cuando sea sin fines comerciales, informando a la Junta Editora de la Revista Griot que el trabajo será publicado nuevamente y dando el crédito correspondiente a la Revista Griot. La publicación de la Revista Griot por su carácter gratuito no da derecho a remuneración económica alguna a los autores. Los lectores podrán reproducir y distribuir los artículos o colaboraciones de la Revista Griot siempre que sea sin fines comerciales, no se les hagan alteraciones al contenido y se cite su origen con información completa: nombre del autor, año, Revista Griot, volumen, número y página.
Relevo de responsabilidades: La Junta Editora de la Revista Griot, la Junta Asesora y la Universidad de Puerto Rico no se hacen responsables de las ideas y opiniones expresadas por los autores de los artículos o colaboraciones. Tampoco tiene control ni se hace responsable de los enlaces e hipertextos que en algunos artículos, posibiliten el acceso a prestaciones y servicios ofrecidos por terceros.
