Males feature prominently in suicide statistics, but relatively little work has been done to date to explore whether endorsement of dominant masculinity norms heightens the risk of or is protective against suicidal thinking. This paper aimed to further knowledge in this area.
We used baseline data from 13,884 men (aged 18–55) in the Australian Longitudinal Study on Male Health (Ten to Men) cohort. These men filled in self-complete questionnaires in 2013/14 which covered a range of topics, including conformity to dominant masculinity norms and suicidal thinking. We conducted logistic regression analyses to estimate the strength of association between these two variables.
After controlling for other key predictors of suicidal thinking, one characteristic of dominant masculinity—self-reliance—stood out as a risk factor for suicidal thinking (AOR 1.34; 95% CI 1.26–1.43).
It suggests that one particular element of dominant masculinity—being self-reliant—may place men at increased risk of suicidal thinking. This finding resonates with current theories of how suicidal thinking develops and leads to action. It also has implications for the full gamut of suicide prevention approaches that target males in clinical settings and in the general population, and for our broader society. Further work is needed, however, to confirm the direction of the relationship between self-reliance and suicidality, and to unpack the means through which self-reliance may exert an influence.
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Tax calculation will be finalised during checkout.
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
Tax calculation will be finalised during checkout.
This breakdown reflects a deliberate oversampling of males in regional areas in Ten to Men.
World Health Organization (2014) preventing suicide: a global imperative. World Health Organization, Geneva
Houle J, Mishara B, Chagnon F (2008) An empirical test of a mediation model of the impact of the traditional male gender role on suicidal behavior in men. J Affect Disord 107:37–43
Moller-Leimkuehler A (2002) Barriers to help-seeking by men: a review of sociocultural and clinical literature with particular reference to depression. J Affect Disord 71:1–9
Hawton K (1998) Why has suicide increased in young males? Crisis 19:119–124
Kendler K, Thornton L, Prescott C (2001) Gender differences in the rates of exposure to stressful life events and sensitivity to their depressogenic effects. Am J Psychiatry 158(4):587–593
Tomova L, von Dawans B, Heinrichs M, Silani G, Lamm C (2014) Is stress affecting our ability to tune into others? Evidence for gender differences in the effects of stress on self-other distinction. Psychoneuroendocrinology 43:95–104
Cleary A (2012) Suicidal action, emotional expression, and the performance of masculinities. Soc Sci Med 74:498–505
Griffith D (2015) “I am a man”: manhood, minority men’s health and health equity. Ethn Dis 25(3):287–293
Mahalik J, Walker G, Levi-Minzi M (2007) Masculinity and health behaviors in Australian men. Psychol Men Masculin 8(4):240–249
Niehaus I (2012) Gendered endings: narratives of male and female suicides in the South African Lowveld. Cult Med Psychiatry 36:327–347
Oliffe J, Ogrodniczuk J, Bottorff J, Johnson J, Hoyak K (2012) “You feel like you can’t live anymore”: suicide from the perspectives of Canadian men who experience depression. Soc Sci Med 74:506–514
Alston M (2012) Rural male suicide in Australia. Soc Sci Med 74:515–522
Fogarty A, Proudfoot J, Whittle E, Player M, Christensen H, Hadzi-Pavlovic D, Wilhelm K (2015) Men’s use of positive strategies for preventing and managing depression: a qualitative investigation. J Affect Disord 188:179–187
Coleman D (2015) Traditional masculinity as a risk factor for suicidal ideation: cross-sectional and prospective evidence from a study of young adults. Arch Suicide Res 19(3):366–384
Granato S, Smith P, Selwyn C (2015) Acquired capability and masculine gender norm adherence: potential pathways to higher rates of male suicide. Psychol Men Masculin 16(3):246–253
Easton S, Renner L, O’Leary P (2013) Suicide attempts among men with histories of child sexual abuse: examining abuse severity, mental health, and masculine norms. Child Abuse Negl 37:380–387
Mansdotter A, Lundin A, Falkstedt D, Hemmingsson T (2009) The association between masculinity rank and mortality patterns: a prospective study based on the Swedish 1969 conscript cohort. J Epidemiol Community Health 63:408–413
Pirkis J, Currier D, Carlin J, Degenhardt L, Dharmage S, Giles-Corti B, Gordon I, Gurrin L, Hocking J, Kavanagh A, Keogh L, Koelmeyer R, LaMontagne A, Patton G, Sanci L, Spittal M, Schlichthorst M, Studdert D, Williams J, English D (2016) Cohort profile: Ten to Men (The Australian Longitudinal Study on Male Health). Int J Epidemiol. doi:10.1093/ije/dyw055
Kroenke K, Spitzer RL, Williams JBW (2001) The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med 16:606–613
Mahalik J, Locke B, Ludlow L, Diemer M, Scott R, Gottfried M, Freitas G (2003) Development of the conformity to masculine norms inventory. Psychol Men Masculin 4(1):3–25
Thompson E, Bennett K (2015) Measurement of masculinity ideologies: a (critical) review. Psychol Men Masculin 16(2):115–133
Iwamoto D, Gordon D, Oliveros A, Perez-Cabello A, Brabham T, Lanza S, Dyson W (2012) The role of masculine norms and informal support on mental health in incarcerated men. Psychol Men Masculin 13(3):283–293
Owen J (2010) Assessing the factor structures of the 55- and 22-item versions of the Conformity to Masculine Norms Inventory. Am J Men’s Health 5:118–128
Australian Bureau of Statistics (2013) Census of population and housing: socio-economic indexes for areas (SEIFA), Australia, 2011 (Cat. No. 2033.0.55.001). Australian Bureau of Statistics, Canberra
Australian Bureau of Statistics (2011) Australian Statistical Geography Standard (ASGS): Volume 5—Remoteness Structure. Australian Bureau of Statistics, Canberra
Tarlov A, Ware J, Greenfield S, Nelson E, Perrin E, Zubkoff M (1989) The medical outcomes study: an application of methods for monitoring the results of Medical Care. J Am Med Assoc 262:925–930
Holmes T, Rahe R (1967) The social readjustment rating scale. J Psychosom Res 11(2):213–218
Pachana N, Brilleman S, Dobson A (2011) Reporting of life events over time: methodological issues in a longitudinal sample of women. Psychol Assess 23(1):277–281
Currier D, Spittal MJ, Patton G, Pirkis J (2016) Life stress and thoughts of death: the relationship between life events and suicidal ideation in Australian men—cross-sectional analysis of Ten to Men baseline data. BMC Public Health 16(Suppl 3):1031. doi:10.1186/s12889-016-3702-9
Babor T, Higgins-Biddle J, Saunders J, Monteiro M (2001) The alcohol use disorders identification test: guidelines for use in primary care, 2nd edn. World Health Organization, Geneva
Australian Bureau of Statistics (2015) The Australian Health Survey. Australian Bureau of Statistics. http://www.abs.gov.au/australianhealthsurvey. Accessed 18 Aug 2015
StataCorp (2013) Stata: Release 13.1. StataCorp LP, College Station TX
Last J (2001) A dictionary of epidemiology. Oxford University Press, Oxford
Mahalik J, Talmadge W, Locke B, Scott R (2005) Using the conformity to masculine norms inventory to work with men in a clinical setting. J Clin Psychol 61(6):661–674
Labouliere C, Kleinman M, Gould M (2015) When self-reliance is not safe: associations between reduced help-seeking and subsequent mental health symptoms in suicidal adolescents. Int J Environ Res Public Health 12:3741–3755
Hom MA, Stanley IH, Joiner TE Jr (2015) Evaluating factors and interventions that influence help-seeking and mental health service utilization among suicidal individuals: a review of the literature. Clin Psychol Rev 40:28–39. doi:10.1016/j.cpr.2015.05.006
Gulliver A, Griffiths KM, Christensen H (2010) Perceived barriers and facilitators to mental health help-seeking in young people: a systematic review. BMC Psychiatry 10:113. doi:10.1186/1471-244X-10-113
O’Connor R (2011) The integrated motivational-volitional model of suicidal behaviour. Crisis 32:295–298
Van Orden K, Witte T, Curkrowicz K, Braithwaite S, Selby E, Joiner T (2010) The interpersonal theory of suicide. Psychol Rev 117:575–600
Uebelacker LA, German NM, Gaudiano BA, Miller IW (2011) Patient health questionnaire depression scale as a suicide screening instrument in depressed primary care patients: a cross-sectional study Prim Care Companion CNS Disord. 13(1). doi:10.4088/PCC.10m01027
Sveticic J, De Leo D (2012) The hypothesis of a continuum in suicidality: a discussion on its validity and practical implications. Mental Illness 4(2):e15
The research on which this paper is based was conducted as part of the Australian Longitudinal Study on Male Health (Ten to Men). We are grateful to the Australian Government Department of Health for funding and to the boys and men who provided the survey data. Ten to Men is managed by the University of Melbourne. Ten to Men data are the intellectual property of the Commonwealth.
Ten to Men was approved by the University of Melbourne Human Research Ethics Committee and, therefore, been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. All participants gave written informed consent.
Conflict of interest
All authors report no conflict of interest.
An erratum to this article is available at https://doi.org/10.1007/s00127-017-1443-4.
About this article
Cite this article
Pirkis, J., Spittal, M.J., Keogh, L. et al. Masculinity and suicidal thinking. Soc Psychiatry Psychiatr Epidemiol 52, 319–327 (2017). https://doi.org/10.1007/s00127-016-1324-2
- Suicidal ideation