Explaining unexpected gender differences in hostility among persons seeking treatment for substance use disorders

Objective: Gender differences in depression and anxiety are found among patients seeking treatment for substance use disorders, but few data exist on differences in hostility. As part of a larger study describing substance abuse treatment seekers, analyses investigated whether women would be more depressed and anxious than men, but less hostile. Method: Data were collected at baseline from 336 outpatients (62% men) at an addiction treatment agency. Most of the outpatients (81%) had DSM-IV chart diagnoses of alcohol dependence or abuse. Results: On the depression, anxiety and hostility subscales of the Brief Symptom Inventory, women had significantly higher scores than did men. When scores were converted to gender-keyed T scores standardized on a normal sample, differences in depression and anxiety were no longer significant. However, differences in hostility remained. A regression analysis indicated that hostility scores were explained not by gender, but by greater severity of adverse consequences from substance use, insomnia, lack of social support, and being married. A childhood history of physical or sexual abuse, although more common in women than men, did not explain gender differences in hostility after controlling for other variables. Conclusions: The women in this study did not appear to be more anxious and depressed than did the men after controlling for gendered population norms. However, the women were more hostile than the men. Women's greater hostility was explained not by gender per se, but by personal and social factors that were differentially distributed across genders. Treatment implications are reviewed.