 PERGAMON Journal of Psychiatric Research 22 "0888# 132Ð149 9911!2845:88:, ! see front matter Þ 0888 Elsevier Science Ltd[ All rights reserved[ PII]S9911!2845"87#99953!7 Gender di}erences in depression] an ethological study of nonverbal behavior during interviews Alfonso Troisi\ Anna Moles Department of Psychiatry\ University of Rome Tor Vergata\ via Guattani 03\ 99050 Rome\ Italy Received 13 March 0887^ received in revised form 06 August 0887^ accepted 01 November 0887 Abstract Previous studies of gender di}erences in the phenomenology of depression have focused mostly on symptoms as measured by self! report questionnaires or clinician!rated scales[ In this study\ we examined gender di}erences in the interpersonal behavior of depressed patients by using ethological techniques which involve direct observation of behavior[ The nonverbal behavior of 61 nondepressed volunteers and 57 patients with a DSM!III!R diagnosis of nonpsychotic unipolar depression was videorecorded during clinical interviews and scored according to an ethological scoring system including 26 behavior patterns\ mostly facial expressions and hand movements[ Both male and female depressed patients showed a global restriction of nonverbal expressiveness re~ecting a tendency towards social withdrawal[ Nonverbal expression of hostility was the only behavioral category on which depressed patients scored higher than nondepressed volunteers[ Even though clinical status exerted marked e}ects on the ethological pro_le\ depression did not obscure some important di}erences in the nonverbal behavior of males and females[ As a group\ depressed women showed more socially interactive behaviors than depressed men[ Their modality of interacting included higher levels both of nonverbal hostility and of submissive and a.liative behaviors[ These results are discussed in view of clinical data indicating a relationship between gender\ style of social interaction and response to antidepressant drugs[ Þ 0888 Elsevier Science Ltd[ All rights reserved[ Key words] Gender^ Depression^ Nonverbal behavior^ Ethology 0[ Introduction Although epidemiological studies have consistently shown that unipolar depressive disorders are about twice as common in women as in men\ studies of gender di}er! ences in the clinical manifestations of depression have generally yielded negative results "Frank et al[\ 0877^ Young et al[\ 0889#[ A possible reason for the failure to document gender di}erences in the phenomenology of depression is that previous studies have employed self! report questionnaires or clinician!rated scales which limit clinical assessment to the investigation of symptoms of depression[ In addition to psychic and somatic symptoms\ inter! personal behavior is an important aspect of the clinical picture of depression[ Empirical studies have consistently demonstrated that depressed patients have di.culties in social functioning "Feldman and Gotlib\ 0882#\ and major theoretical formulations of depression emphasize the importance of interpersonal behavior in the etiology  Corresponding author[ Fax] ¦28!95!3312!1887^ e!mail] alfonso[ troisiÝuniromaz[it[ and maintenance of this disorder "Klerman et al[\ 0873#[ There is some evidence for gender di}erences in the inter! personal behavior of depressed patients[ Compared with depressed men\ depressed women are more a.liative "Bebbington\ 0885#\ tend to use more prosocial coping strategies "Hobfoll et al[\ 0883#\ and are more sensitive to events involving their intimate social network "Nolen! Hoeksema\ 0876#[ In this study\ we applied ethological techniques to the analysis of interpersonal behavior of depressed men and women during clinical interviews[ Our primary goals were] "0# to examine the in~uence of gender on the non! verbal behavior of depressed patients and "1# to test the hypothesis that depressed women show more socially interactive behaviors than depressed men[ In addition\ we aimed at de_ning the dimensions of nonverbal behavior which distinguish between depressed patients and non! depressed persons[ The ethological method involves direct observation\ coding and analysis of speci_c nonverbal behaviors dur! ing social interactions[ Unlike rating scales\ this approach allows for quantitative recording of the individual|s style of interaction during social encounters without the dis! tortions related to the patient|s and clinician|s reporting