Female Medical Students' (Silencing the) Self: Effects on Depression and Dyadic/Sexual Dissatisfaction

Female physicians, residents, and medical students commonly suffer from depression and dyadic and sexual dissatisfaction. To identify self-related risk factors for depression and dyadic and sexual dissatisfaction in female medical students in Israel. In Study 1, 194 female medical students were assessed twice over a 1-year interval. Depressive symptoms, dyadic, and sexual dissatisfaction, and three self-concept factors—self-criticism, self-concept clarity, and silencing the self—were measured twice. Physical symptoms were also assessed at Time 2. In Study 2, 14 female medical students with elevated levels of depression were interviewed, and their narrative accounts were analyzed qualitatively. Elevated baseline levels of silencing the self predicted an increase in depressive symptoms and dyadic and sexual dissatisfaction over time, and high levels of physical symptoms at Time 2. The effect of silencing the self on depression was particularly pronounced under low self-concept clarity. All 14 interviewees alluded to the painful tension between their inner, tumultuous self, and their rehearsed self-presentation and a social prohibition to express negative emotions. Resources should be dedicated in order to assess, trace, and treat masked (silenced) distress among female medical students, interns, and residents.