The objectives of this study were two: (1) to obtain a transcultural useful instrument to measure TGBs with psychometric guarantees (good internal structure and adequate sources of criterion validity); and (2) to investigate the hypothesis that TGBs are associated with stress, depression and the use of maladaptive tactics to resolve conflicts (as a form of IPV). Using different methodological strategies, we obtained a reduced 8-item scale with very good psychometric properties, including criterion validity sources (depressive symptomatology, stress, and IPV). A one-factor solution, which was labeled as general irrationality, was parsimonious and had an excellent fit to the data.
Previous research on the original 92-item OWBS [59] and the 30-item MC-OWBS [43, 44] presented problems in their factor structure based on three areas (love, work, and self) or four cognitive processes (demanding, awfulizing, frustration intolerance, and self-downing). Two reasons may explain these results: (1) it is difficult for women to distinguish between areas and processes and/or (2) irrationality is an overall trait that transcends areas and processes and constitutes a personality feature. While this is difficult to ascertain at this stage, the preference for a general traditional beliefs factor, as proposed in the present study, is consistent even though the scale was originally developed to reflect three content areas and four thought processes [59]. Following a series of analytical strategies, exploratory and confirmatory analyses did not support an item distribution based on these three or four dimensions. Therefore, we propose a one-factor solution of the MC-OWBS-RV (i.e., global traditionalism), which offers a parsimonious factor structure that is moderately associated with important outcomes, namely depressed mood, stress, and IPV, in the expected direction.
Consistent with our proposed unidimensional structure of TGBs, the REBT’s idea of irrationality was initially viewed as a global concept [22]. It was only some years later that this conceptualization evolved to differentiate specific irrational beliefs in diverse areas and according to distinctive cognitive processes. This was further developed by Ellis and Wolfe [24] and extensively applied by Wolfe [80, 81] in allusion to women, covering conditions such as depression, relationship problems, work issues, sexual concerns, eating disorders, and gender abuse. Since Ellis and Wolfe's pioneering work, 48 inventories to assess rational and irrational beliefs have been developed, and many of them failed to report their factor analytic results according to the expected structures [19]. These outcomes may be explained by the use of EFA as opposed to CFA. However, the authors still concluded that there is no evidence to support the theoretical idea that the best way to conceptualize irrational or rational beliefs is through dividing items by processes or areas [19]. It has been suggested that perhaps all the processes, or a combination of some of them, represent a single latent variable [20]. Our results are in line with this alternative.
A strength of the present study is that the strategies used to obtain a psychometrically robust measure of TGBs were beyond the implementation of classic statistics (e.g., Cronbach’s alpha). We conducted different statistical approaches to investigate the psychometric properties of the instrument, combining modern analytical methods (e.g., CFA and AUC). This allowed us to obtain a new reduced version of the scale that meets a varied number of psychometric requirements. Psychometrically, the MC-OWBS-RV is an 8-item unidimensional measure with statements revolving around roles, insights, musts, and gender stereotypes that women might self-impose. The scale also reflects women’s insights into traditional cultural stereotypes involved in gender beliefs. These TGBs, as indicated in past research, diminish their roles as human beings, subordinating their values to what is socially accepted from a patriarchal society [60, 61].
Additional strengths of the MC-OWBS-RV include the fact that these beliefs are relevant cross-culturally [42, 44] and that it has a reduced number of items (8) with a good predictive competence. In relation to the latter, there have been some calls for routine outcome monitoring of patients during therapy [30], which should be performed more frequently (as opposed to the traditional episodic assessment in most randomized controlled trials). Having a reduced number of items, as in the MC-OWBS-RV, makes this more feasible. Ultimately, these eight gender beliefs may be used in goal-oriented clinical settings with the aim of alleviating symptomatology by helping women to become aware of and understand their thoughts and feelings, enhancing metacognitive capacities [64]. From a REBT framework, women and men acquire irrational beliefs from childhood onwards, but women might develop a self-concept affected by specific traditional gender beliefs acquired through social messages related to gender stereotypes that make them unable to minimize the disturbance over the hassles of life and promote the development of psychological disorders [84]. Recent studies have pointed to this important relationship between beliefs and clinical and sub-clinical problems [3, 10].
Irrational beliefs about traditional gender role may be addressed in clinical settings by helping women to identify them, dispute them, and replace them by rational beliefs. The therapeutic strategy is to identify unhealthy emotions and maladaptive behaviors, to investigate the irrational beliefs underlying them, and to learn how to restructure the dysfunctional cognitive processes. With psychotherapy, women can learn to replace an unhealthy emotion such as depression (which, for example, may be caused by low frustration tolerance) into a healthy emotion, such as sadness. In addition, they become aware that, although an adversity may trigger an unhealthy emotion, there is a chance to regulate their emotional response by developing a healthier mindset.
Regarding the relation between beliefs and mental health, our results are in accordance with previous research on the maladaptive role of irrational beliefs in depression and stress [3]. TGBs, as measured with the MC-OWBS-RV, relate to greater severity of stress and depression, which is of critical significance in clinical interventions. Psychologists are committed daily to the real need to help men and women overcome their mental problems, improve their relationships and change attitudes that prevent them from living healthily.
In addition to the association between TGBs and mental health outcomes, an important finding was the association found between TGBs and IPV. These findings are consistent with previous research on the relevance of TGBs and their consequences in IPV [76]. Past research showed that IPV could be understood as a bidirectional phenomenon in which both parties use violence and/or abusive behaviors against one another [41, 73]. This has significant implications for prevention purposes and underlines the critical importance of measuring TGBs. Because TGBs are relatively stable cognitive patterns, attitudes, and behaviors [82, 83], research shows that TGBs act in different contexts and over time [21]. Therefore, addressing TGBs would be crucial in achieving a more egalitarian society. Addressing women’s traditional gender beliefs might socially relevant. Specifically, it represents a real action aimed both at banishing unhealthy beliefs and at applying functional ways of thinking that improve women's ability to acquire new skills that enable them to fully develop in the society, especially in vulnerable groups such as battered women. Recent studies have shown that traditional gender beliefs justify, promote, and perpetuate violence against women [26] by holding irrational beliefs systematically transferred to relationships.
Regarding the prevalence of gender-based violence, it should be noted that the percentage of reported cases is systematically low. In Europe, only one third of abused women report partner abuse [25]. Irrational beliefs about traditional stereotypes may justify the subordination of women to men, tend to blame the victim, legitimize the abuser's behavior, and maintain myths about gender violence. The most common psychological consequences for victims are a loss of self-confidence, feelings of vulnerability, anxiety, and depression, but physical consequences or even death are also frequent. Official reports do not reveal the dimension of a problem that constitutes a dramatic reality, affects the life of many women, and violates some of their fundamental rights, such as dignity, justice and equality [4]. Encouragingly, there is empirical evidence about the effectiveness of cognitive re-education strategies in programs aimed at changing stereotyped beliefs in relation to the dependence and submission of women victims of partner violence [2]. Having a short, psychometrically-sound, and valid instrument might help in this direction by providing the Spanish-speaking professionals with a tool that helps them identify problematic beliefs, guide treatment, and monitor progress. We also expect to inspire other researchers around the globe to obtain similar cross-cultural adaptations.
Since REBT was created, 6 decades of subsequent research has fully evidenced the effectiveness of cognitive behavioral therapies [18]. Thus, REBT and other forms of cognitive-behavioral interventions are now widely recognized as empirically-supported psychosocial treatments [19]. As the cognitive approaches claim, core beliefs related to the self, the other, the world, or the future shape the way people think, feel and behave, by conditioning internal rules, attitudes, and assumptions derived from them [36]. Therefore, the early detection of maladaptive forms of thinking (e.g., TGBs) is extremely relevant in terms of prevention and treatment.
An important milestone in the field of public health is the elimination of gender violence. In this sense, the World Health Organization recommends cognitive behavior therapies as a way of alleviating the psychological consequences of the victims [87]. Therefore, we emphasize the need to identify and challenge irrational cognitions that may have devastating costs and consequences on individuals, communities, and societies, particularly women who suffer gender violence [14]. According to this objective, Zapata-Calvente et al. [91] highlighted that it is essential to change the beliefs promoted by gender socialization, “which foster male dominance and unequal relationships between men and women”. Consequently, assessing TGBs is necessary to both advance in gender research and to construct a fairer society. Again, having a reduced set of core TGBs in the MC-OWBS-RV might facilitate this task.
Beliefs have unique implications for understanding the impact of the experience of gender abuse [2]. When women think irrationally, they hold dysfunctional, inaccurate, unhelpful, judgmental and/or unrealistic beliefs that constitute a vulnerability factor for managing potential stressors. Gender violence is indeed a major public health problem in Spain [53] and globally [87]. Accordingly, the Spanish Government claimed in its Equality Delegation that there is fundamental work to be done toward changing our cultural model, attitudes, and values. To do so, traditional stereotypes need to be eliminated, and equality must be promoted. Similarly, freedom ought to be achieved, and all forms of violence against women need to be eradicated.
Unfortunately, many young women who suffered gender violence are unacknowledged victims who do not view their experience as a form of victimization [48]. Any phenomenon with a gendered view implies observing what is invisible [71] and requires questioning mental patterns such as TGBs that may have been established and naturalized over centuries [85].
As a final contribution, the present work investigated demographic differences in TGBs. Our analyses indicated comparable beliefs when analyzing women who cohabitated with their romantic partners and those with other cohabitation statuses. One might have hypothesized that women who cohabitate with their partner might be more exposed to TGBs, either due to some freedom loss inherent to cohabitating with a partner or due to imposed beliefs when the partner has a conservative view of masculinity/femininity. In our sample, however, these differences in TGBs according to partner cohabitation status did not emerge. It is possible that the characteristics of the sample, at least partly explain the findings. In particular, the sample included young and highly educated women and the literature has evidenced that TGBs are less frequent in this population [67]. Therefore, while cohabiting with a partner has been previously associated with more engrained TGBs [72], our results might indicate that the new generations are better prepared to face the challenges of cohabitating with a partner in terms of gender beliefs.
Limitations
This study is limited due to the characteristics of the sample, which is restricted to mostly young women. However, this may be seen as an indicator of how education is changing—or not—the mindset of younger generations vis-à-vis traditional gender beliefs. Most of the participants were Caucasian and middle class, living in urban areas. Broader samples with women from different social and economic status, age, and geographic origins in the same country may reveal differences in the level of adherence to specific TGBs. The sexual orientation of the participants was unknown, which is another limitation of the study, and we cannot be certain whether the results indicate the presence of irrational thinking related to a specific sexual orientation. Even accounting for the limitations of the sample, it seems clear that there is a moderate association between TGBs, IPV, and their psychological consequences in terms of perceived stress and depression, which supports the utility of the proposed measure of TGBs.
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The role of women's traditional gender beliefs in depression, intimate partner violence and stress: insights from a Spanish abbreviated multicultural measure - BMC Women's Health - BMC Blogs Network
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