{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T18:06:45Z","timestamp":1792174005625,"version":"4.4.0"},"reference-count":50,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2022,2,22]],"date-time":"2022-02-22T00:00:00Z","timestamp":1645488000000},"content-version":"vor","delay-in-days":52,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002341","name":"Academy of Finland","doi-asserted-by":"publisher","award":["334057 and 335901"],"award-info":[{"award-number":["334057 and 335901"]}],"id":[{"id":"10.13039\/501100002341","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,1,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Depression occurs about twice as often in women as in men, a disparity that remains poorly understood. In a previous publication, Hagen and Rosenstr\u00f6m predicted and found that grip strength, a highly sexually dimorphic index of physical formidability, mediated much of the effect of sex on depression. Striking results like this are more likely to be published than null results, potentially biasing the scientific record. It is therefore critical to replicate and extend them.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methodology<\/jats:title><jats:p>Using new data from the 2013\u201314 cycle of the National Health and Nutrition Examination Survey, a nationally representative sample of US households (n = 3650), we replicated models of the effect of sex and grip strength on depression reported in Hagen and Rosenstr\u00f6m, along with additional potential confounds and a new detailed symptom-level exploration.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, the effects from the original paper were reproduced although with smaller effect sizes. Grip strength mediated 38% of the effect of sex on depression, compared to 63% in Hagen and Rosenstr\u00f6m. These results were extended with findings that grip strength had a stronger association with some depression symptoms, like suicidality, low interest and low mood than with other symptoms, like appetite changes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Grip strength is negatively associated with depression, especially its cognitive\u2013affective symptoms, controlling for numerous possible confounds. Although many factors influence depression, few of these reliably occur cross-culturally in a sex-stratified manner and so are unlikely to explain the well-established, cross-cultural sex difference in depression. The sex difference in upper body strength occurs in all populations and is therefore a candidate evolutionary explanation for some of the sex difference in depression.<\/jats:p><jats:p>Lay summary: Why are women at twice the risk of developing depression as men? Depression typically occurs during social conflicts, such as physical or sexual abuse. Physically strong individuals can often single-handedly resolve conflicts in their favor, whereas physically weaker individuals often need help from others. We argue that depression is a credible cry for help. Because men generally have greater strength than women, we argue that men may be more likely to resolve conflicts using physical formidability and women to signal others for help. We find that higher grip strength is associated with lower depression, particularly symptoms like feeling down or thoughts of suicide and that strength accounts for part of the sex difference in rates of depression.<\/jats:p><\/jats:sec>","DOI":"10.1093\/emph\/eoac007","type":"journal-article","created":{"date-parts":[[2022,2,22]],"date-time":"2022-02-22T04:12:48Z","timestamp":1645503168000},"page":"130-141","source":"Crossref","is-referenced-by-count":8,"title":["Strength is negatively associated with depression and accounts for some of the sex difference"],"prefix":"10.1093","volume":"10","author":[{"given":"Caroline B","family":"Smith","sequence":"first","affiliation":[{"name":"Department of Anthropology, Washington State University, Pullman, WA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom","family":"Rosenstr\u00f6m","sequence":"additional","affiliation":[{"name":"Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5758-9093","authenticated-orcid":false,"given":"Edward H","family":"Hagen","sequence":"additional","affiliation":[{"name":"Department of Anthropology, Washington State University, Pullman, WA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,2,22]]},"reference":[{"key":"2022032114560580400_eoac007-B1","doi-asserted-by":"crossref","first-page":"1575","DOI":"10.1016\/S0140-6736(13)61611-6","article-title":"Global burden of disease attributable to mental and substance use disorders: findings from the global burden of disease study 2010","volume":"382","author":"Whiteford","year":"2013","journal-title":"Lancet"},{"key":"2022032114560580400_eoac007-B2","first-page":"117","article-title":"Explaining the sex difference in depression with a unified bargaining model of anger and depression","volume":"2016","author":"Hagen","year":"2016","journal-title":"Evol Med Public Health"},{"key":"2022032114560580400_eoac007-B3","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1038\/s41398-018-0148-0","article-title":"Uncovering the hidden impacts of inequality on mental health: a global study","volume":"8","author":"Yu","year":"2018","journal-title":"Transl Psychiatry"},{"key":"2022032114560580400_eoac007-B4","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1186\/s12888-018-1969-3","article-title":"The \u201cclinician\u2019s illusion\u201d and the epidemiology, diagnosis and treatment of depressive disorders","volume":"18","author":"Patten","year":"2018","journal-title":"BMC Psychiatry"},{"key":"2022032114560580400_eoac007-B5","doi-asserted-by":"crossref","first-page":"1993","DOI":"10.1007\/s40279-018-0952-y","article-title":"Handgrip strength and health in aging adults","volume":"48","author":"McGrath","year":"2018","journal-title":"Sports Med"},{"key":"2022032114560580400_eoac007-B6","doi-asserted-by":"crossref","first-page":"e0198890","DOI":"10.1371\/journal.pone.0198890","article-title":"The economic burden of inpatient care of depression in Poznan (Poland) and Kiel (Germany) in 2016","volume":"13","author":"Zaprutko","year":"2018","journal-title":"PLoS One"},{"key":"2022032114560580400_eoac007-B7","doi-asserted-by":"crossref","first-page":"e1912444117","DOI":"10.1073\/pnas.1912444117","article-title":"Misinformation in and about science","volume":"118","author":"West","year":"2021","journal-title":"Proc Natl Acad Sci USA"},{"key":"2022032114560580400_eoac007-B8","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1037\/a0015108","article-title":"Shall we really do it again? 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