Background: This grounded theory study explored the views of adolescent boys aged 12 and 13 on the factors that influence their help-seeking decisions for less severe forms of psychological distress. Method: Semi-structured interviews with 12 participants from a local secondary school and a community setting were analysed according to grounded theory methods. The data analysis abstracted categories of data to construct a substantive theory of helpseeking. Results: Participants’ views revealed an interaction of ‘pressures and promoters’ that affected adolescent boys’ help-seeking decisions. These related to relationships with others, mental health support and education, being a boy, and individual factors. Conclusion: Mental health education and awareness should be promoted amongst adolescent boys and the adults and professionals that they encounter so that they may be encouraged to seek help for psychological distress.

There is a general perception in the public that mental health problems scarcely exist among elite athletes. The aim of this thesis was to investigate mental health among Swedish elite athletes with a particular focus on depression, overtraining, help seeking and stigma. The sample consisted of 100 athletes; of these 32 % were male and 68 % female, 53 % team athletes and 47 % individual athletes representing 15 different sports. A cross-sectional research design using self-report measures examined variables associated with the mental health of athletes. Results showed the prevalence of depression in the sample was similar to that of the general population. Athletes who reported symptoms of overtraining also reported symptoms of depression. Depressed athletes showed significantly more symptoms of overtraining than non-depressed athletes. Athletes who reported greater symptoms of depression or overtraining also reported higher levels of stigma associated with the condition. In the sample 45 % of participants reported that it was unlikely or extremely unlikely that they would seek help for mental health problems. The results indicate that mental health problems among elite athletes do exist. Athletes that experience problems with their mental health also do not want to disclose these problems. The established relationship between depression and overtraining highlights the difficult in distinguishing between the concepts that may ultimately lead to misdiagnose and ineffective treatment of the symptoms. Sport specialization in health care is required in order to meet the needs of elite athletes. / Det finns en allmän syn i samhället att psykisk ohälsa bland elitidrottare är väldigt ovanligt. Syftet med denna studie var att undersöka psykisk ohälsa bland svenska elitidrottare med fokus på depression, överträning, hjälpsökande och stigma. Urvalet bestod av 100 elitidrottare; av dessa var 32 % män och 68 % kvinnor, 53 % lagidrottare och 47 % individuella idrottare vilka representerade 15 olika idrotter. En tvärsnittsstudie genomfördes med hjälp av självskattningsformulär vilka undersökte variabler förknippade med elitidrottares psykiska hälsa. Resultaten visade en prevalens av depression bland elitidrottarna motsvarande den allmänna populationen. Elitidrottare som rapporterade symptom på överträning rapporterade även symptom på depression. Deprimerade elitidrottare hade signifikant fler symptom på överträning än icke-deprimerade elitidrottare. Elitidrottare som rapporterade fler symptom på depression eller överträning rapporterade även högre nivåer av stigma. I urvalet rapporterade 45 % av deltagarna att det var osannolikt eller extremt osannolikt att de skulle söka hjälp vid problem med psykisk ohälsa. Resultaten visar på att psykisk ohälsa bland elitidrottare existerar. Elitidrottare med psykisk ohälsa är obenägna att avslöja dessa problem för andra. Den påvisade relationen mellan depression och överträning visar på att det är svårt att skilja mellan dessa koncept vilket i förlängningen kan leda till feldiagnostisering av symptomen samt att fel behandlingsinsatser sätts in. För att möta behoven från elitidrottare bör hälso- och sjukvården erbjuda idrottsspecifik behandling.

The aim of this study is to examine how young adults reason when it comes to mental illness among their peers and how they look upon seeking support and help for mental illness. This study is based on three focusgroupinterviews with 14 young adults in Sweden. The theoretical framework is labeling theory, which describes deviation as a process in which society forces social problems as a label onto people until they begin to identifies as deviants. Our results show that young adults are openminded when it comes to mental illness among their peers, but they are on the other hand negative towards seeking help for it. The explanation for this seems to be that many young adults have experiences of mental illness and therefor they believe it is a very important subject, although seeking help for it are strongly connected to stigma because of the prejudice that only people with severe psychological diagnoses are the ones that seek help. Most young adults with mental illness do not have psychological diagnoses and therefor associate seeking help with deviation. Other identified reasons for not wanting to seek help are lack of knowledge and bad experiences with former help-seeking.

The effect of psychoeducation on opinions about mental illness, attitudes toward help seeking, and expectations about psychotherapy were investigated. One group served as a control, one group read a written lecture on information about mental illness, and one group read a written lecture on information about psychotherapy. The control group, and experimental groups immediately after reading the lecture, completed demographic information, Attitudes Toward Help Seeking-Short Form, Expectations About Counseling-Brief Form, Nunnally Conceptions of Mental Illness Questionnaire, and three College Adjustment Scales (Depression, Anxiety, Self Esteem). Participants were asked to complete the same measures four weeks after the initial assessment. Results: No significant improvement in attitudes toward help seeking was demonstrated in either experimental group, at either time of testing. Expectations about psychotherapy were significantly improved in both experimental groups, which remained significant at Time 2. Opinions about mental illness demonstrated an immediate significant improvement in attitudes with the mental illness lecture group, however this effect did not remain at Time 2. The psychotherapy lecture group did not have significantly improved opinions about mental illness at either time of testing. The control group did not produce any significant changes between Time 1 and Time 2 testing. Experimental group scores demonstrated similarity with those who had previous experience with psychotherapy. No relationship was found between level of adjustment and attitudes toward help seeking, expectations about psychotherapy, or opinions about mental illness at either time of testing.

Adolescent dating violence is a prevalent and disconcerting reality for many adolescents. Communication with others (e.g., parents, older siblings, friends) about dating violence may buffer some negative outcomes associated with experiencing dating violence. Although researchers are attending more to this public health problem, what we know about the messages that adolescents receive about dating violence is limited, especially for Latina teens. To address this gap in the literature, 18 Latina adolescents (14-17 years) and their mothers participated in semi-structured interviews to explore their beliefs about what dating violence means to them, messages that are shared about dating violence with mothers and friends, adolescents’ help seeking preferences and behaviors, and reasons for and against talking with parents about problems in dating relationships. Interviews were transcribed and coded for emergent themes. Participants described many examples of problems in dating relationships including some traditional forms of dating violence (e.g., physical harm) and some advancing forms of dating abuse (e.g., aggression through social media). Messages that Latina adolescents receive from parents and friends include advice to “try to work it out or get out of the relationship” and “talk to someone.” Barriers to seeking help from parents and others included “worry about parent’s response” and “lack of closeness or trust.” Themes of supports to seeking help from parents and others included having a “close and trusting relationship” and having had “an established pattern of communication.” Latina adolescents also suggested they may prefer to seek help for problems in dating situations from friends and older siblings. Results suggest that Latina adolescents and their mothers may be knowledgeable about problems in dating situations. However, the messages that Latina adolescents receive differs by who is giving the message and Latina teens may hesitate talking to their parents about problems in dating if they fear negative parental reactions or they do not sense that parents can effectively facilitate the conversations. Given that many victims of dating violence do not tend to disclose their dating problems or seek help, these results highlight the importance of educating parents on how to promote open and effective communication. Results also highlight the importance of informing peers and siblings on how to respond when their friends/siblings experience dating problems. Finally, results suggest implications for primary prevention programs guided by support for culturally tailored interventions.

OBJECTIVE: The study assessed the applicability of the social norms approach to help-seeking behavior in the military by exploring whether Service Members are affected by perceptions of peers’ beliefs about stigma related barriers to mental health care. METHOD: Data were collected from members of the Virginia National Guard (N= 84) during Yellow Ribbon events. Using surveys, Service Members’ own perceptions and their perceptions of their peers’ beliefs about barriers to seeking psychological care were gathered. RESULTS: Participants’ own beliefs about barriers to care were positively correlated with perceptions of peers’ beliefs. Variance in help-seeking status was better accounted for by participants’ own beliefs on stigma-related barriers to care, but perceptions of peers’ beliefs were also correlated with help-seeking status. CONCLUSION: Personal costs of seeking help according to personal and perceptions of peers’ beliefs are explored, as well as implications, next steps for future research, and limitations.

Emerging adulthood is a term coined to recognize 18 to 25 year-olds who engage in self-exploration while not yet fully identifying as adults. Many emerging adult college students experience stress, anxiety, and depression. Although many colleges provide affordable and available mental health resources for students, many students who need help appear to not utilize these services. Gaining greater understanding of underlying processes that influence psychological treatment-seeking behavior is imperative. The current study sought to explore the role experiential avoidance (EA) plays as a treatment-seeking barrier in the context of emerging adulthood. Undergraduate students completed online measures of emerging adulthood dimensions, psychological symptoms, EA, self-stigma of, perceived public stigma of, intentions to, and attitudes and beliefs towards seeking treatment, treatment seeking behavior, and a demographics questionnaire. Binomial hierarchical logistic regressions and correlational analyses examined the relationship of EA and treatment-seeking behaviors, accounting for known barriers and emerging adult characteristics. After controlling for demographic variables, results indicated that EA was significantly positively correlated with self-stigma (r = .187), p < .001), perceived public stigma (r = .178, p < .001), intentions (r - .207, p < .001), psychological symptoms (r = .713, p < .001), and attitudes and beliefs (r = .009, p = .003). These and other findings are discussed further, along with the study limitations and implications, as well as possible future directions for work in this area.

A research report submitted in partial fulfilment for the degree Master of Arts in Social and Psychological Research by Coursework and Research Report (PSYC7022) in the Department of Psychology, Faculty of Humanities at the University of the Witwatersrand, February 2017 / The lifetime prevalence of Major Depressive Disorder (MDD), as reported for South Africa, is 9.7%. However, significant cultural differences occur in the clinical presentation of MDD which are connected to notions of religion, social principles and norms of relationships. With this in mind, this study explores the extent to which Hindu community members’ knowledge of MDD, their beliefs about the aetiology of MDD and their attitudes towards people with MDD impacted their perceptions on the care and management of MDD as well as their help seeking behaviours. The study also explored the extent to which Hindu religious identity mediates or moderates the relationship between aetiology, knowledge and attitudes towards MDD and the care and management of MDD and help seeking behaviour. A questionnaire consisting of a demographics section, a religious identity scale, a MDD knowledge, attitudes and practices scale and the attitudes towards seeking professional psychological help scale was completed by a convenience sample of 264 Hindus from Johannesburg and surrounding areas. Data was analysed using descriptive statistics and multiple regression analyses. Participants in this study had a moderate religious identity and generally positive attitudes towards MDD. This sample believed that stress was the main cause of MDD and that talking to their friends, family and their general practitioner would be the most beneficial in terms of care and management of MDD. Participants also had positive attitudes towards seeking professional help. Two multiple regression analyses were conducted with the attitudes towards professional help seeking as well as all the care and management factors as the dependent variables and religious identity, knowledge of MDD, attitudes towards MDD and all four aetiological factors of MDD as the independent variables. These analyses yielded varying results. Following these analyses, religious identity was explored as both a potential mediator and moderator variable between attitudes towards MDD and help seeking behaviours. These results are discussed within the broader debates on depression and its manifestation across cultures. / XL2018

Successful negotiation of emerging adult transitions predicts positive developmental outcomes across the lifespan. Emerging adults who have experienced childhood trauma are at increased risk for maladaptive development. The purpose of this dissertation study was to (a) provide descriptive demographic and health information about emerging adult survivors of childhood trauma seeking support from a university counseling center and (b) investigate the impact that different types of childhood trauma had on psychological symptoms and aspects of distress experienced by that population during college. It was hypothesized that there would be no significant differences in student distress based on single-type abuse, but that there would be significant differences based on the experience of polyvictimization, with multi-type abuse related to increased distress. Extant client data collected by the University of Oregon Counseling and Testing Center (UO-UCTC) were used to meet study objectives. Participants were college students, age 18-25 years, who voluntarily sought mental health services from UO-UCTC and who endorsed childhood trauma experiences on their intake paperwork. Results from descriptive, finite mixture modeling, logistic regression, chi-square, and multiple regression analyses revealed that (a) there were unique relationships between trauma type and a variety of demographic variables; (b) help-seeking emerging adults reported experiencing childhood emotional single-type abuse most frequently, with childhood emotional-physical abuse being the most commonly reported form of multi-type abuse; (c) the sample endorsed higher than typical psychological symptoms and aspects of distress both in terms of quantity and severity, with particularly elevated depression, family distress, and generalized anxiety scores; (d) a five-component solution emerged, classifying participants into five clusters of symptom reporting; however, no relationship was found between symptom cluster and childhood trauma type; (e) the probability of experiencing generalized anxiety and/or family distress was related to the type of childhood trauma experienced; and (f) the severity of generalized anxiety and/or family distress that participants reported was significantly related to the type of childhood trauma they experienced. Findings highlight the importance of contextualizing current abuse typologies and assessing multi-type abuse. Recommendations for expanding definitions of trauma and providing care to emerging adult survivors of childhood trauma on college campuses are discussed.

Urininkontinens är inte en sjukdom i sig utan ett symtom på bakomliggande orsaker. Att bli inkontinent kan ha flera olika förklaringar, men ofta är behandlingsmöjligheterna goda. Att vara urininkontinent kan bland annat innebära en stor negativ påverkan på livskvaliteten, utgöra en form av begränsning, vara en stor skam samt innebära att inte ha kontroll över sin kropp. Urininkontinensen är ett vanligt problem där många personer förblir obehandlade. Vi söker en bättre förståelse för bakomliggande hinder som påverkar personers val att söka vård. Med bättre förståelse för varför dessa personer inte söker hjälp kan sjuksköterskan bättre nå ut och möta deras behov. Detta arbete skall belysa hinder till att personer väljer att inte söka vård vid urininkontinens och bygger på den forskningsmodell som kallas att bidra till evidensbaserad omvårdnad med grund i analys av kvalitativ forskning. Till denna modell valdes en kvalitativ analysmetod, där analysmaterialet utgjordes av åtta artiklar.Ur analysen framkom sex teman som utgör hinder för personer att söka vård; ”Attityder till urininkontinens”, ”Skam och genans”, ”Ej vara till besvär”, ”Rädsla för behandling/undersökning”, ”Kommunikationsbrister” samt ”Kulturkrock”. Vissa teman byggs upp av subteman. Diskussionen utgörs av reflektioner kring personers attityder till sin kropp med stigande ålder, personers upplevelser av skam som hinder, kunskapsbrister som hinder samt att ej vara till besvär. / Program: Sjuksköterskeutbildning