abstract: Approximately one-third of Iraq and Afghanistan veterans develop mental health problems, yet only 35-40% of those with mental disorders are seeking mental healthcare (Hoge, et al., 2004; Vogt, 2011). Military spouses may be an important resource for facilitating treatment seeking (Warner, et al., 2008), especially if service member mental health issues are impacting the marriage. Military spouses might be hesitant to encourage service member help-seeking, however, due to perceived threat of adverse military career consequences. For this study, 62 military wives completed an online survey. As part of the survey, participants were randomly assigned to one of four vignettes containing a description of a hypothetical military husband with mental health symptoms. Each vignette presented different combinations of marital conflict (high versus low) and service member concerns about adverse career consequences (high versus low). Wives rated on a five-point scale how likely they were to encourage the hypothetical military husband to seek help. It was hypothesized that spouses would be more willing to encourage help-seeking when concerns about adverse military career consequences were low and marital distress was high. No main effects or interaction effect were found for marriage and career. Perceived stigma about seeking mental health treatment in the military, psychological identification as a military spouse, and experience and familiarity with military mental healthcare policies failed to moderate the relationship between marital conflict, career concerns, and encouragement of help-seeking. Correlational analyses revealed that (1) greater experience with military mental healthcare (first- or secondhand), and (2) greater perceptions of stigma regarding seeking mental healthcare in the military each were associated with decreased perceptions of military supportiveness of mental healthcare. Therefore, although the experimental manipulation in this study did not lead to differences in military spouses' encouragement of a hypothetical military service member to seek mental health services, other findings based on participants' actual experiences suggest that experiences with military mental healthcare may generate or reinforce negative perceptions of military mental healthcare. Altering actual experiences with military mental healthcare, in addition to perceptions of stigma, may be a useful area of intervention for military service members and spouses. / Dissertation/Thesis / M.S. Psychology 2013

Background: A range of factors contribute to men with cancer having worse mortality and morbidity rates than women. The research specifically focused on psychosocial issues and health behaviours in men with cancer, and factors affecting help seeking behaviour. Methods: A mixed-methods study recruited adult men with cancer in the East of Scotland. The quantitative cross-sectional study explored psychosocial issues, health behaviours, and desire for support. Data from the Scottish Longitudinal Study were accessed to check sample representativeness. The qualitative study built on the preliminary findings of the quantitative study and used semi-structured interviews to explore factors affecting men's access to support. Inductive thematic analysis was undertaken. Results: 127 men with cancer completed the questionnaire. Being separated or divorced, younger and living in a high deprivation area was associated with poor psychosocial outcomes and some lifestyle behaviours. Social support was also influential. Twenty participants were interviewed. Appraisal of, and coping with, cancer in addition to biopsychosocial antecedents, the role of masculinity, and service contexts impacted on help seeking. The findings support a modified model of the transactional model of stress and coping relevant to men with cancer, which is new and original since it specifically incorporates the role of masculinity, highlights feedback from coping to appraisal, and recognises important service context factors that impact men's service access choices. Discussion: Legitimisation of help seeking and the use of emotion-focused coping styles were needed by some men, particularly where ideas about masculinity played a strong role in men's appraisal of, and coping with cancer. Implications for practice and policy relate to the survivorship agenda given the ongoing support men with cancer may need. Related to this, there is a need to carefully tailor and advertise services to men, and for health professionals to help legitimise the use of certain coping strategies and services.

ABSTRAKT Bakgrund: Självskadebeteende är ett svårdefinierat och svårt problem att handskas med eftersom det oftast sker i hemlighet med en stor känsla av skam och skuld. Mörkertalet är stort och det är en känslig och svårbehandlad grupp, och denna grupp av människor har svårt att söka hjälp. Det finns en tydlig korrelation mellan självskadebeteende och suicidförsök. För att försöka få dessa personer att söka hjälp och minska risken för suicid måste det uppdagas varför dessa personer tvekar till att söka hjälp.   Syfte: Syftet med denna litteraturöversikt är att beskriva varför personer med självskadebeteende tvekar till att söka hjälp.   Metod: Studien är en allmän litteraturöversikt av 8 vetenskapliga artiklar med kvalitativa data. Artiklarna har kvalitetsgranskats och analyserats genom kvalitativ innehållsanalys för att slutligen sammanställas. Databaser som användes var CINAHL, PubMed och PsycINFO.   Resultat: 5 kategorier identifierades: ”Vad är vitsen egentligen?”, “Vissa ser på en som att man vore ett monster”, “Jag vet inte vad jag ska göra eller vart jag ska vända mig”, “Jag skadade mig själv allvarligt med flit idag och nu skäms jag över det” och “Så länge det är under min kontroll är det lugnt”.   Konklusion: När personer med självskadebeteende söker hjälp och får ett negativt bemötande leder det till att deras rädsla att bli dömd bekräftas och känslorna av skuld och skam förstärks. Negativa erfarenheter av att söka vård leder till att hjälp inte söks i framtiden. För personerna som vill söka vård blir det inte lättare när vårdsystemet inte är tydligt med hur personen ska söka hjälp. / ABSTRACT History: Deliberate self-harm is a hard to define phenomena that is hard to deal with because it is often done in secret and with a great feeling of shame and guilt. These patients are hard to treat due to the sensitive nature of the subject and that is why there is a large number of unreported cases. There is a clear correlation between deliberate self-harm and suicide attempts. In order to facilitate help seeking in people who self-harm we need to find out why this group of people don’t seek help in the first place so that further suicide attempts are prevented.   Aim: The aim is to describe the hesitation to why people who self-harm does not seek help.   Method: This study is a qualitative literature review of 8 articles. The data was analyzed inspired by content analysis. The databases used were CINAHL, PubMed and PsycINFO.   Results: 5 categories were identified: “Really, what’s the point?”, “Some people look at you like you are some kind of monster”, “I don’t know what to do or where to turn”, “I hurt myself severely on purpose today and now I feel bad about it” and “As long as it’s under my control I’m fine”.   Conclusion: When people who self-harm seek professional help are met with a poor attitude by staff, their fear of being judged is confirmed and their sense of shame and guilt increases. A negative experience when seeking help may lead to a reluctance for future help-seeking. An unclear process on how to seek help is an obstacle for people trying to receive treatment.

A significant number of youth experience mental health disorders for which they suffer negative consequences. Although there are evidence-based therapies available to help children and their families, most youth do not receive treatment. Parental problem recognition is likely a primary barrier in this process. This study begins to address why parents may have difficulty recognizing mental health problems by extending existing models and integrating evidence about parental perceptions. Specifically, the study aimed to investigate the relationship between parental attributions and parents’ problem determination, and to examine the influence that parental characteristics have on this judgment process. Participants included 164 parents of youth ages 6-11 years. Purposive sampling was used to recruit mothers and fathers from both lower and higher SES communities. Parents completed self-report measures of parental characteristics, including: parental psychopathology, parenting stress, parental tolerance, and parental self-efficacy. Parents read ten brief child behavior vignettes and completed a version of the Written Analogue Questionnaire to rate the cause of each behavior (assuming it was their own child in the vignette) along four dimensions. Parents also rated the extent to which the behavior was seen as a problem. Results indicated that parents’ causal attributions were highly associated with parents’ problem ratings, and the attributions of stability and controllability were particularly robust predictors of problem determination. Hypotheses regarding parental characteristics as moderators of the relationship between attributions and problem determination were not supported. Findings are discussed in light of clinical and public health implications; results suggest that recognizing the influence of parental beliefs and attributions may help to increase the efficacy of outreach efforts for early intervention and help seeking for parental concerns.

The purpose of this study was to delineate variables which relate to reported willingness to seek treatment for menstrual-related distress, and to assess treatment preferences in a population of women often tapped for menstrual research that of college students. Of the 198 volunteers included in the study, 71 stated that they were willing to seek some form of treatment for menstrual-related distress, and 127 stated that they were not willing to do so. The Adjective Checklist (ACL), Menstrual Attitude Questionnaire (MAQ), and Menstrual Distress Questionnaire (MDQ), along with a personal data sheet were administered to subjects. In addition, they were asked to read three paragraph-long descriptions of self-administered, medical, and behavioral treatments for menstrual-related distress and to indicate their preference for each.

Service underutilization is a major problem facing children with emotional and behavioral problems. In addition, parents are often the ones most responsible for seeking help for their children. However, many children do not receive adequate help because parents do not perceive a problem or do not recognize that a child is in need. The present study examined parental thresholds for problem perception and subsequent help-seeking decisions based on children's behaviors presented in a vignette. It was hypothesized that the type of child behavior, child and parent gender, and other parental characteristics would be associated with different thresholds for problem perception and seeking professional help. Participants were 160 mothers and 63 fathers recruited via email using the snowball method and a university participant pool. It was found that mothers sought higher levels of services than fathers and that externalizing and comorbid internalizing and externalizing behaviors were rated as more serious and in need of higher levels of services than internalizing behaviors. In addition, exposure to child psychopathology, parenting stress, and tolerance for behavioral problems were associated with different thresholds for problem perception and help-seeking decisions. Treatment acceptability was also found to partially mediate between parental problem perception and seeking mental health services. In addition, parental characteristics were also found to contribute to differential help seeking decisions. These results are discussed in relation to how parents view their child's emotional and behavioral problems and what factors contribute to their decision to seek formal and informal services. Implications for clinical practice, limitations, and future directions of this research are also discussed.

The literature on the career development of First-Generation College Students of Color (FGCSC) lacks a focus on the career decision-making difficulties consequently from racial microaggressions, academic self-efficacy, academic stress, and mental well-being at PWIs. Furthermore, there is a lack of empirical studies related to FGCSC help-seeking behaviors for racial microaggressions and the utilization of university counseling and career services on these campuses. The following research questions guided this study: a) What is the relationship between help-seeking attitudes and behaviors and racial microaggressions, academic self-efficacy, academic stress, mental well-being, and career decision-making difficulties among first-generation college students of Color (FGCSC) attending PWIs? b) Can the help-seeking behaviors of (FGCSC) attending PWIs be predicted by age, gender, ethnicity, racial microaggressions, academic self-efficacy and stress, mental well-being, and career decision-making difficulties? FGCSC present distinct personal, social, emotional, academic, and cultural needs. The growth in racial microaggressions and racial insults manifested within PWIs requires an examination into how services are tailored within university counseling and career advising centers to meet these needs. Racial microaggressions can result in stress that negatively influences both mental well-being and career decision making. Thus, career and personal counseling services provided on college campuses should be able to help students combat and cope with these stressors. In addition, these services should provide culturally-informed counseling interventions to help FGCSC determine how skills, values, and interests align with a future job that fits their personality and cultural background. A need for more literature that examines the relationship between these variables will assist university counselors and career centers within predominantly White institutions with interventions for this special group of students. The stressors related to racial microaggressions may result in career decision-making difficulties that contribute to low self-efficacy that increase low retention rates and lack of matriculation. A better understanding of the relationships between racial microaggressions, mental well-being and career decision making can result in the tailoring of counseling and advising services on PWIs. Practitioners employed in counseling centers, advising offices, and career services must have a working knowledge of FGCSC experiences with racial microaggressions at the societal, institutional, interpersonal, and individual levels to deliver effective services.

The purpose of this study is to lift and highlight the problem battered gay men face when they seek help for domestic violence in partner relationship. One thing that can make it more difficult to seek help can be because the accepted sexual norm in society is the heterosexual orientation. The study has a qualitative approach, which contain four semi structured interviews with professionals who works in the domestic violence field. The material from the interviews have been analyzed and seven themes appeared during the process, Exclusion, authority/organization, professionals, heterosexual norm and other stereotypes, cooperating, marketing and availability. Research shows that homosexual men does not have the same availability for seeking help due to society’s heterosexual norm. Gay men are afraid not to be taken seriously in the meeting with professionals due to the masculinity and heterosexual stereotypes. Not all domestic violence shelters and crisis center welcomes victims with a homosexual orientation. Organizations who welcomes all different sexual orientations aren’t good at marketing themselves which makes it hard for LGBT people to know where they can seek help without the fear of not be taken seriously. My data shows a need of raising the subject about homosexual men’s vulnerability when seeking help for domestic violence and include every sexual orientation in organizations marketing ads. The conclusion of the report is the need of raising competence among professionals due to different sexual orientations and the following vulnerabilities. Also, be norm critical in the professional role about sexuality and masculinity. So, everyone no matter what sexual orientation easily accessible help when victims have been exposed for domestic violence.

In the United States, eating disorders affect approximately 20 million women annually (National Institutes of Health, 2011). With such a high prevalence, ensuring help-seeking in individuals with eating disorders is critical. A previously-supported eating disorder prevention approach includes cognitive dissonance intervention (CDI). CDI’s purpose is to change a person’s behavior to reflect their attitude or cognition. While true self intervention has not been with previously been applied to eating disorders, it has been efficacious in improving psychological risk factors associated with eating disorder risk. The current study combined true self and CDI to test a more holistic prevention tool (i.e. combining psychological and cognitive approaches to prevention). Specifically, the current study compared the combination prevention to true self intervention only, CDI only, and a control condition to examine outcomes of body satisfaction, eating disorder pathology, psychological outcomes, and help-seeking intentions. Overall, evidence did not support the preventions’ combined prevention superiority to control within the entire sample. When exploring individuals at risk of an eating disorder, however, CDI was significantly better than true self in reducing binge episodes and self-esteem. Furthermore, the combination prevention was significantly better than true self at increasing self-esteem. The following results warrant more research exploring other potential preventions to increase positive psychological outcomes. Moreover, future research should explore more options for increasing help-seeking intentions.

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