Hintergrund und Fragestellung: Weiter steigende Raten des Konsums psychotroper Substanzen und klinisch bedeutsamer Substanzstörungen vor allem bei Jugendlichen und jungen Erwachsenen, veränderte Gebrauchs- und Problemkonstellationen der Konsumentengruppen und die Einführung neuer Therapien und Versorgungsmodelle (Prävention, Frühintervention, Therapie und Rehabilitation) erfordern insbesondere angesichts der begrenzten Finanz- und Versorgungsressourcen neue Bedarfs- und Allokationsmodelle. Diese sollen praxisnah und effizient zu entscheiden helfen wann, bei welchen Rahmenbedingungen, welche Interventionsart und -strategie die individuell erfolgversprechendste ist. Diese Fragen werden in einem Forschungsprojekt des Suchtforschungsverbundes ASAT bearbeitet, das in einer umschriebenen Region mittels schrittweiser, epidemiologisch basierter Bedarfsund Bedürfnisanalysen die Ableitung und Priorisierung von institutionellen und therapeutischen Zuordnungsstrategien untersucht. Methodik: Basierend auf einem prospektiv-epidemiologischen Design wurden (1) bei einer repräsentativen regionalen Bevölkerungsstichprobe (EDSP-Studie) Inzidenzmuster, Spontanverlauf, Risikofaktoren und Konsequenzen des Substanzgebrauchs, -missbrauchs und der -abhängigkeit sowie Inanspruchnahmeverhalten, gedeckter und ungedeckter Bedarf beurteilt. (2) Ergänzt wird diese Erhebung durch eine Gesamterfassung und Evaluation des regionalen Suchthilfesystems. (3) Über statistische Analysen von Verläufen und Suchthilfeangeboten in der Region sollen "natürliche" Allokationsprozesse dargestellt und "outcome"-orientiert bewertet werden. (4) Anhand der dabei sichtbaren Mängel und Defizite können dann zusammen mit den Einrichtungen verbesserte Allokationsrichtlinien für einzelne sowie Gruppen von Patienten abgeleitet werden. Die Ergebnisse sollen in das regionale Suchhilfesystem übertragen werden. Ergebnisse und Diskussion: Erste Ergebnisse des Projekts bestätigen die Möglichkeit, Risikogruppen über spezifische Verlaufsanalysen zu identifizieren (z.B. regelmäßige Cannabiskonsumenten, Mehrfachkonsumenten, mehr weibliche Konsumenten mit einem höherem Abhängigkeitsrisiko). Die Inanspruchnahmemuster deuten in Teilbereichen (Frühintervention) auf ein hohes Ausmaß ungedeckten Bedarfs hin und scheinen neue Allokationsentwürfe zu erfordern. Den Einrichtungsträgern und regional Verantwortlichen der Suchthilfe können nach Auswertung weiterer Daten umfassende Bedarfsabschätzungen und verschiedene alternative Allokationsmodelle basierend auf der Perspektive von KlientInnen/ PatientInnen bereitgestellt werden. / Background and Aims: Increasing rates of substance use and substance use disorders especially in adolescents and young adults, changing patterns of use and associated problems and the introduction of new therapies and programs of care (prevention, early intervention, therapy, rehabilitation) require new need and allocation models especially because of restricted financial and care resources. These models should provide a rational basis for the improvement of allocation processes as well as setting priorities in the provision and restructuring of community and patientoriented interventions. In the present paper, we will present a project of the ASAT research network program which aims at a multi-staged, integrated epidemiology-based need and program evaluation in an area to determine institutional and therapeutical allocation processes. Methods: Based on a prospective epidemiological design, (1) prevalence and incidence, risk factors and course of substance use, abuse and dependence are investigated in a representative sample of the community-based EDSP study. Additionally, helpseeking behaviors, met and unmet need are assessed. (2) The investigation is supplemented by a survey of all substance use services in the area. (3) Course of substance use and service provision of substance use services in the area will be analyzed and reviewed to identify natural allocation processes and to determine the outcome. (4) With the knowledge of deficits and unmet need, improved allocation guidelines for specific groups of clients and patients will be developed. The results will be transferred into the regional health care system. Results and discussion: First results show that the identification of new risk groups with the help of course typologies is possible. The patterns of help-seeking point to a high rate of unmet need, especially with regard to the targeted early intervention, and a need of alternative allocation models. After the assessment and the overall data analyses, need evaluations and several alternative allocation models based on the clients'/patients' perspective will be provided.

Purpose of the study is to examine the relationship of ruminative tendency, internal working models of attachment (Self-Model and Other-Model) and help seeking attitudes (Positive Beliefs and Negative Beliefs) with psychological symptoms among the university students. In scope of the current research, the mediation role of rumination in the relationship between internal model of self and psychological symptoms was examined. By applying convenient sampling procedure, six hundred and ten university students were included into the current study from 9 different state universities in Ankara and Istanbul. Turkish version of Relationship Questionnaire (Bartholomew &amp / Horowitz, 1991), Relationship Scale Questionnaire (Griffin &amp / Bartholomew, 1994), Brief Symptom Inventory (Derogatis, 1992), Ruminative Response Scale (Nolen-Hoeksema &amp / Marrow, 1991) and Attitudes toward Seeking Psychological Help - Shortened (T&uuml / rk&uuml / m, 2001) were delivered to the university students at university campuses. Multiple regression analyses were implemented to evaluate the research hypotheses. The results revealed that rumination, internal model of others, and negative beliefs about psychological help significantly predicted the increase in psychological symptoms of Turkish university students. Positive beliefs about psychological help did not relate to psychological symptoms of university students for the current set of data. In addition to this, rumination mediated the relationship between internal model of self and psychological symptoms of university students. The research findings were discussed by relying on the previous research premises.

Thesis (M.A.)--Kutztown University of Pennsylvania, 2001. / Source: Masters Abstracts International, Volume: 45-06, page: 2775. Typescript. Abstract precedes thesis as preliminary leaf ix. Includes bibliographical references (leaves 32-39).

published_or_final_version / Nursing Studies / Master / Master of Nursing in Advanced Practice

Clinical depression has been prevalent in international health statistics but people are often found to be reluctant to seek help when they encounter depression. This thesis built and evaluated a mental health promotion campaign to encourage help-seeking through first forming a behavioral model to conceptualize the interplays of various factors in shaping one’s help-seeking intention and behavior for depression in Hong Kong. The thesis began with in-depth illness narrative qualitative interviews with 18 participants through purposive sampling from the general public of Hong Kong. Through the interview results and close reference to the theory of planned behavior (TPB), a behavioral model was drafted highlighting impacts of view on depression, help-seeking and other factors had on individual’s help-seeking intention and behavior. Followed by that, 70 quantitative questionnaires completed by members of the general public were then done through snowball sampling to validate the model. 16 items were then retained in the model that uses attitude towards help-seeking, subjective norm and perceived behavioral control to explain individual’s help-seeking intention and behavior. At the same time, the interviews and questionnaires found that participants seem to have a limited view of treatment options and have diverse views of the symptoms of depression, both of which profoundly affect their motivation to seek help. The role of family and friends and a holistic approach to mental health education were found to be particularly important for encouraging help-seeking behavior in future campaigns concerning depression. The content for this mental health promotion campaign was then designed into 4-weeks of email campaign material according to the factors mentioned in the model to encourage help-seeking for depression built and validated in the previous stages. The participant recruitment for the media campaign was done through the social media Facebook through two paid advertisements. A total of 5,405 clicks were gained through the Facebook advertisements and these Facebook users were then directed to a Survey Monkey email registration site to the campaign. 383 people registered their emails in the site with 199 of them completed the pre-test and joined the 4-week campaign. The 199 participants were randomly divided in two groups with one receiving the campaign material and another group receiving information from tradition leaflet issued by the Hospital Authority in Hong Kong. Pre-test and post-test were done before and after the campaign to measure the difference in help-seeking intention after reading the two sets of material respectively. As a result, 116 participants completed the campaign and the post-test. With a post-test only design, no significant change has been found in primary outcomes including attitude, subjective norm and perceived behavioral control, but significant change has been found in secondary outcome, which participants were found to have better mental health literacy after the campaign. This thesis has shown the practicality and effectiveness of using online media and theory-guided material for mental health promotion campaigns. It is important for future studies to take advantage of the popularity of online media and conduct primitive and evaluative research on these campaigns. / published_or_final_version / Journalism and Media Studies Centre / Master / Master of Philosophy

This purpose of this study was to investigate the relationship between religious beliefs, religious affiliation, religious orientation, as defined by Allport and Ross (1967) and help-seeking behaviour amongst students at the University of KwaZulu-Natal, Pietermaritzburg campus. The need for this research has been motivated by the limited amount of previous research in this area. The influence of gender on help-seeking behaviour and on religious orientation was also explored. Questionnaires comprising of the Religious Orientation Scale, General Help-seeking questionnaire and demographic information in terms of age, gender and religious affiliation were administered to students at the University of KwaZulu-Natal, Pietermaritzburg campus. The sample consisted of 100 students from various religions, language, sexual orientation, age. The results revealed a significant difference between religious beliefs and religious orientation on help-seeking behaviour. In terms of demographic variables, gender had influence on religious orientation or help-seeking behaviour, respectively. However, religious affiliation had no influence on help-seeking behaviour. / Thesis (M.A.)-University of KwaZulu-Natal, Pietermaritzburg, 2011.

Syftet med studien är att undersöka vilka strategier som är effektivast för att få hjälp och påkalla lärares uppmärksamhet i klassrummet samt om dessa skiljer sig mellan pojkar och flickor respektive årskurs två och sex. Frågeställningarna lyder: hur påkallar eleverna lärares uppmärksamhet och söker hjälp i klassrummet? Hur länge behöver eleverna vänta på hjälp? Metoden för studien är observation och totalt genomfördes 66 observationer i årskurs två och sex. Ett observationsschema med färdiga kategorier, grundade i tidigare forskning, användes. Tre typer av strategier för att be om hjälp och påkalla lärarens uppmärksamhet registrerades: handuppräckning, verbala strategier och fysiska strategier. De två förstnämnda observerades under lärarledd undervisning, medan samtliga strategier observerades under enskilt arbete. Flickor sökte överlag mer hjälp i klassrummet än vad pojkar gjorde. Flickor i årskurs två använde handuppräckning i störst utsträckning, medan pojkar i årskurs två framför allt använde verbala och fysiska strategier. Däremot var det pojkar som väntade kortast tid vid handuppräckning och flickor som väntade kortast tid vid användandet av verbala och fysiska strategier. Det är en signifikant skillnad i väntetiden mellan handuppräckning och de två övriga strategierna. Till exempel väntar elever i årskurs sex i snitt 71,9 sekunder vid handuppräckning medan de får hjälp efter 4,3 sekunder vid användandet av verbala strategier. I årskurs sex sökte pojkar hjälp och påkallade lärarens uppmärksamhet i större utsträckning än flickor i årskurs sex. Av alla elevgrupper behövde flickor i årskurs sex vänta längst tid på hjälp vid handuppräckning respektive kortast tid vid användandet av verbala och fysiska strategier. Studien har bidragit till ökad förståelse om hjälpsökande i klassrummet. Vi tror att valet av strategi har olika betydelse beroende på om man är pojke eller flicka och att det kan förklara varför både strategier och väntetider skiljer sig dem emellan. Elever i årskurs två och sex har olika förväntningar på sig eftersom de befinner sig i olika kognitiva utvecklingsstadier och det är lätt att anta att deras val av strategi således skiljer sig åt. Vi tror dock att det finns andra förklaringar inom till exempel det sociokulturella perspektivet. / The aim of this study is to examine what strategies are the most efficient when pupils ask for help and seek their teachers’ attention in the classroom. In addition we examine whether these strategies differ between boys and girls and between second and sixth year junior pupils. How do pupils seek teachers’ attention and ask for help in the classroom? For how long do pupils wait for teachers’ help? The empirical study was carried out through observation with a total of 66 observations in second and sixth year junior classrooms. A form with premade categories, based on published scientific reports, was used. Three different strategies of help and attention seeking were noted: raising hands, verbal strategies and physical strategies. Raising hands and verbal strategies were observed during teaching while all of the above were observed during self studies. Over all, girls sought help more frequently than boys. Regarding second year junior classes, girls mainly raised hands, while boys mainly used verbal and physical strategies. Meanwhile, the waiting time for boys was the shortest when raising hands while girls waited the shortest when using verbal and physical strategies. Generally, there is a significant difference in waiting time between raising hands and the two remaining strategies. When raising hands second year junior pupils and sixth year junior pupils wait on average 71,9 seconds and 97,1 seconds respectively, in comparison to verbal strategies where they wait on average 9,5 seconds and 4,3 seconds respectively. Boys in sixth year junior classrooms sought teachers’ attention and asked for help more frequently than girls in sixth year junior classrooms. Over all, girls in sixth year junior classrooms waited the longest and the shortest when raising hands and when using verbal and physical strategies respectively. This study has contributed to increased knowledge regarding help and attention seeking in classrooms. We believe that choices of strategies have varied effect depending on sex, which can explain why strategies and waiting time differ between boys and girls. Since second and sixth year junior pupils experience different levels of pressure based on how far gone they are in the cognitive development progress, it seems like a safe assumption that this is why the use of different strategies varies between age groups. However, we argue that other explanations may be found when looked upon through a socio-cultural perspective.

The general aim of the thesis was to contribute to the knowledge about co-occurring symptoms of ADHD and depression in adolescence, focusing on sex differences, as well as aetiology, help-seeking and assessment. Studies I–III used epidemiological samples of self-reports from all students in Västmanland aged 15–16 and 17–18 years. Study I investigated the prevalence of co-occurring symptoms of ADHD and depression, as well as associations between co-occurring symptoms of ADHD and depression and one environmental stress factor; experience of sexual abuse. Study II examined associations between one biological factor—a polymorphism in TFAP-2β—and co-occurring symptoms of ADHD with andco-occurringsymptoms of depression. Study III investigated the association between the parent–adolescent relationship and seeking help from specialized mental health services in relation to symptoms of ADHD and/or depression. Study IV was a clinical study among adolescent psychiatric patients that compared self-reported ADHD symptoms via the Adult ADHD Self-Report Scale–Adolescent version (ASRS-A) and the Adult ADHD Self-Report Scale–Adolescent–Screening version (ASRS-A-S) with an ADHD diagnosis determined by the gold-standard method; the Kiddie Schedule of Affective Disorders and Schizophrenia diagnostic interview. Studies I–III showed that the phenotype of co-occurring symptoms of ADHD and depression is frequent, with a distinct preponderance among girls. Approximately 50% of both boys and girls with co-occurring symptoms of ADHD and depression had also experienced sexual abuse, indicating that this is a group with multiple risk factors for long-term impaired mental health. Results also support biological sex differences because girls with symptoms of ADHD and a common polymorphism of TFAP-2β (absence of a 9 repeat) reported more symptoms of depression, but boys did not. Further, only 5% of the adolescents with symptoms of ADHD and/or depression sought help from specialized mental health services. The co-occurrence of symptoms of ADHD and depression was a stronger predictor of help-seeking than all other psychosocial factors investigated, including secure attachment cognitions styles to parents. Among help-seeking girls, co-occurring symptoms of ADHD and depression were more common than symptoms of ADHD without co-occurring symptoms of depression. The ASRS-A/ASRS-A-S showed promising psychometric properties for further validation in adolescentsresults as a screening tool for use in adolescents.

Women treated for a gynecological cancer report longstanding post-treatment difficulties for which they rarely seek or receive help. Few intervention studies have successfully improved global sexual health within this population. Research in this domain is challenging due to inconsistent measurements of sexuality, low response rates and high attrition rates. The overarching study objectives were: (a) To contribute to the advancement of research on supportive care needs (including sexual health needs), desire for help, and predictors of needs; and, (b) To inform the development of services for gynecological cancer survivors. In Study 1, a qualitative interview study explored the experiences of 15 gynecological cancer survivors. Interviews were conducted and analysed based on the Interpretive Description approach . In Study 2 (for which results were analyzed in two parts), a descriptive, cross-sectional needs assessment was conducted to measure supportive care needs, desire for help, sexual health and vaginal changes, and service format preferences in 113 patients. In Part 1 of Study 2, descriptive and regression analyses explored patient needs, desire for help and potential predictors of these variables. In Part 2, a descriptive analysis explored sexual health needs and vaginal changes, desire for help with sexual health needs, and their associations with sociodemographic and medical variables. Qualitative results from Study 1 suggested that psychological, emotional and relational aspects of sexuality were as important to the participants as physiological sexual response. In the needs assessment, the strongest predictors of greater unmet needs and increased readiness for help were younger age and shorter time since treatment. Moderate to high sexual and social needs were equally prevalent in women recently treated and those treated several years prior to the study, suggesting that sexual and social needs may remain unaddressed over time. Further, many women who reported a need did not desire help, demonstrating the subjectivity of needs and distress, as well as the potential presence of barriers to seeking help. Both studies revealed a common finding, where sexual health needs were a product of the discordance between participants’ current sexual experiences and their perceptions of ideal sexual health. Overall, the two studies indicate that a significant subgroup of patients experience unmet needs in cancer survivorship, most of which are non-physical; also, while some needs were higher following treatment, unmet social and sexual health needs show little relationship with time since treatment. Ambivalence about receiving help with unmet needs is related to beliefs about the role of the health care team in meeting non-physical needs, as well as other perceived barriers. Patient’s perceived sexual health needs and barriers to receiving help should be evaluated within a comprehensive framework of needs and discussed one-on-one. Future research should explore the added predictive value of other groups of medical and psychological variables.

Thesis (M.A.)--University of Texas at El Paso, 2008. / Title from title screen. Vita. CD-ROM. Includes bibliographical references. Also available online.