Background: Depression within the older adult population is common. Previous reviews of the literature have considered the efficacy of psychological therapies for older adults. However, they have exclusively focussed on evidence provided by randomised controlled trials neglecting emergent evidence from other therapeutic modalities. Despite the efficacy of psychological and pharmacological treatments many depressed older people go without treatment. The barriers to treatment remain unclear, however the literature has previously suggested that they may fall within three factors; patients, health care providers and health care organisations. This study focussed on patient related factors. The literature has suggested that older adults not be as accurate in recognising symptoms of depression than adults of working age. In turn, lack of recognition of the presence of a mental health problem may influence older adult’s attitudes to seeking psychological help. The literature suggests a number of factors may influence treatment seeking attitudes in older people. These may include accuracy of depression recognition, cognitive fusion; engagement in valued activities although these did not appear to have previously been considered. Aims: The aims of this thesis were addressed by the systematic review of the literature and empirical research paper comprising it. Systematic review aimed, in light of a recent efficiency target issued by the The Scottish Government to update the literature relating to the efficacy of standalone psychological therapies for older adults and to consider the efficiency implications of the results. The empirical article had two overall aims. It sought to determine the predictive effect of attitudes to ageing and degree of depression on older adult’s ability to conceptualise their symptoms of psychological distress as depression. This study also sought to consider, in light of a paucity of empirical evidence to date, the relative predictive effect of attitudes to ageing, depression, recognition of depression symptoms, cognitive fusion and engagement in valued activities on the treatment seeking attitudes of a cohort of depressed older adults. Method: A systematic review of the literature was undertaken to consider the efficacy and efficiency of psychological therapies in the treatment of late life depression. An empirical cross sectional survey recruiting older adults (n = 281), aged ≥ 65 years was undertaken to examine the effects of depression, cognitive fusion, attitudes to ageing, and valued behaviour on attitudes to seeking professional psychological help. Results: In the systematic review, of the 1493 articles identified 11 were retained for review. Papers reviewed considered the effectiveness psychological interventions including: Cognitive Behavioural Therapies, Reminiscence Therapies, Acceptance and Commitment Therapy and Problem Solving Therapy. The results of the statistical analysis in the empirical work suggested that a significant proportion of ‘depressed’ older adults (n = 43) recruited to our study were not able to recognise they were depressed at the time of their participation in the study. A binomial logistic regression suggested that depression severity rather than attitudes to ageing predicted depression recognition in this sample. A hierarchical multiple regression undertaken to analyse the predictive influence of depression, depression recognition, cognitive fusion, attitudes to ageing and engagement in valued activities suggested that non of these variables significantly predicted our sample’s attitudes to seeking professional psychological help. Conclusions: Our results demonstrate that there is increasing evidence that some psychological therapies could be offered as alternatives to antidepressant medication for older people and within an efficient model of stepped care. The results of the empirical element of this project suggest that attitudes to ageing and cognitive fusion are both predictors of attitudes to treatment seeking. The results further suggest that many depressed older people don’t recognise when they are depressed suggesting a lack of mental health. These findings suggest several implications for clinical practice, psychological therapies and public health.

This article reports the findings of a grounded theory study of the processes involved in adherence and treatment seeking delay for febrile neutropenia in chemotherapy patients. Interviews were conducted with 12 patients. Six theoretical constructs were generated, namely ‘Recall of Treatment Advice’, ‘Impact of Emotions’, ‘Influence of Social Networks’, ‘Symptom Monitoring Behaviour’, ‘Symptom Interpretation’, and ‘Preparation and Journey Time’. A model was developed to reflect the complex interplay between these theoretical constructs. Data extracts are presented to illustrate the grounding of the model in patients’ accounts, and the model is discussed with reference to previous theory and research.

Overweight and obesity are associated with an array of negative physical and psychosocial symptoms in adolescents. Numerous pediatric obesity interventions have emerged in an attempt to address this significant public health concern. However, few have focused on African American females, a particularly high risk group for negative health behaviors and associated complications. Moreover, research examining the psychosocial changes associated with increases in physical activity and fitness, although promising in elder and adult populations, is nearly nonexistent in adolescents. Thus, the current study addressed limitations in the research and examined the psychosocial outcomes of adolescent participants in T.E.E.N.S., a culturally sensitive, multidisciplinary weight loss intervention. From baseline to 6 month post-testing, program participants demonstrated significant improvements in physical, emotional, and social functioning, as well as body dissatisfaction. Moreover, increases in physical activity and cardiorespiratory fitness were associated with significant enhancements in several domains of psychological well-being.

No description available.

Background. Mori (2000) put forward evidence that international students were at greater risk for psychological problems. He also said that mental health concerns of international students on American campuses were often overlooked. Stigma associated with mental illness and seeking treatment is the reason most often cited that people do not seek counseling and other mental health services (Corrigan, 2004). No studies have focused on international students’ beliefs about service seeking or stigma around health treatment seeking. Objective. The basic aims of this study are to examine international students’ beliefs about mental health services and relationships between stigma and mental health treatment seeking. Method. Participants are 35 international students who were invited to fill out an online questionnaire. The measures included in the questionnaire were designed to collect demographic information (i.e. sex, age, country of birth, etc.), students’ perceived stigma regarding help seeking (i.e. social stigma), students’ overall distress level, students’ prior treatment seeking and willingness to seek treatment from various people (i.e. family/friends, psychologists, teachers, doctors, etc.), and students’ willingness to seek treatment from a psychologist in various settings (i.e. Community clinic, private practice, primary care, etc.). Results. International students at ETSU generally reported feeling moderate levels of stigma regarding mental health treatment [M=2.02, SD=.466, N=36 (1= little/no experienced stigma and 4 = extremely high levels of experienced stigma). Additionally, they reported being equally as likely to seek help from others as to deal with their troubles on their own (M=2.47, SD=.416, N=34). Among the students who hadn’t talked with family members/close friends, doctors, or psychologists about their problems, the more stigma that they felt, the less willing that they were to talk with family members/close friends, doctors, or psychologists in the future (r=-.474, p<.05, N=19; r=-.503, p<.01, N=27; r=-.689, p<.001, N=27). Among all international students, the more stigma they felt, the less willing that they were to seek treatment from a psychologist (counselor or therapist) working at their school or community behavior and health center (r=-.39, p<.05, N=30; r=-.415, p<.05, N=31). However, stigma was not found to be significantly correlated with treatment seeking from a psychologist working in any other setting (ie. private practice or doctors’ office). Implications. Even though the results show that international students generally only feel a moderate amount of stigma, the stigma that they do experience significantly influences their willingness to seek mental health treatment. Future research should focus on identifying new ways addressing this major barrier to mental health treatment seeking to hopefully increase mental health service utilization by international student on college campuses.

No description available.

Despite demonstrating eating disorder rates equivalent to White women, African American and Asian American women are less likely to seek treatment and are more likely to terminate treatment prematurely. One of the most successful programs for eating disorder prevention has only focused on surface-level cultural adaptations. Prevention literature maintains that deep-structure cultural adaptation (e.g., integrating cultural values and beliefs) can enhance outcomes for ethnic minorities. This dissertation examined the feasibility of Sustainable Adapted Treatments for Eating Disorders (SATED), a pilot intervention that included a culturally- targeted pre-treatment to an eating disorder dissonance-based intervention. A sample of 72 women (ages 18-30) were recruited via the SONA pool, student organizations, and community organizations. In Study 1, 47 women participated in focus groups (i.e., 21 African American women and 26 Asian American women). Grounded theory was used to analyze data, and this data was then used to develop a culturally-informed pre-treatment. Pre-treatment protocols (30- 45 minutes) were developed for both African American and Asian American groups and were refined prior to implementing the intervention. In Study 2, a pilot intervention, 25 women were assigned either to a pre-treatment condition, or 30-45 minute, individualized session (N = 12) or a no pre-treatment condition (N = 13) prior to completing an eating disorder DBI which took place over two 2-hour sessions. Participants completed a battery of questionnaires at baseline, post-intervention, and at 2 to 3-month follow-up. Constructs assessed included eating disorder symptomatology, attitudes towards seeking professional psychological help, and body dissatisfaction. Overall feasibility and acceptability of the pre-treatment and pilot intervention were assessed via triangulation of methods including third-party observations, in-depth interviews, and fidelity checks. Preliminary findings from the questionnaires indicated that there was a general downward trend for eating pathology across both the pre-treatment and no pre- treatment condition, except for eating restraint. Body dissatisfaction decreased for both groups from baseline to post-test, but increased at follow-up. Attitudes towards treatment-seeking increased for both groups from baseline to follow-up. Results may inform feasibility issues that accompany translational research with ethnic minorities and inform a future definitive trial.

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.

<p>The main aim of the current study is to examine the relationship between community violence exposure and the development of psychopathology and examine the relationship between community violence exposure and other types of trauma, that is, childhood trauma and stressful life events. It was hypothesised that exposure to community violence will have a high correlation with development of psychological disorders such as mood and anxiety and psychotic disorders. The main study employed a quantitative research design in order to determine the relationship between PTSD in children and adolescents. The current study used secondary data to measure the correlation between exposure to community violence and the development of psychopathology. The data for this study was collected from 132 consecutive referrals between the ages of 13 to 19 (mean age = 15.4, SD = 1.6) from a youth stress clinic at a university in the Western Cape. Findings indicated that community violence prevalence was higher than previous South African studies but lower compared to American studies. There was generally a high prevalence of PTSD and major depressive disorder (MDD) in this sample compared to previous South African studies. An unexpected outcome was that even though there was a high prevalence of PTSD, there was no relationship between community violence exposure and PTSD in this sample, rather, community violence exposure was related to MDD. Furthermore, MDD and not PTSD was related to experiences of childhood trauma. Stressful life events were related to acute stress disorder (ASD).</p>

This thesis uses a critical medical anthropology approach to explore healthcare professionals’ perspectives of Hansen’s disease (HD) patients’ treatment-seeking experiences in the United States. During semi-structured interviews my eight informants discussed challenges patients face when seeking treatment. The number one challenge discussed was that of knowledge gaps among healthcare professionals which influence misconceptions of HD being highly contagious and dangerous. Such misconceptions negatively influence patients’ treatment from start to finish. My informants discussed their understandings of, and roles in minimizing challenges for their patients.