How are perceived stigma, self-stigma, and self-reliance related to treatment-seeking? A three-path model.

Jennings, Kristen S.; Cheung, Janelle H.; Britt, Thomas W.; Goguen, Kandice N.; Jeffirs, Stephanie M.; Peasley, Allison L.; Lee, Abigail C.

doi:10.1037/prj0000138

Cited by 143 publications

(134 citation statements)

References 38 publications

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“…Conversely, we found no evidence of resilience to MDD, as shown by a similar effect across ages. Despite this long-term effect of parental alcoholism, many adults with depression do not seek treatment because of a desire for self-reliance and the perceived stigma of mental health difficulties (16). Children of alcoholics often desire secrecy about their parents’ alcoholism (17), and this additional stigma may further compound the lack of treatment seeking among adult offspring of alcoholics.…”

Section: Discussionmentioning

confidence: 99%

Time-Varying Effects of Parental Alcoholism on Depression

2017

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IntroductionChildren of alcoholic parents are at increased risk for lifetime depression. However, little is known about how this risk may change in magnitude across age, especially in mid-adulthood and beyond.MethodsWe used a nationally representative sample (N = 36,057) of US adults from the National Epidemiologic Survey on Alcohol and Related Conditions, wave III. After adjusting for demographic characteristics, we examined the relationship between parental alcoholism and outcomes of 1) major depressive disorder, Diagnostic and Statistical Manual of Mental Disorders-5th edition (DSM-5) and 2) DSM-5 persistent depressive disorder. To examine continuous moderation of this relationship across participants’ age, we used time-varying effect models.ResultsParental alcoholism was associated in general with a higher risk for both major depressive disorder (odds ratio [OR], 1.98, 95% confidence interval [CI], 1.85–2.11; P < .001) and persistent depressive disorder (OR, 2.28, 95% CI, 2.04–2.55; P < .001). The association between parental alcoholism and major depressive disorder was stable and positive across age, but the association with persistent depressive disorder significantly declined among older adults; respondents older than 73 years old were not at increased risk for persistent depressive disorder.ConclusionsFindings from this study show that the risk of parental alcoholism on depression is significant and stable among individuals of a wide age range, with the exception of a decline in persistent depressive risk among older adults. These findings highlight the importance of screening for depression among adults with parental alcoholism.

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Section: Discussionmentioning

confidence: 99%

Time-Varying Effects of Parental Alcoholism on Depression

2017

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“…Commonly cited barriers to help seeking include a preference for self-reliance and stigma [15–17], whereas positive past experiences of services are often considered to increase the intention to seek help [15, 18, 19]. This suggests those with a history of mental health referral may adopt more adaptive help seeking strategies when faced with problems.…”

Section: Introductionmentioning

confidence: 99%

Help-seeking in emerging adults with and without a history of mental health referral: a qualitative study

2016

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BackgroundYoung people are generally reluctant to seek professional help when experiencing problems. However, past experience of services is often cited as increasing the intention to seek help, therefore those with a history of mental health referral may adopt more adaptive help seeking strategies. The current study investigated whether the pattern of different help seeking strategies and barriers to help seeking differed as a function of previous referral history.MethodsSemi-structured interviews were conducted with 29 emerging adults (12 males, 17 females); 17 with a history of mental health referral and 12 without and analysed using thematic analysis.ResultsOverall, those with a referral to services were more likely than those without to rely on avoidant coping, especially techniques that depended upon suppression. This could help account for the increased use of strategies involving self-harm and substances in those with past referral. An exploration of barriers to help seeking showed those with a history of mental health referral were much more likely to self-stigmatise and this became attached to their sense of identity.ConclusionsEmerging adults with a history of referral are more likely to adopt avoidant coping strategies when dealing with problems and self-stigmatise to a greater degree than those without a history of referral. This suggests that current approaches to mental health in emerging adults are not decreasing the sense of stigma with potentially far-reaching consequences for the developing sense of self and choice of help seeking strategies.

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“…Although brief interventions, such as those based upon motivational interviewing (MI), have been shown to significantly reduce heavy drinking in college students (Carey, Scott-Sheldon, Carey, & DeMartini, 2007), few college students recognize it as a problem and infrequently voluntarily seek help (~2%; Wu, Pilowsky, Schlenger, & Hasin, 2007). Stigma, combined with a desire to handle a problem on one’s own, is a primary reason why college students do not seek mental health services (Jennings et al, 2015). Alternative non-stigmatizing interventions are therefore needed to increase the number of individuals who access treatment.…”

mentioning

confidence: 99%

Sedentary college student drinkers can start exercising and reduce drinking after intervention.

Weinstock¹,

Petry²,

Pescatello³

et al. 2016

Psychology of Addictive Behaviors

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Heavy drinking by college students is exceedingly harmful to the individuals and to the overall college environment. Current interventions to reduce drinking and negative consequences are infrequently utilized. This randomized clinical trial examined an alternative approach that sought to increase exercise behavior, a substance free activity, in sedentary heavy drinking college students. Participants (N = 70) were randomized to an 8-week exercise intervention: (1) motivational interviewing plus weekly exercise contracting (MI+EC) or (2) motivational interviewing and weekly contingency management for exercise (MI+CM). Follow-up evaluations occurred at post-treatment (2 months) and 6 months post baseline. Participants in both interventions significantly increased exercise frequency initially, and the MI+CM participants exercised significantly more than the MI+EC intervention participants during the intervention period (d = 1.70). Exercise behavior decreased during the follow-up period in both groups. Significant reductions in drinking behaviors and consequences were noted over time, but were not related to changes in exercise or the interventions (ds ≤ 0.01). This study underscores the complex nature of promoting one specific health behavior change with the goal of changing another.

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How are perceived stigma, self-stigma, and self-reliance related to treatment-seeking? A three-path model.

Cited by 143 publications

References 38 publications

Time-Varying Effects of Parental Alcoholism on Depression

Time-Varying Effects of Parental Alcoholism on Depression

Help-seeking in emerging adults with and without a history of mental health referral: a qualitative study

Sedentary college student drinkers can start exercising and reduce drinking after intervention.

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