Disclosing Mental Illness Information to a Friend: Exploring How the Disclosure Decision-Making Model Informs Strategy Selection

ABSTRACT

Within the context of mental illness disclosure between friends, this study tested the disclosure decision-making model (DD-MM; Greene, 2009) to comprehensively investigate factors that predict disclosure enactment strategies. The DD-MM describes how individuals determine whether they will reveal or conceal non-visible health information. Processes of revealing, called disclosures, take various forms including preparation and rehearsal, directness, third-party disclosure, incremental disclosures, entrapment, and indirect mediums (Afifi & Steuber, 2009). We explore the disclosure decision-making process to understand how college students select to disclose their mental illness information with a friend. Participants were 144 students at a Midwestern university who had disclosed their mental illness information to a friend. Structural equation modeling analyses revealed that college students choose strategies based on their evaluation of information assessment and closeness, and that for some strategies, efficacy mediates the relationship between information assessment and strategy. This manuscript discusses implications of findings and suggests direction for future research.

Notes

¹ The DD-MM (Greene, 2009) describes that IA predicts both recipient assessment and disclosure efficacy. However, tests of the model indicate that although both IA and relational assessment predict efficacy, IA may not consistently predict receiver assessment (Greene et al., 2012), and this relationship is not included in our proposed model.

² Results reflected associations when participants anticipated disclosing. However, results did not reflect associations between closeness and specific strategies when participants reported having revealed their secrets.

³ We initially recruited friendship dyads in which one participant had disclosed his/her MI to the other in the past five years, yielding 59 dyads. This sample was not large enough to fully test our hypotheses; as a result, we then recruited college students who had disclosed their MI to friends, gaining an additional 85 participants. We conducted a series of t-tests to determine whether the samples were significantly different. None of these t-tests were significant, indicating the two samples did not differ significantly.

⁴ Participants provided open-ended details of their MI and could report more than one illness. Because of this, percentages total greater than 100%. Information concerning the complete breakdown of mental illness diagnoses if available from the first author.

⁵ In an effort to best align with the DD-MM’s theoretical construct of information assessment, we proceeded with this four factor solutions.

⁶ Specific statistical analyses are available from the first author.