Investigating institutional abuse survivors’ help-seeking attitudes with the Inventory of Attitudes towards Seeking Mental Health Services

Figures & data

Table 1. CFA and bifactor model fit indices for IASMHS.

	χ^2	df	CFI	TLI	RMSEA (90% CI)	BIC^a
One-factor model	931.1*	252	.705	.677	.111 (.104;.119)	17182.95
Three-factor model	438.6*	249	.918	.909	.059 (.050;.068)	16768.05
Bifactor model	395.5*	228	.927	.912	.058 (.048;.068)	16831.07

^aEstimated using robust maximum likelihood estimation (MLR); *significant relative to degrees of freedom, p < .01.

Table 2. Standardized and unstandardized factor loadings including standard errors and interfactor correlations for the three-factor model of IASMHS.

Scale	(#) Item	β	B	SE
PO	(1) ‘There are certain problems which should not be discussed outside of one’s immediate family’	0.30	1.00	-
	(4) ‘Keeping one’s mind on a job is a good solution for avoiding personal worries and concerns’	0.23	0.78	0.31
	(7) ‘It is probably best not to know everything about oneself’	0.33	1.13	0.41
	(9) ‘People should work out their own problems; getting professional help should be a last resort’	0.79	2.67	0.76
	(12) ‘Psychological problems, like many things, tend to work out by themselves’	0.65	2.19	0.66
	(14) ‘There are experiences in my life I would not discuss with anyone’	0.48	1.62	0.46
	(18) ‘There is something admirable in the attitude of people who are willing to cope with their conflicts and fears without resorting to professional help’	0.56	1.89	0.57
	(21) ‘People with strong characters can get over psychological problems by themselves and would have little need for professional help’	0.55	1.86	0.56
HSP	(2) ‘I would have a very good idea of what to do and who to talk to if I decided to seek professional help for psychological problems’	0.50	0.66	0.09
	(5) ‘If good friends asked my advice about a psychological problem, I might recommend that they see a professional’	0.60	0.78	0.08
	(8) ‘If I were experiencing a serious psychological problem at this point in my life, I would be confident that I could find relief in psychotherapy’	0.82	1.07	0.06
	(10) ‘If I were to experience psychological problems, I could get professional help if I wanted to’	0.52	0.68	0.10
	(13) ‘It would be relatively easy for me to find the time to see a professional for psychological problems’	0.63	0.82	0.07
	(15) ‘I would want to get professional help if I were worried or upset for a long period of time’	0.88	1.14	0.07
	(19) ‘If I believed I was having a mental breakdown, my first inclination would be to get professional attention’	0.77	1.00	-
	(22) ‘I would willingly confide intimate matters to an appropriate person if I thought it might help me or a member of my family’	0.76	0.99	0.07
IS	(3) ‘I would not want my significant other (spouse, partner, etc.) to know if I were suffering from psychological problems’	0.74	1.14	0.11
	(6) ‘Having been mentally ill carries with it a burden of shame’	0.64	1.00	-
	(11) ‘Important people in my life would think less of me if they were to find out that I was experiencing psychological problems’	0.71	1.11	0.09
	(16) ‘I would be uncomfortable seeking professional help for psychological problems because people in my social or business circles might find out about it’	0.86	1.34	0.12
	(17) ‘Having been diagnosed with a mental disorder is a blot on a person’s life’	0.62	0.97	0.10
	(20) ‘I would feel uneasy going to a professional because of what some people would think’	0.86	1.34	0.13
	(23) ‘Had I received treatment for psychological problems, I would not feel that it ought to be “covered up”’	0.25	0.38	0.17
	(24) ‘I would be embarrassed if my neighbour saw me going into the office of a professional who deals with psychological problems’	0.77	1.19	0.12
	PO	IS
IS	.52	-
HSP	.70	.25

PO = Psychological openness, IS = Indifference to stigma, HSP = Help seeking propensity; all but one factor loadings were statistically significant at p < .01; item 23 was significant at p < .05

Table 3. Binominal logistic regression analysis to predict current MHS use.

Variable	B	SE	OR (95% CI)
PO	0.03	0.03	1.03 (0.97;1.10)
HSP	0.09*	0.03	1.10 (1.03;1.17)
IS	−0.04	0.03	0.96 (0.91;1.01)
PTSD intrusion	0.52*	0.19	1.68 (1.15;2.45)
PTSD avoidance	−0.13	0.16	0.88 (0.65;1.19)
PTSD negative alterations in cognition and mood	0.57	0.32	1.76 (0.94;3.29)
PTSD alterations in arousal and reactivity	0.33	0.29	1.39 (0.79;2.43)
Depression	−0.63*	0.26	0.53 (0.32;0.90)
Age	−0.04	0.02	0.96 (0.93;1.00)
Gender (male)	−0.51	0.34	0.60 (0.31;1.16)

PO = Psychological openness, IS = Indifference to stigma, HSP = Help seeking propensity, PTSD = Posttraumatic stress disorder; *p < .05

Table 4. Bivariate correlations of variables included in regression model.

	2	3	4	5	6	7	8	9	10
1 PO	.414**	.377**	−.076	−.090	−.185**	−.170*	−.125	−.087	.123
2 HSP		.149*	.041	.163*	.150*	.094	.047	−.108	.162*
3 IS			−.290**	−.262**	−.170*	−.298**	−.193**	.093	.095
4 Depression				.574**	.405**	.769**	.660**	−.284**	−.055
5 PTSD intrusion					.577**	.663**	.625**	−.304**	.076
6 PTSD avoidance						.501**	.421**	−.203**	.135*
7 PTSD negative alterations^a							.755**	−.396**	.022
8 PTSD alterations in arousal^b								−.338**	.054
9 Age									−.135*
10 Gender

Pearson correlation coefficients of variables included in the regression model; point biserial correlation coefficient for gender; ^a negative alterations in cognition and mood; ^b alterations in arousal and reactivity; *p < .05; **p < .01.

Table 5. Characteristics of study population and comparison with selected IASMHS samples.

Scale	Study Sample			^aWatson & Hunter			^bDrapeau, Cerel, & Moore			^cMesidor & Sly			^dTroeung, Gasson, & Egan
	M	SD	95% CI	M	SD	t(df)^e	M	SD	t(df)	M	SD	t(df)	M	SD	t(df)
PO	17.33	6.48	[16.46, 18.19]	15.66	5.41	2.20 (313)*	-	-	-	17.01	5.60	0.44 (329)	15.61	8.82	2.48(545)*
HSP	25.03	6.01	[25.03, 26.63]	18.57	5.60	8.93 (313)***	25.97	5.14	2.07 (636)*	21.52	5.88	5.05 (329)***	24.10	6.69	1.66 (545)
IS	24.16	6.85	[23.24, 25.07]	16.83	9.18	7.83 (313)***	24.50	5.94	0.65 (636)	20.22	5.00	5.38 (329)***	-	-	-
Full scale	67.32	14.25	[65.41, 69.22]	-	-	-	74.76	12.80	6.71 (636)***	57.92	11.54	6.02 (329)***	-	-	-

PO = Psychological openness, HSP = Help seeking propensity, IS = Indifference to stigma; ^aWatson and Hunter (2015): N = 95, African American women with possible anxiety/depression symptoms;^b Drapeau et al. (2016): N = 418, suicide-bereaved adults; PO subscale was excluded due to low internal consistency (α = 0.68);^c Mesidor and Sly (2014): N = 111, African American College Students with possible psychological distress;^d Troeung et al. (2015): N = 327, Australian adults with Parkinson’s Disease and possible mental health problems;^e t-tests comparing study sample to previous research samples; *p < .05; **p < .01; ***p < 0.001.

Watson, N. N., & Hunter, C. D. (2015). Anxiety and depression among African American women: The costs of strength and negative attitudes toward psychological help-seeking. Cultural Diversity & Ethnic Minority Psychology, 21, 604–612. doi:10.1037/cdp0000015

 PubMed Web of Science ®Google Scholar

Drapeau, C. W., Cerel, J., & Moore, M. (2016). How personality, coping styles, and perceived closeness influence help-seeking attitudes in suicide-bereaved adults. Death Studies, 40, 165–171. doi:10.1080/07481187.2015.1107660

 PubMed Web of Science ®Google Scholar

Mesidor, J. K., & Sly, K. F. (2014). Mental health help-seeking intentions among international and african american college students: An application of the theory of planned behavior. Journal of International Students, 4, 137–149.

 Google Scholar

Troeung, L., Gasson, N., & Egan, S. J. (2015). Patterns and predictors of mental health service utilization in people with Parkinson’s disease. Journal of Geriatric Psychiatry and Neurology, 28, 12–18. doi:10.1177/0891988714541869

 Web of Science ®Google Scholar