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Help-seeking mothers and their children.

Forty-three mothers sought help with management of childhood behaviors. Presenting complaints in half or more of the families included stubbornness, talking back to parents, disobedience and other traits indicative of parent-child interaction difficulties. Pretreatment behavioral observations revealed that mothers shared common characteristics of being low in positive warmth and high in negative and oppositional responses. The children were observed to share common traits of little independent play, frequent frustration, and either ignored their mothers or were verbally and physically oppositional. Behavioral counselling and monitored rehearsal served to reverse many of the behaviors. Almost all mothers reported reduction in problem behaviors. Mothers varied widely in attributing usefulness to different program components.

Attitude↗

Interpersonal and self-reported hostility among combat veterans with and without posttraumatic stress disorder.

The present study investigated self-reported and interpersonal hostility in 70 Vietnam combat veterans with and without posttraumatic stress disorder (PTSD) and 60 comparison community volunteer subjects. Veterans were 50 help-seeking, male Vietnam combat veterans with PTSD and 20 non-help-seeking male combat veterans without PTSD. Vietnam veterans with PTSD not only reported more hostility than non-PTSD veterans and healthy community volunteers, but also reacted behaviorally with more hostility during an interpersonal interaction. Compared to veterans without PTSD, veterans with PTSD reported significantly higher levels of hostility and demonstrated significantly greater non-verbal expressions of hostility during an interpersonal task. These results suggest that the level of hostility in PTSD combat veterans may be high as compared to comparison groups. The implications of these results and possible research directions are presented.

Case-Control Studies↗

Managing acute stress response to major trauma.

In this article, the authors review the current empiric literature on early interventions. Findings on the effects, course, help-seeking, and recovery from disasters are first reviewed, with recommendations given that are pertinent to intervention following mass casualties. In reviewing the most commonly used interventions, it is clear that evidence from well-controlled studies showing that early intervention can help prevent longer-term problems is limited. The authors discuss the approaches that have received the most attention or empiric support as early interventions following trauma, which include psychologic debriefing, cognitive-behavioral interventions, eye movement desensitization and processing (EMDR) and other neoteric approaches, and psychopharmacology. At this time, the most promising results for prevention of psychopathology have been achieved with brief four- or five-session cognitive-behavioral therapy. In contrast, randomized clinical trials on psychologic debriefing currently suggest that this approach is either ineffective at preventing psychopathology, or contributive to post-traumatic stress disorder symptoms. Research support is currently lacking for EMDR and pharmacotherapy as early interventions. A major challenge to the field is to integrate the practical experience and knowledge of professional responders with well-controlled, timely intervention research, and to effectively disseminate these findings to practitioners in the field.

Acute Disease↗

Parents of adolescents: help-seeking intentions as a function of help sources and parenting issues.

This study examined the declared intentions of parents of adolescents to seek help from potential sources for a variety of hypothetical problems related to parenting. The relationship between hypothetical help-seeking and certain characteristics of the help-seeker (sex, educational level, parenting, self-confidence, birth order, and sex of the adolescent), and the source of help (natural support system, professional support system, and media); and the problem type were investigated. The research population included 187 parents of adolescents. A questionnaire was formulated for the purpose of the study which examined help-seeking from nine sources of help on eight hypothetical parenting issues. Intention to seek help was found to be a function of both the particular problem type and the potential source of help. In general, parents declared their intention to seek help from and rely on a variety of sources. It was found that parents said that they were most likely to seek help from their spouses regardless of the issue, whereas professional sources were most likely to be consulted in their area of expertise.

Adolescent↗

Social networks and patterns of help-seeking behaviour.

Previous research has suggested that patterns of help-seeking behaviour are influenced by who the sufferer consults when deciding whether to seek medical care or not. This research has been extended to include episodes of illness and injury where more formal contacts are brought into the consultation process. The results show that the perceived urgency with which medical care is required is influenced by who the person has contact with. Some groups such as the police, bystanders and neighbours and friends may be more likely to suggest that the sufferer should seek medical attention than other consultants. This difference was explained in terms of the social, economic, moral and legal pressures associated with these people's positions.

Adolescent↗

Social support: diverse theoretical perspectives.

The useful predictions and interpretations about social support which can be derived from attribution, coping, equity, loneliness and social comparison theories have typically not been recognized. Attribution theory can enable explanation of motives of donors, the phenomena of help-seeking and helping, and negative effects of support efforts. Coping theory demonstrates how social support and coping interface in the stress process; adds a cognitive dimension to support; and considers costs of support. Equity theory explains reactions to support from donor and recipient viewpoints and the reciprocal nature of social support. Loneliness theory attests to the significance of social relationships and emphasizes the affective dimension of support. Social comparison theory is helpful in interpreting positive and debilitating effects of support when the donor is a peer. Further, these five theories enhance theoretical interpretation of social support through their distinctive explanations of the concepts of 'appraisal' and 'helping'. Relevance to health professional assessment and practice can be delineated.

Adaptation, Psychological↗

Parental stress, psychosocial problems and responsiveness in help-seeking parents with small (2-45 months old) children.

Experienced parental stress in 75 mothers and 65 fathers seeking help for their young child (M = 14.5 months; SD = 9.4 months) in a Specialist Child Health Centre was examined and related to child problem load, psychosocial problems and parental problems in responding to the child's signals and demands. Maternal stress level was compared with a population-based sample of 1500 mothers with children of similar ages. The measure of parental stress was a revised Swedish version of the American Parenting Stress Index (Parent Domain). Mothers in the clinical sample indicated higher levels of parental stress compared to fathers in the same families and to mothers in the comparison sample. A clear association was found between higher stress and a global clinical assessment of parental unresponsiveness to the child. Child problem load was associated with mothers' overall stress level. A clinical estimate of the parents' psychosocial situation was also associated with mothers' and fathers' stress level, and gave a large unique contribution to the variability in mothers' stress scores. It was concluded that focus in intervention programs should be on the whole family, and that the father should be seen as a resource that might well be more involved in the caretaking of the child. The study also clearly demonstrated the discriminant and construct validity of the parental stress instrument.

Adult↗

Self-control skillfulness and caregiver burden among help-seeking elders.

Self-control skills are coping responses that help to organize one's own behavior and to manage cognitive and emotional responses that disrupt ongoing, adaptive behavior. The concept of self-control is applied to the chronically stressful caregiving experience. The present study examined the relationship between caregivers' role-specific burden and their self-control skillfulness. Forty-four caregivers of cognitively impaired spouses were assessed. Demographic characteristics, psychiatric symptomatology, role-specific burden, functional impairment of their spouse, and dispositional self-control skillfulness were measured. Highly skillful caregivers reported lower burden, fewer memory and behavior problems for their care recipient, and fewer psychiatric symptoms than less skilled caregivers. Hierarchical multiple regression analyses revealed that self-control skillfulness was associated with caregiver burden net the effects of covariates including age, education, memory and behavior problems of the care recipient, and caregivers' psychological distress. Results suggest that self-control skills may play an important role in caregiving and may help to explain why some caregivers adapt better than others to their role.

Adaptation, Psychological↗

Coping and help-seeking in the UK adult population.

A large national sample of the UK adult population was surveyed to find out how respondents would cope and whom they would turn to for help if they experienced psychological problems. Overall, the most frequently endorsed coping methods were cognitive or behavioural rather than avoidance- or substance-based. Respondents tended to endorse informal rather than formal helpers, especially partners and close relatives, although the family doctor was given greater endorsement than in corresponding US studies. Individual differences in coping and help seeking were examined with respect to demographic variables and level of reported psychological symptoms. Respondents who reported higher levels of symptoms tended to endorse more coping methods, especially avoidance methods, and to show greater readiness to seek help. The implications of the findings for traditional clinical work and for mental health education and promotion are discussed.

Adaptation, Psychological↗

The nature of help-seeking during psychiatric emergency service visits by a patient and an accompanying adult.

Utilization rates for urban psychiatric emergency services remain high, and the decision to seek care in this setting is poorly understood. Three hundred individuals accompanying patients to a psychiatric emergency service were interviewed about their help seeking and choice of treatment setting. Twenty-three of the interviewees (7.7 percent) were caregivers accompanying patients with severe and persistent mental illness. They were significantly more likely than other interviewees to know the difference between psychiatric emergency services and services offered by other outpatient providers. More than half reported that the patient they accompanied was intermittently noncompliant, which required visiting either a walk-in service during a moment when the patient was cooperative or a facility equipped to provide involuntary treatment.

Adolescent↗

Help-seeking preference of college students in urban China after the implementation of the "open-door" policy.

A sample of 466 college students (228 males, 238 females) in urban China completed a questionnaire to indicate their help-seeking preferences with respect to 8 types of problem. The results indicated that our subjects, particularly male students, preferred to rely on their own in resolving their problems, although this self-reliant tendency was less obvious for problems of future employment and severe psychological distress. When help was sought, the tendency to rely on parents was found to be stronger among females than males. Male students were more likely than their female counterparts to seek help from friends and psychiatric consultation. Nevertheless, there was still great reluctance among the college students to use mental health services, particularly psychiatric consultation. Lack of credibility of the professionals was a barrier more negative than stigmatization which prevented students from seeking psychiatric consultation. Moral rather than psychosocial attribution of psychiatric illness was most predictive of the tendency to use mental health services. Findings inconsistent with those reported in other Chinese communities are discussed.

Adolescent↗

Help-seeking and social support in Japanese sojourners.

Research shows that social support is essential for healthy psychological functioning. Help seeking and social support are soc ial processes shaped by cultural understandings about how need should be expressed, to whom, and in what circumstances. This study used grounded theory methodology to examine how cultural factors regulate help seeking and social support in a sample of 25 Japanese sojourners' wives living in America. Culturally based social edicts such as mutual responsibility and in-group solidarity were found to promote help seeking and social support. In contrast, culturally specific factors such as enryo (polite deference) hierarchy, and the cultural rules governing reciprocity inhibited these behaviors. From these data, a cultural model of social exchange allowing for cultural diversity, is proposed. This model can increase the effectiveness of nursing interventions aimed at community-based health promotion.

Adult↗

The role of significant life events in discriminating help-seeking among illicit drug users.

This paper examines the role of significant life events in distinguishing two samples of illicit drug users: 120 help-seekers (the "agency group") and 120 not seeking help (the "non-agency group"). We examined 10 life areas clustered around the general categories of "substance use," "social functioning," and "emotional and interpersonal functioning." A range of objective and self-reported information was collected regarding each life area covering the 12 months prior to interview. Analysis revealed that the agency group experienced a greater number of negatively perceived drug-related life events than the non-agency group. These life events were also more likely to have occurred in recent months, prompting reported "concern" and "need for help" among the agency group. Additionally, length of use of current primary drug was seen to be a contributory variable in distinguishing between the groups.

Adult↗

High school students' responses to dating aggression.

The purpose of this study was to identify high school students' actions in response to physical aggression in their dating relationships. The association of these actions with race/ethnicity and gender was also examined. From a sample of high school students (N = 476), a subsample who reported that they had experienced at least one episode of being victimized by physical aggression in a dating relationship (n = 183), served as the sample of interest. On average, students engaged in two help-seeking actions, with females reporting more actions than males. Overall, the most common responses to physical aggression in a dating relationship were aggressive action (e.g., fight back), informal help seeking, threatened or actual breakup, and doing nothing (males) or crying (females). Females were more likely to fight back than were males. Race was largely unrelated to students' actions. Intervention opportunities and areas for future research are discussed.

Adolescent↗

Phenomenology and neurobiology of social phobia: comparison with panic disorder.

Like panic disorder, social phobia is a common, frequently severe, anxiety disorder that can cause significant work and social impairment. Unlike panic disorder, social phobia has only recently begun to undergo neurobiologic study and to receive pharmacotherapeutic attention. There is a high comorbidity between social phobia and panic disorder; however, many differences exist--including age at onset, gender distribution, contextual framework of anxiety, help-seeking and help-avoidance behavior, quality of sleep and sleep patterns, caffeine and lactate sensitivity, and, most probably, pharmacologic responses. Social phobia can now be included among the growing number of anxiety disorders that respond to pharmacotherapy.

Adult↗

Children's reactions to the receipt of direct and indirect help.

First, third, and fifth graders' (N = 201) reactions to 2 types of aid (direct help [answers] and indirect help [hints]) commonly used by helpers to assist children were examined. The children were randomly assigned to receive either direct or indirect help on a task, and then were asked to try a similar task immediately and again a few days later. Direct help was expected to elicit dependency, whereas indirect help was expected to elicit independent reactions. Age and/or sociocognitive level were predicted to moderate the effects of help. Direct help resulted in feelings of threat, low perceived control, and high dependency help-seeking for girls, but not for boys. Boys who received indirect help and understood the notion of consistency of personality requested less dependent help than did boys with less of this sociocognitive skill. Moreover, children high in the understanding of consistency of personality were more autonomous (i.e., helped themselves more) in the indirect than in the direct help condition.

Child↗

[Little recognition of mental problems in children by parents and family physicians].

OBJECTIVE: To determine the prevalence of psychic problems in children in the Dutch GP-practice and to determine how often parents and general practitioners (GPs) recognize psychic problems in children. DESIGN: Descriptive. SETTING: World Health Organisation Collaborating Centre for Primary Health Care (NIVEL) and Academic Hospital, Department of Child and Adolescent Psychiatry, Utrecht, the Netherlands. METHOD: In 810 children presence or absence of emotional and behavioural problems was studied by means of the Child Behaviour Checklist (CBCL) filled out by a parent at the moment of contact with a GP. The GPs findings in these were also recorded. RESULTS: 7.7% of all children obtained a total CBCL score indicating presence of emotional and behavioural problems (> P90). These children had problems at school, had repeated a school year, and followed special education more often. Nevertheless most of their parents (86%) did not experience problems with their children and 40% of the parents did not report any psychic problem in the preceding 2 weeks. Only 15% of these children were completely free of signs and symptoms, however, as against 40% of children with low scores. The percentages of children with high scores consulting a GP, social work or mental health care agency were somewhat higher than the percentages of children without these problems, but only the last-mentioned difference was significant. Children saw the GP rarely because of psychosocial problems (n = 7; less than 1%; 1 had a high CBCL score). Regardless of the presence of emotional and behavioural problems, as assessed by the CBCL, the GP seldom diagnosed psychological or social problems in children (n = 11; 1.4%; 2 had a high CBCL score) and rarely suspected the complaints had a psychosocial background. CONCLUSION: Children with a high CBCL score did not visit their GPs more often. The perception by the parent appears to be crucial in the help-seeking process. In many children in whom the screening instrument indicated the presence of emotional and behavioural problems, parents did not consider their children as problematic and did not seek the help of a GP.

Adolescent↗