Doctor of Philosophy, The Ohio State University, 2014, Psychology

Untreated mental illness is a significant public health problem with nearly 58 million American adults suffering from a diagnosable mental disorder each year and only 30% of these individuals seeking professional care. Without adequate treatment, mental illness can result in unstable education and employment, interpersonal difficulties, physical ailment, and suicide. It also accounts for more than 100 billion dollars in economic costs in the United States alone every year. One's decision to seek treatment is likely influenced by sociodemographic, cognitive, and behavioral factors. Limited research, however, has been completed examining these constructs in relation to actual service use, particularly over time with individuals in distress. Further, many constructs such as insight, attitudes, and avoidance appear to be malleable, yet few interventions have been designed or tested targeting these variables and encouraging service use. The current study examined sociodemographic, cognitive, and behavioral constructs associated with mental health care service use in prospective design with a clinically-distressed sample. Participant recruitment was completed in a primary care facility as individuals in distress often utilize primary care as an initial pathway for help. Primary care patients reporting significant depressive symptoms were randomized into one of three intervention arms designed to increase mental health service use. The effect of an avoidance-reduction intervention on participant treatment-seeking following referral was contrasted against enhanced-referral and psychoeducation interventions. Ethnic minority-status and attitudes toward treatment were the strongest predictors of service use. The effect of intervention on increased service use was trending toward a significant effect, and the effect of the avoidance-reduction intervention on the reduction of depressive symptoms, compared to the other two conditions was moderate. Results of this stud (open full item for complete abstract)

Committee: Jennifer Cheavens Ph.D. (Advisor); Daniel Strunk Ph.D. (Committee Member); Michael Edwards Ph.D. (Committee Member) Subjects: Psychology; Psychotherapy; Public Health

PhD, University of Cincinnati, 2016, Arts and Sciences: Psychology

The prevalence of sexual problems and dysfunctions (SPD) among Black women is well-documented and can negatively impact one's quality of life and relationship satisfaction. Unfortunately, lower rates of treatment use for medical and psychological interventions are reported for Black women. Although previous research highlights barriers, representative samples of Black women are often missing and ignore relevant sociocultural factors. This study investigated which sociocultural (i.e., healthcare access, medical mistrust, dysfunctional sexual beliefs, partner communication, and religion/spirituality) and predisposing factors (i.e., sexual dysfunction and distress) predict a Black woman's willingness to seek treatment and examined whether age and partner status moderated this relationship. Black women (n=103) completed surveys while receiving services in beauty salons or online. Multiple regression results indicated that perceived access to healthcare, sexual partner communication, religion/spirituality, and dysfunctional sexual beliefs significantly predicted one's willingness to seek treatment. Additionally, women in committed relationships who were high in partner communication were more willing to seek treatment than those who scored lower. For women in uncommitted relationships, partner communication was associated with less willingness to seek treatment. The implications of these findings are discussed.

Committee: Ann Kathleen Hoard Burlew Ph.D. (Committee Chair); Rachel Kallen Ph.D. (Committee Member); Monica Mitchell Ph.D. (Committee Member) Subjects: Behavioral Sciences

Doctor of Psychology (PsyD), Wright State University, 2014, School of Professional Psychology

The study of facilitators of treatment seeking and compliance in people with severe mental illness represents a significant gap in the current literature. The present study, using a Participatory Action Research (PAR) approach, attempted to identify facilitators to treatment seeking and compliance through the lived experiences of people living with severe mental illness. Interviews were used to gather information about the experience of people with severe mental illness regarding disability identity development, recovery, interactions with treatment and treatment providers, the experience of being diagnosed with a severe mental illness, and the impact of psychiatric disability on family, friends, and functioning. Results reflected the importance of religion and spirituality, trust, coping and self-care, disability identity, and social and family support as key facilitators to treatment seeking and compliance in people with severe mental illness. Implications for the provision of services to people with severe mental illness and for future research are discussed.

Committee: Julie Williams Psy.D., ABPP (Committee Chair); Michelle Schultz Psy.D. (Committee Member); Irma Johnston Psy.D. (Committee Member) Subjects: Psychology

Doctor of Psychology (Psy.D.), Xavier University, 2021, Psychology

Despite the high rates of mental health concerns within the college population, treatment utilization remains low (American College Health Association [ACHA], 2018; Cadigan et al., 2019; Lipson & Lattie, 2019). The current study explored the impact of psychological help-seeking stigma, perceived symptom severity, and perceived mattering on treatment engagement within a university psychology training clinic. One hundred thirty-four clients completed study measures prior to their intake appointment. Treatment engagement was operationalized as attending at least 4 sessions of individual therapy within the first 60 days of beginning treatment. A secondary non-clinical sample (n = 112) was collected from the psychology participant pool at the same university. Clinical participants scheduled an average of 7.85 therapy sessions and attended an average of 6.42 therapy sessions; most (n =103) clients engaged in treatment. Results indicated clinical sample participants reported significantly lower help-seeking stigma, higher perceived symptom severity, and lower perceived mattering to others pretreatment compared to participants in the non-clinical sample. A significant inverse relation between mattering to others and help-seeking stigma was found in the non-clinical sample, p < .001, but not for the clinical sample, p = .44. A prediction model was built within the clinical sample using logistic regression with treatment engagement as the outcome variable. The final prediction model for the clinical sample included only one variable, perceived mattering to others, that showed a significant relation and increased odds of treatment engagement, β = .05, p = .01, OR = 1.04. These findings provide evidence that efforts to reduce premature termination within university clinics should focus on increasing perceived mattering to others.

Committee: Susan L. Kenford Ph.D. (Committee Chair); Jennifer E. Gibson Ph.D. (Committee Member); Nicholas L. Salsman Ph.D., ABPP (Committee Member) Subjects: Clinical Psychology

Master of Arts, Case Western Reserve University, 2021, Psychology

Latinx children are less likely to utilize mental health care services than their White non-Latinx counterparts. Cultural values such as machismo, caballerismo, and familismo have been shown be associated with mental health-seeking behaviors for the self, but it has yet to be established whether those differ for care-seeking behaviors for one's child. This study explored the relationship between cultural values and mental help-seeking behaviors for one's child, defined by responses to vignettes, and parental attitudes towards psychological help for themselves based on a questionnaire. An MTurk survey (N = 209) included samples of Latinx (n = 109) and White non-Latinx (n = 96) parents of children between the ages of 0-18 (mean = 8, SD = 4.5). Responses indicate that the association between cultural values on behaviors and attitudes related to mental health may be in part explained by machismo, caballerismo, and religiosity above and beyond culturally-agnostic Traditional Family Values.

Committee: amy przeworski phd (Committee Chair); julie exline phd (Committee Member); arin connell phd (Committee Member) Subjects: Psychology

Master of Arts (MA), Bowling Green State University, 2019, Psychology/Clinical

Somatic Symptom Disorder (SSD) is characterized by persistent somatic symptoms and associated cognitive, affective, and behavioral factors. Perceived susceptibility to illness may contribute to the maintenance of SSD and treatment seeking intent and behavior. There are no studies to date examining perceived susceptibility to illness and treatment seeking intent in people with SSD features. The primary aim of the current study was to determine whether individuals with SSD features differ from individuals without SSD features with respect to perceived susceptibility to illness and treatment seeking intent when faced with health-related information. After completing pre-video measures, participants were randomly assigned to watch either a chronic inflammation video or a nature video. Subsequently, participants' mood, perceived susceptibility to illness, and treatment-seeking intent was assessed using self-report measures. One hundred and thirty (N = 130) participants out of three hundred and fifty-eight (N = 358) were identified as meeting criteria for SSD. Results indicated that participants with SSD features reported greater perceived susceptibility to illness and treatment seeking intent. Additionally, the chronic inflammation video was associated with higher perceived susceptibility to illness. However, there was no interaction between video condition and SSD features on perceived susceptibility to illness and treatment seeking intent. The current study provides novel evidence that people with SSD features experience greater perceived susceptibility to illness than people without SSD features, regardless of the type of information (health-related vs non-health related) they are exposed to.

Committee: William H. O'Brien Ph.D. (Advisor); Abby L. Braden Ph.D. (Committee Member); Dara R. Musher-Eizenman Ph.D. (Committee Member) Subjects: Clinical Psychology

Psy. D., Antioch University, 2019, Antioch New England: Clinical Psychology

Continued engagement in military conflicts and known underutilization of mental health services by veterans necessitates understanding of factors influencing veterans' attitudes about mental health treatment and decisions to seek services. The present study examined relationships between posttraumatic stress disorder (PTSD) symptom severity, perceived support from spouse, and attitudes toward mental health help-seeking among married U.S. veterans. Participants (N =39) were recruited using social media outreach, an online gaming platform, and through print fliers. First, it was hypothesized that perceived spousal support would be significantly positively correlated with attitudes toward treatment seeking, which was supported to a moderate degree (r=.345, p=.031). Second, it was hypothesized that PTSD symptom severity and perceived support from spouse would be negatively correlated at a significance level of .05, which was not supported (r=-0.184, p=.263). Third, it was hypothesized that participation in mental health treatment would be associated with more positive attitudes toward mental health services, which was supported, t(37)=2.51, p=0.016. Furthermore, PTSD diagnostic status was found to moderate the relationship between perceived support from spouse and attitudes toward mental health treatment, such that support was associated with more positive treatment attitudes for married veterans without PTSD (r=.440, p=0.012); but this relationship may be reversed or extinguished in the presence of posttraumatic symptoms above clinical threshold for probable diagnosis. Clinical implications of study findings, limitations to the study, and directions for future research are discussed.

Committee: Gargi Roysircar EdD (Committee Chair); Melissa Boudreau PsyD (Committee Member); Bryan Clarke PsyD (Committee Member) Subjects: Clinical Psychology

Doctor of Philosophy (PhD), Ohio University, 0, Experimental Psychology (Arts and Sciences)

Although many Americans report experiencing mental illness, not everyone seeks treatment for mental health issues. The present research investigates why people avoid mental health treatment, informed from a social psychological perspective—specifically, do stereotypes of mental health professionals contribute to mental health treatment avoidance? Using the Stereotype Content Model (SCM) as an overarching theoretical framework, I consider two possible explanations giving rise to (negative) perceptions of mental health professionals as low in competence: (1) they lack the necessary (scientific) skills to deliver treatment, and/or (2) they are unpredictable in their behavior (e.g., unreliable, personally unstable). Results suggested that mental health providers were perceived as warmer (Study 1a), but less competent and less scientifically oriented (Studies 1a and 1b), than medical health providers. Further, people reported lower intentions to seek treatment from a mental health provider to the extent they were viewed as lower in scientific orientation (Study 1b, Study 2), and competence (Study 2). Provider instability did not appear to have any effect on participants' intentions to seek treatment (Study 2). Although directly manipulating scientific orientation (Studies 3 and 4) and warmth (Study 4) did not impact stereotype content or intentions to seek treatment, correlational evidence supports the relationship between stereotypes of mental health professionals and intentions to seek treatment from mental health providers. Overall, the present work has implications for efforts to improve attitudes toward mental health treatment seeking, as well as extends applications of the SCM to a specific occupation: mental health professionals.

Committee: Kimberly Rios (Advisor) Subjects: Psychology

MA, University of Cincinnati, 2010, Arts and Sciences : Anthropology

It is well recognized that treatment care for diseases and afflictions may take a variety of paths within pluralistic medical settings including the use of Western biomedicine and traditional treatment options. This study identifies and describes different factors that affect health care choices within the Northern Region of Malawi through interviews with 71 informants. Analysis of informant responses took two paths: (1) a quantitative assessment using cultural consensus analysis to understand informants' views of seriousness and treatment options, and (2) a qualitative assessment of descriptive interviews about disease and affliction as well as depression and witchcraft. The results from this study show that within northern Malawi, the majority of laypeople treat what they see as the most serious diseases and afflictions within the Western biomedical system. Additionally, indicators such as wealth, education and sex did not have a significant effect on preferences for treatment. Distance from Western biomedical health faculties did show a significant difference in treatment choice. Results indicate that the majority of people treat major diseases such as HIV/AIDS and malaria within the Western biomedical system but traditional syndromes, and some illnesses that are thought to be in the realm of the supernatural, such as pneumonia and epilepsy, are treated within a traditional system.

Committee: Clement Jeffrey Jacobson PhD (Committee Chair); Jeremy Koster PhD (Committee Member) Subjects: Cultural Anthropology

Doctor of Philosophy, Case Western Reserve University, 2007, Nursing

Acute Myocardial Infarction (AMI) is one of the main causes of morbidity and mortality among women in the United States. Women are more likely to perceive their symptoms as less serious than men and they are less likely to seek treatment when these symptoms occur. Hence, their help seeking behavior might be delayed; a poor health outcome is one consequence. The purpose of this study was to describe the relationship between knowledge of AMI risk factors and symptoms and perceptions of their symptoms seriousness, describe the relationships among knowledge of AMI risk factors and symptoms, perception of symptoms seriousness, treatment-seeking behavior, and time-to-treatment in women with first time AMIs, and to examine the direct and indirect effects of knowledge of AMI risk factors and symptoms, perception of symptoms seriousness, treatment-seeking behavior and time-to-treatment on psychological distress for women with first time AMIs. Based on Leventhal's Self-Regulation Theory, a correlational cross-sectional design with path analysis was used. A convenience sample of 53 hospitalized women (mean age 60.3 years, SD, 13.7) with first time AMIs participated in face-to-face interviews after they were physiologically stable. Results showed that median time-to-treatment was three hours. One third of the participants perceived their symptoms as serious and one third perceived their symptoms as not at all serious. In addition, 67% of the participants used self-medication strategies to cope with their symptoms. The majority of women had high knowledge regarding typical risk factors and symptoms associated with AMI, and reported low knowledge regarding gender-specific risk factors and atypical symptoms of AMI. Regression analysis revealed that knowledge of AMI symptoms mostly predicted perception of symptoms seriousness. Controlling for education, race, marital status, type of treatment, and perception of severity of AMI, path analysis indicated that treatment-seeking behavio (open full item for complete abstract)

Committee: Faye Gary (Advisor) Subjects:

Doctor of Philosophy, Case Western Reserve University, 1994, Organizational Behavior

This study explored a duration dependent model of illness as a function of job stress and social support. Specifically, the purpose of this study was to determine whether exposure time models of stress could be verified using the methods of failure time analysis. Existing theories outlining the process of job stress are, in essence, static models. In this study, job stress is viewed as a dynamic process, wherein both time and history are considered to be essential components of determining the timing of stress-related illnesses. It was further postulated that certain characteristics of the person and the work environment contribute to variations in the speed at which individuals exhibit the effects of stress in the form of a physical illness, and ultimately, seeking treatment for health problems. The results of this study indicate that failure time modeling of stress and illness provides valuable information about the timing and occurrences of seeking health treatment. The number of health treatments in the year preceding the administration of surveys was the best predictor of the speed to the first health treatments following the assessment of stress. Furthermore, it was discovered that higher stress levels significantly increase the speed to seeking health treatment. It was also determined th at the speed to seeking health treatment is delayed for employees who report higher satisfaction with the support they receive from others. The results of this study suggest that organizations can diminish the impact of stress-related illnesses by providing social support systems that help employees both anticipate and cope with stressful work events.

Committee: Donald Wolfe (Advisor) Subjects: Psychology, Industrial