Top

Social Psychiatry and Psychiatric Epidemiology

Published in:

01-09-2006 | ORIGINAL PAPER

Attitudes and illness factors associated with low perceived need for depression treatment among young adults

Authors: Benjamin W. Van Voorhees, MD, MPH, Joshua Fogel, PhD, Thomas K. Houston, MD, MPH, Lisa A. Cooper, MD, MPH, Nae-Yuh Wang, PhD, Daniel E. Ford, MD, MPH

Published in: Social Psychiatry and Psychiatric Epidemiology | Issue 9/2006

Abstract

Background

We do not yet fully understand how low perceived need for treatment leads many young adults to not seek care for their depression.

Methods

A cross-sectional study of 10,962 depressed young adults (ages 16–29) who visited a depression screening/education Internet website. Based on the Theory of Reasoned Action, we developed a multivariate model to determine the effects of beliefs and attitudes, social norms, past treatment behavior, and symptom severity on low perceived depression treatment need (i.e., not agreeing that one needs depression treatment).

Results

Negative beliefs and attitudes, social norms, and past treatment behavior predicted low perceived depression treatment need and explained more than half the model variance. Even after adjusting for depression severity and symptoms of other mental disorders, lacking confidence in either a biological or counseling based explanation or treatment approach for depression predicted low perceived depression treatment need.

Conclusions

Lack of helpful treatment experiences and/or confidence in either of the currently practiced depression treatment models may prevent many young adults from seeking depression treatment.

Ajzen I (1996) The directive influence of attitudes on behavior. In: Gollwitzer, PM, Bargh, JA (eds) The psychology of action: Linking cognition and motivation to behavior. The Guilford Press, New York, NY, USA, pp 385–403

Andrews G, Anstey K, Brodaty H, Issakidis C, Luscombe G (1999) Recall of depressive episode 25 years previously. Psychol Med 29(4):787–791PubMedCrossRef

Andrews G, Issakidis C, Carter G (2001) Shortfall in mental health service utilisation. Brit J Psych 179:417–425CrossRef

Arnett JJ (2000) Emerging adulthood. A theory of development from the late teens through the twenties. Amer Psychol 55(5):469–480CrossRef

Battaglia J, Coverdale JH, Bushong CP (1990) Evaluation of a mental illness awareness week program in public schools. Amer J Psych 147(3):324–329

Bedi N, Chilvers C, Churchill R, Dewey M, Duggan C, Fielding K, Gretton V, Miller P, Harrison G, Lee A, Williams I (2000) Assessing effectiveness of treatment of depression in primary care. Partially randomised preference trial. Brit J Psych 177:312–318CrossRef

Blumenthal R, Endicott J (1996) Barriers to seeking treatment for major depression. Dep Anxiety 4(6):273–278CrossRef

Borzekowski DL, Rickert VI (2001) Adolescent cybersurfing for health information: a new resource that crosses barriers. Arch Pediatr Adol Med 155(7):813–817

Chilvers C, Dewey M, Fielding K, Gretton V, Miller P, Palmer B, Weller D, Churchill R, Williams I, Bedi N, Duggan C, Lee A, Harrison G (2001) Antidepressant drugs and generic counselling for treatment of major depression in primary care: randomised trial with patient preference arms. Brit Med J 322(7289):772–775PubMedCrossRef

Cooper-Patrick L, Powe NR, Jenckes MW, Gonzales JJ, Levine DM, Ford DE (1997) Identification of patient attitudes and preferences regarding treatment of depression. J Gen Int Med 12(7):431–438CrossRef

Cooper LA, Brown C, Vu HT, Palenchar DR, Gonzales JJ, Ford DE, Powe NR (2000) Primary care patients’ opinions regarding the importance of various aspects of care for depression. Gen Hosp Psych 22(3):163–173CrossRef

Cooper LA, Gonzales JJ, Gallo JJ, Rost KM, Meredith LS, Rubenstein LV, Wang NY, Ford DE (2003) The acceptability of treatment for depression among African-American, Hispanic, and white primary care patients. Med Care 41(4):479–489PubMedCrossRef

Corruble E, Legrand JM, Zvenigorowski H, Duret C, Guelfi JD (1999) Concordance between self-report and clinician’s assessment of depression. J Psych Res 33(5):457–465CrossRef

Druss BG, Hoff RA, Rosenheck RA (2000) Underuse of antidepressants in major depression: prevalence and correlates in a national sample of young adults. J Clin Psych 61(3):234–237

Eagly AH, Chaiken S (1998) Attitude structure and function. In: Gilbert DT, Fiske ST (eds) The handbook of social psychology, vol. 1, 4th edn. McGraw-Hill, New York, NY, US, pp 269–322

Eysenbach G, Wyatt J (2002) Using the Internet for surveys and health research. J Med Int Res 4(2):E13

Fabrigar LR, Smith SM, Brannon LA (1999) Applications of social cognition: Attitudes as cognitive structures, In: Durso, FT (ed) (1999) Handbook of applied cognition, pp 173 206. John Wiley & Sons Ltd, Chichester, England, xxii, 881 pp

Fortney J, Rost K, Zhang M (1998) A joint choice model of the decision to seek depression treatment and choice of provider sector. Med Care 36(3):307–320PubMedCrossRef

Greenley JR, Mechanic D, Cleary PD (1987) Seeking help for psychologic problems. A replication and extension. Med Care 25(12):1113–1128PubMedCrossRef

Hagger MS, Chatzisarantis NL, Biddle SJ, Chatzisarantis N (2002) The influence of autonomous and controlling motives on physical activity intentions within the Theory of Planned Behaviour:The influence of self-efficacy and past behaviour on the physical activity intentions of young people. Brit J Health Psych 7(Part 3):283–297CrossRef

Halgin RP, Weaver DD, Edell WS, Spencer PG (1987) Relation of depression and help-seeking history to attitudes toward seeking professional psychological help. J Counsel Psychol 34(2):177–185CrossRef

Hallowell EM, Bemporad J, Ratey JJ (1989) Depression in the transition to adult life. In: Feinstein SC, Esman AH (eds) Adolescent psychiatry: Developmental and clinical studies, vol. 16. Annals of the American Society for Adolescent Psychiatry. The University of Chicago Press, Chicago, IL, US, pp 175–188

Horwitz AV, White HR (1991) Becoming married, depression, and alcohol problems among young adults. J Health Soc Behav 32(3):221–237PubMedCrossRef

Houston TK, Cooper LA, Vu HT, Kahn J, Toser J, Ford DE (2001) Screening the public for depression through the Internet. Psych Serv 52(3):362–367CrossRef

Howland MJ (1997) Examining the decision to seek professional psychological help: A comparison of attribution and attitude theory in predicting helpseeking intention using the Theory of Reasoned Action. University of Illinois at Urbana-Champaign, US

Jorm AF, Christensen H, Medway J, Korten AE, Jacomb PA, Rodgers B (2000a) Public belief systems about the helpfulness of interventions for depression: associations with history of depression and professional help-seeking. Soc Psych Psych Epidemiol 35(5):211–219CrossRef

Jorm AF, Korten AE, Rodgers B, Pollitt P, Jacomb PA, Christensen H, Jiao Z (1997) Belief systems of the general public concerning the appropriate treatments for mental disorders. Soc Psych Psych Epidemiol 32(8):468–473

Jorm AF, Medway J, Christensen H, Korten AE, Jacomb PA, Rodgers B (2000b) Attitudes towards people with depression: effects on the public’s help-seeking and outcome when experiencing common psychiatric symptoms. Austr NZ J Psych 34(4):612–618CrossRef

Katerndahl DA (2000) Symptom severity and perceptions in subjects with panic attacks. Arch Family Med 9(10):1028–1035CrossRef

Kessler RC, Walters EE (1998) Epidemiology of DSM-III-R major depression and minor depression among adolescents and young adults in the National Comorbidity Survey. Dep Anxiety 7(1):3–14CrossRef

Leaf PJ, Bruce ML, Tischler GL (1986) The differential effect of attitudes on the use of mental health services. Soc Psych 21(4):187–192CrossRef

Leaf PJ, Bruce ML, Tischler GL, Freeman DH Jr., Weissman MM, Myers JK (1988) Factors affecting the utilization of specialty and general medical mental health services. Med Care 26(1):9–26PubMed

Lenert L, Skoczen S (2002) The Internet as a research tool: worth the price of admission? Annals Behav Med 24(4):251–256CrossRef

Lin E, Parikh SV (1999) Sociodemographic, clinical, and attitudinal characteristics of the untreated depressed in Ontario. J Affect Disord 53(2):153–162PubMedCrossRef

Mechanic D (1982) The epidemiology of illness behavior and its relationship to physical and psychological stress. Symptoms, Illness Behavior and Help Seeking, 1–24

Mechanic D, Angel RJ, Davies L (1992) Correlates of using mental health services: implications of using alternative definitions. Amer J Pub Health 82(1):74–78CrossRef

Mojtabai R, Olfson M, Mechanic D (2002) Perceived need and help-seeking in adults with mood, anxiety, or substance use disorders. Arch Gen Psych 59(1):77–84CrossRef

Narrow WE, Rae DS, Robins LN, Regier DA (2002) Revised prevalence estimates of mental disorders in the United States: using a clinical significance criterion to reconcile 2 surveys’ estimates. Arch Gen Psych 59(2):115–123CrossRef

Paykel ES, Tylee A, Wright A, Priest RG, Rix S, Hart D (1997) The Defeat Depression Campaign: psychiatry in the public arena. Amer J Psych 154(6 Suppl):59–65

Pear R (2000) Number of uninsured Americans is up for the first time since 87. New York Times, 29 September, pp A26

Rabinowitz J, Gross R, Feldman D (1999) Correlates of a perceived need for mental health assistance and differences between those who do and do not seek help. Soc Psych Psych Epidemiol 34(3):141–146CrossRef

Reinherz HZ, Giaconia RM, Hauf AMC, Wasserman MS, Silverman AB (1999) Major depression in the transition to adulthood: Risks and impairments. J Abnor Psychol 108(3):500–510CrossRef

Rost K, Nutting PA, Smith J, Werner JJ (2000) Designing and implementing a primary care intervention trial to improve the quality and outcome of care for major depression. Gen Hosp Psych 22(2):66–77CrossRef

Sareen J, Stein MB, Campbell DW, Hassard T, Menec V (2005) The relation between perceived need for mental health treatment, DSM diagnosis, and quality of life: a Canadian population-based survey. Can J Psych 50(2):87–94

Segee PF, Maguire L, Ross J, Malik ML, Colket J, Davidson JR (1999) Demographics, treatment seeking, and diagnoses of anxiety support group participants. J Anxiety Disord 13(3):315–334PubMedCrossRef

Sherbourne CD, Dwight-Johnson M, Klap R (2001) Psychological distress, unmet need, and barriers to mental health care for women. Womens Health Issues 11(3):231–243PubMedCrossRef

Skodol AE, Schwartz S, Dohrenwend BP, Levav I, Shrout PE (1994) Minor depression in a cohort of young adults in Israel. Arch Gen Psych 51(7):542–551

Thompson A, Hunt C, Issakidis C (2004) Why wait? Reasons for delay and prompts to seek help for mental health problems in an Australian clinical sample. Soc Psych Psych Epidemiol 39(10):810–817

Thornett A (2001) Assessing the effect of patient and prescriber preference in trials of treatment of depression in general practice. Med Sci Monitor 7(5):1086–1091

Van Voorhees BW, Cooper LA, Rost KM, Nutting P, Rubenstein LV, Meredith L, Wang NY, Ford DE (2003) Primary care patients with depression are less accepting of treatment than those seen by mental health specialists. J Gen Int Med 18(12):991–1000CrossRef

Van Voorhees BW, Fogel J, Houston TK, Cooper LA, Wang NY, Ford DE (2005) Beliefs and attitudes associated with the intention to not accept the diagnosis of depression among young adults. Ann Family Med 3(1):38–46CrossRef

Veroff J, Kulka RA, Douvan E (1981) Mental health seeking in America: patterns of help-seeking from 1957 to 1976. Basic Books, New York

Young AS, Klap R, Sherbourne CD, Wells KB (2001) The quality of care for depressive and anxiety disorders in the United States. Arch Gen Psych 58(1):55–61CrossRef

Title: Attitudes and illness factors associated with low perceived need for depression treatment among young adults
Authors: Benjamin W. Van Voorhees, MD, MPH
Joshua Fogel, PhD
Thomas K. Houston, MD, MPH
Lisa A. Cooper, MD, MPH
Nae-Yuh Wang, PhD
Daniel E. Ford, MD, MPH
Publication date: 01-09-2006
Publisher: Steinkopff-Verlag
Published in: Social Psychiatry and Psychiatric Epidemiology / Issue 9/2006
Print ISSN: 0933-7954
Electronic ISSN: 1433-9285
DOI: https://doi.org/10.1007/s00127-006-0091-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Attitudes and illness factors associated with low perceived need for depression treatment among young adults

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 9/2006

Violence in psychiatric units

Social support, ethnicity and mental health in adolescents

Suicidal expressions among young people in Nicaragua

Suicide in the homeless within 12 months of contact with mental health services

Mental illness in a rural area

The influence of stigma and attitudes on seeking help from a GP for mental health problems