Skip to main content
Top
Published in: BMC Public Health 1/2016

Open Access 01-12-2016 | Research article

Understanding help-seeking intentions in male military cadets: An application of perceptual mapping

Authors: Sarah Bauerle Bass, Javier Muñiz, Thomas F. Gordon, Laurie Maurer, Freda Patterson

Published in: BMC Public Health | Issue 1/2016

Login to get access

Abstract

Background

Research suggests that men are less likely to seek help for depression, substance abuse, and stressful life events due to negative perceptions of asking for and receiving help. This may be exacerbated in male military cadets who exhibit higher levels of gender role conflict because of military culture.

Methods

This exploratory study examined the perceptions of 78 male military cadets toward help-seeking behaviors. Cadets completed the 31-item Barriers to Help Seeking Scale (BHSS) and a component factor analysis was used to generate five composite variables and compare to validated factors. Perceptual mapping and vector modeling, which produce 3-dimensional models of a group’s perceptions, were then used to model how they conceptualize help-seeking.

Results

Factor analysis showed slightly different groupings than the BHSS, perhaps attributed to different characteristics of respondents, who are situated in a military school compared to general university males. Perceptual maps show that cadets perceive trust of doctors closest to them and help-seeking farthest, supporting the concept that these males have rigid beliefs about having control and its relationship to health seeking. Differences were seen when comparing maps of White and non-White cadets. White cadets positioned themselves far away from all variables, while non-White cadets were closest to “emotional control”.

Conclusion

To move these cadets toward help-seeking, vector modeling suggests that interventions should focus on their general trust of doctors, accepting lack of control, and decreasing feelings of weakness when asking for help. For non-White cadets a focus on self-reliance may also need to be emphasized. Use of these unique methods resulted in articulation of specific barriers that if addressed early, may have lasting effects on help-seeking behavior as these young men become adults. Future studies are needed to develop and test specific interventions to promote help-seeking among military cadets.
Literature
1.
3.
go back to reference Blazina C, Watkins CE. Masculine gender role conflict: Effects on college men’s psychological well-being, chemical substance usage, and attitudes towards help-seeking. J Couns Psychol. 1996;43:461–5. doi:10.1037/0022-0167.43.4.461.CrossRef Blazina C, Watkins CE. Masculine gender role conflict: Effects on college men’s psychological well-being, chemical substance usage, and attitudes towards help-seeking. J Couns Psychol. 1996;43:461–5. doi:10.​1037/​0022-0167.​43.​4.​461.CrossRef
6.
go back to reference Farrimond H. Beyond the caveman: Rethinking masculinity in relation to men’s help-seeking. Health (London). 2012;16:208–25.CrossRef Farrimond H. Beyond the caveman: Rethinking masculinity in relation to men’s help-seeking. Health (London). 2012;16:208–25.CrossRef
7.
go back to reference Evans J, Frank B, Oliffe JL, Gregory D. Health, illness, men and masculinities (HIMM): a theoretical framework for understanding men and their health. J Men’s Health. 2011;8:7–15.CrossRef Evans J, Frank B, Oliffe JL, Gregory D. Health, illness, men and masculinities (HIMM): a theoretical framework for understanding men and their health. J Men’s Health. 2011;8:7–15.CrossRef
8.
go back to reference Creighton G, Oliffe JL. Theorizing masculinities and men’s health: A brief history with a view to practice. Health Sociol Rev. 2010;19:409–18.CrossRef Creighton G, Oliffe JL. Theorizing masculinities and men’s health: A brief history with a view to practice. Health Sociol Rev. 2010;19:409–18.CrossRef
9.
go back to reference Kakakioz M. Men’s health-the way forward. N S W Public Health Bull. 2001;12:315–7.CrossRef Kakakioz M. Men’s health-the way forward. N S W Public Health Bull. 2001;12:315–7.CrossRef
10.
go back to reference Malcher G. Men’s health, GPs, and ‘GPs4Men’. Aust Fam Physician. 2005;34:21–3.PubMed Malcher G. Men’s health, GPs, and ‘GPs4Men’. Aust Fam Physician. 2005;34:21–3.PubMed
11.
go back to reference Millan G. Men’s health matters: A framework for action on men’s health in Central Sydney area health service during 2002. Sydney: Central Sydney Area Health Service; 2002. Millan G. Men’s health matters: A framework for action on men’s health in Central Sydney area health service during 2002. Sydney: Central Sydney Area Health Service; 2002.
12.
14.
go back to reference Segal AG, Diaz CE, Nezu CM, Nezu AM. Social problem solving as a predictor of attitudes toward seeking mental health care and medical care among veterans. Military Behavioral Health. 2014;2:304–15. Segal AG, Diaz CE, Nezu CM, Nezu AM. Social problem solving as a predictor of attitudes toward seeking mental health care and medical care among veterans. Military Behavioral Health. 2014;2:304–15.
15.
go back to reference Jeffrey OW, Nicole SB, Paul JA. Drinking and other risk taking behaviors of enlisted male soldiers in the US Army. Work J Prev Assess Rehabil. 2002;18:141–50. Jeffrey OW, Nicole SB, Paul JA. Drinking and other risk taking behaviors of enlisted male soldiers in the US Army. Work J Prev Assess Rehabil. 2002;18:141–50.
16.
go back to reference Blais RK, Renshaw KD, Jakupcak M. Posttraumatic stress and stigma in active‐duty service members relate to lower likelihood of seeking support. J Trauma Stress. 2014;27:116–9.CrossRefPubMed Blais RK, Renshaw KD, Jakupcak M. Posttraumatic stress and stigma in active‐duty service members relate to lower likelihood of seeking support. J Trauma Stress. 2014;27:116–9.CrossRefPubMed
17.
go back to reference Clement S, Schauman O, Graham T, Maggioni F, Evans-Lacko S, Bezborodovs N, Morgan C, Rusch N, Brown JSL, Thornicroft G. What is the impact of mental health-related stigma on help-seeking? A systematic review of quantitative and qualitative studies. Psychol Med. 2015;45:11–27.CrossRefPubMed Clement S, Schauman O, Graham T, Maggioni F, Evans-Lacko S, Bezborodovs N, Morgan C, Rusch N, Brown JSL, Thornicroft G. What is the impact of mental health-related stigma on help-seeking? A systematic review of quantitative and qualitative studies. Psychol Med. 2015;45:11–27.CrossRefPubMed
18.
go back to reference Britt TW, Greene-Shortridge TM, Castro CA. The stigma of mental health problems in the military. Mil Med. 2007;172:157–61.CrossRefPubMed Britt TW, Greene-Shortridge TM, Castro CA. The stigma of mental health problems in the military. Mil Med. 2007;172:157–61.CrossRefPubMed
19.
go back to reference Blais RK, Renshaw KD. Self-stigma fully mediates the association of anticipated enacted stigma and help-seeking intentions in National Guard service members. Mil Psychol. 2014;26:114–9.CrossRef Blais RK, Renshaw KD. Self-stigma fully mediates the association of anticipated enacted stigma and help-seeking intentions in National Guard service members. Mil Psychol. 2014;26:114–9.CrossRef
20.
go back to reference Wade NG, Vogel DL, Armistead-Jehle P, Meit SS, Heath PJ, Strass HA. Modeling stigma, help-seeking attitudes, and intentions to seek behavioral healthcare in a clinical military sample. Psychiatr Rehabil J. 2015;38:135–41.CrossRefPubMed Wade NG, Vogel DL, Armistead-Jehle P, Meit SS, Heath PJ, Strass HA. Modeling stigma, help-seeking attitudes, and intentions to seek behavioral healthcare in a clinical military sample. Psychiatr Rehabil J. 2015;38:135–41.CrossRefPubMed
21.
go back to reference Link BG, Cullen FT, Struening EL, Shrout PE, Dohrenwend BP. A modified labeling theory approach to mental disorders: An empirical assessment. Am Sociol Rev. 1989;54:400–23. doi:10.2307/2095613.CrossRef Link BG, Cullen FT, Struening EL, Shrout PE, Dohrenwend BP. A modified labeling theory approach to mental disorders: An empirical assessment. Am Sociol Rev. 1989;54:400–23. doi:10.​2307/​2095613.CrossRef
22.
go back to reference Zinzow HM, Britt TW, Pury CLS, Raymond MA, McFadden AC, Burnette CM. Barriers and facilitators of mental health treatment seeking among active-duty army personnel. Mil Psychol. 2013;25:514–35.CrossRef Zinzow HM, Britt TW, Pury CLS, Raymond MA, McFadden AC, Burnette CM. Barriers and facilitators of mental health treatment seeking among active-duty army personnel. Mil Psychol. 2013;25:514–35.CrossRef
23.
go back to reference Bulling D, DeKraai M, Abdel-Monem T, Nieuwsma JA, Cantrell WC, Ethridge K, Meador K. Confidentiality and mental health/chaplaincy collaboration. Mil Psychol. 2014;25:557–67. doi:10.1037/mil0000019.CrossRef Bulling D, DeKraai M, Abdel-Monem T, Nieuwsma JA, Cantrell WC, Ethridge K, Meador K. Confidentiality and mental health/chaplaincy collaboration. Mil Psychol. 2014;25:557–67. doi:10.​1037/​mil0000019.CrossRef
24.
go back to reference Woelfel J, Fink E. The measurment of communication processes. New York: Academic; 1980. Woelfel J, Fink E. The measurment of communication processes. New York: Academic; 1980.
26.
go back to reference Mertler CA, Vannatta RA. Advanced and multivariate statistical methods. Los Angeles: Pyrczak Publishing; 2002. Mertler CA, Vannatta RA. Advanced and multivariate statistical methods. Los Angeles: Pyrczak Publishing; 2002.
27.
go back to reference Bass SB, Gordon TF, Ruzek SB, Hausman AJ. Mapping perceptions related to acceptance of smallpox vaccination by hospital emergency room personnel. Biosecurity Bioterrorism. 2008;6:179–90.CrossRefPubMed Bass SB, Gordon TF, Ruzek SB, Hausman AJ. Mapping perceptions related to acceptance of smallpox vaccination by hospital emergency room personnel. Biosecurity Bioterrorism. 2008;6:179–90.CrossRefPubMed
28.
go back to reference Bass SB, Gordon TF, Ruzek SB, Wolak C, Ruggieri D, Mora G, Rovito MJ Britto J, Parameswaran L, Abedin Z, Ward S, Paranjape A, Lin K, Meyer B, Pitts K. Developing a computer touch-screen interactive colorectal screening decision aid for a Low-Literacy African American Population: lessons learned. Health Promot Pract. 2013;14:589–98.CrossRefPubMed Bass SB, Gordon TF, Ruzek SB, Wolak C, Ruggieri D, Mora G, Rovito MJ Britto J, Parameswaran L, Abedin Z, Ward S, Paranjape A, Lin K, Meyer B, Pitts K. Developing a computer touch-screen interactive colorectal screening decision aid for a Low-Literacy African American Population: lessons learned. Health Promot Pract. 2013;14:589–98.CrossRefPubMed
29.
go back to reference Ruggieri DG, Bass SB, Rovito MJ, Ward S, Gordon TF, Paranjape A, Lin K, Meyer B, Parameswaran L, WOlak C, Britto J, Ruzek SB. Perceived colonoscopy barriers and facilitators among Urban African American Patients and their medical residents. J Health Commun. 2013;18:372–90. doi:10.1080/10810730.2012.727961.CrossRefPubMed Ruggieri DG, Bass SB, Rovito MJ, Ward S, Gordon TF, Paranjape A, Lin K, Meyer B, Parameswaran L, WOlak C, Britto J, Ruzek SB. Perceived colonoscopy barriers and facilitators among Urban African American Patients and their medical residents. J Health Commun. 2013;18:372–90. doi:10.​1080/​10810730.​2012.​727961.CrossRefPubMed
30.
go back to reference Bass SB, Wolak C, Greener J, Tedaldi E, Nanavati A, Ruppert K, et al. Using perceptual mapping methods to understand gender differences in perceived barriers and benefits of clinical research participation in urban minority HIV+ patients. AIDS Care. 2016;28L:528–36.CrossRef Bass SB, Wolak C, Greener J, Tedaldi E, Nanavati A, Ruppert K, et al. Using perceptual mapping methods to understand gender differences in perceived barriers and benefits of clinical research participation in urban minority HIV+ patients. AIDS Care. 2016;28L:528–36.CrossRef
31.
go back to reference Shiffman SS, Reynolds ML, Young FW. Introduction to multidimensional scaling: Theory, methods, and applications. New York: Academic; 1981. Shiffman SS, Reynolds ML, Young FW. Introduction to multidimensional scaling: Theory, methods, and applications. New York: Academic; 1981.
32.
go back to reference Sjodahl Hammarlund C, Nilsson M, Idvall M, Rosas S, Hagell P. Conceptualizing and prioritizing clinical trial outcomes from the perspectives of people with Parkinson’s disease versus health care professionals: a concept mapping study. Qual Life Res. 2014;23:1687. doi:10.1007/s11136-013-0614-3.CrossRefPubMed Sjodahl Hammarlund C, Nilsson M, Idvall M, Rosas S, Hagell P. Conceptualizing and prioritizing clinical trial outcomes from the perspectives of people with Parkinson’s disease versus health care professionals: a concept mapping study. Qual Life Res. 2014;23:1687. doi:10.​1007/​s11136-013-0614-3.CrossRefPubMed
33.
go back to reference Houston E, McKirnan D, Cervone D, Johnson M, Sandfort T. Assessing treatment motivation among patients receiving antiretroviral therapy: A multidimensional approach. Psych Health. 2012;27:674–87. Houston E, McKirnan D, Cervone D, Johnson M, Sandfort T. Assessing treatment motivation among patients receiving antiretroviral therapy: A multidimensional approach. Psych Health. 2012;27:674–87.
34.
go back to reference Robinson J, Trochim W. An examination of community members’, researchers’ and health professionals’ perceptions of barriers to minority participation in medical research: an application of concept mapping. Ethnic Health. 2007;12:521–39.CrossRef Robinson J, Trochim W. An examination of community members’, researchers’ and health professionals’ perceptions of barriers to minority participation in medical research: an application of concept mapping. Ethnic Health. 2007;12:521–39.CrossRef
35.
go back to reference Rush C, Wheeler J. Ascertaining disabling perceptions using perceptual mapping: applications to teachers’ perceptions of adolescents with attention-deficit/hyperactivity disorder. Disability Soc. 2011;26:743–56.CrossRef Rush C, Wheeler J. Ascertaining disabling perceptions using perceptual mapping: applications to teachers’ perceptions of adolescents with attention-deficit/hyperactivity disorder. Disability Soc. 2011;26:743–56.CrossRef
36.
go back to reference Whaley A, Longoria R. Assessing cultural competence readiness in community mental health centers: A multidimensional scaling analysis. Psych Servs. 2008;5:169–83.CrossRef Whaley A, Longoria R. Assessing cultural competence readiness in community mental health centers: A multidimensional scaling analysis. Psych Servs. 2008;5:169–83.CrossRef
37.
go back to reference Quartana PJ, Wilk JE, Thomas JL, Bray RM, Rae Olmsted KL, Brown JM, Williams J, Kim PY, Clarke-Walper K, Hoge CW. Trends in mental health services utilization and stigma in US soldiers from 2002 to 2011. AJPH. 2014;104:1671–79.CrossRef Quartana PJ, Wilk JE, Thomas JL, Bray RM, Rae Olmsted KL, Brown JM, Williams J, Kim PY, Clarke-Walper K, Hoge CW. Trends in mental health services utilization and stigma in US soldiers from 2002 to 2011. AJPH. 2014;104:1671–79.CrossRef
38.
go back to reference Kehle SM, Polusny MA, Murdoch M, Erbes CR, Arbisi PA, Thuras P, Meis LA. Early mental health treatment-seeking among US National Guard soldiers deployed to Iraq. J Trauma Stress. 2010;23:33–40.PubMed Kehle SM, Polusny MA, Murdoch M, Erbes CR, Arbisi PA, Thuras P, Meis LA. Early mental health treatment-seeking among US National Guard soldiers deployed to Iraq. J Trauma Stress. 2010;23:33–40.PubMed
39.
go back to reference Sharp M, Fear NT, Rona RJ, Wessely S, Greenberg N, Jones N, Goodwin L. Stigma as a barrier to seeking health care among military personnel with mental health problems. Epidemiol Rev. 2015;37:144–62. doi:10.1093/epirev/mxu012.CrossRefPubMed Sharp M, Fear NT, Rona RJ, Wessely S, Greenberg N, Jones N, Goodwin L. Stigma as a barrier to seeking health care among military personnel with mental health problems. Epidemiol Rev. 2015;37:144–62. doi:10.​1093/​epirev/​mxu012.CrossRefPubMed
40.
go back to reference Hammond W, Matthews D, Mohottige D, Agyemang A, Corbie-Smith G. Masculinity, medical mistrust, and preventive health services delays among community-dwelling African-American men. JGIM. 2010;25:1300–8.CrossRefPubMedPubMedCentral Hammond W, Matthews D, Mohottige D, Agyemang A, Corbie-Smith G. Masculinity, medical mistrust, and preventive health services delays among community-dwelling African-American men. JGIM. 2010;25:1300–8.CrossRefPubMedPubMedCentral
41.
go back to reference Viera A, Thorpe J, Garrett J. Effects of sex, age, and visits on receipt of preventive healthcare services: a secondary analysis of national data. BMC Health Serv Res. 2006;6:15.CrossRefPubMedPubMedCentral Viera A, Thorpe J, Garrett J. Effects of sex, age, and visits on receipt of preventive healthcare services: a secondary analysis of national data. BMC Health Serv Res. 2006;6:15.CrossRefPubMedPubMedCentral
42.
go back to reference Jacobs EA, Rolle I, Ferrans CE, Whitaker EE, Warnecke RB. Understanding African Americans’ views of the trustworthiness of physicians. J Gen Intern Med. 2006;21:642–7.CrossRefPubMedPubMedCentral Jacobs EA, Rolle I, Ferrans CE, Whitaker EE, Warnecke RB. Understanding African Americans’ views of the trustworthiness of physicians. J Gen Intern Med. 2006;21:642–7.CrossRefPubMedPubMedCentral
45.
go back to reference Edefonti V, Bravi F, Garavello W, La Vecchia C, Parpinel M, Franseschi S, Dal Maso L, Bosetti C, Boffetta P, Ferraroni M, Decarli A.. Nutrient-based dietary patterns and laryngeal cancer: Evidence from an exploratory factor analysis. Cancer Epidemiol Biomarkers Prev. 2010;19:18–27.CrossRefPubMed Edefonti V, Bravi F, Garavello W, La Vecchia C, Parpinel M, Franseschi S, Dal Maso L, Bosetti C, Boffetta P, Ferraroni M, Decarli A.. Nutrient-based dietary patterns and laryngeal cancer: Evidence from an exploratory factor analysis. Cancer Epidemiol Biomarkers Prev. 2010;19:18–27.CrossRefPubMed
46.
47.
go back to reference Lantz PM, Golderstein E, House JS, Moreoff J. Socioeconomic and behavioral risk factors for mortality in national 19-year prospective study of US adults. Soc Sci Med. 2010;70:1558–66.CrossRefPubMedPubMedCentral Lantz PM, Golderstein E, House JS, Moreoff J. Socioeconomic and behavioral risk factors for mortality in national 19-year prospective study of US adults. Soc Sci Med. 2010;70:1558–66.CrossRefPubMedPubMedCentral
48.
go back to reference Springer K, Mouzon D. “Macho men” and preventive health care: Implications for older men in different social classes. J Hlth Soc Behav. 2011;52:212–27.CrossRef Springer K, Mouzon D. “Macho men” and preventive health care: Implications for older men in different social classes. J Hlth Soc Behav. 2011;52:212–27.CrossRef
Metadata
Title
Understanding help-seeking intentions in male military cadets: An application of perceptual mapping
Authors
Sarah Bauerle Bass
Javier Muñiz
Thomas F. Gordon
Laurie Maurer
Freda Patterson
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2016
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-016-3092-z

Other articles of this Issue 1/2016

BMC Public Health 1/2016 Go to the issue