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      Investigating institutional abuse survivors’ help-seeking attitudes with the Inventory of Attitudes towards Seeking Mental Health Services Translated title: 标题:使用精神健康服务求助态度清单考察机构内虐待的幸存者的求助态度 Translated title: Investigación de las actitudes de búsqueda de ayuda de los sobrevivientes de abuso institucional con el Inventario de actitudes respecto a la búsqueda de servicios de salud mental

      research-article
      , ,
      European Journal of Psychotraumatology
      Taylor & Francis
      Trauma survivors, institutional abuse, attitudes, PTSD, mental health service use, sobrevivientes de trauma, abuso institucional, actitudes, 24 TEPT, uso de servicios de salud mental, 创伤幸存者, 机构内虐待, 态度, 24 PTSD, 精神健康服务使用, • The three-factor structure of IASMHS was supported by a confirmatory factor analysis.• Institutional abuse survivors’ current mental health service use was predicted by the help-seeking propensity scale of IASMHS, higher levels of PTSD intrusion, and lower levels of depression.• Early post-trauma interventions should target trauma survivors’ help-seeking propensity to facilitate mental health service use.

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          ABSTRACT

          Background: Although effective treatments exist, many trauma survivors delay or avoid professional help. Attitudes towards help-seeking are associated with intentions to and actual treatment use, but were neglected in research on trauma survivors so far.

          Objective: This study aimed to investigate the reliability, construct validity, and predictive power of the Inventory of Attitudes towards Seeking Mental Health Services (IASMHS) and to investigate attitudes of adult institutional abuse survivors.

          Method: A total of 220 adult survivors of institutional abuse were interviewed using IASMHS, the PTSD Checklist for DSM-5 (PCL-5), the Childhood Trauma Questionnaire Short-Form (CTQ-SF), the Life Events Checklist (LEC-5), and the depression-subscale of the Brief Symptom Inventory (BSI-18). They were further asked about their current mental health service use. We assessed the fit of different models of IASMHS with confirmatory factor analyses and predicted current mental health service use with a binominal logistic regression model.

          Results: The three-factor structure of IASMHS provided the best fit. One of the three scales (help-seeking propensity), the PTSD-intrusion scale, and the depression scale significantly contributed to the prediction of current mental health service use. Single items of the psychological openness scale loaded weakly on the according factor. Our sample showed a similar IASMHS profile compared to other samples with mental health problems.

          Conclusion: Overall, IASMHS appears to be a useful instrument to assess attitudes towards seeking mental health services in trauma survivors. It can be used to investigate help-seeking attitudes and its correlates to better understand and facilitate survivors’ treatment use.

           

          Planteamiento: Aunque existen tratamientos eficaces, muchos sobrevivientes de trauma retrasan o evitan ayuda profesional. Las actitudes respecto a buscar ayuda están asociadas con las intenciones y el uso real del tratamiento, pero, hasta el momento, se han descuidado en la investigación con muestras de trauma.

          Objetivo: El presente estudio tuvo como objetivo investigar la fiabilidad, la validez de constructo y el poder predictivo del Inventario de actitudes respecto a búsqueda de servicios de salud mental (IASMHS, siglas de Inventory of Attitudes towards Seeking Mental Health Services) e investigar las actitudes de los adultos que han sobrevivido al abuso institucional.

          Método: Un total de 220 adultos sobrevivientes de abuso institucional fueron entrevistados usando el IASMHS, la Lista de Verificación del TEPT para el DSM-5 (PCL-5, siglas de PTSD Checklist for DSM-5), la versión corta del Cuestionario sobre trauma infantil (CTQ-SF, siglas de Childhood Trauma Questionnaire Short-Form), la Lista de verificación de acontecimientos vitales (LEC-5; siglas de Life Events Checklist) y la sub-escala de depresión del Inventario breve de síntomas (BSI-18, siglas de Brief Symptom Inventory). También se les preguntó por su uso actual de servicios de salud mental. Se evaluó cómo encajaban los diferentes modelos del IASMHS con análisis de factores de confirmación y se predijo el uso actual de servicios de salud mental con un modelo de regresión logística binominal.

          Resultados: La estructura de tres factores del IASMHS fue la que mejor encajó. Una de las tres escalas (propensión a la búsqueda de ayuda), la escala de intrusión del TEPT y la escala de depresión contribuyeron significativamente a la predicción del uso actual de servicios de salud mental. Los elementos individuales de la escala de apertura psicológica se cargaron débilmente en el factor correspondiente. Nuestra muestra mostró un perfil similar del IASMHS en comparación con otras muestras con problemas de salud mental.

          Conclusión: En general, el IASMHS parece ser un instrumento útil para evaluar las actitudes respecto a la búsqueda de servicios de salud mental en los sobrevivientes de trauma. Puede utilizarse para investigar las actitudes de búsqueda de ayuda y sus correlatos para comprender mejor y facilitar el uso del tratamiento a los supervivientes.

           

          背景:尽管有效的治疗存在,许多创伤幸存者延迟或者回避专业帮助。求助态度和对治疗的使用意图以及实际使用有关,但在创伤样本的研究中至今被忽视。

          目标:本研究旨在考察使用精神健康服务的求助态度清单(IASMHS)的信效度和预测能力,以及机构内虐待的成年幸存者的求助态度。

          方法:使用IASMHS、DSM-5 PTSD检查表(PCL-5)、短版童年创伤问卷(CTQ-SF)、生活事件检查表(LEC-5)和简明症状清单(BSI-18)的抑郁分量表对总共220名机构内虐待的成年幸存者进行访谈。更一步询问了他们目前的精神健康服务的使用。我们使用验证性因素分析评估了IASMHS的不同模型,并使用二项式Logistic回归分析考察其对目前精神健康服务使用的预测能力。

          结果:IASMHS的三因子结构拟合最佳。其中的求助倾向量表(help-seeking propensity)、PTSD的闯入量表和抑郁量表对预测目前精神健康服务使用情况有显著贡献。心理开放(psychological openness)题目在相应的因子上载荷较低。我们的样本和其它具有精神健康问题的样本一样,显示相似的IASMHS剖面结构。

          结论:总体上,IASMHS是评估创伤幸存者使用精神健康服务求助态度的有用工具。它可以用来考察求助态度,有助于更好理解和促进幸存者的治疗使用行为。

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          Most cited references48

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          Psychometric analysis of the PTSD Checklist-5 (PCL-5) among treatment-seeking military service members.

          The Posttraumatic Stress Disorder Checklist (PCL-5; Weathers et al., 2013) was recently revised to reflect the changed diagnostic criteria for posttraumatic stress disorder (PTSD) in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association, 2013). We investigated the psychometric properties of PCL-5 scores in a large cohort (N = 912) of military service members seeking PTSD treatment while stationed in garrison. We examined the internal consistency, convergent and discriminant validity, and DSM-5 factor structure of PCL-5 scores, their sensitivity to clinical change relative to PTSD Symptom Scale-Interview (PSS-I; Foa, Riggs, Dancu, & Rothbaum, 1993) scores, and their diagnostic utility for predicting a PTSD diagnosis based on various measures and scoring rules. PCL-5 scores exhibited high internal consistency. There was strong agreement between the order of hypothesized and observed correlations among PCL-5 and criterion measure scores. The best-fitting structural model was a 7-factor hybrid model (Armour et al., 2015), which demonstrated closer fit than all other models evaluated, including the DSM-5 model. The PCL-5's sensitivity to clinical change, pre- to posttreatment, was comparable with that of the PSS-I. Optimally efficient cut scores for predicting PTSD diagnosis were consistent with prior research with service members (Hoge, Riviere, Wilk, Herrell, & Weathers, 2014). The results indicate that the PCL-5 is a psychometrically sound measure of DSM-5 PTSD symptoms that is useful for identifying provisional PTSD diagnostic status, quantifying PTSD symptom severity, and detecting clinical change over time in PTSD symptoms among service members seeking treatment. (PsycINFO Database Record
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            Age, gender, and the underutilization of mental health services: the influence of help-seeking attitudes.

            The objectives of this study were to explore age and gender differences in attitudes toward seeking professional psychological help, and to examine whether attitudes negatively influence intentions to seek help among older adults and men, whose mental health needs are underserved. To achieve these objectives 206 community-dwelling adults completed questionnaires measuring help-seeking attitudes, psychiatric symptomatology, prior help-seeking, and intentions to seek help. Older age and female gender were associated with more positive help-seeking attitudes in this sample, although age and gender interacted with marital status and education, and had varying influences on different attitude components. Age and gender also influenced intentions to seek professional psychological help. Women exhibited more favourable intentions to seek help from mental health professionals than men, likely due to their positive attitudes concerning psychological openness. Older adults exhibited more favourable intentions to seek help from primary care physicians than younger adults, a finding that was not explained by age differences in attitudes. Results from this study suggest that negative attitudes related to psychological openness might contribute to men's underutilization of mental health services. Help-seeking attitudes do not appear to be a barrier to seeking professional help among older adults, although their intentions to visit primary care physicians might be. These findings suggest the need for education to improve men's help-seeking attitudes and to enhance older adults' willingness to seek specialty mental health services.
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              [The German version of the Childhood Trauma Questionnaire (CTQ): preliminary psychometric properties].

              Given the relevance of child maltreatment for the development and treatment of many mental disorders, the objective of our study was the psychometric evaluation of the German version of the Childhood Trauma Questionnaire (CTQ). In a sample of psychiatric patients (N=1 524) the established factor structure (i.e. sexual, physical and emotional abuse as well as physical and emotional neglect) was replicated by means of confirmatory factor analysis. The internal consistency of all scales (apart from physical neglect) was high (Cronbachs α ≥ 0.89). Correlations between the CTQ and self-report measures for posttraumatic stress, dissociation and general psychopathology were low to moderate. The psychometric properties of the German version of the CTQ were similar to the American original; it proved to be a reliable and valid screen for the retrospective assessment of child maltreatment. © Georg Thieme Verlag KG Stuttgart · New York.
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                Author and article information

                Journal
                Eur J Psychotraumatol
                Eur J Psychotraumatol
                ZEPT
                zept20
                European Journal of Psychotraumatology
                Taylor & Francis
                2000-8066
                2017
                12 October 2017
                : 8
                : 1
                : 1377528
                Affiliations
                [ a ] Faculty of Psychology, University of Vienna , Vienna, Austria
                Author notes
                CONTACT Viktoria Kantor viktoria.kantor@ 123456univie.ac.at Faculty of Psychology, University of Vienna , Liebiggasse 5, Vienna 1010, Austria
                Author information
                http://orcid.org/0000-0003-1485-8123
                http://orcid.org/0000-0003-0632-0673
                Article
                1377528
                10.1080/20008198.2017.1377528
                5687789
                29163858
                bb5c0e23-f948-4fa6-80fc-a386319de970
                © 2017 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 08 March 2017
                : 10 July 2017
                Page count
                Tables: 5, References: 67, Pages: 11
                Funding
                Funded by: Austrian Science Fund 10.13039/501100002428
                Award ID: P26584
                This project was supported by the Austrian Science Fund (FWF): P26584.
                Categories
                Research Article
                Clinical Research Article

                Clinical Psychology & Psychiatry
                trauma survivors,institutional abuse,attitudes,ptsd,mental health service use,sobrevivientes de trauma,abuso institucional,actitudes,24 tept,uso de servicios de salud mental,创伤幸存者,机构内虐待,态度,24 ptsd,精神健康服务使用,• the three-factor structure of iasmhs was supported by a confirmatory factor analysis.• institutional abuse survivors’ current mental health service use was predicted by the help-seeking propensity scale of iasmhs, higher levels of ptsd intrusion, and lower levels of depression.• early post-trauma interventions should target trauma survivors’ help-seeking propensity to facilitate mental health service use.

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