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Depressive Symptoms and Help-Negation among Chinese University Students in Taiwan: The Role of Gender, Anxiety and Help-seeking Attitudes

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Abstract

This study extended the consideration of help-negation in regard to suicide to that of depressive symptoms in a large sample of 981 Chinese university students in Taiwan. The study examined the help-negation effects of depression and the impact of gender, anxiety, and help-seeking attitudes on that relationship. Chinese students, aged 17 to 27 years, completed a self-report survey that included measures of help-seeking behavior, depression, anxiety, and help-seeking attitudes. Results revealed higher levels of depressive symptoms were related to decreased likelihood of seeking help from friends and parents, indicating a possible help-negation effect of depression. In regard to the impact of gender, anxiety, and help-seeking attitudes, results showed that help-seeking attitudes were consistently positively correlated with seeking help from friends, parents, and professional helpers. Gender significantly moderated the relationship between depression and professional help-seeking. Implications for intervention are discussed within the Chinese cultural context.

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References

  • Adlaf, E. M., Gliksman, L., Demers, A., & Newton-Taylor, B. (2001). The prevalence of elevated psychological distress among Canadian undergraduates: findings from the 1998 Canadian campus survey. Journal of American College Health, 50, 67–72.

    Article  PubMed  Google Scholar 

  • Beck, A. T., Epstein, N., Brown, G., & Steer, R. A. (1988). An inventory for measuring clinical anxiety: psychometric properties. Journal of Consulting and Clinical Psychology, 56, 893–897.

    Article  PubMed  Google Scholar 

  • Beck, A. T., & Steer, R. A. (1990). Manual for the Beck Anxiety Inventory. San Antonio: The Psychological Corporation (Chinese version).

    Google Scholar 

  • Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Manual for the Beck Depression Inventory-II. San Antonio: Psychological Corporation (Chinese version).

    Google Scholar 

  • Beuke, C. J., Fischer, R., & McDowall, J. (2003). Anxiety and depression: why and how to measure their separate effects? Clinical Psychology Review, 23, 831–848.

    Article  PubMed  Google Scholar 

  • Belfer, M. L. (2008). Child and adolescent mental disorders: the magnitude of the problem across the globe. Journal of Child Psychology and Psychiatry, 49(3), 226–236.

    Article  PubMed  Google Scholar 

  • Boey, K. W. (1999). Help-seeking preference of college students in urban China after the implementation of the “open-door” policy. International Journal of Social Psychiatry, 45, 104–116.

    Article  PubMed  Google Scholar 

  • Boldero, J., & Fallon, B. (1995). Adolescent help-seeking: what do they help for and from whom? Journal of Adolescence, 18, 193–209.

    Article  Google Scholar 

  • Carlton, P. A., & Deane, F. P. (2000). Impact of attitudes and suicidal ideation on adolescents’ intentions to seek professional psychological help. Journal of Adolescence, 23, 35–45.

    Article  PubMed  Google Scholar 

  • Chang, H. (2005). Dimensions of the Chinese Beck Depression Inventory-II in a university sample. Individual Differences Research, 3, 193–199.

    Google Scholar 

  • Chang, H. (2008). Help-seeking for stressful events among Chinese college students in Taiwan: roles of gender, prior history of counseling, and help-seeking attitudes. Journal of College Student Development, 49(1), 41–51.

    Article  Google Scholar 

  • Chen, T., Bi, Y., Mao, Z., Rappe, P., & Edwards, G. D. (2002). Identifying factors influencing mental health development of college students in China. Social Behavior and Personality, 30, 547–560.

    Article  Google Scholar 

  • Chiu, M. Y. L. (2004). Why Chinese women do not seek help: a cultural perspective on the psychology of women. Counselling Psychology Quarterly, 17, 155–166.

    Article  Google Scholar 

  • Clark, D., & Fawcett, B. (1992). Review of empirical risk factors for evaluation of the suicidal patient. In B. Bongar (Ed.), Suicide: Guidelines for assessment, management, and treatment (pp. 16–48). New York: Oxford University Press.

    Google Scholar 

  • Cohen, J., Cohen, P., West, S. G., & Aiken, L. S. (2003). Applied multiple regression/correlation analysis for the behavioral sciences (3rd ed.). Mahwah: Lawrence Erlbaum.

    Google Scholar 

  • Cramer, K. M. (1999). Psychological antecedents to help-seeking behavior: a reanalysis using path modeling structures. Journal of Counseling Psychology, 46, 381–387.

    Article  Google Scholar 

  • Deane, F. P., & Chamberlain, K. (1994). Treatment fearfulness and distress as predictors of professional psychological help-seeking. British Journal of Guidance & Counseling, 22, 207–217.

    Article  Google Scholar 

  • Fischer, E. H., & Farina, A. (1995). Attitudes toward seeking professional psychological help: a shortened form and considerations for research. Journal of College Student Development, 36, 368–373.

    Google Scholar 

  • Furr, S. R., Westefeld, J. S., McConnell, G. N., & Jenkins, J. M. (2001). Suicide and depression among college students: a decade later. Professional Psychology: Research and Practice, 32, 97–100.

    Article  Google Scholar 

  • Gonzalez, J. M., Tinsley, H. E. A., & Kreuder, K. R. (2002). Effects of psycho educational interventions on opinions of mental illness, attitudes toward help seeking, and expectations about psychotherapy in college students. Journal of College Student Development, 43, 51–63.

    Google Scholar 

  • Gulliver, A., Griffiths, K. M., & Christensen, H. (2010). Perceived barriers and facilitators to mental health help-seeking in young people: a systematic review. BMC Psychiatry, 10, 113.

    Article  PubMed Central  PubMed  Google Scholar 

  • Hatchett, G. T. (2006). Additional validation of the attitudes toward seeking professional psychological help scale. Psychological Reports, 98, 279–284.

    Article  PubMed  Google Scholar 

  • Huang, C. Y., & Guo, S. E. (2009). Stress, perceived support, resourcefulness and depressive symptoms in Taiwanese adolescents. Journal of Clinical Nursing, 18, 3271–3279.

    Article  PubMed  Google Scholar 

  • Jiang, G., & Wang, M. (2003). A study on help-seeking propensity of Chinese undergraduates. Chinese Journal of Clinical Psychology, 11, 180–184 (In Chinese).

    Google Scholar 

  • Kessler, R. C., Berglund, P., Demler, O., Jin, R., & Walters, E. E. (2005). Lifetime prevalence and age-of-onset distribution for DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62, 593–602.

    Article  PubMed  Google Scholar 

  • Kung, W. W. (2003). Chinese Americans’ help seeking for emotional distress. The Social Service Review, 77, 110–134.

    Article  Google Scholar 

  • Lee, S., Tsang, A., & Kwok, K. (2006). Twelve-month prevalence, correlates, and treatment preference of adults with DSM-IV major depressive episode in Hong Kong. Journal of Affective Disorders. doi:10.1016/j.jad.2006.07.009.

    Google Scholar 

  • Leaf, P. J., Bruce, M. L., & Tischler, G. L. (1986). The differential effect of attitudes on the use of mental health services. Social Psychiatry, 21, 187–192.

    Article  PubMed  Google Scholar 

  • Leong, F. T. L., & Lau, A. S. L. (2001). Barriers to providing effective mental health services to Asian Americans. Mental Health Service Research, 3(4), 201–214.

    Article  Google Scholar 

  • Leong, F. T. L., & Zachar, P. (1999). Gender and opinions about mental illness as predictors of attitudes toward seeking professional psychological help. British Journal of Guidance & Counseling, 27, 123–132.

    Article  Google Scholar 

  • Leung, P., Cheung, M., & Tsai, V. (2012). Help-seeking behaviors among Chinese Americans with depressive symptoms. Social Work, 57, 61–71.

    Article  PubMed  Google Scholar 

  • Mo, P. K. H., & Mak, W. W. S. (2009). Help-seeking for mental health problems among Chinese. Social Psychiatry and Psychiatric Epidemiology, 44, 675–684.

    Article  PubMed  Google Scholar 

  • Morgan, T., Ness, D., & Robinson, M. (2003). Students’ help-seeking behavior by gender, racial background, and student status. Canadian Journal of Counseling, 37, 151–166.

    Google Scholar 

  • Nam, S. K., Chu, H. J., Lee, M. K., Lee, J. H., Kim, N., & Lee, S. M. (2010). A meta-analysis of gender differences in attitudes toward seeking professional psychological help. Journal of American College Health, 59(2), 110–116.

    Article  PubMed  Google Scholar 

  • Oliver, J. M., Reed, C. K. S., Katz, B. M., & Haugh, J. A. (1999). Students’ self-reports of help-seeking: the impact of psychological problems, stress, and demographic variables on utilization of formal and informal support. Social Behavior and Personality, 27, 109–128.

    Article  Google Scholar 

  • Rickwood, D. J., & Braithwaite, V. A. (1994). Social-psychological factors affecting help-seeking for emotional problems. Social Science and Medicine, 39, 563–572.

    Article  PubMed  Google Scholar 

  • Rosenthal, B. S., & Schreiner, A. C. (2000). Prevalence of psychological symptoms among undergraduate students in an ethnically diverse urban public college. Journal of American College Health, 49, 12–19.

    Article  PubMed  Google Scholar 

  • Schonert-Reichl, K. A., & Muller, J. R. (1996). Correlates of help-seeking in adolescence. Journal of Youth and Adolescence, 25, 705–732.

    Article  Google Scholar 

  • Sen, B. (2004). Adolescent propensity for depressed mood and help seeking: race and gender differences. Journal of Mental Health Policy and Economics, 7, 133–145.

    PubMed  Google Scholar 

  • Shea, M., & Yeh, C. (2008). Asian American students’ cultural values, stigma, and relational self-construal: correlates of attitudes toward professional help seeking. Journal of Mental Health Counseling, 30, 157–172.

    Google Scholar 

  • Sue, S., & Morishima, J. K. (1982). The mental health of Asian Americans. San Francisco: Jossey-Bass.

    Google Scholar 

  • Thompson, A., Hunt, C., & Issakidis, C. (2004). Why wait? Reasons for delay and prompts to seek help from mental health problems in an Australian clinical sample. Social Psychiatry and Psychiatric Epidemiology, 39, 810–817.

    PubMed  Google Scholar 

  • Wilson, C. J. (2010). General psychological distress symptoms and help-seeking intentions in young Australians. Advances in Mental Health, 9, 63–72.

    Article  Google Scholar 

  • Wilson, C. J., Deane, F. P., & Ciarrochi, J. (2005). Can hopelessness and adolescents’ belief about seeking help account for help negation? Journal of Clinical Psychology, 61, 1525–1539.

    Article  PubMed  Google Scholar 

  • Wilson, C. J., & Deane, F. P. (2010). Help-negation and suicidal ideation: the role of depression, anxiety and hopelessness. Journal of Youth and Adolescence, 39, 291–305.

    Article  PubMed  Google Scholar 

  • Wilson, C., & Deane, F. (2011). Predicting adolescents’ future intentions to seek help for mental health problems. Youth Studies Australia, 30, 27–33.

    Google Scholar 

  • Wilson, C. J., Deane, F. P., Marshall, K. L., & Dalley, A. (2010). Adolescents’ suicidal thinking and reluctance to consult general medical practitioners. Journal of Youth and Adolescence, 39, 343–356.

    Article  PubMed  Google Scholar 

  • Wilson, C. J., Rickwood, D., & Deane, F. P. (2007). Depressive symptoms and help-seeking intentions in young people. Clinical Psychologist, 11, 98–107.

    Article  Google Scholar 

  • Yan, J. Y., Xiao, H. Q., Wang, L., Zheng, X. Q., Xiu, X. Y., & Hai, L. S. (2012). Associations among impulsivity, aggression, and sub threshold depression in Chinese university students. Social Behavior and Personality: An International Journal, 40, 239–249.

    Article  Google Scholar 

  • Zong, J.G., Cao, X.Y., Cao, Y., Shi, Y.F., Wang, Y.N., Yan, C., Abela, J.R.Z., Gan, Y.Q., Gong, Q.Y., & Chan, R.C.K. (2010). Coping flexibility in college students with depressive symptoms. Health and Quality of Life Outcomes: Open Access, 8:66. http://www.hqlo.com/content/8/1/66

    Google Scholar 

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Correspondence to Hsiaowen Chang.

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Chang, H. Depressive Symptoms and Help-Negation among Chinese University Students in Taiwan: The Role of Gender, Anxiety and Help-seeking Attitudes. Int J Adv Counselling 36, 204–218 (2014). https://doi.org/10.1007/s10447-013-9200-1

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