Personality correlates of outpatient mental health service utilization

Findings from the U.S. national comorbidity survey
  • Lachlan A. McWilliams
  • Brian J. Cox
  • Murray W. Enns
  • Ian P. Clara



The present paper investigated the relationships between several personality constructs and the use of outpatient mental health services.


Respondents were from the National Comorbidity Survey (NCS) Part II data set and included those with a past-year mood, anxiety, alcohol/substance use disorder (n=1750). Bivariate logistic regressions were used to examine associations between participants’ self-reports of personality traits and outpatient mental health service utilization. Similar multivariate analyses were used to investigate these associations after adjusting for sociodemographic variables and the presence of psychiatric disorders and their comorbidity.


The bivariate and multivariate analyses revealed significant positive associations between outpatient mental health service utilization and both Powerful Others Locus of Control and Self-criticism.


These findings suggest that personality traits may play a role in treatment seeking behaviors for mental health problems over and above the presence of psychiatric disorders alone. The assessment of relevant personality constructs has the potential to inform and improve treatment outreach efforts.

Key words

epidemiology outpatient psychiatry  


  1. 1.
    Bland RC, Newman SC, Orn H (1997) Help-seeking for psychiatric disorders. Can J Psychiatry 42:935–941PubMedGoogle Scholar
  2. 2.
    Greenley JR, Mechanic D (1976) Social selection in seeking help for psychological problems. J Health Soc Behav 17:249–262PubMedGoogle Scholar
  3. 3.
    Kessler RC, Zhao S, Katz SJ, Kouzis A, Frank RG, Edlund M, Leaf P (1999) Past-year use of outpatient services for psychiatric problems in the National Comorbidity Survey. Am J Psychiatry 156:115–123PubMedGoogle Scholar
  4. 4.
    Greenley JR, Mullen JA (1990) Help seeking and the use of mental health services. Res Community Ment Health 6:325–350Google Scholar
  5. 5.
    Pescosolido BA, Boyer CA (1999) How do people come to use mental health services? Current knowledge and changing perspectives. In: Horwitz AV, Scheid TL (eds) A handbook for the study of mental health: social contexts, theories, and systems, Cambridge University Press, Cambridge, pp 392–411Google Scholar
  6. 6.
    Krueger RF, Caspi A, Moffitt TE: Epidemiological personology (2000) The unifying role of personality in population-based research on problem behaviors. J Pers 68:967–998CrossRefGoogle Scholar
  7. 7.
    Goodwin RD, Hoven CW, Lyons JS, Stein MB (2002) Mental health service utilization in the United States: the role of personality factors. Soc Psychiatry Psychiatr Epidemiol 37:561–566CrossRefPubMedGoogle Scholar
  8. 8.
    Kessler RC, McGonagle KA, Zhao S, Nelson CB, Hughes M, Eshleman S, Wittchen HU, Kendler KS (1994) Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States: Results from the National Comorbidity Survey. Arch Gen Psychiatry 51:8–19PubMedGoogle Scholar
  9. 9.
    Rotter J (1966) Generalized expectancies for internal versus external control of reinforcement. Psychol Monogr 80:1–28PubMedGoogle Scholar
  10. 10.
    Strickland BR (1978) Internal–external expectancies and health-related behaviors. J Consult Clin Psychol 46:1192–1211CrossRefPubMedGoogle Scholar
  11. 11.
    Norris FH, Kaniasty KZ, Scheer DA (1990) Use of mental health services among victims of crime: frequency, correlates, and subsequent recovery. J Consult Clin Psychol 58:538–547CrossRefPubMedGoogle Scholar
  12. 12.
    Schonert-Reichl KA, Offer D, Howard KI (1995) Seeking help from informal and formal resources during adolescence: sociodemographic and psychological correlates. In: Marohn RC, Feinstein SC (eds) Adolescent psychiatry, vol. 20. Analytic Press, Hillsdale, NJ, pp 165–178Google Scholar
  13. 13.
    Gianakos I (2002) Predictors of coping with work stress: the influence of sex, gender role, social desirability, and locus of control. Sex Roles 46:149–158CrossRefGoogle Scholar
  14. 14.
    Levenson H (1973) Multidimensional locus of control in psychiatric patients. J Consult Clin Psychol 41:397–404PubMedGoogle Scholar
  15. 15.
    Wallston KA, Wallston BS, Smith S, Dobbins CJ (1989) Perceived control and health. In: Johnston M, Marteau T (eds) Applications in health psychology, Transaction Publishers, New Brunswick, NJ, pp 5–25Google Scholar
  16. 16.
    Steptoe A, Wardle J (2001) Locus of control and health behaviour revisited: A multivariate analysis of young adults from 18 countries. Br J Psychol 92:659–672CrossRefPubMedGoogle Scholar
  17. 17.
    Enns MW, Cox BJ (1997) Personality dimensions and depression: review and commentary. Can J Psychiatry 42:274–284PubMedGoogle Scholar
  18. 18.
    Schonert-Reichl KA, Muller JR (1996) Correlates of help-seeking in adolescence. J Youth Adolesc 25:705–731CrossRefGoogle Scholar
  19. 19.
    Kessler RC, Olfson M, Berglund PA (1998) Patterns and predictors of treatment contact after first onset of psychiatric disorders. Am J Psychiatry 155:62–69PubMedGoogle Scholar
  20. 20.
    Kessler RC, Sonnega A, Bromet E, Hughes M, Nelson CB (1999) Posttraumatic stress disorder in the National Comorbidity Survey. Arch Gen Psychiatry 52:1048–1060Google Scholar
  21. 21.
    Mojtabai R, Olfson M, Mechanic D (2002) Perceived need and help-seeking in adults with mood, anxiety, or substance use disorders. Arch Gen Psychiatry 59:77–84CrossRefPubMedGoogle Scholar
  22. 22.
    World Health Organization (1990) Composite International Diagnostic Interview World Health Organization, Geneva, SwitzerlandGoogle Scholar
  23. 23.
    Wittchen HU (1994) Reliability and validity studies of the WHO Composite International Diagnostic Interview (CIDI): a critical review. J Psychiatr Res. 28:57–84CrossRefPubMedGoogle Scholar
  24. 24.
    Bromet E, Sonnega A, Kessler RC (1998) Risk factors for DSM-III-R posttraumatic stress disorder: findings from the National Comorbidity Survey. Am J Epidemiol 147:353–361PubMedGoogle Scholar
  25. 25.
    Horn JL (1965) A rationale and test for the number of factors in factor analysis. Psychometrika 30:179–185CrossRefPubMedGoogle Scholar
  26. 26.
    James SA, Hartnett SA, Kalsbeek WD (1983) John Henryism and blood pressure differences among black men. J Behav Med 6:259–278CrossRefPubMedGoogle Scholar
  27. 27.
    Blatt SJ, D’Afflitti JP, Quinlan DM (1976) Depressive experiences questionnaire. Yale University Press, New Haven, CTGoogle Scholar
  28. 28.
    Rosenberg M (1965) Society and the adolescent self-image. Princeton Univesity Press, Princeton, NJGoogle Scholar
  29. 29.
    Research Triangle Institute (2000) Software for the statistical analysis of correlated data (SUDDAN), Release 7.5. Research Triangle Institute, Research Triangle Park, NCGoogle Scholar
  30. 30.
    Goldberg D, Huxley P (1980) Mental illness in the community. The pathway to psychiatric care. Tavistock Publications, LondonGoogle Scholar
  31. 31.
    Tessler RC, Schwartz SH (1972) Helpseeking, self-esteem, and achievement motivation: An attributional analysis. J Pers Soc Psychol 21:318–326PubMedGoogle Scholar
  32. 32.
    Zuroff DC, Blatt SJ, Sanislow CA, Bondi CM, Pilkonis PA (1999) Vulnerability to depression: reexamining state dependence and relative stability. J Abnorm Psychol 108:76–89CrossRefPubMedGoogle Scholar

Copyright information

© Steinkopff Verlag Darmstadt 2006

Authors and Affiliations

  • Lachlan A. McWilliams
    • 1
  • Brian J. Cox
    • 1
  • Murray W. Enns
    • 1
  • Ian P. Clara
    • 1
  1. 1.Department of PsychologyAcadia UniversityWolfvilleCanada

Personalised recommendations