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Attitudes Toward Mental Health Services and Illness Perceptions Among Adolescents with Mood Disorders

Child and Adolescent Social Work Journal volume 26, pages 447–466 (2009)Cite this article

Abstract

The present study describes how adolescents perceive their mood disorders (MD; e.g., acute vs. chronic) and their attitudes toward mental health services. The study also explores the relationships between demographics, clinical characteristics, perceptions of illness and attitudes. Finally, we examine the psychometric properties of the Illness Perception Questionnaire-Revised (Moss-Morris et al. in Psychology & Health 17(1):1–16, 2002). Seventy adolescents were recruited from the greater Cleveland area. Structured interviews were conducted utilizing standardized instruments. Results show that adolescents with MD have fairly positive attitudes, with Caucasian youth reporting more positive attitudes than their non-white ounterparts. Illness perceptions were related to psychological openness and indifference to stigma. Implications are discussed.

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References

  • American Psychological Association. (2003). Guidelines on multicultural education, training, research, practice, and organizational change for psychologist. The American Psychologist, 58(5), 377–402. doi:10.1037/0003-066X.58.5.377.

    Article  Google Scholar 

  • Axelson, D., Birmaher, B., Strober, M., Gill, M. K., Valeri, S., Chiapetta, L., et al. (2006). Phenomenology of children and adolescents with bipolar spectrum disorders. Archives of General Psychiatry, 63(10), 1139–1148. doi:10.1001/archpsyc.63.10.1139.

    PubMed  Article  Google Scholar 

  • Ayalon, L., & Alvidrez, J. (2007). The experience of black consumers in the mental health system-identifying barriers and facilitators of mental health treatment using the consumers’ perspective. Issues in Mental Health Nursing, 28, 1323–1340. doi:10.1080/01612840701651454.

    PubMed  Article  Google Scholar 

  • Blank, M. B., Mahmood, M., Fox, J. C., & Guterbock, T. (2002). Alternative mental health services: The role of the Black church in the south. American Journal of Public Health, 92(10), 1668–1672. doi:10.2105/AJPH.92.10.1668.

    PubMed  Article  Google Scholar 

  • Brown, C., Battista, D. R., Sereika, S. M., Bruehlman, R. D., Dunbar-Jacob, J., & Thase, M. E. (2007). Primary care patients’ personal illness models for depression: Relationship to coping behavior and functional disability. General Hospital Psychiatry, 29(6), 492–500. doi:10.1016/j.genhosppsych.2007.07.007.

    PubMed  Article  Google Scholar 

  • Brown, R. T., Boeving, A., LaRosa, A., & Carpenter, L. A. (2006). Health and chronic illness. In D. A. Wolfe & E. J. Mash (Eds.), Behavioral and emotional disorders in adolescents (pp. 505–534). New York, NY: The Guilford Press.

    Google Scholar 

  • Brown, C., Dunbar-Jacob, J., Palenchar, D. R., Kelleher, K. J., Bruehlman, R. D., Sereika, S., et al. (2001). Primary care patients’ personal illness models for depression: A preliminary investigation. Family Practice, 18(3), 314–320. doi:10.1093/fampra/18.3.314.

    PubMed  Article  Google Scholar 

  • Burke, K. C., Burke, J. D., Regier, D. A., & Rae, D. S. (1990). Age at onset of selected mental disorders in five community populations. Archives of General Psychiatry, 47, 511–518.

    PubMed  Google Scholar 

  • Burns, B. J., Costello, E. J., Angold, A., Tweed, D., Stangl, D., Farmer, E. M. Z., et al. (1995). Children’s mental health service use across service sectors. Health Affairs, 14(3), 147–159. doi:10.1377/hlthaff.14.3.147.

    PubMed  Article  Google Scholar 

  • Cabassa, L. J., Lagomasino, I. T., Dwight-Johnson, M., Hansen, M. C., & Xie, B. (2008). Measuring latinos’ perceptions of depression: A confirmatory factor analysis of the illness perceptions questionnaire. Cultural Diversity and Ethnic Minority Psychology, 14, 377–384.

    PubMed  Article  Google Scholar 

  • Cabassa, L. J., Lester, R., & Zayas, L. H. (2007). “It’s like being in a labyrinth”: Hispanic immigrants’ perceptions of depression and attitudes toward treatments. Journal of Immigrant Health, 9, 1–16.

    Google Scholar 

  • Chandra, A., & Minkovitz, C. S. (2006). Stigma starts early: Gender differences in teen willingness to use mental health services. Journal of Adolescent Health, 38, 754.e1–754.e8.

    Article  Google Scholar 

  • Chandra, A., & Minkovitz, C. S. (2007). Factors that influence mental health stigma among 8th grade adolescents. Journal of Youth and Adolescence, 36, 763–774. doi:10.1007/s10964-006-9091-0.

    Article  Google Scholar 

  • Copeland, V. C. (2006). Disparities in mental health service utilization among low-income African American adolescents: Closing the gap by enhancing practitioner’s competence. Child and Adolescent Social Work Journal, 23(4), 407–431. doi:10.1007/s10560-006-0061-x.

    Article  Google Scholar 

  • Costello, E. J., Erkanli, A., & Angold, A. (2006). Is there an epidemic of child or adolescent depression. Journal of Child Psychology and Psychiatry and Allied Disciplines, 47(12), 1263–1271.

    Google Scholar 

  • Cote, J. E., & Levine, C. (2002). Identity formation, agency, and culture: A social psychological synthesis. Mahwah, NJ: Erlbaum.

    Google Scholar 

  • Cote, J. E., & Schwartz, S. J. (2002). Comparing psychological and sociological approaches to identity: Identity status, identity capital, and the individualization process. Journal of Adolescence, 25, 571–586. doi:10.1006/jado.2002.0511.

    PubMed  Article  Google Scholar 

  • Diego, M., Field, T., & Sanders, C. (2003). Academic performance, popularity, and depression predict adolescent substance use. Adolescence, 38(149), 35–42.

    PubMed  Google Scholar 

  • Erikson, E. H. (1968). Identity: Youth and crisis. New York: W.W. Norton & Company, Incorporated.

    Google Scholar 

  • Fergusson, D. M., & Woodward, L. J. (2002). Mental health, educational, and social role outcomes of adolescents with depression. Archives of General Psychiatry, 59, 225–231. doi:10.1001/archpsyc.59.3.225.

    PubMed  Article  Google Scholar 

  • Fishbein, M., & Ajzen, I. (1975). Belief, attitude, intention, and behavior: An introduction to theory and research. Reading, MA: Addison Wesley.

    Google Scholar 

  • Floersch, J., Townsend, L., Longhofer, J., Munson, M., Winbush, V., Kranke, D., et al. (2009). Adolescent experience of psychotropic treatment. Transcultural Psychiatry, 46(1), 157–179. doi:10.1177/1363461509102292.

    PubMed  Article  Google Scholar 

  • Fortune, G., Barrowclough, C., & Lobban, F. (2004). Illness representations in depression. The British Journal of Clinical Psychology, 43, 347–364. doi:10.1348/0144665042388955.

    PubMed  Article  Google Scholar 

  • Garland, A. F., & Zigler, E. F. (1994). Psychological correlates of help-seeking attitudes among children and adolescents. The American Journal of Orthopsychiatry, 64(4), 586–593. doi:10.1037/h0079573.

    PubMed  Article  Google Scholar 

  • Goldman, S. L., Whitney-Saltiel, D., Granger, J., & Rodin, J. (1991). Children’s representations of “everyday” aspects of health and illness. Journal of Pediatric Psychology, 16(6), 747–766. doi:10.1093/jpepsy/16.6.747.

    PubMed  Article  Google Scholar 

  • Gonzalez, J. M., Alegria, M., & Prihoda, T. J. (2005). How do attitudes toward mental health treatment vary by age, gender, and ethnicity/race in young adults. Journal of Community Psychology, 33(5), 611–629. doi:10.1002/jcop.20071.

    Article  Google Scholar 

  • Griva, K., Myers, L. B., & Newman, S. (2000). Illness perceptions and self efficacy beliefs in adolescents and young adults with insulin dependent diabetes mellitus. Psychology & Health, 15, 733–750. doi:10.1080/08870440008405578.

    Article  Google Scholar 

  • Gump, B. B., Matthews, K. A., Scheier, M. F., Schultz, R., Bridges, M. W., & Macgovern, G. J. (2001). Illness representations according to age and effects on health behaviors following coronary artery bypass graft surgery. Journal of the American Geriatrics Society, 49(3), 284–289. doi:10.1046/j.1532-5415.2001.4930284.x.

    PubMed  Article  Google Scholar 

  • Kaufman, J., Birmaher, B., Brent, D., Rao, U., Flynn, C., Moreci, P., et al. (1997). Schedule for affective disorders and schizophrenia for school-age children-present and lifetime version; initial reliability and validity data. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 980–988. doi:10.1097/00004583-199707000-00021.

    PubMed  Article  Google Scholar 

  • Keller, M. B., Lavori, P. W., Beardslee, W. R., Wunder, J., & Ryan, N. (1991). Depression in children and adolescents: New data on ‘undertreatment’ and a literature review on the efficacy of available treatments. Journal of Affective Disorders, 21, 163–171. doi:10.1016/0165-0327(91)90037-S.

    PubMed  Article  Google Scholar 

  • Kelly, A. E., & Achter, J. A. (1995). Self-concealment and attitudes toward counseling in university students. Journal of Counseling Psychology, 42(1), 40–46. doi:10.1037/0022-0167.42.1.40.

    Article  Google Scholar 

  • Leaf, P. J., Alegria, M., Cohen, P., Goodman, S., Horwitz, S., McCue, S., et al. (1996). Mental health service use in the community and schools: Results from the four-community MECA study. Journal of the American Academy of Child and Adolescent Psychiatry, 35(7), 889–897. doi:10.1097/00004583-199607000-00014.

    PubMed  Article  Google Scholar 

  • Leaf, P. J., Bruce, M. L., Tischler, G. L., & Holzer, C. E. (1987). The relationship between demographic factors and attitudes toward mental health services. Journal of Community Psychology, 15(2), 275–284. doi:10.1002/1520-6629(198704)15:2<275::AID-JCOP2290150216>3.0.CO;2-J.

    PubMed  Article  Google Scholar 

  • Leventhal, H., Brisette, I., & Leventhal, E. A. (2003). The common-sense model of self-regulation of health and illness. In L. D. Cameron & H. Leventhal (Eds.), The self-regulation of health and illness behavior (pp. 42–65). New York: Routledge.

    Google Scholar 

  • Leventhal, H., Diefenbach, M., & Leventhal, E. A. (1992). Illness cognition: Using common sense to understand treatment adherence and affect cognition interactions. Cognitive Therapy and Research, 16(2), 143–163. doi:10.1007/BF01173486.

    Article  Google Scholar 

  • Levin, J. S. (1984). The role of the black church in community medicine. Journal of the National Medical Association, 76(5), 477–483.

    PubMed  Google Scholar 

  • Lewinsohn, P. M., Hops, H., Roberts, R. E., Seeley, J. R., & Andrews, J. A. (1993). Adolescent psychopathology: I. Prevalence and incidence of depression and other DSM-III-R disorders in high school students. Journal of Abnormal Psychology, 102, 133–144. doi:10.1037/0021-843X.102.1.133.

    PubMed  Article  Google Scholar 

  • Lewinsohn, P. M., Rohde, P., Seeley, J. R., Klein, D. N., & Gotlib, I. H. (2003). Psychosocial functioning of young adults who have experienced and recovered from major depressive disorder during adolescence. Journal of Abnormal Psychology, 112(3), 353–363. doi:10.1037/0021-843X.112.3.353.

    PubMed  Article  Google Scholar 

  • Little, R. J. A., & Rubin, D. B. (2002). Statistical analysis with missing data (2nd ed.). New York: Wiley.

    Google Scholar 

  • Lobban, F., Barrowclough, C., & Jones, S. (2003). A review of the role of illness models in severe mental illness. Clinical Psychology Review, 23, 171–196. doi:10.1016/S0272-7358(02)00230-1.

    PubMed  Article  Google Scholar 

  • Lum, D. (2004). Social work practice and people of color: A process-stage approach (5th ed.). Belmont, CA: Brooks Cole.

    Google Scholar 

  • Mackenzie, C. S., Gekoski, W. L., & Knox, V. J. (2006). Age, gender, and the underutilization of mental health services: The influence of help-seeking attitudes. Aging & Mental Health, 10(6), 574–582. doi:10.1080/13607860600641200.

    Article  Google Scholar 

  • Mackenzie, C. S., Knox, V. J., Gekoski, W. L., & Macaulay, H. L. (2004). An adaptation and extension of the attitudes toward seeking professional psychological help scale. Journal of Applied Social Psychology, 34, 2410–2435. doi:10.1111/j.1559-1816.2004.tb01984.x.

    Article  Google Scholar 

  • Marcia, J. E. (1980). Identity in adolescence. In J. Adelson (Ed.), Handbook of adolescent psychology (pp. 159–187). New York: Wiley.

    Google Scholar 

  • Merikangas, K. R., Akiskal, H. S., Angst, J., Greenberg, P. E., Hirschfeld, R. M. A., Petukhova, M., et al. (2007). Lifetime and 12-month prevalence of bipolar spectrum disorder in the National Comorbidity Survey replication. Archives of General Psychiatry, 64(5), 543–552.

    PubMed  Article  Google Scholar 

  • Moreno, C., Laje, G., Blanco, C., Jiang, H., Schmidt, A., & Olfson, M. (2007). National trend in the outpatient diagnosis and treatment of bipolar disorder in youth. Archives of General Psychiatry, 64(9), 1032–1039. doi:10.1001/archpsyc.64.9.1032.

    PubMed  Article  Google Scholar 

  • Moss-Morris, R., Weinman, J., Petrie, K. J., Horne, R., Camerson, L. D., & Buick, D. (2002). The revised illness perceptions questionnaire (IPQ-R). Psychology & Health, 17(1), 1–16. doi:10.1080/08870440290001494.

    Article  Google Scholar 

  • Murray, C. J., & Lopez, A. D. (1996). The global burden of disease and injury series: A comprehensive assessment of mortality and disability from diseases, injuries, and risk factors in 1990 and projected to 2020. Cambridge: Harvard University Press.

    Google Scholar 

  • Newman, D. L., Moffit, T. E., Caspi, A., Magdol, L., Silva, P. A., & Stanton, W. R. (1996). Psychiatric disorder in a birth cohort of young adults: Prevalence, comorbidity, clinical significance and new case incidence from ages 11–21. Journal of Consulting and Clinical Psychology, 64, 552–562. doi:10.1037/0022-006X.64.3.552.

    PubMed  Article  Google Scholar 

  • Offord, D. R., Boyle, M. H., & Szatmari, P. (1987). Ontario child health study, II: Six month prevalence rates of disorder and services. Archives of General Psychiatry, 44, 832–836.

    PubMed  Google Scholar 

  • Olfson, M., Shaffer, D., Marcus, S. C., & Greenberg, T. (2003). Relationship between antidepressant medication treatment and suicide in adolescents. Archives of General Psychiatry, 60, 978–982. doi:10.1001/archpsyc.60.9.978.

    PubMed  Article  Google Scholar 

  • Pickett-Schenk, S. A. (2002). Church-based support groups for African American families coping with mental illness: Outreach and outcomes. Psychiatric Rehabilitation Journal, 26(2), 173–180. doi:10.2975/26.2002.173.180.

    PubMed  Article  Google Scholar 

  • Rice, D. P., & Miller, L. S. (1995). The economic burden of affective disorders. The British Journal of Psychiatry, 27(Supplement), 34–42.

    Google Scholar 

  • Roeloffs, C., Sherbourne, C., Unutzer, J., Fink, A., Tang, L., & Wells, K. B. (2003). Stigma and depression among primary care patients. General Hospital Psychiatry, 25, 311–315. doi:10.1016/S0163-8343(03)00066-5.

    PubMed  Article  Google Scholar 

  • Saunders, J. A., Morrow-Howell, N., Spitznagel, E., Dore, P., Proctor, E. K., et al. (2006). Imputing missing data: A comparison of methods for social work researchers. Social Work Research, 30(1), 19–31.

    Google Scholar 

  • Skinner, T. C., Howells, L., Greene, S., Edgart, K., McEvilly, A., & Johansson, A. (2003). Development, reliability, and validity of the Diabetes Illness Representations Questionnaire: Four studies with adolescents. Diabetic Medicine, 20, 283–289. doi:10.1046/j.1464-5491.2003.00923.x.

    PubMed  Article  Google Scholar 

  • Tamres, L. K., Janicki, D., & Helgeson, V. S. (2002). Sex differences in coping behavior: A meta-analytic review and an examination of relative coping. Personality and Social Psychology Review, 6(1), 2–29. doi:10.1207/S15327957PSPR0601_1.

    Article  Google Scholar 

  • Taylor, R. J., Hardison, C. B., & Chatters, L. M. (1996). Kin and non-kin as sources of informal assistance. In H. H. Neighbors & J. S. Jackson (Eds.), Mental health in Black America (pp. 130–145). Thousand Oaks, CA: Sage Publications.

    Google Scholar 

  • Thompson, V. L. S., Bazile, A., & Akbar, M. (2004). African Americans’ perceptions of psychotherapy and psychotherapists. Professional Psychology, Research and Practice, 35(1), 19–26. doi:10.1037/0735-7028.35.1.19.

    Article  Google Scholar 

  • Townsend, L., Demeter, C. A., Findling, R. L., & Wilson, M. (2007). Update on pediatric bipolar disorder. Current Psychiatry Reports, 9(6), 529–534. doi:10.1007/s11920-007-0072-0.

    PubMed  Article  Google Scholar 

  • Vogel, D. L., & Wester, S. R. (2003). To seek help or not to seek help: The risks of self-disclosure. Journal of Counseling Psychology, 50(3), 351–361. doi:10.1037/0022-0167.50.3.351.

    Article  Google Scholar 

  • Warner, R. (2005). Local projects of the world psychiatric association programme to reduce stigma and discrimination. Psychiatric Services (Washington DC), 56(5), 570–575. doi:10.1176/appi.ps.56.5.570.

    Google Scholar 

  • Watkins, D. C., & Neighbors, H. W. (2007). An initial exploration of what ‘mental health’ means to young black men. Journal of Men’s Health & Gender, 4, 271–282. doi:10.1016/j.jmhg.2007.06.006.

    Article  Google Scholar 

  • Weinman, J. A., & Petrie, K. J. (1997). Introduction to the perceptions of health and illness. In K. J. Petrie & J. A. Weinman (Eds.), Perceptions of health and illness (pp. 1–17). Amsterdam, The Netherlands: Harwood Academic Publishers.

    Google Scholar 

  • Whaley, A. L. (2001). Cultural mistrust and mental health services for African Americans: A review and meta-analysis. The Counseling Psychologist, 29(4), 513–531. doi:10.1177/0011000001294003.

    Article  Google Scholar 

  • Wozniak, J., Biederman, J., Kiely, K., Ablon, J. S., Faraone, S. V., Mundy, F., et al. (1995). Mania-like symptoms suggestive of childhood-onset bipolar disorder in clinically referred children. Journal of the American Academy of Child and Adolescent Psychiatry, 34(7), 867–876. doi:10.1097/00004583-199507000-00010.

    PubMed  Article  Google Scholar 

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Acknowledgment

Dr. Munson would like to thank Dr. L. J. Cabassa for reading an early draft of this manuscript.

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Affiliations

  1. Mandel School of Applied Social Sciences, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH, USA

    Michelle R. Munson & Jerry E. Floersch

  2. Rutgers University School of Social Work, New Brunswick, NJ, USA

    Lisa Townsend

  3. Center for Education and Research on Mental Health Therapeutics, New Brunswick, NJ, USA

    Lisa Townsend

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  1. Michelle R. Munson
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  2. Jerry E. Floersch
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  3. Lisa Townsend
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Correspondence to Michelle R. Munson.

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Munson, M.R., Floersch, J.E. & Townsend, L. Attitudes Toward Mental Health Services and Illness Perceptions Among Adolescents with Mood Disorders. Child Adolesc Soc Work J 26, 447–466 (2009). https://doi.org/10.1007/s10560-009-0174-0

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Keywords

  • Adolescents
  • Attitudes toward mental health services
  • Illness perceptions
  • Mood disorders