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Correlates of Help-Seeking Intentions among Airmen in the Context of Family Maltreatment Perpetration: Practical Barriers as a Moderating Influence

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Abstract

Efforts are warranted to understand correlates of formal help-seeking among active-duty military members self-reporting family maltreatment perpetration. Drawing from the Integrated Model of Determinants of Behavioral Intentions, we evaluate a hypothesized model in which the intention to seek formal services is associated with a set of plausible social-psychological variables. Practical barriers to help-seeking is assessed as a moderating influence. A representative sample of 5326 Airmen (88% male) from the 2011 Air Force Community Assessment Survey who self-reported recent family maltreatment perpetration is used for structural equation modeling to estimate direct associations between social support and intention to seek services, and indirect associations via career stigma, unit-based stigma, and sense of community. Social support is negatively associated with career stigma and unit-based stigma, and positively associated with sense of community. Career stigma and sense of community are negatively associated with intention to seek services. Significant indirect effects include a positive effect between social support and intention to seek services via a reduction in career stigma, and a negative effect via increases in sense of community. Higher levels of practical barriers magnify most associations. Especially when facing practical barriers, social support can both increase help-seeking intentions by reducing career stigma, and reduce intentions, either directly or indirectly by strengthening a sense of community. Military leaders should address career stigma perceptually and systematically, and engage in public awareness efforts and trainings to position members of informal networks to guide individuals with problematic behavior toward relevant formal services.

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References

  • Addis, M. E., & Mahalik, J. R. (2003). Men, masculinity, and the contexts of help seeking. American Psychologist, 58, 5–14.

    Article  Google Scholar 

  • Ali, K., Farrer, L., Fassnacht, D. B., Gulliver, A., Bauer, S., & Griffiths, K. M. (2017). Perceived barriers and facilitators towards help-seeking for eating disorders: A systematic review. International Journal of Eating Disorders, 50, 9–21.

    Article  Google Scholar 

  • Andersson, L. M., Schierenbeck, I., Strumpher, J., Krantz, G., Topper, K., Backman, G., et al. (2013). Help-seeking behaviour, barriers to care and experiences of care among persons with depression in eastern cape, South Africa. Journal of Affective Disorders, 151, 439–448.

    Article  PubMed  Google Scholar 

  • Bentler, P. M. (1990). Comparative fit indexes in structural models. Psychological Bulletin, 107, 238–246.

    Article  CAS  PubMed  Google Scholar 

  • Blais, R. K., & Renshaw, K. D. (2013). Stigma and demographic correlates of help-seeking intentions in returning service members. Journal of Traumatic Stress, 26, 77–85.

    Article  PubMed  Google Scholar 

  • Bowen, G. L., Jensen, T. M., Martin, J. A., & Mancini, J. A. (2016). The willingness of military members to seek help: The role of social involvement and social responsibility. American Journal of Community Psychology, 57, 203–215.

    Article  PubMed  Google Scholar 

  • Bowen, G. L., Jensen, T. M., & Martin, J. A. (2016a). A measure of comprehensive airman fitness: Construct validation and invariance across air force service components. Military Behavioral Health, 4, 149–158.

    Article  Google Scholar 

  • Bowen, G., Jensen, T., & Martin, J. A. (2016b). Confirmatory factor analysis of a measure of comprehensive airman fitness. Military Behavioral Health, 4, 409–419.

    Article  Google Scholar 

  • Bowen, G. L., Jensen, T. M., & Williams, B. (2017). Prevention of family maltreatment in the US air force: A systematic review of research on active-duty military personnel. Journal of Family Social Work, 20, 52–80.

    Article  Google Scholar 

  • Bowen, G., Jensen, T., & Martin, J. (2019). Standing strong in the context of organizational and family demands: A measure of USAF civilian spouse fitness. In R. Moelker, M. Andres, & N. Rones (Eds.), The politics of military families: State, work organizations, and the rise of the negotiation household (pp. 211–230). New York: Routledge.

    Chapter  Google Scholar 

  • Browne, M. W., & Cudeck, R. (1993). Alternative ways of assessing model fit. In K. A. Bollen & J. S. Long (Eds.), Testing structural equation models (pp. 136–162). Newbury Park, CA: Sage.

    Google Scholar 

  • Chen, F. F., Sousa, K. H., & West, S. G. (2005). Teacher's corner: Testing measurement invariance of second-order factor models. Structural Equation Modeling: A Multidisciplinary Journal, 12, 471–492.

    Article  Google Scholar 

  • Cheung, G. W., & Rensvold, R. B. (2002). Evaluating goodness-of-fit indexes for testing measurement invariance. Structural Equation Modeling: A Multidisciplinary Journal, 9, 233–255.

    Article  Google Scholar 

  • Chou, C., & Huh, J. (2012). Model modification in structural equation modeling. In R. H. Hoyle (Ed.), Handbook of structural equation modeling (pp. 232–246). New York: Guilford.

    Google Scholar 

  • Clement, S., Schauman, O., Graham, T., Maggioni, F., Evans-Lacko, S., Bezborodovs, N., Morgan, C., Rüsch, N., Brown, J. S. L., & Thornicroft, G. (2015). What is the impact of mental health-related stigma on help-seeking? A systematic review of quantitative and qualitative studies. Psychological Medicine, 45, 11–27.

    Article  CAS  PubMed  Google Scholar 

  • Coker, A. L., Davis, K. E., Arias, I., Desai, S., Sanderson, M., Brandt, H. M., & Smith, P. H. (2002). Physical and mental health effects of intimate partner violence for men and women. American Journal of Preventive Medicine, 23, 260–268.

    Article  PubMed  Google Scholar 

  • Cornish, M. A., Thys, A., Vogel, D. L., & Wade, N. G. (2014). Post-deployment difficulties and help seeking barriers among military veterans: Insights and intervention strategies. Professional Psychology: Research and Practice, 45, 405–409.

    Article  Google Scholar 

  • Department of Defense. (2016). 2016 demographics: Profile of the military community. Washington DC: Department of Defense.

    Google Scholar 

  • Dimitrov, D. M. (2010). Testing for factorial invariance in the context of construct validation. Measurement and Evaluation in Counseling and Development, 43(2), 121–149.

    Article  Google Scholar 

  • Enders, C. K. (2010). Applied missing data analysis. New York: Guilford Press.

    Google Scholar 

  • Flittner O'Grady, A. E., MacDermid Wadsworth, S., Willerton, E., Cardin, J. F., Topp, D., Mustillo, S., & Lester, P. (2015). Help seeking by parents in military families on behalf of their young children. Psychological Services, 12, 231–240.

    Article  Google Scholar 

  • Flora, D. B., & Curran, P. J. (2004). An empirical evaluation of alternative methods of estimation for confirmatory factor analysis with ordinal data. Psychological Methods, 9, 466–491.

    Article  PubMed  PubMed Central  Google Scholar 

  • Galdas, P. M., Cheater, F., & Marshall, P. (2005). Men and health help-seeking behaviour: Literature review. Journal of Advanced Nursing, 49, 616–623.

    Article  PubMed  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  PubMed Central  Google Scholar 

  • Hamilton, J. A., Coleman, J. A., & Davis, W. J. (2017). Leadership perspectives of stigma-related barriers to mental health care in the military. Military Behavioral Health, 5, 81–90.

    Article  Google Scholar 

  • Holland, K. J., Rabelo, V. C., & Cortina, L. M. (2014). Sexual assault training in the military: Evaluating efforts to end the “invisible war”. American Journal of Community Psychology, 54, 289–303.

    Article  PubMed  Google Scholar 

  • Hu, L. T., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis. Conventional criteria versus new alternatives. Structural Equation Modeling, 6, 1–55.

    Article  Google Scholar 

  • Institute of Medicine. (2013). Returning home from Iraq and Afghanistan: Assessment of the readjustment needs of veterans, service members, and their families. Washington, DC: The National Academies Press.

    Google Scholar 

  • Jaccard, J., & Levitz, N. (2016). Parent-based interventions to reduce adolescent problem behaviors: New directions for self-regulation approaches. In G. Oettingen & P. Gollwitzer (Eds.), Self-regulation in adolescence. New York: Cambridge University Press.

    Google Scholar 

  • Jensen, T. M., & Bowen, G. L. (2018). Informing efforts to prevent family maltreatment among airmen: A focus on personal resilience. Journal of Family Social Work, 21, 129–151.

    Article  Google Scholar 

  • Lee, T., Cai, L., & MacCallum, R. C. (2012). Power analysis for tests of structural equation models. In R. H. Hoyle (Ed.), Handbook of structural equation modeling (pp. 181–194). New York: Guilford.

    Google Scholar 

  • Li, C. (2013). Little's test of missing completely at random. The Stata Journal, 13(4), 795–809.

    Article  Google Scholar 

  • Liang, B., Goodman, L., Tummala-Narra, P., & Weintraub, S. (2005). A theoretical framework for understanding help-seeking processes among survivors of intimate partner violence. American Journal of Community Psychology, 36, 71–84.

    Article  PubMed  Google Scholar 

  • MacDermid Wadsworth, S. M. (2010). Family risk and resilience in the context of war and terrorism. Journal of Marriage and Family, 72, 537–556.

    Article  Google Scholar 

  • Mancini, J. A., & Bowen, G. L. (2013). Families and communities: A social organization theory of action and change. In G. Peterson & K. Bush (Eds.), Handbook of marriage and the family (3rd ed., pp. 781–812). New York: Springer.

    Chapter  Google Scholar 

  • Mancini, J. A., Nelson, J. P., Bowen, G. L., & Martin, J. A. (2006). Changing the ways communities support families to prevent intimate partner violence. Journal of Aggression, Maltreatment & Trauma, 13, 203–227.

    Article  Google Scholar 

  • Mancini, J. A., O'Neal, C. W., Martin, J. A., & Bowen, G. L. (2018). Community social organization and military families: Theoretical perspectives on transitions, contexts, and resilience. Journal of Family Theory & Review, 10, 550–565.

    Article  Google Scholar 

  • Martin, J. A., & Bowen, G. L. (2003). 2002 Air force community assessment: Reference matrix (Doc. No. F41622-03-M-1026). San Antonio, TX: Brooks air force (AFMOA/SGZF).

  • Martin, J. A., & Sherman, M. D. (2009). The impact of military life on individuals and families: Resources and intervention. In S. Price & C. Price (Eds.), Families and change: Coping with stressful events and transitions (4th ed., pp. 381–397). New York: Sage.

    Google Scholar 

  • Meade, A. W., Johnson, E. C., & Braddy, P. W. (2008). Power and sensitivity of alternative fit indices in tests of measurement invariance. Journal of Applied Psychology, 93(3), 568–592.

    Article  Google Scholar 

  • Meyer, E. G., Writer, B. W., & Brim, W. (2016). The importance of military cultural competence. Current Psychiatry Reports, 3, 1–8.

    Google Scholar 

  • Michalopoulou, L. E., Welsh, J. A., Perkins, D. F., & Ormsby, L. (2017). Stigma and mental health service utilization in military personnel: A review of the literature. Military Behavioral Health, 5, 12–25.

    Article  Google Scholar 

  • Milner, J. S. (2015). Child maltreatment in United States military families: The military family advocacy program has given increased attention to the prevention of family violence. Child Abuse & Neglect, 47, 102–113.

    Article  Google Scholar 

  • Muthén, L. K., & Muthén, B. O. (2019). Mplus user’s guide (8th ed.). Los Angeles, CA: Author.

    Google Scholar 

  • Norman, R. E., Byambaa, M., De, R., Butchart, A., Scott, J., & Vos, T. (2012). The long-term health consequences of child physical abuse, emotional abuse, and neglect: A systematic review and meta-analysis. PLoS Medicine, 9, e1001349.

    Article  PubMed  PubMed Central  Google Scholar 

  • O'Donnell, L., Karlin, B., Landon, M. K., Dash, K., & Reed, G. (2018). Soldiers' recognition and response to mental health problems: Using vignettes to elicit attitudes and barriers to help seeking. Military Behavioral Health, 6, 82–92.

    Article  Google Scholar 

  • Pury, C. L., Britt, T. W., Zinzow, H. M., & Raymond, M. A. (2014). Blended courage: Moral and psychological courage elements in mental health treatment seeking by active duty military personnel. The Journal of Positive Psychology, 9, 30–41.

    Article  Google Scholar 

  • Rickwood, D., Deane, F. P., Wilson, C. J., & Ciarrochi, J. (2005). Young people’s help-seeking for mental health problems. Australian e-journal for the Advancement of Mental health, 4, 218–251.

    Article  Google Scholar 

  • Sass, D. A., Schmitt, T. A., & Marsh, H. W. (2014). Evaluating model fit with ordered categorical data within a measurement invariance framework: A comparison of estimators. Structural Equation Modeling: A Multidisciplinary Journal, 21(2), 167–180.

    Article  Google Scholar 

  • Sharp, M. L., Fear, N. T., Rona, R. J., Wessely, S., Greenberg, N., Jones, N., & Goodwin, L. (2015). Stigma as a barrier to seeking health care among military personnel with mental health problems. Epidemiologic Reviews, 37, 144–162.

    Article  PubMed  Google Scholar 

  • Smith Slep, A. M., Foran, H. M., Heyman, R. E., & Snarr, J. D. (2010). Unique risk and protective factors for partner aggression in a large scale air force survey. Journal of Community Health, 35, 375–383.

    Article  Google Scholar 

  • Smith Slep, A. M., Foran, H. M., Heyman, R. E., Snarr, J. D., & US Air Force Family Advocacy Program. (2011). Risk factors for clinically significant intimate partner violence among active-duty members. Journal of Marriage and Family, 73, 486–501.

    Article  Google Scholar 

  • Tofighi, D., & MacKinnon, D. P. (2011). RMediation: An R package for mediation analysis confidence intervals. Behavior Research Methods, 43, 692–700.

    Article  PubMed  PubMed Central  Google Scholar 

  • Welsh, J. A., Olson, J., Perkins, D. F., Travis, W. J., & Ormsby, L. (2015). The role of natural support systems in the post-deployment adjustment of active duty military personnel. American Journal of Community Psychology, 56, 69–78.

    Article  PubMed  Google Scholar 

  • Zinzow, H. M., Britt, T. W., Pury, C. L., Raymond, M. A., McFadden, A. C., & Burnette, C. M. (2013). Barriers and facilitators of mental health treatment seeking among active-duty army personnel. Military Psychology, 25, 514–535.

    Article  Google Scholar 

  • Zinzow, H. M., Britt, T. W., Pury, C. L., Jennings, K., Cheung, J. H., & Raymond, M. A. (2015). Barriers and facilitators of mental health treatment-seeking in US active duty soldiers with sexual assault histories. Journal of Traumatic Stress, 28, 289–297.

    Article  PubMed  Google Scholar 

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  1. School of Social Work, University of North Carolina, Chapel Hill, NC, USA

    Todd M. Jensen & Gary L. Bowen

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Correspondence to Todd M. Jensen.

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This research was supported with a subaward through Kansas State University (Grant # 2017-39575-27343) from the U.S. Air Force Family Advocacy Program (AFMOA/SGHW). The views expressed are those of the author(s) and do not necessarily reflect the official policy or position of the Air Force, the Department of Defense, or the U.S. Government.

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Jensen, T.M., Bowen, G.L. Correlates of Help-Seeking Intentions among Airmen in the Context of Family Maltreatment Perpetration: Practical Barriers as a Moderating Influence. J Fam Viol 37, 423–434 (2022). https://doi.org/10.1007/s10896-020-00186-w

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