Daniel G. Lannin

Does self-stigma reduce the probability of seeking mental health information?

An important first step in seeking counseling may involve obtaining information about mental health concerns and treatment options. Researchers have suggested that some people may avoid such information because it is too threatening due to self-stigma and negative attitudes, but the link to actual help-seeking decisions has not been tested. Therefore, the purpose of the present study was to examine whether self-stigma and attitudes negatively impact decisions to seek information about mental health concerns and counseling. Probit regression models with 370 undergraduates showed that self-stigma negatively predicted decisions to seek both mental health and counseling information, with attitudes toward counseling mediating self-stigmas influence on these decisions. Among individuals experiencing higher levels of distress, the predicted probabilities of seeking mental health information (8.5%) and counseling information (8.4%) for those with high self-stigma were nearly half of those with low self-stigma (17.1% and 15.0%, respectively). This suggests that self-stigma may hinder initial decisions to seek mental health and counseling information, and implies the need for the development of early interventions designed to reduce help-seeking barriers.

Reducing the stigma associated with seeking psychotherapy through self-affirmation.

Psychotherapy may be underutilized because people experience self-stigma-the internalization of public stigma associated with seeking psychotherapy. The purpose of this study was to experimentally test whether the self-stigma associated with seeking psychotherapy could be reduced by a self-affirmation intervention wherein participants reflected on an important personal characteristic. Compared with a control group, we hypothesized that a self-affirmation writing task would attenuate self-stigma, and thereby evidence indirect effects on intentions and willingness to seek psychotherapy. Participants were 84 undergraduates experiencing psychological distress. After completing pretest measures of self-stigma, intentions, and willingness to seek psychotherapy, participants were randomly assigned to either a self-affirmation or a control writing task, and subsequently completed posttest measures of self-stigma, intentions, and willingness to seek psychotherapy. Consistent with hypotheses, participants who engaged in self-affirmation reported lower self-stigma at posttest. Moreover, the self-affirmation writing task resulted in a positive indirect effect on willingness to seek psychotherapy, though results failed to support an indirect effect on intentions to seek psychotherapy. Findings suggest that self-affirmation theory may provide a useful framework for designing interventions that seek to address the underutilization of psychological services through reductions in self-stigma.

Predicting Self-Esteem and Intentions to Seek Counseling The Internalized Stigma Model

This investigation introduced the Internalized Stigma Model to test the mechanisms by which the stigma of mental illness and of seeking psychological help affect self-esteem and intentions to seek counseling. We hypothesized that both stigmas would predict decreased self-esteem, but only stigma of seeking psychological help would predict decreased intentions to seek counseling. Furthermore, we predicted that these links follow a process wherein people’s perceptions of societal stigma are fully mediated by internalization of that stigma. Public stigmas predict their respective self-stigmas, which subsequently predict self-esteem and intentions. Using structural equation modeling, we tested the hypothesized relationships in a sample of undergraduates (N = 448). Results supported the hypotheses. Self-stigma mediated the relationship between public stigma and both outcomes; both self-stigma of mental illness and self-stigma of seeking psychological help predicted decreased self-esteem, but only self-stigma of seeking psychological help predicted decreased intentions to seek counseling.

Mindfulness, Psychological Flexibility, and Counseling Self-Efficacy Hindering Self-Focused Attention as a Mediator

The purpose of this study was to explore the mechanism by which counselor trainees’ mindfulness and psychological flexibility are positively associated with counseling self-efficacy. First, it was hypothesized that having fewer experiences of hindering self-focused attention (i.e., counselor trainees’ awareness of their own anxiety and distracting thoughts in sessions) would mediate the association between mindfulness and counseling self-efficacy. Second, it was hypothesized that having fewer experiences of hindering self-focused attention would mediate the association between psychological flexibility and counseling self-efficacy. Participants included 154 graduate counselor trainees. Results supported our hypotheses that counselor trainees with greater mindfulness reported having fewer experiences of hindering self-focused attention, which in turn was positively associated with counseling self-efficacy. Similarly, those with greater psychological flexibility also reported having fewer experiences of hindering self-focused attention, which in turn was positively associated with counseling self-efficacy. These findings were significant after controlling for age and number of practicum courses.

Stigma of Seeking Psychological Services: Examining College Students Across Ten Countries/Regions:

Stigma is an important barrier to seeking psychological services worldwide. Two types of stigma exist: public stigma and self-stigma. Scholars have argued that public stigma leads to self-stigma, and then self-stigma is the primary predictor of attitudes toward seeking psychological services. However, this assertion is largely limited to U.S. samples. The goal of this research was to provide a first step in understanding the relationship between public stigma, self-stigma, and attitudes toward seeking psychological services in international contexts (N = 3,276; Australia, Brazil, Canada, Hong Kong, Portugal, Romania, Taiwan, Turkey, United Arab Emirates, and United States). Using structural equation modeling, we found that self-stigma mediated the relationship between public stigma and attitudes toward seeking services among college students in each country and region. However, differences in path strengths emphasize the need to pay attention to the role of public and self-stigma on attitudes toward seeking psychological services throughout the world.

Do self-compassion and self-coldness distinctly relate to distress and well-being? A theoretical model of self-relating.

The current research tested a theoretical model of self-relating that examined the unique relationships of self-compassion and self-coldness with distress and well-being. Self-coldness has recently been identified as theoretically distinct from self-compassion, rather than part of a unitary self-compassion construct. As such, the incremental value of self-compassion and self-coldness on clinically relevant outcomes is unclear. Therefore, the current research tested a theoretical model of the unique relationships of self-compassion and self-coldness and both distress and well-being among university students (N = 457) and community adults (N = 794), as well as interactions between these 2 constructs. Structural equation modeling results in both samples revealed that self-compassion was uniquely related to well-being (&bgr;s = .36–.43), whereas self-coldness was uniquely related to distress (&bgr;s = −.34) and well-being (&bgr;s = .65–.66). Consistent with the Theory of Social Mentalities, across samples self-compassion more strongly related to well-being, whereas self-coldness more strongly related to distress. Self-compassion did not demonstrate a unique direct relationship with distress, but it did buffer the relationship between self-coldness and distress in both samples and the relationship between self-coldness and well-being in the community sample. Overall, results suggest that clinicians would benefit from tailoring the use of self-compassion and self-coldness interventions. Implications for future research and practice are discussed.

Longitudinal effect of defensive denial on relationship instability.

Maladaptive communication may often undermine the long-term stability of romantic relationships. We hypothesized that defensive denial may be a salient type of maladaptive communication that erodes relationship stability over time because it may lead to more caustic conflict-escalating behaviors. Additionally, we hypothesized that defensive denial observed in romantic relationships could be linked back to defensive denial observed in the family of origin. Using data from the Family Transitions Project, we specified longitudinal models in which observed defensive denial in romantic relationships affected self-reported and partner-reported relationship instability both directly and indirectly through self-reported and partner-reported conflict-escalating behaviors. Models also traced defensive denial observed in romantic relationships back to defensive denial observed in the family of origin nearly 10 years earlier, while participants were in late adolescence. Results from structural equation models supported the first two hypotheses. For both men and women, defensive denial was mediated by conflict-escalating behaviors to cause greater relationship instability over time. Additionally, there was evidence that the expressions of defensive denial in romantic relationships may have been learned in the family of origin for women, but not for men.

Reducing threat responses to help-seeking information: Influences of self-affirmations and reassuring information.

This research was an examination of the effects of two types of self-affirmation interventions in reducing threat responses associated with receiving help-seeking information. Help-seeking information can be threatening to one’s positive self-perceptions and people may avoid seeking such information to protect themselves. There is evidence that reflecting on personal values (values affirmation) may bolster self-integrity and mitigate this avoidance, and it is possible that reflecting on safe, close social relationships (social affirmation) could exhibit similar effects. To experimentally examine this theoretical idea, we applied a 2 × 2 × 2 factorial design in the present study on 384 participants and experimentally manipulated their values affirmations (values affirmation vs. no values affirmation) and social affirmations (social affirmation vs. no social affirmation). In addition, because there is no consensus as to the most effective presentation of help-seeking information, the type of help-seeking information presented to potential help-seekers was also manipulated (reassuring help-seeking information vs. nonreassuring help-seeking information). Results indicated that values affirmation and reassuring information were linked to lower threat responses, but social affirmation was not. Values affirmation and reassuring information might be effective strategies for reducing threat responses associated with the presentation of psychological help-seeking information.

The Importance of Counseling Self-efficacy: Physiologic Stress in Student Helpers

ABSTRACT This study tested whether high counseling self-efficacy was associated with less physiologic stress for student helpers facing difficult helping situations. A total of 225 students completed a counseling self-efficacy measure before providing supportive help. During this time, participants’ blood pressure and heart rate were evaluated. Between the time that participants learned about their upcoming roles as student helpers and began experiencing session-management problems, diastolic blood pressure decreased for those with high self-efficacy, but not for those with low self-efficacy. The results suggest that mental health agencies may consider utilizing counseling self-efficacy measures to identify and develop capable student helpers.

A Biphasic Process of Resistance Among Suspects: The Mobilization and Decline of Self-Regulatory Resources.

We conducted two experiments to test whether police interrogation elicits a biphasic process of resistance from suspects. According to this process, the initial threat of police interrogation mobilizes suspects to resist interrogative influence in a manner akin to a fight or flight response, but suspects’ protracted self-regulation of their behavior during subsequent questioning increases their susceptibility to interrogative influence in the long-run. In Experiment 1 (N = 316), participants who were threatened by an accusation of misconduct exhibited responses indicative of mobilization and more strongly resisted social pressure to acquiesce to suggestive questioning than did participants who were not accused. In Experiment 2 (N = 160), self-regulatory decline that was induced during questioning about misconduct undermined participants’ ability to resist suggestive questioning. These findings support a theoretical account of the dynamic and temporal nature of suspects’ responses to police interrogation over the course of questioning.