Kristen S. Jennings

How are perceived stigma, self-stigma, and self-reliance related to treatment-seeking? A three-path model.

OBJECTIVE Many college students may experience mental health problems but do not seek treatment from mental health professionals. The present study examined how perceived stigma and self-stigma toward seeking mental health treatment, as well as perceptions of self-reliance for coping with mental health problems, relate to college student treatment-seeking. METHOD In total, 246 students completed a self-report survey that included measures of perceived stigma and self-stigma for treatment-seeking, self-reliance for addressing mental health concerns, self-reported mental health problems, symptoms of depression and alcohol-related problems, attitudes toward treatment-seeking, and treatment-seeking behavior. RESULTS Regression analyses revealed that higher perceived stigma, self-stigma, and self-reliance were all related to a more negative attitude toward treatment-seeking. In a 3-path mediation model, bootstrapping results indicated an indirect effect where perceived stigma was related to attitude toward treatment-seeking and treatment-seeking behaviors through self-stigma and self-reliance. Specifically, higher perceived stigma was related to higher self-stigma, higher self-stigma was related to higher self-reliance, and higher self-reliance was associated with a more negative attitude toward treatment-seeking in the overall sample, and a decreased probability of having sought treatment among those who screened positive for a mental health problem. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE Perceived stigma may influence whether or not college students seek treatment for mental health problems by potentially increasing stigmatizing attitudes toward themselves and increasing preferences for handling problems on their own. Researchers and practitioners are recommended to seek a better understanding of the complex treatment barriers to reduce stigma and facilitate treatment-seeking.

The Role of Different Stigma Perceptions in Treatment Seeking and Dropout Among Active Duty Military Personnel

OBJECTIVE Many military personnel with mental health problems do not seek treatment from mental health professionals, and if they do seek treatment, they drop out of treatment before receiving the recommended number of sessions. The present study examined the role of 4 different stigma perceptions on these outcomes: perceived stigma to career, perceived stigma of differential treatment, self-stigma from seeking treatment, and stigmatizing perceptions of soldiers who seek treatment. METHOD One thousand three hundred twenty-four active duty soldiers completed a self-report survey assessment that included measures of the 4 different stigma perceptions, indices of mental health symptoms, receipt of mental health treatment, and whether they had dropped out of treatment before it was completed. RESULTS Participants screening positive for a mental health problem reported higher scores on all 4 stigma perceptions. All 4 stigma perceptions were each associated with a reduced likelihood of treatment seeking when considered individually, but only stigmatizing beliefs about those who seek treatment were uniquely associated with treatment seeking. Perceived stigma for ones career and differential treatment from others, along with self-stigma from treatment seeking, were associated with an increased probability of dropping out of mental health treatment. Self-stigma from treatment seeking was the only unique predictor of dropout. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE Different stigma perceptions were associated with treatment seeking and dropout. Further longitudinal research is needed to examine how stigma perceptions influence these important outcomes. Practitioners need to be aware of how different stigma perceptions can influence treatment seeking and potentially target stigma perceptions during treatment to prevent dropout.

Barriers and facilitators of mental health treatment-seeking in U.S active duty soldiers with sexual assault histories

Despite significant mental health needs among sexual assault (SA) victims in the military, little is known about treatment-seeking patterns or factors associated with service use. This study examined service use behavior, barriers, and facilitators of mental health treatment-seeking in an active duty sample of 927 U.S. Army soldiers with mental health problems. SA victims (n = 113) did not differ from non-victims on barriers or facilitators after adjusting for demographic and mental health variables, with stigma rated as the largest barrier. Most SA victims (87.6%) had sought informal support and 59.3% had sought formal treatment. One third of treatment-seekers had dropped out of treatment. Multivariate logistic regression analyses identified several correlates of treatment-seeking among SA victims: Black race (OR = 7.57), SA during the military (OR = 4.34), positive treatment beliefs (OR = 2.22), social support for treatment (OR = 2.14), self-reliance (OR = 0.47), and stigma towards treatment seekers (OR = 0.43). Mental health symptoms were not associated with treatment seeking. Findings suggested that treatment-facilitating interventions should focus on improving recognition of mental health symptoms, altering perceptions related to self-reliance, and reducing stigma. Interventions should also enlist support for treatment-seeking from unit members, leaders, and significant others.

Determinants of mental health treatment seeking among soldiers who recognize their problem: implications for high-risk occupations

ABSTRACT Although research has documented an increased risk of mental health problems among employees in high-stress occupations, little attention has been devoted to the process by which employees seek treatment for these problems. Using components of the Stages of Change Model (Prochaska & DiClemente, 1982), this study examined the correlates of considering and receiving treatment for such problems among active-duty military personnel in the U.S. Army. A multidimensional assessment of determinants of treatment seeking was administered to 1725 military personnel, along with measures of mental health symptoms and treatment seeking. These determinants were examined as predictors of considering and receiving treatment among a sub-sample of 466 personnel who recognized having a current mental health problem. Multinomial logistic regressions indicated that attitudes towards treatment and a preference for self-reliance distinguished those considering treatment from those who had not sought treatment. A larger number of factors distinguished soldiers considering treatment from those who had actually received treatment, with operational barriers and self-reliance being the strongest and unique correlates. The discussion focuses on the importance of what organizations can do to facilitate treatment seeking among employees in high-risk environments.

Who benefits from family support? Work schedule and family differences.

Prior research has demonstrated the benefits of family-supportive organization perceptions (FSOP) for reducing stress, increasing satisfaction, and increasing worker commitment; however, less research has studied health outcomes or possible differences in the effects of FSOP based on worker characteristics. The present study examined relationships between FSOP and health outcomes, as well as how those relationships may depend on work schedule and family differences. Using a sample of 330 acute care nurses, the findings indicated that FSOP predicted several health and well-being outcomes obtained 9 months later. Further, the relationships between FSOP and the outcome variables depended on some work schedule and family differences. In terms of family differences, FSOP was most strongly related to life satisfaction for those who cared for dependent adults. The relationship between FSOP and health outcomes of depression, musculoskeletal pain, and physical health symptoms were generally significant for workers with dependent children, but not significant for workers with no children. Regarding schedule differences, the relationship between FSOP and life satisfaction was significant for those on nonstandard (evening/night) shifts but not significant for standard day shift workers; however, there were no differences in FSOP relationships by number of hours worked per week. The findings demonstrate that FSOP may benefit some employees more than others. Such differences need to be incorporated into both future work-family theory development and into efforts to document the effectiveness of family-supportive policies, programs, and practices.

Auditory Attention and Comprehension During a Simulated Night Shift Effects of Task Characteristics

Objective: The current study investigated performance on a dual auditory task during a simulated night shift. Background: Night shifts and sleep deprivation negatively affect performance on vigilance-based tasks, but less is known about the effects on complex tasks. Because language processing is necessary for successful work performance, it is important to understand how it is affected by night work and sleep deprivation. Method: Sixty-two participants completed a simulated night shift resulting in 28 hr of total sleep deprivation. Performance on a vigilance task and a dual auditory language task was examined across four testing sessions. Results: The results indicate that working at night negatively impacts vigilance, auditory attention, and comprehension. The effects on the auditory task varied based on the content of the auditory material. When the material was interesting and easy, the participants performed better. Night work had a greater negative effect when the auditory material was less interesting and more difficult. Conclusion: These findings support research that vigilance decreases during the night. The results suggest that auditory comprehension suffers when individuals are required to work at night. Maintaining attention and controlling effort especially on passages that are less interesting or more difficult could improve performance during night shifts. Application: The results from the current study apply to many work environments where decision making is necessary in response to complex auditory information. Better predicting the effects of night work on language processing is important for developing improved means of coping with shiftwork.

Occupational stress and mental health symptoms: Examining the moderating effect of work recovery strategies in firefighters.

The goal of this research was to examine the moderating effect of work recovery strategies on the relationship between occupational stress experienced by firefighters and mental health symptoms. Work recovery strategies were identified through semistructured interviews with 20 firefighters and a literature search on recovery strategies. A total of 7 work recovery strategies emerged using the 2 methods: work-related talks, stress-related talks, time with coworkers/supervisor, exercise, recreational activities, relaxation, and mastery experiences. Using a prospective study design with a 1-month time interval in a sample of 268 firefighters, experienced occupational stress at Time 1 was positively related to mental health symptoms at Time 2. In addition, with the exception of spending time with coworkers/supervisor, exercise and mastery experiences, recovery strategies at Time 1 were negatively related to mental health symptoms at Time 2. Lastly, all work recovery strategies, except stress-related talks and relaxation, moderated the relationship between experienced occupational stress at Time 1 and mental health symptoms at Time 2. Specifically, the positive relationship between experienced occupational stress and mental health symptoms was stronger when firefighters engaged in low, rather than high, work recovery strategies. Implications for research and practice are discussed.

Characterizing the Health and Attitudes of Rear Detachment Soldiers

ABSTRACT This study characterized the health and attitudes of 849 soldiers assigned to the rear detachment (separated into organizational or personal reasons for nondeployed status) compared with 2,181 deployed soldiers. Rear detachment soldiers assigned for personal reasons reported more health symptoms and lower unit climate than deployed soldiers and soldiers assigned to the rear detachment for organizational reasons. Rear detachment soldiers assigned for organizational reasons reported symptom levels and unit climate similar to that of deployed soldiers. Better rear detachment leadership was associated with better soldier adjustment even after controlling for general leadership. Implications for supporting rear detachment soldiers are discussed.

The role of personality traits and barriers to mental health treatment seeking among college students.

Many college students experience a mental health problem yet do not seek treatment from a mental health professional. In the present study, we examined how perceived barriers (stigma perceptions, negative attitudes about treatment, and perceptions of practical barriers), as well as the Big Five personality traits, relate to treatment seeking among college students reporting a current mental health problem. The sample consisted of 261 college students, 115 of which reported experiencing a current problem. Results of a series of logistic regressions revealed that perceived stigma from others (OR = .32), self-stigma (OR = .29), negative attitudes about treatment (OR = .27), and practical barriers (OR = .34) were all associated with a lower likelihood of having sought treatment among students experiencing a problem. Of the five-factor model personality traits, only Neuroticism was associated with a higher likelihood of having sought treatment when experiencing a mental health problem (OR = 2.71). When we considered all significant predictors in a final stepwise conditional model, only self-stigma, practical barriers, and Neuroticism remained significant unique predictors. Implications for addressing barriers to treatment and encouraging treatment seeking among college students are discussed.

Enhancing the Meaningfulness of Work for Astronauts on Long Duration Space Exploration Missions

INTRODUCTION Numerous authors have identified the stressors likely to be encountered on long duration space exploration missions (e.g., to Mars), including the possibility of significant crises, separation from family, boredom/monotony, and interpersonal conflict. Although many authors have noted that meaningful work may be beneficial for astronauts on these missions, none have detailed the sources of meaningful work for astronauts and how these sources may differ between astronauts. The present article identifies how engagement in meaningful work during long duration missions may mitigate the adverse effects of demands and increase the potential for benefits resulting from the missions. METHOD Semistructured interviews were conducted with nine NASA personnel, including astronauts, flight directors, and flight surgeons. Questions addressed sources of meaning for astronauts, characteristics of tasks that enhance vs. detract from meaning, and recommendations for enhancing meaning. RESULTS Personnel mentioned contributing to humanity and the next generation, contributing to the mission, and exploration as the most meaningful aspects of their work. Characteristics of tasks that enhanced meaning included using a variety of skills, feeling personal control over their schedule, autonomy in the execution of tasks, and understanding the importance of the experiments conducted on the mission. Top recommendations to sustain meaning were insuring social needs were met through such activities as the strategic use of social media, giving astronauts autonomy as well as structure, and conducting training during transit. DISCUSSION Implications are addressed for tailoring meaning-based interventions for astronauts participating on long duration missions and assessing the effectiveness of these interventions.Britt TW, Sytine A, Brady A, Wilkes R, Pittman R, Jennings K, Goguen K. Enhancing the meaningfulness of work for astronauts on long duration space exploration missions. Aerosp Med Hum Perform. 2017; 88(8):779-783.