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PubMed1995

Dealing with hypertension: using theory to promote behavioral change.

1. Controlling hypertension and related disease requires that health professionals focus more attention on primary prevention strategies as a means of decreasing hypertensive risks. 2. Behavioral theories help identify attitudes, beliefs, and knowledge influencing behaviors that increase one's risk for hypertension. 3. Using information based on the behavioral theories will help occupational health nurses develop more effective programs for primary prevention of hypertension.

Health Behavior↗
PubMed1997

When the Going Gets Tough, Do the Tough Ask for Help? Help Seeking and Power Motivation in Organizations.

Individuals do not seek help, even when help is needed and available, because help seeking implies incompetence and dependence, and therefore is related to powerlessness. It was hypothesized that gender, status, and organizational norms affect the importance of maintaining and accruing power, which in turn affect help seeking behaviors. A laboratory and a field study showed that there was more help seeking between equal-status than unequal-status individuals. Further, both studies revealed that males sought more help in collective than individualistic organizational norms, though the trend was not apparent for females. These results shed light on the psychological mechanisms underlying help seeking behaviors and have practical implications for developing steps to foster help seeking in organizations. Copyright 1997 Academic Press.

Journal Article↗
PubMed1983

"Company motivates the miserable": the impact of consensus information on help seeking for psychological problems.

Based on an attribution theory analysis, it was predicted that normal individuals (people who do not evidence a particular target problem) would be least motivated to seek help for a psychological problem when they believe that the problem is actuarially common (i.e., high consensus). Based on an analysis of how target problem people evaluate their psychological problem, however, it was predicted that such individuals (unlike normal individuals) should be maximally motivated to seek help when they believe that the problem is common. To test these predictions, target problem and normal individuals (high vs. average test anxious females) were given feedback that they possessed a problem (test anxiety). Individuals were then told that their problem was either common, uncommon, or given no consensus information. As predicted, the higher consensus information led to the least help-seeking behavior for the normal individuals and to the most help-seeking behavior for the target problem individuals.

Anxiety Disorders↗
PubMed2004

Guided self-help versus cognitive-behavioral group therapy in the treatment of bulimia nervosa.

OBJECTIVE: The aim of the current study was to evaluate whether guided self-help was effective in the short and long term in the treatment of bulimia nervosa. METHOD: Eighty-one patients with bulimia nervosa were randomly assigned to either a self-help manual with a maximum of 18 short weekly visits (guided self-help) or to 18 weekly 1.5-h sessions of cognitive-behavioral group therapy (CBT). The primary outcome variables were monthly frequencies of self-reported binge eating and vomiting episodes. Secondary outcome variables were eating disorder-related psychopathology (assessed with the Eating Disorders Inventory [EDI]) and depression (assessed by the Beck Depression Inventory [BDI]). Patients were followed up 1 year after the end of treatment. RESULTS: A mixed-effects linear regression analysis indicated that subjects in both treatment conditions showed a significant decrease over time in binge eating and vomiting frequencies, in the scores of the EDI subscales, and in the BDI. Both treatment modalities led to a sustained improvement at follow-up. A separate analysis of the completer sample showed significantly higher remission rates in the self-help condition (74%) compared with the CBT condition (44%) at follow-up. CONCLUSIONS: Guided self-help incorporating the use of a self-help manual offers an approach that can be effective in the short and long-term treatment of bulimia nervosa.

Adolescent↗
PubMedDate not supplied

Structured interview questions for selecting productive, emotionally mature, and helpful employees.

Behavioral description questions for a structured interview format are provided so that managers can probe an applicant's intelligence, emotional intelligence, and organizational citizenship behaviors. Research suggests that the best performing employees are high on intelligence, and the most socially competent employees are high on emotional intelligence. A study was conducted with a nursing department, and results indicate that emotional intelligence is related to organizational citizenship behaviors. Those individuals high on organizational citizenship behaviors exceed formal role expectations and positively influence organization outcomes.

Emotions↗
PubMed1997

Identification of patient attitudes and preferences regarding treatment of depression.

OBJECTIVES: To identify attitudes that influence patient help-seeking behavior and aspects of treatment that influence patient preferences for management of depression. DESIGN: Three focus group discussions (two patient groups stratified by race and one professional group). Questions addressed experience with depression, help-seeking behaviors, treatment preferences, and perceived barriers to mental health care. SETTING: Academic medical center. PATIENTS/PARTICIPANTS: Eight black patients and eight white patients with depression: seven health care professionals (four physicians and three social workers). MEASUREMENTS AND MAIN RESULTS: Discussions were audiotaped, transcribed, and reviewed independently by two investigators to identify and group distinct comments into categories with specific themes. Differences were adjudicated by a third investigator. Comments within categories were then checked for relevance and consistency by a health services researcher and a psychiatrist. More than 90% of the 806 comments could be grouped into one of 16 categories. Black patients raised more concerns than white patients regarding spirituality and stigma. Patients made more comments than professionals regarding the impact of spirituality, social support systems, coping strategies, life experiences, patient-provider relationships, and attributes of specific treatments. They discussed the role these factors played in their help-seeking behavior and adherence to treatment. CONCLUSIONS: In-depth focus group discussions with depressed patients can provide valuable and unique information about patient experiences and concerns regarding treatment for depression. Clinicians, researchers, and policymakers need to incorporate the range of factors identified by patients into their decision making for individuals with depression.

Academic Medical Centers↗
PubMed1997

Predictors of help seeking among a longitudinal sample of the general population, 1984-1992.

OBJECTIVE: This article considers the predictors of help-seeking behavior, and the types of help sought among the general population. METHOD: Longitudinal data are used, collected during in-person interviews with 2,234 (1190 female) individuals in 1984 and again in 1992. The focus is on help seeking during the follow-up interval, with an emphasis on baseline alcohol-related problems as predictors of seeking help for one's drinking over the 8-year period. Correlates of help seeking are shown separately for respondents who at baseline had already experienced, in their lifetime, three or more dependence-related symptoms, and those who had not. RESULTS: Significant predictors of help seeking during the longitudinal follow-up period include male gender, younger age. Hispanic ethnicity, and having already (at baseline) experienced three or more alcohol-related social consequences. Alcoholics Anonymous (AA) was the most frequent treatment experience that was reported among those seeking help during the study period. CONCLUSIONS: Longstanding social consequences appear to play a key role in decisions to seek help for one's drinking, even when dependence-related symptoms are also considered. In this study Hispanics had an increased likelihood to seek help for their drinking (compared to whites), but blacks did not. AA continues to attract the largest number of help-seekers when compared to other alternatives.

Adolescent↗
PubMed2000

Barriers to and need for alcohol services for women in rural populations.

BACKGROUND: This article reviews and summarizes the research on alcohol problems and issues related to alcohol services for rural women. METHODS: We discuss the prevalence of alcohol problems, help-seeking behavior and barriers to help-seeking for rural women and suggest directions for future research for rural women with alcohol problems. We also address key methodological issues in measuring rurality that must be considered when designing research on rural women. RESULTS: Little is known about these topics, specifically for rural women, and much has to be currently inferred either from studies of psychiatric disorders in rural populations, from studies of urban or suburban women, or from general research about rural life. CONCLUSIONS: Increased knowledge regarding specific issues for women with alcohol problems in rural areas, particularly about gender-specific barriers to obtaining services and gender-specific needs for particular services, will be beneficial for developing programs designed to meet the unique needs of this group of women.

Alcoholism↗
PubMed2005

Prevalence of mental illness among homeless men in the community--approach to a full census in a southern German university town.

AIM: Within the framework of a study of homeless men in the university town of Tubingen in southern Germany, the prevalence of psychiatric disorders and the existing help-seeking behavior, among other things, were to be recorded. METHOD: A total of 151 men belonging to the target group were identified; 91 of them participated in the study. Besides the psychiatric diagnosis, the registered data included psychopathology, cognitive capacity, social functioning and satisfaction with life, as well as social history and case history. RESULTS: Of the probands, 73% were suffering from at least one ongoing psychiatric disorder (diagnosed according to ICD-10 and DSM-IV), primarily alcohol dependence (74%) and drug dependence (34 %), 26% were suffering from an anxiety disorder, 15% from an affective disorder, and 11 % from a disorder of the schizophrenic spectrum. Comorbidity was diagnosed in 67%. Targeted help-seeking behavior concerning the psychiatric or addictive symptoms was extremely rare. Emergency contacts existed with hospitals and general practitioners. DISCUSSION: This study represents the first attempt within Germany and Europe at a full census of homeless men. In international terms, the target region-a small town on the fringes of a conurbation-is a special case. However, compared with studies of help-seeking populations in large cities, virtually no differences were recorded with respect to the prevalence of psychiatric disorders or to help-seeking behavior concerning psychiatric problems and addictions. On the other hand, a substantial number of those concerned evade a resource-intensive, outreach-based study like the present one. Because of German data protection legislation, data on these subjects remain sparse. Concepts aimed at improving the health care system for this target group were found to be dependent in no small measure on the success of the initial contact.

Adult↗
PubMed1995

Suicidality in a sample of methadone maintenance clients.

Previous work has shown that suicide is a significant cause of death among substance abusers, including methadone-maintained clients, and that the prediction of suicidal ideation and behavior is difficult. Preliminary review of data collected at admission on a population of 438 methadone-maintained clients found 55 expressing some level of suicidal behaviors during the course of treatment. These clients were compared with a randomly selected comparison group of 55 nonsuicide clients matched for gender and race/ethnicity on measures of psychological dysfunction, drug use, family dysfunction, and help-seeking behaviors. Results showed that at time of admission suicidal clients reported: 1) more psychological dysfunction as evidenced by higher levels of depression, social dysfunction, hostility, risk-taking, and previous thoughts of suicide; 2) less family support at the present time and during childhood; and 3) more help-seeking behavior as evidenced by self-referral, number of previous treatment episodes, attendance at self-help meetings, and higher scores on motivational measures of desire for help. Differences in preadmission drug-using behaviors were not found between the two groups.

Adult↗
PubMed2002

Self-help and long-term behavior therapy for obesity.

The Trevose Behavior Modification Program, a self-help group offering continuing care for obesity, has recently been shown to produce large long-term weight losses. The present study aimed to replicate this finding across different settings and participants, assessing the weight losses and attrition rates of 128 participants in three Trevose program satellite groups that used the same treatment procedures and manual as the central Trevose group. The satellite groups' results closely paralleled those of the Central Group. Mean intent-to-treat weight loss, or final losses recorded for all participants regardless of their treatment termination date, was 13.7 +/- 0.7% of initial body weight (1.8 +/- 0.7 kg). At two years, 43.8% of participants remained in treatment, having lost a mean of 19.0 +/- 0.8% of their body weight (16.2 +/- 1.0 kg); at five years, 23.4% remained, having lost 18.4 +/- 1.1% of body weight (15.6 +/- 1.5 kg). These results demonstrate that the Trevose model of weight control, combining self-help and continuing care, can be extended and disseminated to other settings, with potentially significant public health consequences.

Behavior Therapy↗
PubMed1991

Acceptance of mental retardation and help-seeking by mothers and fathers of children with mental retardation.

Help-seeking preferences of parents of children with mental retardation were examined. A specially constructed Acceptance of Retardation Scale was administered to 25 fathers and 25 mothers. Respondents were asked to consider a number of need situations associated with their child's retardation and rate the likelihood that they would try to help themselves or seek external help from various sources. Results showed that mothers and fathers may have different help-seeking patterns. The fathers' help-seeking behavior seems to be instrumental, whereas mothers seem to be affected by ego considerations. Several demographic correlates of help-seeking behavior were also collected. Implications were discussed.

Adaptation, Psychological↗
PubMed2006

Effect of referral source on outcome with cognitive-behavior therapy self-help.

Little is known about how psychiatric patients' source of referral relates to treatment outcome. This study examines the effect of referral source on clinical outcome with computer-aided cognitive-behavior therapy (CCBT) for anxiety and depressive disorders. Three hundred fifty-five referrals to a clinic that offered CCBT with brief backup from a clinician were classified into general practitioner (GP) referrals (34%), mental health (MH) professional referrals (42%), and self-referrals (SR, 24%), and compared on sociodemographic and clinical features and treatment outcome. At intake, referrals from all 3 sources had similar sociodemographic features and problem duration, but GP referrals had less comorbidity, whereas MH professional referrals were being treated for their problem more often and were less motivated to change than were SR. Among treatment completers, SRs had the least and MH professional referrals had the most impaired work/social adjustment. Each referral group improved on generic and syndrome-specific measures; however, GP referrals improved the most and MH professional referrals the least. The 3 groups received similar therapist support and were equally satisfied after treatment. We conclude that GP referrals had the best outcome with CCBT for anxiety/depressive disorders. Referral source can be important in psychotherapy research because it may affect the type of patient seen and may predict treatment outcome.

Adult↗
PubMed2004

Experimental evidence of a link between breeding conditions and the decision to breed or to help in a colonial cooperative bird.

In many species mature individuals delay independent reproduction and may help others to reproduce. This behaviour is often explained through ecological constraints, although recently attention has also been paid to the variation in habitat quality. If the quality of vacant habitat influences the fitness trade-off between delaying reproduction and breeding independently, individuals should delay reproduction when conditions for breeding are poor. Yet, no study has experimentally manipulated habitat quality or the conditions experienced during the breeding period to test this assertion conclusively. We report results from an experiment conducted on a colonial cooperative bird with no territory constraints on reproduction. We artificially improved breeding conditions in several colonies of sociable weavers, Philetairus socius, through the provision of an easily obtainable and unlimited supply of food. We provide experimental evidence showing that under enhanced conditions some individuals reduce their age at first reproduction, a greater proportion of colony members engage in independent breeding and proportionally fewer birds act as helpers. Hence, these results also provide evidence for a direct influence of reproductive costs on life-history decisions such as age at first reproduction and breeding and helping behaviours.

Age Factors↗
PubMed1982

Natural networks: help-giving and help-seeking in two rural communities.

A group of 213 respondents in rural communities were interviewed about their help-giving and help-seeking behaviors related to 11 problems of living. Respondents were asked whom they had talked to within their natural community networks, who was most helpful, and how effective they rated the helping. The results indicate that over 80% of the respondents saw themselves as active help-givers and receivers in exchanges with spouses, friends, relatives, and others. A wide range of helping activities were reported, led by attempts to understand another person's situation and feelings and just listening. Differences in help-giving and help-seeking were noted. Respondents indicated a general willingness to tackle problems, a preference for help from people within their networks, and that this type of help is effective.

Adaptation, Psychological↗
PubMedDate not supplied

Long-term associations of helpful and harmful spousal behaviors with smoking cessation.

It has repeatedly been demonstrated that increased levels of social support are positively associated with a smoker's likelihood of achieving abstinence. It remains unclear, however, what specific support behaviors influence smoking cessation. This study explores the effects of supportive and undermining behaviors experienced by subjects (N = 624) in the context of a romantic/marital relationship on a number of smoking cessation outcomes. The associations of social support behaviors with one-, two-, and three-year abstinence and recycling and making quit attempts at 6, 12, 24, and 34 months were examined. Frequencies of both supportive and undermining behaviors predicted the dependent variables under study. Subjects whose spouses demonstrated fewer undermining behaviors were more likely to be successful continuous abstainers, whereas participants' recycling and making quit attempts seemed to be best predicted by a greater frequency of supportive behaviors. Initial success at cessation might be associated with increased supportive behaviors by a spouse, whereas lower rates of undermining behaviors might be associated with long-term maintenance. Long-term tailored feedback to spouses of smokers wanting to quit might be helpful.

Adult↗
PubMed2006

The impact of providing symptom management assistance on caregiver reaction: results of a randomized trial.

This research evaluates the impact of a randomized clinical trial for lowering family members' reactions and increasing their involvement in assisting cancer patients undergoing chemotherapy to better manage their symptoms. The cognitive behavioral intervention was directed toward both the patient and family caregivers. At 10 weeks, caregivers who received the experimental intervention had significantly lower total reactions to assisting with symptoms and assisted with significantly fewer symptoms (linked to patient improvement in symptom severity) than caregivers receiving conventional care alone. Female caregivers receiving the intervention reported significantly lower reaction per symptom where assistance was provided compared to female caregivers in the control group. Thus, the intervention did not increase caregiver involvement in symptom management, quite possibly due to reduced symptom severity among patients in the intervention group. This research offers a model for evaluating trials directed toward both members of a dyad.

Adult↗