A "Self-Milieux" perspective on help-seeking: examining the impact of a person's sociocultural background on help-seeking in people with untreated depressive symptoms

BACKGROUND

Mental illness is a global concern and the leading cause of years lived with disability. Research on help-seeking behaviour has focused on individual factors, but there is still much unexplained variance. Suggesting complex interactions between determinants of human behaviour a new framework called Self-Milieux is proposed to represent a person's sociocultural background. The article introduces a statistical approach to determine Self-Milieux and exemplarily examines its predictive validity for health-related research.

METHODS

Self-Milieux are determined through a two-stage clustering method based on the determinants socioeconomic status and self-construal profile. Descriptive analyses are used to compare Self-Milieux characteristics. Hierarchical binary logistic regression models test the association between Self-Milieux and help-seeking behaviour, while controlling for socioeconomic status as an established predictor.

RESULTS

The sample size was N = 1535 (Mage = 43.17 and 64.89% female participants). Average depression severity was M = 12.22, indicating mild to moderate symptoms. Six Self-Milieux were determined and named. Participants from privileged (aOR = 0.38) and self-sufficient (aOR = 0.37) milieux were less likely to seek help from a general practitioner than those from the entitled milieu. Participants from privileged (aOR = 0.30), collaborators (aOR = 0.50), disadvantaged (aOR = 0.33), and self-sufficient (aOR = 0.21) milieux were less likely to seek help from family members than those from the entitled and family-bound milieux.

DISCUSSION

The study's strengths and limitations, as well as the cluster methodology, are discussed. The comparative results for the six Self-Milieux are interpreted based on current research. For example, participants from some milieux follow a help-seeking process proposed in previous research, while participants from other milieux seem to show a different process, one that ends in informal help-seeking.

The differential influence of self-construal on the effect of self-efficacy on the help-seeking process: A quasi-experimental online study among people with untreated depressive symptoms

BACKGROUND

Despite available professional healthcare, people often delay or avoid help-seeking. Understanding the underlying reasons is crucial and research has explored the role of self-efficacy in this context. Additionally, studies have highlighted the significance of culturally influenced self-construals in individuals' health behaviour. There seems to be a relationship between self-efficacy and self-construal. The aim of the study is to explore the influence of self-efficacy on help-seeking, considering self-construal as a moderator. Differential experiences of self-efficacy and varying associations among help-seeking variables based on self-construal are posited.

METHODS

A quasi-experimental online study is conducted with a baseline assessment, including self-efficacy interventions, and follow-ups at three and six months. Self-construal groups are compared, i.e., independent vs. interdependent individuals. A series of multi-group path analyses are conducted to examine potential variations in the interventional effects and among the help-seeking variables respective of help-seeking instance, i.e. professional mental health care or informal care. Self-construal functions as the global moderator.

RESULTS

The study included N = 1'368 participants, 65.6 % identifying as female and an average age of 42.38 (SD = 15.22). More independent compared to more interdependent individuals were older, more frequently identified as male, had higher socioeconomic status, fewer depressive symptoms, and greater self-efficacy. Multi-group path analyses for professional mental health care (CFI = 0.992, RMSEA = 0.018, SRMR = 0.004) and informal help (CFI = 0.999, RMSEA = 0.004, SRMR = 0.006) demonstrated excellent model fits. The analysis for informal help was interpretable, as the unconstrained model had a significantly better fit than the constrained model. There were varying associations among help-seeking variables based on self-construals. The intervention effect was differential, with independent participants benefiting significantly (β = 0.203), while the effect was non-significant for interdependent participants.

DISCUSSION

The study's findings, strengths, and limitations are discussed in relation to current research. Results indicate differential experiences of self-efficacy interventions based on individuals' self-construal. Moreover, varying associations among help-seeking variables suggest self-construal-based differences in their interrelationships. These findings highlight the importance of considering self-construal in health related research.

A Data-Driven Analysis of Sociocultural, Ecological, and Economic Correlates of Depression Across Nations

The prevalence of depression varies widely across nations, but we do not yet understand what underlies this variation. Here we use estimates from the Global Burden of Disease study to analyze the correlates of depression across 195 countries and territories. We begin by identifying potential cross-correlates of depression using past clinical and cultural psychology literature. We then take a data-driven approach to modeling which factors correlate with depression in zero-order analyses, and in a multiple regression model that controls for covariation between factors. Our findings reveal several potential correlates of depression, including cultural individualism, daylight hours, divorce rate, and GDP per capita. Cultural individualism is the only factor that remains significant across all our models, even when adjusting for spatial autocorrelation, mental healthcare workers per capita, multicollinearity, and outliers. These findings shed light on how depression varies around the world, the sociocultural and environmental factors that underlie this variation, and potential future directions for the study of culture and mental illness.

The Influence of Tertiary Education Disciplines on Self-Construals and Conflict Management Tendencies

While cultural difference on self-construal are well-documented, how acculturation to a new cultural environment could change an individual’s self-construal remains under-explored. In this research, how tertiary education disciplines could be associated with the endorsement of self-construals which, in turn, affect students’ conflict management tendencies were explored. Study 1 revealed that across the United States and Singapore, college students from business and social science disciplines exhibited the trend of endorsing more independent and interdependent self-construal respectively, regardless of the different dominant self-construals in the two countries. Study 2 explored how tertiary education disciplines is associated with individuals’ conflict management tendencies via the endorsement of different self-construals among Singaporeans. Findings showed that individuals from business discipline possess a more independent self-construal and in turn endorsed more of a competing conflict management style than those from social sciences. Different disciplinary cultures could link to conflict management tendencies via the endorsement of self-construals, yielding significant theoretical and practical implications.

Unpacking Structure-Oriented Cultural Differences Through a Mediated Moderation Model: A Tutorial With an Empirical Illustration

Explaining cultural differences in the magnitude of psychological constructs and associations between psychological constructs is pivotal in cross-cultural psychology. Although unpacking level-oriented cultural differences has been well documented in the literature, discussion on methods to unpack structure-oriented cultural differences is limited. To tackle this problem, we propose an application of mediated moderation analysis. By estimating and comparing the “indirect (mediated) moderation effects of culture” through different mediated moderators, researchers can evaluate the explanatory power of an underlying mechanism relative to other mediated moderators. To facilitate the use of the mediated moderation model to unpack structure-oriented cultural differences, we discuss technical issues on how to specify a mediated moderation model, how to interpret the moderation effects of culture, and how large the sample size needs to be. An empirical illustration is also presented to demonstrate the application of the method with syntax for different software programs.

Differences in Compassion, Well-being, and Social Anxiety between Japan and the USA

Research has shown that self-compassion can improve individual well-being in many cultures; however, little research has examined cultural differences regarding compassion for others and individual well-being. Cross-cultural research has indicated that interdependent happiness and Taijin Kyofusho (TKS) (other-focused social anxiety) are aspects of well-being and psychopathology, respectively, related to interdependent (i.e., collectivistic) cultures such as Japan. First, we hypothesized that self-compassion would foster greater positive affect and satisfaction with life in the US than in Japan. Our second hypothesis was that the compassion for others would be association with greater interdependent happiness, and with less TKS symptoms in Japan than in the US. Through a web-based survey of Japanese and American adults, we found that self-compassion was related to positive and negative affect, SAD and TKS symptoms, and well-being in both countries. Compassion for others was found to be associated with increased positive affect and decreased TKS symptoms across both cultures. Simple slope tests revealed that self-compassion had a stronger relation with positive affect among U.S. adults than their Japanese counterparts, whereas compassion for others was related to interdependent happiness only in Japan. These findings suggest that the link between compassion, well-being, and psychopathology might be universal, although the effects of two types of compassion have different patterns between the two cultures.

The relationship of self-efficacy to catastrophizing and depressive symptoms in community-dwelling older adults with chronic pain: A moderated mediation model

Self-efficacy has been consistently found to be a protective factor against psychological distress and disorders in the literature. However, little research is done on the moderating effect of self-efficacy on depressive symptoms in the context of chronic pain. This cross-sectional study aimed to examine if pain self-efficacy attenuated the direct relationship between pain intensity and depressive symptoms, as well as their indirect relationship through reducing the extent of catastrophizing when feeling pain (moderated mediation). 664 community-dwelling Chinese older adults aged 60-95 years who reported chronic pain for at least three months were recruited from social centers. They completed a battery of questionnaires on chronic pain, pain self-efficacy, catastrophizing, and depressive symptoms in individual face-to-face interviews. Controlling for age, gender, education, self-rated health, number of chronic diseases, pain disability, and pain self-efficacy, pain catastrophizing was found to partially mediate the connection between pain intensity and depressive symptoms. Furthermore, the relationship between pain intensity and depressive symptoms was moderated by pain self-efficacy. Self-efficacy was also found to moderate the relationship between pain intensity and catastrophizing and the moderated mediation effect was confirmed using bootstrap analysis. The results suggested that with increasing levels of self-efficacy, pain intensity's direct effect on depressive symptoms and its indirect effect on depressive symptoms via catastrophizing were both reduced in a dose-dependent manner. Our findings suggest that pain self-efficacy is a significant protective factor that contributes to psychological resilience in chronic pain patients by attenuating the relationship of pain intensity to both catastrophizing and depressive symptoms.

Cultural Self-Awareness as Awareness of Culture's Influence on the Self: Implications for Cultural Identification and Well-Being

Cultural self-awareness refers to the awareness of how culture has influenced the self. This research investigated how such awareness might be related to cultural identification and well-being. In Study 1, we developed a scale measure that differentiated individuals' awareness of how culture has influenced them (cultural self-awareness) and how their own personality and personal experiences have influenced them (personal self-awareness). Factor analysis and item analysis showed a two-factor model with acceptable scale reliability. Study 2 showed that cultural self-awareness positively predicted well-being through higher cultural identification, whereas personal self-awareness positively predicted well-being through higher behavioral authenticity. Study 3 manipulated the valence of individuals' cultural experience. The indirect effect of cultural self-awareness on well-being was stronger when cultural experience was positive (vs. negative). Study 4 provided a specific cultural context for the well-being measures and replicated the findings of Studies 2 and 3. Implications on the link between culture and self were discussed.