Stigma and attitudes toward seeking counseling
A pilot study of cross-cultural differences between college students in the US and Cyprus
Abstract
The present study investigated differences between college students from Cyprus and a small, Midwestern university in the U.S. with regards to public and self-stigma towards seeking professional psychological help as well as help-seeking attitudes. Three ANCOVA tests, controlling for gender, were used to assess differences between the samples from the two countries. Participants from Cyprus reported greater public stigma toward counseling than participants from the U.S. did. However, the two groups did not differ in terms of self-stigma and attitudes towards seeking psychological help. Clinical implications in regards to public stigma and attitudes toward seeking counseling in Cyprus are discussed.
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References
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Andrews, G., Issakidis, C., & Carter, G. (2001). Shortfall in mental health service utilization. British
Journal of Psychiatry, 179 (5), 417-425.
Bebbington, P., Meltzer, H., Brugha, T., et al. (2000). Unequal access and unmet need:
neurotic disorders and the use of primary care services. Psychological Medicine, 30, 1359-1368. http://dx.doi.org/10.1017/S0033291799002950
Coker, E. M. (2005). Selfhood and social distance: Toward a cultural understanding of psychiatric stigma in Egypt. Social Science & Medicine, 61, 920-930. http://dx.doi.org/10.1016/j.socscimed.2005.01.009
Conner, K. O., Copeland, V. C., Grote, N. K., Koeske, G., Rosen, D., Reynolds, C. F., III, & Brown, C. (2010). Mental health treatment seeking among older adults with depression: The impact of stigma and race. American Journal of Geriatric Psychiatry, 18, 531-543. http://dx.doi.org/10.1097/JGP.0b013e3181cc0366
Cooper, A. E., Corrigan, P. W., & Watson, A. C. (2003). Mental illness stigma and care seeking. The Journal of Nervous and Mental Disease, 191 (5), 339-341. http://dx.doi.org/10.1097/01.NMD.0000066157.47101.22
Corrigan, P. W. (2004). How stigma interferes with mental health care. American
Psychologist, 59(7), 614-625. http://dx.doi.org/10.1037/0003-066X.59.7.614
Corrigan, P. W., & Penn, D. L. (1999). Lessons from social psychology on discrediting psychiatric stigma. American Psychologist, 54 (9), 765-776. http://dx.doi.org/10.1037/0003-066X.54.9.765
Corrigan, P., Thompson, V., Lambert, D., Sangster, Y., Noel, G., & Campbell, J. (2003). Perceptions of discrimination among persons with serious mental illness. Psychiatric Services, 54 (8), 1105-1110. http://dx.doi.org/10.1176/appi.ps.54.8.1105
Corrigan, P. W., & Watson, A. C. (2007). The stigma of psychiatric disorders and the gender, ethnicity, and education of the perceiver. Community Mental Health Journal, 43, 439-458. http://dx.doi.org/10.1007/s10597-007-9084-9
Cramer, K. M. (1999). Psychological antecedents to help-seeking behavior: A reanalysis using path modeling structures. Journal of Counseling Psychology, 46 (3), 381-387. http://dx.doi.org/10.1037/0022-0167.46.3.381
Fischer, E. H., & Farina, A. (1995). Attitudes toward seeking professional psychological help: A
shortened form and considerations for research. Journal of College
Student Development, 36 (4), 368-373.
Georgas, J. (1997). The relationship of family bonds to family structure and function across cultures. Journal of Cross-Cultural Psychology, 28 (3), 303-320. http://dx.doi.org/10.1177/0022022197283006
Goldston, D. B., Molock, S. D., Whitbeck, L. B., Murakami, J. L., Zayas, L. H., & Hall, G. C. N. (2008). Cultural considerations in adolescent suicide prevention and psychosocial treatment. American Psychologist, 63, 14-31. http://dx.doi.org/10.1037/0003-066X.63.1.14
Kessler, R. C., Berglund, P. A., Bruce, M. L., Koch, J. R., Laska, E. M., Leaf, P. J., Manderscheid, R. W., Rosenheck, R. A., Walters, E. E., & Wang, P. S. (2001). The prevalence and correlates of untreated serious mental illness. Health Services Research, 36(6), 987-1007.
Komiya, N., Good, G. E., & Sherrod, N. B. (2000). Emotional openness as a predictor of college
students’ attitudes toward seeking psychological help. Journal of Counseling Psychology, 47 (1), 138-143.
Link, B. G., Struening, E. L., Neese-Todd, S., Asmussen, S., & Phellan, J. C. (2001). The
consequences of stigma for the self-esteem of people with mental illnesses.
Psychiatric Services, 52 (12), 1621-1626.
Ludwikowski, W., Vogel, D. L., & Armstrong, P. I. (2009). Attitudes towards career counseling: The role of public and self-stigma. Journal of Counseling Psychology, 56, 408-416. http://dx.doi.org/10.1037/a0016180
National Institute for Mental Health (2005. Prevalence of serious mental illness among U.S. adults by age, sex and race. Retrieved from http://www.nimh.nih.gov/statistics /SMI_AASR.shtml
Papadopoulos, C., Foster, J., & Caldwell, K. (2013). ‘Individualism-collectivism’ as an explanatory device for mental illness stigma. Community Mental Health Journal, 49 (3), 270-280. doi: 10.1007/s10597-012-9534-x
Papadopoulos, C., Leavey, G., & Vincent, C. (2002). Factors influencing stigma: A comparison of Greek-Cypriot and English attitudes towards mental illness in north London. Social Psychiatry and Psychiatric Epidemiology, 37 (9), 430-434. doi: 10.1007/s00127-002-0560-9
Price, B. K., & McNeill, B. W. (1992). Cultural commitment and attitudes toward seeking counseling services in American Indian college students. Professional Psychology: Research and Practice, 23 (5), 376-381. http://dx.doi.org/10.1037/0735-7028.23.5.376
Sirey, J., Bruce, M. L., Alexopoulos, G. S., Perlick, D. A., Raue, P., Friedman, S. J., & Meyers, B. S.
(2001). Perceived stigma as a predictor of treatment discontinuation in young and older outpatients with depression. American Journal of Psychiatry, 158, 479-481. http://dx.doi.org/10.1176/appi.ajp.158.3.479
Tsemberis, S. J., & Orfanos, S. D. (1996). Greek families. In M. McGoldrick, J. K. Pearce, & J. Giordano (Eds.), Ethnicity and Family Therapy (pp. 517-529). New York: Guilford Press.
Wade, N. G., Post, B., Cornish, M., Vogel, D. L., & Tucker, J. (2011). Predictors of the change in self-stigma following a single session of group counseling. Journal of Counseling Psychology, 58, 170-182. http://dx.doi.org/10.1037/a0022630
Vogel, D. L., Armstrong, P. I., Tsai, P., Wade, N. G., Hammer, J. H., Holtman, E., Liao, H., Efstathiou, G., Kouvaraki, E., Shechtman, Z., & Topkaya, N. (2013). Cross-cultural validity of the Self-Stigma of Seeking Help (SSOSH) Scale: examination across six nations. Journal of Counseling Psychology, 60 (2), 303-310. http://dx.doi.org/10.1037/a0032055
Vogel, D. L., Bitman, R. L., Hammer, J. H., & Wade, N. G. (2013). Is stigma internalized? The longitudinal impact of public stigma on self-stigma. Journal of Counseling Psychology, 60 (2), 311-316. http://dx.doi.org/10.1037/a0031889
Vogel, D. L., Heimerdinger-Edwards, S. R., Hammer, J. H., & Hubbard, A. (2011). “Boys don’t cry”: examination of the links between endorsement of masculine norms, self-stigma, and help-seeking attitudes for men from diverse backgrounds. Journal of Counseling Psychology, 58 (3), 368-382.
Vogel, D. L., Shechtman, Z., & Wade, N. (2010). The role of public and self-stigma in predicting attitudes toward group counseling. Counseling Psychologist, 38, 904-922. http://dx.doi.org/10.1177/0011000010368297
Vogel, D. L., Wade, N. G., & Haake, S. (2006). Measuring the self-stigma associated with seeking
psychological help. Journal of Counseling Psychology, 53 (3), 325-337. http://dx.doi.org/10.1037/0022-0167.53.3.325
Vogel, D. L., Wade, N. G., & Hackler, A. H. (2007). Perceived public stigma and the willingness to seek counseling: the mediating roles of self-stigma and attitudes toward counseling. Journal of Counseling Psychology, 54(1), 40-50. http://dx.doi.org/10.1037/0022-0167.54.1.40
Vogel, D. L., & Wester, S. R. (2003). To seek help or not to seek help: the risks of self-disclosure. Journal of Counseling Psychology, 50 (3), 351-361. http://dx.doi.org/10.1037/0022-0167.50.3.351
Andrews, G., Issakidis, C., & Carter, G. (2001). Shortfall in mental health service utilization. British
Journal of Psychiatry, 179 (5), 417-425.
Bebbington, P., Meltzer, H., Brugha, T., et al. (2000). Unequal access and unmet need:
neurotic disorders and the use of primary care services. Psychological Medicine, 30, 1359-1368. http://dx.doi.org/10.1017/S0033291799002950
Coker, E. M. (2005). Selfhood and social distance: Toward a cultural understanding of psychiatric stigma in Egypt. Social Science & Medicine, 61, 920-930. http://dx.doi.org/10.1016/j.socscimed.2005.01.009
Conner, K. O., Copeland, V. C., Grote, N. K., Koeske, G., Rosen, D., Reynolds, C. F., III, & Brown, C. (2010). Mental health treatment seeking among older adults with depression: The impact of stigma and race. American Journal of Geriatric Psychiatry, 18, 531-543. http://dx.doi.org/10.1097/JGP.0b013e3181cc0366
Cooper, A. E., Corrigan, P. W., & Watson, A. C. (2003). Mental illness stigma and care seeking. The Journal of Nervous and Mental Disease, 191 (5), 339-341. http://dx.doi.org/10.1097/01.NMD.0000066157.47101.22
Corrigan, P. W. (2004). How stigma interferes with mental health care. American
Psychologist, 59(7), 614-625. http://dx.doi.org/10.1037/0003-066X.59.7.614
Corrigan, P. W., & Penn, D. L. (1999). Lessons from social psychology on discrediting psychiatric stigma. American Psychologist, 54 (9), 765-776. http://dx.doi.org/10.1037/0003-066X.54.9.765
Corrigan, P., Thompson, V., Lambert, D., Sangster, Y., Noel, G., & Campbell, J. (2003). Perceptions of discrimination among persons with serious mental illness. Psychiatric Services, 54 (8), 1105-1110. http://dx.doi.org/10.1176/appi.ps.54.8.1105
Corrigan, P. W., & Watson, A. C. (2007). The stigma of psychiatric disorders and the gender, ethnicity, and education of the perceiver. Community Mental Health Journal, 43, 439-458. http://dx.doi.org/10.1007/s10597-007-9084-9
Cramer, K. M. (1999). Psychological antecedents to help-seeking behavior: A reanalysis using path modeling structures. Journal of Counseling Psychology, 46 (3), 381-387. http://dx.doi.org/10.1037/0022-0167.46.3.381
Fischer, E. H., & Farina, A. (1995). Attitudes toward seeking professional psychological help: A
shortened form and considerations for research. Journal of College
Student Development, 36 (4), 368-373.
Georgas, J. (1997). The relationship of family bonds to family structure and function across cultures. Journal of Cross-Cultural Psychology, 28 (3), 303-320. http://dx.doi.org/10.1177/0022022197283006
Goldston, D. B., Molock, S. D., Whitbeck, L. B., Murakami, J. L., Zayas, L. H., & Hall, G. C. N. (2008). Cultural considerations in adolescent suicide prevention and psychosocial treatment. American Psychologist, 63, 14-31. http://dx.doi.org/10.1037/0003-066X.63.1.14
Kessler, R. C., Berglund, P. A., Bruce, M. L., Koch, J. R., Laska, E. M., Leaf, P. J., Manderscheid, R. W., Rosenheck, R. A., Walters, E. E., & Wang, P. S. (2001). The prevalence and correlates of untreated serious mental illness. Health Services Research, 36(6), 987-1007.
Komiya, N., Good, G. E., & Sherrod, N. B. (2000). Emotional openness as a predictor of college
students’ attitudes toward seeking psychological help. Journal of Counseling Psychology, 47 (1), 138-143.
Link, B. G., Struening, E. L., Neese-Todd, S., Asmussen, S., & Phellan, J. C. (2001). The
consequences of stigma for the self-esteem of people with mental illnesses.
Psychiatric Services, 52 (12), 1621-1626.
Ludwikowski, W., Vogel, D. L., & Armstrong, P. I. (2009). Attitudes towards career counseling: The role of public and self-stigma. Journal of Counseling Psychology, 56, 408-416. http://dx.doi.org/10.1037/a0016180
National Institute for Mental Health (2005. Prevalence of serious mental illness among U.S. adults by age, sex and race. Retrieved from http://www.nimh.nih.gov/statistics /SMI_AASR.shtml
Papadopoulos, C., Foster, J., & Caldwell, K. (2013). ‘Individualism-collectivism’ as an explanatory device for mental illness stigma. Community Mental Health Journal, 49 (3), 270-280. doi: 10.1007/s10597-012-9534-x
Papadopoulos, C., Leavey, G., & Vincent, C. (2002). Factors influencing stigma: A comparison of Greek-Cypriot and English attitudes towards mental illness in north London. Social Psychiatry and Psychiatric Epidemiology, 37 (9), 430-434. doi: 10.1007/s00127-002-0560-9
Price, B. K., & McNeill, B. W. (1992). Cultural commitment and attitudes toward seeking counseling services in American Indian college students. Professional Psychology: Research and Practice, 23 (5), 376-381. http://dx.doi.org/10.1037/0735-7028.23.5.376
Sirey, J., Bruce, M. L., Alexopoulos, G. S., Perlick, D. A., Raue, P., Friedman, S. J., & Meyers, B. S.
(2001). Perceived stigma as a predictor of treatment discontinuation in young and older outpatients with depression. American Journal of Psychiatry, 158, 479-481. http://dx.doi.org/10.1176/appi.ajp.158.3.479
Tsemberis, S. J., & Orfanos, S. D. (1996). Greek families. In M. McGoldrick, J. K. Pearce, & J. Giordano (Eds.), Ethnicity and Family Therapy (pp. 517-529). New York: Guilford Press.
Wade, N. G., Post, B., Cornish, M., Vogel, D. L., & Tucker, J. (2011). Predictors of the change in self-stigma following a single session of group counseling. Journal of Counseling Psychology, 58, 170-182. http://dx.doi.org/10.1037/a0022630
Vogel, D. L., Armstrong, P. I., Tsai, P., Wade, N. G., Hammer, J. H., Holtman, E., Liao, H., Efstathiou, G., Kouvaraki, E., Shechtman, Z., & Topkaya, N. (2013). Cross-cultural validity of the Self-Stigma of Seeking Help (SSOSH) Scale: examination across six nations. Journal of Counseling Psychology, 60 (2), 303-310. http://dx.doi.org/10.1037/a0032055
Vogel, D. L., Bitman, R. L., Hammer, J. H., & Wade, N. G. (2013). Is stigma internalized? The longitudinal impact of public stigma on self-stigma. Journal of Counseling Psychology, 60 (2), 311-316. http://dx.doi.org/10.1037/a0031889
Vogel, D. L., Heimerdinger-Edwards, S. R., Hammer, J. H., & Hubbard, A. (2011). “Boys don’t cry”: examination of the links between endorsement of masculine norms, self-stigma, and help-seeking attitudes for men from diverse backgrounds. Journal of Counseling Psychology, 58 (3), 368-382.
Vogel, D. L., Shechtman, Z., & Wade, N. (2010). The role of public and self-stigma in predicting attitudes toward group counseling. Counseling Psychologist, 38, 904-922. http://dx.doi.org/10.1177/0011000010368297
Vogel, D. L., Wade, N. G., & Haake, S. (2006). Measuring the self-stigma associated with seeking
psychological help. Journal of Counseling Psychology, 53 (3), 325-337. http://dx.doi.org/10.1037/0022-0167.53.3.325
Vogel, D. L., Wade, N. G., & Hackler, A. H. (2007). Perceived public stigma and the willingness to seek counseling: the mediating roles of self-stigma and attitudes toward counseling. Journal of Counseling Psychology, 54(1), 40-50. http://dx.doi.org/10.1037/0022-0167.54.1.40
Vogel, D. L., & Wester, S. R. (2003). To seek help or not to seek help: the risks of self-disclosure. Journal of Counseling Psychology, 50 (3), 351-361. http://dx.doi.org/10.1037/0022-0167.50.3.351
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Stigma and attitudes toward seeking counseling: A pilot study of cross-cultural differences between college students in the US and Cyprus. (2017). Journal of Interdisciplinary Studies in Education, 5(2), 26-37. https://ojed.org/jise/article/view/1562
