Men's Service Use for Depression and Anxiety Disorders

描述（由申请人提供）：男性因抑郁症、药物滥用、身体残疾和生活压力事件等各种问题寻求心理健康服务的可能性明显低于女性。在寻求帮助方面持续存在的性别差异对公共卫生的影响是巨大的。男性患抑郁症和焦虑症的比例正在上升，男性自杀率是女性的四倍。男性情绪或焦虑障碍的存在也与药物滥用、愤怒和暴力等重大附带问题有关。迄今为止，很少有理论或实证研究关注于理解男性特有问题与寻求帮助行为之间的关系。目前的R34提案描述了在低收入不同男性样本中对男性抑郁症和焦虑症心理健康服务利用模型的初步测试。基于性别的社会心理学（GBSP）模型认为，个体在遵守传统男性规范和信念方面的差异会激活基本的社会心理过程，从而阻碍寻求帮助。尽管该模型得到了男性气质与心理健康以及寻求帮助的社会心理学的实证研究的充分支持，但很少有机制在有能力寻求心理健康服务的成年非大学男性中进行了测试。100名有抑郁或焦虑症症状的男性将通过报纸、广播和电视广告以及当地非精神卫生社区设置的摊位招募。参与者将完成对GBSP模型中心结构的测量，并将在6个月后返回进行后续评估，以确定模型的预测有效性。将进行20次单独的定性访谈，以支持对与寻求心理健康服务有关的男子态度和行为的集中趋势和变化进行有根据的理论分析。该模型初始测试的数据将用于为简短评估和个性化反馈干预的开发提供信息，旨在提高男性寻求情绪和焦虑障碍帮助的可能性。这种干预将针对寻求帮助的社会心理障碍，包括自我耻辱感、对不规范的看法、男子气概信念和其他障碍。干预措施将在最初的试点研究中进行测试，以评估其可行性和可接受性，并估计计划后续随机试验的效应大小。

DESCRIPTION (provided by applicant): Men are significantly less likely than women to seek mental health services for problems as diverse as depression, substance abuse, physical disabilities, and stressful life events. The public health implications of the consistent gender differences in help seeking are dramatic. Men's rates of depression and anxiety disorders are increasing, and men's rates of completed suicide are four times higher than women's. The presence of mood or anxiety disorders in men has also been linked to significant collateral problems such as substance abuse, anger, and violence. To date, very little theoretical or empirical work has focused on understanding how issues specific to men are related to help-seeking behavior. The current R34 proposal describes an initial test of a model of men's mental health service utilization for depression and anxiety disorders, in a sample of low-income diverse men. The gender-based social psychological (GBSP) model posits that individual differences in adherence to traditionally masculine norms and beliefs activate basic social psychological processes that militate against help seeking. Although the model is well-supported by empirical research on masculinity and mental health, and the social psychology of help-seeking, few of the mechanisms have been tested in adult non-college men who are in a position to seek mental health services. 100 men experiencing symptoms of depression or anxiety disorders will be recruited through newspaper, radio, and television advertisements, and at booths in local non-mental health community settings. Participants will complete measures of constructs central to the GBSP model and will return 6 months later for a follow-up assessment to determine the predictive validity of the model. 20 separate qualitative interviews will be conducted to support a grounded theory analysis of central tendencies and variations in men's attitudes and behaviors related to seeking mental health services. Data from the initial test of the model will be used to inform development of a brief assessment and personalized feedback intervention designed to increase men's likelihood of help seeking for mood and anxiety disorders. This intervention will target social psychological barriers to help seeking, including self-stigma, perceptions of non-normativeness, masculinity beliefs, and other barriers. The intervention will be tested in an initial pilot study to evaluate its feasibility and acceptability, and to estimate effect sizes for planning a subsequent randomized trial.