바로가기메뉴

본문 바로가기 주메뉴 바로가기

logo

메뉴

자기 구성과 역기능적 태도가 심리적 도움추구와 관련된 자기낙인에 미치는 영향

The Effects of Self Construal and Dysfunctional Attitude on Self Stigma Associated with Seeking Psychological Help

초록

본 연구는 자기구성(독립, 관계), 역기능적 태도(성취, 의존)와 자기낙인의 관련성을 살펴보고, 역기능적 태도 처치가 상담이점 교육 처치에 비해 심리적 도움추구와 관련된 자기낙인을 줄이고 상담의도를 증가시키는지 탐색하였다. 연구 1에서는 일반 성인 209명을 대상으로 설문연구를 실시하여 자기구성, 역기능적 태도와 자기낙인의 관계를 살펴보았다. 그 결과, 독립적 자기구성이 높을수록 자기낙인이 낮아지는 경향이 있었고, 역기능적 태도(성취, 의존) 수준이 높을수록 자기낙인이 높아지는 것으로 나타났지만, 관계적 자기구성과 자기낙인은 유의한 상관을 보이지 않았다. 성차를 분석한 결과, 낮은 독립적 자기구성 수준이 자기낙인에 미치는 영향력은 남성보다 여성이 더 높았고, 자기구성의 영향을 통제했을 때, 여성의 경우 성취, 의존 역기능적 태도 모두 자기낙인을 추가 설명한 반면, 남성의 경우 성취 역기능적 태도만이 추가설명력을 보였다. 연구 2에서는 유능, 관계적 자기와 관련된 역기능적 신념을 수정하기 위한 유능성, 관계성 역기능적 태도 처치 집단을 구성하여 상담이점 교육 처치와 비교하였다. 총 71명이 실험에 참여하였고, 사전, 사후, 추후(일주일 후) 시기에 자기낙인, 역기능적 태도, 상담의도를 측정하였다. 연구 결과, 세 처치 집단에서 시간에 따른 개선 효과가 나타났지만 처치 집단 간 차이, 시기와 집단 간 상호작용 효과는 나타나지 않았다. 하지만 집단별로 측정치 변화량 간의 상관을 살펴보면, 처치의 차별적 경향이 나타났다. 역기능적 태도 처치 두 집단(유능성, 관계성)은 역기능적 태도가 감소함에 따라 자기낙인도 감소하고, 자기낙인이 감소함에 따라 상담의도가 증가하는 경향을 보인 반면, 상담이점 교육 집단에서는 이러한 상관 패턴이 나타나지 않았다. 마지막으로 본 연구의 의의와 제한점 및 후속 연구를 위한 제언을 논의하였다.

keywords
자기낙인, 도움추구, 자기구성, 역기능적 태도, self stigma, seeking psychological services, self-construal, dysfunctional attitude

Abstract

The purpose of this study was to explore self-characteristics that influence self-stigma associated with seeking counseling. The role of self-construal and dysfunctional attitude in the process of self-stigmatization was examined, and whether the change in dysfunctional attitude increases the intention to seek counseling by reducing self-stigma was investigated. In Study 1, with the participation of 209 college students, the relationships among self-construal, dysfunctional attitude, and self-stigma were examined. It showed that a higher level of independent self-construal related to the lower level of self-stigma, whereas there was no significant correlation between relational self-construal and self-stigma. The result also showed that a higher level of dysfunctional attitude(autonomy, sociotropy) related to the higher level of self-stigma. It showed that self-stigma exerted negative influence on the intention to seek counseling. Study 2 explored the strategies for reducing self-stigma. For this purpose, the author developed two dysfunctional attitude treatment conditions, each of which was made to modify the dysfunctional belief in autonomous or sociotropic self and was then compared to the educational treatment with counseling benefits that did not directly handle self. Total 71 subjects participated in the experiment and self-stigma, dysfunctional attitude, and intentions to seek counseling were measured at three times(pre-treatment, post-treatment, and a week following the treatment). The result showed improvement for the three treatment groups after the treatment, whereas there was no difference among the treatment groups, and there was no interaction between time and the groups. However, when the correlation between the change in measurements for different groups was examined, treatments showed a differential tendency. Diminished dysfunctional attitude correlated with decreased self-stigma and decreased self-stigma correlated with increased intention to seek counseling for the two dysfunctional attitude treatment groups. Futhermore, the treatment effect of intention to seek counseling was lasted more on dysfunctional attitude treatment groups than on education group. Lastly, the implications and limitations of this study were discussed with suggestions for further research.

keywords
자기낙인, 도움추구, 자기구성, 역기능적 태도, self stigma, seeking psychological services, self-construal, dysfunctional attitude

참고문헌

1.

권석만 (1994). 한국판 역기능적 태도척도의 신뢰도, 타당도 및 요인구조. 심리과학, 3(1), 100-111.

2.

권석만 (2007). 우울증: 침체와 절망의 늪. 서울: 학지사.

3.

김미영 (2014). 조현병환자의 내재화된 낙인 감소를 위한 인지행동프로그램 개발 및 효과검증. 부산대학교 대학원 박사학위논문.

4.

김미영, 전성숙 (2012). 조현병 환자의 내재화된 낙인에 영향을 미치는 요인. 정신간호학회지, 21(2), 108-117.

5.

김미영, 전성숙, 변은경 (2017). 정신장애인의 내재화된 낙인 극복 경험. Journal of Korean Academy of Psychiatric and Mental Health Nursing, 26(3), 238- 247.

6.

김수현 (2009). 전문적도움 추구 행동 증진을 위한 교육프로그램의 개발과 효과검증. 사회과학연구, 26(2), 89-138.

7.

김은경 (2004). 자아해석 양식에서 성차와 사회불안 및 우울의 관계. 이화여자대학교 대학원 석사학위논문.

8.

김은아, 손혜련, 김은하 (2018). 상담에서 전문적 도움추구의 선행요인에 대한 고찰. 상담학연구, 19(1), 87-111.

9.

김정수 (2018). 상담 이용의사와 낙인 및 전문적 도움 추구 태도와의 관계. 수산해양교육연구, 30(3), 947-957.

10.

김주미 (2002). 심리적 불편감, 자기 은폐, 사회 지지망, 개인주의-집단주의가 전문적 도움 추구 태도에 미치는 영향. 이화여자대학교 대학원 석사학위논문.

11.

김지경, 김명소 (2003). 한국 남녀의 관계적 자기의 특성: 다원적 구성요인 탐색 및 타당성 분석. 한국심리학회지: 사회문제, 9(2), 41-59.

12.

김현경 (2007). 우울장애 환자의 스티그마와 치료추구행위. 연세대학교 대학원 석사학위논문.

13.

김희철 (2018). 대학생의 심리적 디스트레스와 전문적 도움추구태도의 관계에서 낙인의 매개효과. 정신보건과 사회사업, 46(1), 5-33.

14.

박순희 (2009). 내현적 자기애와 분노표현 양식이 대인관계와 심리적 고통에 미치는 영향. 경남대학교 대학원 석사학위논문.

15.

박연숙 (2015). 역기능 가정 청소년의 자아존중감 향상을 위한 해결중심 단기 상담에 관한 질적 연구: 상담자의 치료적 요인. 한국교원대학교 교육대학원 석사학위논문.

16.

박준호, 서영석 (2009). 남자 대학생들의 성역할갈등과 상담 의도와의 관계: 사회적 낙인, 자기 낙인, 상담에 대한 태도의 매개 효과. 한국심리학회지: 상담 및 심리치료, 21(1), 25-48.

17.

방희정, 조혜자 (2003). 관계적 자아의 암묵적 표상. 미간행.

18.

보건복지부, 삼성서울병원 (2017). 2016년도 정신질환실태 조사. 서울: 보건복지부.

19.

서동우 (2007). 정신보건의 역사적 변화선상에서 본 우리나라 정신보건법의 문제와 개선안. 보건복지포럼, 123, 42-56.

20.

신연희, 안현의 (2005). 전문적 도움추구 행동에서 접근요인과 회피요인의 상대적 중요성 고찰. 한국심리학회지: 상담 및 심리치료, 17(1), 177-195.

21.

신은혜 (2015). 자기가치 확인 유형이 심리적 고통을 호소하는 대학생의 상담에 대한 자기 낙인에 미치는 영향: 내재적, 외재적 자기가치 확인의 효과 비교. 서울대학교 대학원 석사학위논문.

22.

신재호 (2005). 초보상담자의 상담성과에 관한 질적분석(도움된 경험을 중심으로). 가톨릭대학교 대학원 석사학위논문.

23.

안수정, 서영석 (2017). 중년 남성의 전문적 도움추구에 관한 연구: 성역할 갈등, 자기 낙인, 상담 태도, 상담 의도 간 관계에서 중년의 위기감과 상담 친화적 환경의 조절된 매개효과 검증. 한국심리학회지: 상담 및 심리치료, 29(3), 629-657.

24.

양주영 (2014). 상담자와 내담자가 인식하는 상담 성과에 관한 질적 연구: 초보 상담자 관점을 중심으로. 한국교원대학교 대학원 석사학위논문.

25.

유성경, 유정이 (2000). 집단주의-개인주의 성향과 상담에 대한 태도와의 관계. 한국심리학회지: 상담 및 심리치료, 12(1), 19-32.

26.

윤은영 (2013). 치료대상 아동 어머니의 낙인지각과 치료관계: 도움추구태도를 매개요인으로. 고려대학교 교육대학원 석사학위논문.

27.

윤지영 (2007). 낙인, 자기은폐, 자기개방이 도움추구에 미치는 영향. 이화여자대학교 대학원 석사학위논문.

28.

이구현 (2013). 개인의 자기-해석과 가치 확인이 자기 평가에 미치는 영향. 성균관대학교 대학원 석사학위논문.

29.

이민지, 손은정 (2007). 낙인과 전문적 도움추구 의도 간의 관계: 전문적 도움추구 태도의 매개 효과. 한국심리학회지: 상담 및 심리치료, 19(4), 949-966.

30.

이윤승 (2010). 상담모와 비상담모의 자기낙인, 자기은폐, 사회적 지지수용도가 전문적 도움추구 태도에 미치는 영향. 숙명여자대학교 대학원 석사학위논문.

31.

이장호, 정남운, 조성호 (2005). 상담심리학의 기초. 서울: 학지사.

32.

장영임 (1999). 문제의 심각도, 사회적지지 및 상담자에 대한 신뢰가 상담요청 가능성에 미치는 영향. 가톨릭대학교 대학원 석사학위논문.

33.

장윤진 (2012). 사회적 낙인, 자기 낙인과 상담에 대한 태도와의 관계에서 수치심의 매개효과. 이화여자대학교 대학원 석사학위논문.

34.

장현정 (2014). 초등학생 부모의 집단주의-개인주의 성향에 따른 아동 상담에 대한 태도: 자기낙인과 사회적 낙인을 중심으로. 경남대학교 교육대학원 석사학위논문.

35.

전현화 (2012). 정신병원 직원과 일반인의 정신질환에 대한 질병지식 및 태도 비교 연구. 건국대학교 행정대학원 석사학위논문.

36.

정선호, 서동기 (2016). 회귀분석을 이용한 매개된 조절효과와 조절된 매개효과 검증 방법. 한국심리학회지: 일반, 35(1), 257- 282.

37.

정진철, 양난미 (2010). 낙인과 자존감, 전문적 도움추구 태도 간의 관계. 한국심리학회지: 상담 및 심리치료, 22(3), 631-652.

38.

조영일, 김지현, 한우리, 조유정 (2015). 임상 연구에서 조절효과 및 매개효과의 비교 및 통합. Korean Journal of Clinical Psychology, 34(4), 1113-1131.

39.

조은영 (2000). 정신장애인 편견극복 운동: 정신질환을 가진 사람들에 대한 스티그마 줄이기. 한국정신보건사회복지학회 학술발표논문집, 65-86.

40.

최윤미 (2012). 한국과 미국 대학상담센터의 현황. 인간이해, 33(2), 21-36.

41.

최효진 (2010). 중년 남성들의 성역할 갈등과 전문적 도움추구 행동과의 관계: 자기은폐, 사회적 낙인, 자기낙인의 매개효과 검증. 가톨릭대학교 대학원 석사학위논문.

42.

황태연, 이우경, 한은선, 권의정 (2006). 한국판 정신질환의 내재화된 낙인 척도의 신뢰도 및 타당도 연구. 신경정신의학, 45(5), 418- 426.

43.

Adewuya, A. O., Owoeye, A. O., Erinfolami, A. O., & Ola, B. A. (2011). Correlates of self-stigma among outpatients with mental illness in Lagos, Nigeria. International Journal of Social Psychiatry, 57(4), 418-427.

44.

Angermeyer, M. C., & Matschinger, H. (2004). The stereotype of schizophrenia and its impact on discrimination against people with schizophrenia: results from a representative survey in Germany. Schizophrenia Bulletin, 30(4), 1049-1061.

45.

Atkinson, D. R., Wampold, B. E., Lowe, S. M., Matthews, L., & Ahn, H. N. (1998). Asian American preferences for counselor characteristics: Application of the Bradley- Terry-Luce model to paired comparison data. The Counseling Psychologist, 26(1), 101-123.

46.

Bampi, P. (2013). Relationship between stigma, gender, personality, stress, self-efficacy and quality of life (Bachelor dissertation, DBS School of Arts).

47.

Baron, R. M., & Kenny, D. A. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51(6), 1173-1182.

48.

Beck, A. T. (1987). Cognitive models of depression. Journal of Cognitive Psychotherapy: An International Quarterly, 1(1), 5-37.

49.

Ben-Porath, D. D. (2002). Stigmatization of individuals who receive psychotherapy: An interaction between help-seeking behavior and the presence of depression. Journal of Social and Clinical Psychology, 21(4), 400-413.

50.

Berge, M. & Ranney, M. (2005). Self-esteem and stigma among persons with schizophrenia: implications for mental health. Care Management Journals, 6(3), 139-144.

51.

Biernat, M., & Dovidio, J. F. (2000). Stigma and stereotypes. The social psychology of stigma, 88-125.

52.

Brion, J. M., Leary, M. R., & Drabkin, A. S. (2014). Self-compassion and reactions to serious illness: The case of HIV. Journal of Health Psychology, 19(2), 218-229.

53.

Busby-Grant, J., Bruce, C. P., & Batterham, P. J. (2015). Predictors of personal, perceived and self-stigma towards anxiety and depression. Epidemiology and Psychiatric Sciences, 24(1), 1-8.

54.

Cash, T. F., Begley, P. J., McCown, D. A., & Weise, B. C. (1975). When counselors are heard but not seen: Initial impact of physical attractiveness. Journal of Counseling Psychology, 22(4), 273-279.

55.

Cash, T. F., Kehr, J., & Salzbach, R. F. (1978). Help-seeking attitudes and perceptions of counselor behavior. Journal of Counseling Psychology, 25(4), 264-269.

56.

Cheng, H. L., McDermott, R. C., & Lopez, F. G. (2015). Mental Health, Self-Stigma, and Help-Seeking Intentions Among Emerging Adults An Attachment Perspective. The Counseling Psychologist, 43(3), 463-487.

57.

Corrigan, P. W. (2004). How stigma interferes with mental health care. American Psychologist, 59(7), 614-625.

58.

Corrigan, P. W., & Calabrese, J. D. (2005). Strategies for assessing and diminishing self-stigma. In P. Corrigan (Ed.), On the stigma of mental illness: Practical strategies for research and social change(pp. 239-256). Washington, DC: American Psychological Association.

59.

Corrigan, P. W., Kosyluk, K. A., & Rüsch, N. (2013). Reducing self-stigma by coming out proud. American Journal of Public Health, 103(5), 794-800.

60.

Corrigan, P. W., Rafacz, J., & Rüsch, N. (2011). Examining a progressive model of self-stigma and its impact on people with serious mental illness. Psychiatry Research, 189(3), 339-343.

61.

Corrigan, P. W., & Watson, A. C. (2002). The paradox of self‐stigma and mental illness. Clinical Psychology: Science and Practice, 9(1), 35-53.

62.

Corrigan, P. W., Watson, A. C., & Barr, L. (2006). The self-stigma of mental illness: Implications for self-esteem and self-efficacy. Journal of Social and Clinical Psychology, 25(8), 875-884.

63.

Crisp, A. H., Gelder, M. G., Rix, S., Meltzer, H. I., & Rowlands, O. J. (2000). Stigmatisation of people with mental illnesses. The British Journal of Psychiatry, 177(1), 4-7.

64.

Crocker, J. & Major, B. (1989). Social stigma and self-esteem: The self-protective properties of stigma. Psychological Review, 96(4), 608-630.

65.

Crocker J, & Major B. (2003). The self-protective properties of stigma: Evolution of a modern classic. Psychological Inquiry, 14(3 & 4), 232-237.

66.

Cross, S. E., Bacon, P. L., & Morris, M. L. (2000). The relational-interdependent self- construal and relationships. Journal of Personality and Social Psychology, 78(4), 791-808.

67.

Cross, S. E., & Madson, L. (1997). Models of the self: Self-construals and gender. Psychological Bulletin, 122(1), 5-37.

68.

Eisenberg, D., Downs, M. F., Golberstein, E., & Zivin, K. (2009). Stigma and help seeking for mental health among college students. Medical Care Research and Review, 66(5), 522-541.

69.

Elmes, D. G., Kantowitz, B. H., & Roediger III, H. L. (2011). Research methods in psychology. Cengage Learning.

70.

Farina, A. (1981). Are women nicer people than men? Sex and the stigma of mental disorders. Clinical Psychology Review, 1(2), 223-243.

71.

Fenton, W. S., Blyler, C. R., & Heinssen, R. K. (1997). Determinants of medication compliance in schizophrenia: empirical and clinical findings. Schizophrenia Bulletin, 23(4), 637-651.

72.

Fischer, E. H., & Farina, A. (1995). Attitudes toward seeking professional psychologial help: A shortened form and considerations for research. Journal of College Student Development, 36(4), 368-373.

73.

Fischer, E. H., & Turner, J. L. (1970). Orientations to seeking professional help: Development and research utility of an attitude scale. Journal of Consulting and Clinical Psychology, 35(1), 79-90.

74.

Fung, K. M., Tsang, H. W., Corrigan, P. W., Lam, C. S., & Cheng, W. M. (2007). Measuring self-stigma of mental illness in China and its implications for recovery. International Journal of Social Psychiatry, 53(5), 408-418.

75.

Fung, K. M., Tsang, H. W., & Cheung, W. M. (2011). Randomized controlled trial of the self-stigma reduction program among individuals with schizophrenia. Psychiatry Research, 189(2), 208-214.

76.

Gellis, Z. D., Huh, N. S., Lee, S., & Kim, J. (2003). Mental health attitudes among Caucasian-American and Korean counseling students. Community Mental Health Journal, 39(3), 213-224.

77.

Girden, E. R. (1992). ANOVA: Repeated measures. Sage Publications.

78.

Goffman, E. (1963). Stigma: Notes on the management of spoiled identity. Engiewood Cliffs: Prentice-Hall.

79.

Halgin, R. P., Weaver, D. D., Edell, W. S., & Spencer, P. G. (1987). Relation of depression and help-seeking history to attitudes toward seeking professional psychological help. Journal of Counseling Psychology, 34(2), 177-185.

80.

Hasson-Ohayon, I., Or, S. E. B., Vahab, K., Amiaz, R., Weiser, M., & Roe, D. (2012). Insight into mental illness and self-stigma: the mediating role of shame proneness. Psychiatry Research, 200(2), 802-806.

81.

Hayes, A. F. (2013). Introduction to mediation, moderation, and conditional process analysis. New York: Guilford Press.

82.

Heath, P. J., Brenner, R. E., Lannin, D. G., & Vogel, D. L. (2018). Self-compassion moderates the relationship of perceived public and anticipated self-stigma of seeking help. Stigma and Health, 3(1), 65-69.

83.

Hill, C. V., Oei, T. P. S., & Hill, M. A. (1989). An empirical investigation of the specificity and sensitivity of the Automatic Thoughts Questionnaire and Dysfunctional Attitudes Scale. Journal of Psychopathology and Behavioral Assessment, 11(4), 291-311.

84.

Hollon, S. D., Kendall, P. C., & Lumry, A. (1986). Specificity of depressotypic cognitions in clinical depression. Journal of Abnormal Psychology, 95(1), 52-59.

85.

Holmes, E. P., & River, L. P. (1998). Individual strategies for coping with the stigma of severe mental illness. Cognitive and Behavioral Practice, 5(2), 231-239.

86.

Jennings, K. S., Cheung, J. H., Britt, T. W., Goguen, K. N., Jeffirs, S. M., Peasley, A. L., & Lee, A. C. (2015). How Are Perceived Stigma, Self-Stigma, and Self-Reliance Related to Treatment-Seeking? A Three-Path Model. Psychiatric Rehabilitation Journal, 38(2), 109- 116.

87.

Kashima, Y., Yamaguchi, S., Kim, U., Choi, S. C., Gelfand, M. J., & Yuki, M. (1995). Culture, gender, and self: a perspective from individualism-collectivism research. Journal of Personality and Social Psychology, 69(5), 925- 937.

88.

Kelly, A. E., & Achter, J. A. (1995). Self- concealment and attitudes toward counseling in university students. Journal of Counseling Psychology, 42(1), 40-46.

89.

Kessler, R. C., Berglund, P. A., Bruce, M. L., Koch, J. R., Laska, E. M., Leaf, P. J., ... & Wang, P. S. (2001). The prevalence and correlates of untreated serious mental illness. Health Services Research, 36(6), 987-1007.

90.

Kim, B. S. (2007). Adherence to Asian and European American cultural values and attitudes toward seeking professional psychological help among Asian American college students. Journal of Counseling Psychology, 54(4), 474-480.

91.

King, P., Newton, F., Osterlund, B., & Baber, B. (1973). A counseling center studies itself. Journal of College Student Personnel, 14(4), 338-344.

92.

Kittler, J. E., Menard, W., & Phillips, K. A. (2007). Weight concerns in individuals with body dysmorphic disorder. Eating Behaviors, 8(1), 115-120.

93.

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.

94.

Kushner, M. G., & Sher, K. J. (1991). The relation of treatment fearfulness and psychological service utilization: An overview. Professional Psychology: Research and Practice, 22(3), 196-203.

95.

Lannin, D. G., Guyll, M., Vogel, D. L., & Madon, S. (2013). Reducing the stigma associated with seeking psychotherapy through self-affirmation. Journal of Counseling Psychology, 60(4), 508-519.

96.

Lannin, D. G., Vogel, D. L., Brenner, R. E., & Tucker, J. R. (2015). Predicting Self-Esteem and Intentions to Seek Counseling The Internalized Stigma Model. The Counseling Psychologist, 43(1), 64-93.

97.

Lawlor, A., & Kirakowski, J. (2014). Online support groups for mental health: A space for challenging self-stigma or a means of social avoidance?. Computers in Human Behavior, 32, 152-161.

98.

Leaf, P. J., Bruce, M. L., & Tischler, G. L. (1986). The differential effect of attitudes on the use of mental health services. Social Psychiatry, 21(4), 187-192.

99.

Levant, R. F. (1992). Toward the reconstruction of masculinity. Journal of Family Psychology, 5(3 & 4), 379-402.

100.

Leventhal, N. (2007). Perfectionism, Self-concealment, and Attitudes Toward Mental Health Treatment. Unpublished doctoral dissertation, The New school for Social Research.

101.

Link, B. G., Cullen, F. T., Frank, J., & Wozniak, J. F. (1987). The social rejection of former mental patients: Understanding why labels matter. American Journal of Sociology, 92(6), 1461-1500.

102.

Lucksted, A., Drapalski, A., Calmes, C., Forbes, C., DeForge, B., & Boyd, J. (2011). Ending self-stigma: Pilot evaluation of a new intervention to reduce internalized stigma among people with mental illnesses. Psychiatric Rehabilitation Journal, 35(1), 51-54.

103.

Luoma, J. B., Kohlenberg, B. S., Hayes, S. C., Bunting, K., & Rye, A. K. (2008). Reducing self-stigma in substance abuse through acceptance and commitment therapy: Model, manual development, and pilot outcomes. Addiction Research & Theory, 16(2), 149-165.

104.

Luoma, J. B., Kohlenberg, B. S., Hayes, S. C., & Fletcher, L. (2012). Slow and steady wins the race: a randomized clinical trial of acceptance and commitment therapy targeting shame in substance use disorders. Journal of Consulting and Clinical Psychology, 80(1), 43-53.

105.

Lysaker, P. H., Roe, D., & Yanos, P. T. (2007). Toward understanding the insight paradox: internalized stigma moderates the association between insight and social functioning, hope, and self-esteem among people with schizophrenia spectrum disorders. Schizophrenia Bulletin, 33(1), 192-199.

106.

Mackenzie, C. S., Erickson, J., Deane, F. P., & Wright, M. (2014). Changes in attitudes toward seeking mental health services: A 40-year cross-temporal meta-analysis. Clinical Psychology Review, 34(2), 99-106.

107.

Mak, W. W., & Wu, C. F. (2006). Cognitive insight and causal attribution in the development of self-stigma among individuals with schizophrenia. Psychiatric Services, 57(12), 1800-1802.

108.

Margetić, B. A., Jakovljević, M., Ivanec, D., Margetić, B., & Tošić, G. (2010). Relations of internalized stigma with temperament and character in patients with schizophrenia. Comprehensive Psychiatry, 51(6), 603-606.

109.

Markus, H. R., & Kitayama, S. (1991). Culture and the self: Implications for cognition, emotion, and motivation. Psychological Review, 98(2), 224-253.

110.

McCay, E., Beanlands, H., Leszcz, M., Goering, P., Seeman, M. V., Ryan, K., . . . Vishnevsky, T. (2006). A group intervention to promote healthy self-concepts and guide recovery in first episode schizophrenia: A pilot study. Psychiatric Rehabilitation Journal, 30(2), 105- 111.

111.

Mittal, D., Sullivan, G., Chekuri, L., Allee, E., & Corrigan, P. W. (2012). Empirical studies of self-stigma reduction strategies: a critical review of the literature. Psychiatric Services, 63(10), 974-981.

112.

Möller-Leimkühler, A. M. (2002). Barriers to help-seeking by men: a review of sociocultural and clinical literature with particular reference to depression. Journal of Affective Disorders, 71(1), 1-9.

113.

Nam, S. K., & Lee, S. M. (2015). The Role of Attachment and Stigma in the Relationship Between Stress and Attitudes Toward Counseling in South Korea. Journal of Counseling & Development, 93(2), 212-224.

114.

Owen, J., Thomas, L., & Rodolfa, E. (2013). Stigma for seeking therapy self-stigma, social stigma, and therapeutic processes. The Counseling Psychologist, 41(6), 857-880.

115.

Park, S. G., Bennett, M. E., Couture, S. M., & Blanchard, J. J. (2013). Internalized stigma in schizophrenia: relations with dysfunctional attitudes, symptoms, and quality of life. Psychiatry Research, 205(1), 43-47.

116.

Pasupuleti, R. V. (2013). Cultural factors, stigma, stress, and help-seeking attitudes among college students (Doctoral dissertation, University of Rhode Island).

117.

Regan, D. T., & Fazio, R. (1977). On the consistency between attitudes and behavior: Look to the method of attitude formation. Journal of Experimental Social Psychology, 13(1), 28-45.

118.

Rusch, L. C., Kanter, J. W., Manos, R. C., & Weeks, C. E. (2008). Depression stigma in a predominantly low income African American sample with elevated depressive symptoms. The Journal of Nervous and Mental Disease, 196(12), 919-922.

119.

Rüsch, N., Corrigan, P. W., Wassel, A., Michaels, P., Olschewski, M., Wilkniss, S., & Batia, K. (2009). Ingroup perception and responses to stigma among persons with mental illness. Acta Psychiatrica Scandinavica, 120(4), 320-328.

120.

Russinova, Z., Rogers, E. S., Gagne, C., Bloch, P., Drake, K. M., & Mueser, K. T. (2014). A randomized controlled trial of a peer-run antistigma photovoice intervention. Psychiatric Services, 65(2), 242-246.

121.

Sibicky, M., & Dovidio, J. F. (1986). Stigma of psychological therapy: Stereotypes, interpersonal reactions, and the self-fulfilling prophecy. Journal of Counseling Psychology, 33(2), 148- 154.

122.

Singelis, T. M. (1994). The Measurement of independent and interdependent self-construals. Personality and Social Psychology Bulletin, 20(5), 580-591.

123.

Stanley, I. H., Hom, M. A., & Joiner, T. E. (2018). Modifying mental health help-seeking stigma among undergraduates with untreated psychiatric disorders: A pilot randomized trial of a novel cognitive bias modification intervention. Behaviour research and therapy, 103, 33-42.

124.

Stevelink, S. A. M., Wu, I. C., Voorend, C. G., & van Brakel, W. H. (2012). The psychometric assessment of internalized stigma instruments: a systematic review. Stigma Research and Action, 2(2), 100-118.

125.

Stewart, H., Jameson, J. P., & Curtin, L. (2015). The relationship between stigma and self-reported willingness to use mental health services among rural and urban older adults. Psychological Services, 12(2), 141-148.

126.

Tata, S. R., & Leong, F. T. L. (1994). Individualism-collectivism, social-network orientation, and acculturation as predictors of attitudes toward seeking professional psychological help among Chinese Americans. Journal of Counseling Psychology, 41(3), 280-287.

127.

Topkaya, N. (2014). Gender, Self-stigma, and Public Stigma in Predicting Attitudes toward Psychological Help-seeking. Educational Sciences: Theory & Practice, 14(2), 10-17.

128.

Triandis, H. C. (1994). Major cultural syndromes and emotion. In S. Kitayama & H. R. Markus (Eds.), Culture and emotion: Empirical studies of mutual influence. Washington, DC: American Psychological Association.

129.

Tsang, H. W. H., Fung, K. M. T., & Chung, R. C. K. (2010). Self-stigma and stages of change as predictors of treatment adherence of individuals with schizophrenia. Psychiatry Research, 180(1), 10-15.

130.

Veit, C. T., & Ware, J. E. (1983). The structure of psychological distress and well-being in general populations. Journal of Consulting and Clinical Psychology, 51(5), 730-742.

131.

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.

132.

Vogel, D. L., Wade, N. G., & Ascheman, P. L. (2009). Measuring perceptions of stigmatization by others for seeking psychological help: Reliability and validity of a new stigma scale with college students. Journal of Counseling Psychology, 56(2), 301-308.

133.

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.

134.

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.

135.

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.

136.

Vogel, D. L., Wester, S. R., Wei, M., & Boysen, G. A. (2005). The Role of Outcome Expectations and Attitudes on Decisions to Seek Professional Help. Journal of Counseling Psychology, 52(4), 459-470.

137.

Wahl, O. F. (1999). Mental health consumers' experience of stigma. Schizophrenia Bulletin, 25(3), 467-478.

138.

Wampold, B. E. (2001). The great psychotherapy debate. Mahwah. NJ: Lawrence Erlbaum Associates, Inc.

139.

Ward, D. E. (2014). A weight off the shoulders: The effects of self-compassion on affect and self-stigma following negative association with weight and body-image. villanova university.

140.

Watson, A. C., Corrigan, P., Larson, J. E., & Sells, M. (2007). Self-stigma in people with mental illness. Schizophrenia Bulletin, 33(6), 1312-1318.

141.

Weissman, A. N., & Beck, A. T. (1978). Developmental validation of the Dysfunctional Attitude Scale. Paper presented at the annual meeting if the Association of Advancement of Behavioral Therapy, Chicago, IL.

142.

Yanos, P. T., Lucksted, A., Drapalski, A. L., Roe, D., & Lysaker, P. (2014). Interventions Targeting Mental Health Self-Stigma: A Review and Comparison. Psychiatric Rehabilitation Journal, 38(2), 171-178.

143.

Yanos, P. T., Roe, D., & Lysaker, P. H. (2011). Narrative enhancement and cognitive therapy: a new group-based treatment for internalized stigma among persons with severe mental illness. International Journal of Group Psychotherapy, 61(4), 576-595.

144.

Yen, C. F., Chen, C. C., Lee, Y., Tang, T. C., Ko, C. H., & Yen, J. Y. (2009). Association between quality of life and self‐stigma, insight, and adverse effects of medication in patients with depressive disorders. Depression and Anxiety, 26(11), 1033-1039.

145.

Yoo, S. K. (1997). Individualism-collectivism, attribution styles of mental illness, depression symptomatology, and attitudes toward seeking professional help: A comparative study between Koreans and Americans. Doctoral Dissertation. University of Minnesota, USA.

logo