Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK.
South London & Maudsley NHS Foundation Trust, UK.
Psychol Psychother. 2018 Mar;91(1):117-140. doi: 10.1111/papt.12144. Epub 2017 Oct 31.
To identify viewpoints among men with depression about depression and its treatment, consider how these might influence help-seeking behaviour, and generate ideas for interventions and future research.
Q methodology.
Twenty-nine men with depression completed a Q sort by ranking a set of statements about depression and help-seeking according to their relative agreement with each statement. Factor analysis was used to identify viewpoints relating to male understandings of depression and help-seeking, which were interpreted in the context of participant characteristics and additional information from post-sorting interviews.
A two-factor solution accounting for 45% of the total variance was considered the best fit for the data. The 2 factors were: (1) Help is available if you can get to the point of asking for it (34% of the variance) and (2) depression should be dealt with in private; help-seeking makes you vulnerable (11% of the variance). Participants who were significantly associated with both factors described a sense of shame, relating to their own or others' views that being depressed and help-seeking are in conflict with socially constructed 'masculine' values, such as strength and self-sufficiency. In the viewpoint represented by Factor 1, however, the benefits of help-seeking outweigh the negatives. In contrast, the viewpoint represented in Factor 2 holds that depression should remain a private struggle and that help-seeking is too risky a move to make.
In order to access treatment, men must first recognize depression, then overcome considerable perceived and internalized stigma to ask for help. Improving public knowledge about the nature of depression; positive messages about the act of help-seeking, types of treatment available, and effectiveness of treatments; and work to overcome the challenges posed by long waiting times and other service constraints may increase rates of help-seeking, and represent areas for future research.
Interventions to improve recognition of depression symptoms, particularly in the absence of recent negative life events or suicidal ideation, might help to improve help-seeking rates among men. Media campaigns should consider focusing on the positive elements of help-seeking and potential for recovery, and the impact of such campaigns should be evaluated. Improving public knowledge of the types of non-medical intervention that are available for depression may help to increase help-seeking rates. Clinical services and commissioners should be aware of the impact of long waiting times and strict discharge policies on service users, especially those who have difficulty asking for help.
确定患有抑郁症的男性对抑郁症及其治疗的看法，探讨这些看法如何影响他们寻求帮助的行为，并提出干预措施和未来研究的思路。
采用 Q 方法对 29 名抑郁症男性进行了 Q 分类，他们根据对每个陈述的相对认同程度对一组关于抑郁和寻求帮助的陈述进行了排序。采用因素分析方法识别与男性对抑郁和寻求帮助的理解相关的观点，并结合参与者特征和排序后访谈的附加信息进行解释。
占总方差 45%的两因素解被认为最适合数据。这两个因素是：（1）如果你能求助，帮助就会到来（占总方差的 34%）和（2）抑郁应该私下处理；寻求帮助会使你变得脆弱（占总方差的 11%）。与两个因素都显著相关的参与者描述了一种羞耻感，这种羞耻感与他们自己或他人的观点有关，即抑郁和寻求帮助与社会构建的“男性”价值观，如力量和自给自足相冲突。然而，在第一个因素所代表的观点中，寻求帮助的好处超过了负面影响。相比之下，第二个因素所代表的观点认为，抑郁应该是一个私人的挣扎，寻求帮助是一个太冒险的举动。
为了接受治疗，男性必须首先认识到抑郁，然后克服相当大的感知和内化的耻辱感来寻求帮助。提高公众对抑郁性质的认识；关于寻求帮助行为、可用治疗类型和治疗效果的积极信息；以及克服长时间等待和其他服务限制带来的挑战的工作，可能会提高寻求帮助的比率，并代表未来研究的领域。
干预措施以提高对抑郁症状的认识，特别是在没有近期负面生活事件或自杀意念的情况下，可能有助于提高男性寻求帮助的比率。媒体宣传活动应考虑将重点放在寻求帮助的积极方面和康复的可能性上，并评估此类宣传活动的效果。提高公众对非药物干预治疗抑郁症的类型的认识，可能有助于提高寻求帮助的比率。临床服务和管理者应意识到长时间等待和严格的出院政策对服务使用者的影响，特别是那些难以寻求帮助的人。
