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一种关于求助行为的“自我环境”视角:审视个体社会文化背景对未治疗抑郁症状患者求助行为的影响。

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.

作者信息

McLaren Thomas, Peter Lina-Jolien, Tomczyk Samuel, Muehlan Holger, Schomerus Georg, Schmidt Silke

机构信息

Department of Health and Prevention, Institute of Psychology, University of Greifswald, Robert-Blum Str. 13, 17489, Greifswald, Germany.

Department of Psychiatry and Psychotherapy, Medical Faculty, University Leipzig, Leipzig, Germany.

出版信息

Soc Psychiatry Psychiatr Epidemiol. 2025 Mar;60(3):579-592. doi: 10.1007/s00127-024-02720-3. Epub 2024 Aug 4.

Abstract

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 (M = 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.

摘要

背景

精神疾病是一个全球性问题,也是导致残疾生存年数的主要原因。对求助行为的研究主要集中在个体因素上,但仍有许多无法解释的差异。鉴于人类行为决定因素之间存在复杂的相互作用,提出了一个名为“自我环境”的新框架来代表一个人的社会文化背景。本文介绍了一种确定自我环境的统计方法,并举例检验了其在健康相关研究中的预测效度。

方法

自我环境通过基于社会经济地位和自我建构概况这两个决定因素的两阶段聚类方法来确定。描述性分析用于比较自我环境特征。分层二元逻辑回归模型在控制社会经济地位这一既定预测因素的同时,检验自我环境与求助行为之间的关联。

结果

样本量为N = 1535(平均年龄M = 43.17岁,女性参与者占64.89%)。平均抑郁严重程度为M = 12.22,表明症状为轻度至中度。确定并命名了六种自我环境。来自优越环境(调整后比值比[aOR] = 0.38)和自给自足环境(aOR = 0.37)的参与者比来自应享权利环境的参与者向全科医生求助的可能性更小。来自优越环境(aOR = 0.30)、协作环境(aOR = 0.50)、弱势环境(aOR = 0.33)和自给自足环境(aOR = 0.21)的参与者比来自应享权利环境和家庭约束环境的参与者向家庭成员求助的可能性更小。

讨论

讨论了该研究的优势和局限性以及聚类方法。基于当前研究对六种自我环境的比较结果进行了解释。例如,来自某些环境的参与者遵循先前研究中提出的求助过程,而来自其他环境的参与者似乎表现出不同的过程,即最终以非正式求助告终的过程。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fa6a/11870981/43518d8a2bbf/127_2024_2720_Fig1_HTML.jpg

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