DuPont-Reyes Melissa J, Villatoro Alice P, Phelan Jo C, Painter Kris, Link Bruce G
Departments of Sociomedical Sciences and Epidemiology, Columbia University Mailman School of Public Health, USA.
Public Health Program, Santa Clara University, USA.
SSM Popul Health. 2024 Jul 2;27:101695. doi: 10.1016/j.ssmph.2024.101695. eCollection 2024 Sep.
Familial transmission of mental illnesses and health behaviors is well established. However, little research has examined familial transmission of mental health help-seeking behaviors despite social science theoretical traditions that support its occurrence including social learning theory and the network episode model. Among parent-adolescent dyads, extant literature supports consideration of adolescent-autonomy versus parent-gatekeeping according to whether or not parents recognize a mental health problem in their adolescent. Given this, we examined familial transmission of self-reported mental health help-seeking among parent-adolescent dyads over an 18-month period from a school-based study (N = 422; Texas, USA). Generalized estimating equations tested the effect of multiple forms of parent help-seeking on similar forms of adolescent help-seeking, controlling for personal/family characteristics. We also examined interaction by parent recognition of a mental health problem in their adolescent to discern unique intergenerational processes across these subgroups of parent-adolescent dyads. Owing to effect modification by parent problem recognition (p<0.01), two unique familial transmission of help-seeking pathways emerged. When parent problem recognition was present, parent self help-seeking history reduced adolescent help-seeking net of controls. In contrast, when parent problem recognition was absent, parent self help-seeking history increased adolescent help-seeking net of controls. Our findings provide evidence of familial transmission of mental health help-seeking behaviors, but the direction of influence fundamentally depends on parent recognition of a mental health problem in their adolescent in order to reveal intergenerationally transmitted processes. The findings support our hypotheses that familial transmission of help-seeking starts early in adolescence and is likely influenced by parent modeling and gatekeeping, though explanations for the patterns observed, such as short- and long-term positive and negative mixed impacts of past help-seeking experiences of parents, require further study to ascertain.
精神疾病和健康行为的家族传播已得到充分证实。然而，尽管社会科学理论传统支持其发生，包括社会学习理论和网络事件模型，但很少有研究考察心理健康求助行为的家族传播。在父母与青少年二元组中，现有文献支持根据父母是否认识到其青少年存在心理健康问题来考虑青少年自主性与父母把关的问题。鉴于此，我们在一项为期18个月的基于学校的研究（N = 422；美国得克萨斯州）中，考察了父母与青少年二元组中自我报告的心理健康求助行为的家族传播。广义估计方程检验了多种形式的父母求助行为对类似形式的青少年求助行为的影响，并控制了个人/家庭特征。我们还考察了父母对其青少年心理健康问题的认知所产生的交互作用，以辨别这些父母与青少年二元组亚组中独特的代际过程。由于父母问题认知的效应修正（p<0.01），出现了两条独特的求助行为家族传播途径。当存在父母问题认知时，父母的自我求助历史在控制因素后减少了青少年的求助行为。相比之下，当不存在父母问题认知时，父母的自我求助历史在控制因素后增加了青少年的求助行为。我们的研究结果为心理健康求助行为的家族传播提供了证据，但影响方向从根本上取决于父母对其青少年心理健康问题的认知，以揭示代际传播过程。这些发现支持了我们的假设，即求助行为的家族传播在青春期早期就开始了，并且可能受到父母的示范和把关的影响，尽管对观察到的模式的解释，例如父母过去求助经历的短期和长期正负混合影响，需要进一步研究来确定。
