Masculinity and barriers to seeking counseling: The buffering role of self-compassion

Social rank and compassion: How insecure striving, social safeness and fears of compassion mediate the relationship between masculinity, depression and anxiety

OBJECTIVE

Traditional masculinity norms displayed by men attempt to signal a dominance or 'toughness' to others; however, traditional masculine norms are associated with a range of mental health difficulties, including depression and anxiety. Based on social rank theory, we tested the mediating role of insecure striving, social safeness and fears of compassion on the relationship between masculinity, anxiety and depression. We also examined whether compassionate goals were negatively correlated with masculine norm adherence.

DESIGN

We used a cross-sectional survey design recruiting 844 men, aged 18-60 years (M = 34.0, SD = 14.4).

RESULTS

Our results replicated previous findings with masculine norms significantly associated with depression and anxiety. Extending on previous work, we found insecure striving, social safeness and fears of compassion fully mediated these relationships for anxiety and partially for depression. This relationship was strongest for the masculinity subtypes of self-reliance and emotional control. Compassionate goals were negatively associated with masculine norm adherence.

CONCLUSIONS

Social rank theory offers a helpful explanatory framework to understand the links between traditional masculinity and mental health, highlighting the importance of social safeness and insecure striving for men.

"I think the best athletes use it": Masculinities and self-compassion among men varsity athletes

We examined how men varsity athletes' embodiments of masculinities shaped their perceptions and experiences of self-compassion to manage sport-related challenges. Two semi-structured interviews were conducted with 11 men varsity athletes (20 interviews total). Vignettes depiciting athletes low and high in self-compassion were used as talk elicitation tools during interviews. Data were analyzed using reflexive thematic analysis and four themes were identified from the mens' accounts. Participants utilized self-compassion as a coping strategy in sport and other life-domains to maintain well-being. Self-compassion was used to balance self-criticism to support achievement striving efforts. The experience of contrasting masculine ideologies (hegemonic and inclusive) promoted and constrained the men's implementation of self-compassion. Traditional masculine narratives created tensions for participants who at times embodied the (mis)belief that self-compassion promotes complacency in the pursuit of athletic achievement. Findings contribute to understandings of men athletes' experiences of self-compassion and masculinities in relation to sport-related challenges and performance.

Not Always a "Buffer": Self-Compassion as Moderator of the Link Between Masculinity Ideologies and Help-Seeking Intentions After Experiences of Intimate Partner Violence

Many women and men experience intimate partner violence (IPV) during their lifetime. However, only relatively few people actually seek formal help after such an experience. The current study applied the mediated-moderation model of self-compassion and stigma that has previously been used to explain men's help-seeking behavior for depressive symptoms. The current study analyzed whether conformity to masculinity ideologies (CMI), self-stigma, and self-compassion were related to women's and men's intention to seek formal help after IPV experiences. A cross-sectional online questionnaire study was conducted with 491 German-speaking participants (65.8% women/34.2% men; age: M = 36.1 years; SD = 14.2). Participants read three vignettes about experienced IPV and then indicated how likely they would be to seek medical or psychological help if they were in the main character's situation. Additionally, the Conformity to Masculine Norms Inventory, Self-Stigma of Seeking Help Scale, and Self-Compassion Scale were used. Separate manifest path models for women and men revealed that strong CMI was linked to strong self-stigma in women and men. In turn, strong self-stigma was linked to weak intentions to seek formal help after IPV experiences. In men, strong self-compassion weakened (i.e., "buffered") the link between CMI and self-stigma. However, direct associations between strong CMI and weak intentions to seek formal help remained, especially for those participants with strong self-compassion. The current study adds to the existing literature on associations between CMI, self-compassion, and self-stigma by showing that those links are also relevant in women. However, self-compassion might not always act as a "buffer" and mediators that explain links between strong CMI and weak intentions to seek formal help in people with strong self-compassion need to be found in future studies.

Counseling With Male Clients: The Case for Relational Resilience Approach

Although there is no lack of research on masculinity and help-seeking behavior, men continue to seek counseling less often than women. It is crucial we find effective therapeutic approaches to connect and meet men where they are, acknowledging the positive aspects of their masculinity while addressing their needs in the counseling setting. In this conceptual research article, we propose a new approach for counselors to utilize with men seeking counseling, the Relational Resilience Approach, which applies tenets of Relational-Cultural Theory, Positive Psychology, and Shame Resilience Theory.

Stigma, self-compassion, and psychological distress among people with Parkinson's

PURPOSE

People with Parkinson's disease (hereafter Parkinson's) can experience stigma through the attitudes and actions of others (enacted stigma) and through anticipation of enacted stigma and internalisation of negative stereotypes (felt stigma). Self-compassion may protect against the impact of stigma. This study aimed to investigate the relationships between self-compassion, stigma, and psychological distress among people with Parkinson's.

METHODS

A total of 130 people with Parkinson's completed questionnaires measuring self-compassion, enacted and felt stigma, and depression, anxiety, and stress. Correlation, mediation, and moderation models were used to investigate relationships between variables.

RESULTS

All variables correlated significantly in the expected directions. Felt stigma mediated the relationship between self-compassion and the three outcome variables - depression, anxiety, and stress. Self-compassion did not moderate the relationship between enacted stigma and distress and suggested enacted stigma was associated with distress, regardless of levels of self-compassion.

CONCLUSIONS

Self-compassion and both enacted and felt stigma are important predictors of distress for people with Parkinson's. Part of the relationship between lower self-compassion and psychological distress appears to occur via the internalisation of stigma. These findings may be relevant to the development of individualised and societal interventions with the aim of improving the psychological wellbeing of people with Parkinson's.Implications for rehabilitationSelf-compassion was associated with lower levels of psychological distress (i.e., depression, anxiety, and stress) and self-stigma partially mediated this relationship.Self-compassion did not moderate the relationship between enacted stigma and psychological distress, suggesting enacted stigma increases distress, regardless of self-compassion.The development and assessment of the effectiveness of compassion-focused interventions tailored for people with Parkinson's may be important as well as systemic stigma focused interventions.

Feasibility and acceptability of implementing the Making Friends with Yourself intervention on a college campus

Objective: To assess the feasibility and acceptability of Making Friends with Yourself (MFY): A Mindful Self-Compassion Program for Teens and Young Adults with a sample of college students. A secondary objective was to explore changes in psychosocial outcomes. Participants: Twenty-five students (23 females; mean age 20.35 years) enrolled in the 8-week intervention. Methods: Feasibility was measured by attendance and retention of participants; acceptability was determined through analysis of focus group data. Psychosocial outcomes were assessed through analyses of pre- and post-intervention measures. Results: The intervention was feasible as 20 students attended at least seven of eight classes, and 21 completed the program. Students found the intervention acceptable and reported significant increases in mindfulness and self-compassion and decreased perceived stress from pre- to post-intervention. However, academic stress increased. Conclusions: MFY may be a feasible and acceptable program to offer to college students. Further piloting in college student populations is recommended.

Feasibility and acceptability of video-based microinterventions for eating disorder prevention among adolescents in secondary schools

OBJECTIVE

Eating disorders (EDs) often emerge in late adolescence. Schools are ideal settings for prevention programs; however, cost and time limit implementation. Microinterventions may overcome these challenges. This study adapted two microinterventions (cognitive dissonance, self-compassion) and assessed feasibility and acceptability among mid-adolescents to provide proof-of-concept for further investigation.

METHOD

Feedback from staff (n = 5) and student (n = 15) focus groups contributed iteratively to the adaptation of intervention materials. Students in Grade 10 and 11 (N = 101, M_age  = 15.80, SD = 0.68) were then randomly allocated by class to a 20-min video-based cognitive-dissonance or self-compassion intervention, accessed on their school devices. ED risk and protective factors were assessed at baseline, immediate postintervention (state outcomes), and 1-week follow-up (trait outcomes). Acceptability items were included at both timepoints.

RESULTS

Implementation was deemed feasible. Girls generally reported greater acceptability than boys. Among girls, the self-compassion intervention demonstrated greater acceptability. Among boys, some aspects of acceptability (e.g., lesson endorsement, utilization of techniques) were rated higher in the cognitive dissonance group whereas other aspects (e.g., understanding, interest) were greater in the self-compassion group. All groups exhibited favorable changes in most state outcomes, however trait outcome change was varied.

DISCUSSION

Microinterventions provide a feasible way of implementing prevention strategies in a time-poor educational context. Future large-scale evaluation is warranted to determine efficacy, following modifications based on current findings.

PUBLIC SIGNIFICANCE

This study shows promising feasibility and acceptability of two brief, self-guided video-based lessons (microinterventions) for adolescents in school classrooms, that use psychological techniques to target appearance pressures as a key risk factor for eating disorders. Such interventions are easier to implement in school settings than longer, facilitator-led interventions, to encourage greater uptake and ongoing use. Findings support further research to evaluate effectiveness, to ultimately provide accessible and gender-inclusive tools for busy schools.

The influence of self-compassion on mental health of postgraduates: Mediating role of help-seeking behavior

This study explores the relationship between self-compassion and mental health of postgraduates based on the perspective of the dual-factor model (DFM) of mental health and the mediating role of help-seeking behavior. A total of 605 postgraduates were investigated with a questionnaire. The results showed that the DFM of mental health was better than the one-factor model for the mental health status of postgraduates. Among them, those with complete mental health accounted for the highest proportion (63.3%), followed by vulnerable (25.1%), troubled (9.1%), and symptomatic but content (2.5%). Self-compassion and non-professional help-seeking behavior had a positive predictive effect on positive mental health factors of the postgraduates, while self-compassion had a negative predictive effect on their psychological symptoms. Non-professional help-seeking behavior played a partial mediating role between self-compassion and positive mental health factors.

Early Maladaptive Schemas and Self-Stigma in People with Physical Disabilities: The Role of Self-Compassion and Psychological Flexibility

Self-stigmatizing thoughts may be rooted in one's core beliefs, and in turn be associated with early maladaptive schemas (EMS). Psychological flexibility, an ability to distance and accept one's thoughts, is reported to diminish EMS's effect on well-being, while self-compassion, a mindful attitude towards one's suffering, often reduces self-stigma. The objective of this study was to examine associations between EMS, self-stigma, psychological flexibility and self-compassion in individuals with disabilities, as they are at higher risk of experiencing self-stigma. Participants were 238 persons with disabilities. The Self-Stigma Scale, Young's Schemas Questionnaire, the Self-Compassion Scale Short and the Acceptance and Action-II Questionnaire were used. Hierarchical regression and mediation analysis were used to establish (1) predictors and (2) potential mediators of self-stigma in people with disabilities. Hierarchical regression showed that EMS alone accounted for 39% of the variance explained by self-stigma, and with the addition of psychological flexibility-an additional 2% was explained. Parallel mediation analyses indicated that psychological flexibility partially mediated the relationship between EMS domains and self-stigma. It appears that psychological rigidity is related to self-stigma and should be addressed in treatment through evidence-based approaches such as Schema Therapy and Acceptance and Commitment Therapy to enhance individuals' healthy life patterns, flexibility and self-compassion.

The mediating role of positive reappraisal and self-compassion on the relationship between mindfulness and posttraumatic growth in patients with cancer

The beneficial effect of mindfulness in promoting posttraumatic growth has been well established in research, but it remains unclear what psychological mechanisms mediate it. This study examined the mediating roles of positive reappraisal and self-compassion on the relationship between mindfulness and posttraumatic growth in patients with cancer. A random sample of 550 patients drawn from two medical health care institutions in southeast, Nigeria participated in this study. Results of mediation analysis showed that positive reappraisal and self-compassion independently mediated the relationship between mindfulness and posttraumatic growth. These findings underscore the usefulness of mindfulness-based therapies in promoting cognitive emotional processes such as positive reappraisal abilities and self-compassion, which are essential in facilitating posttraumatic growth in patients with cancer.

Investigating the Links Between Performers' Self-Compassion, Mental Toughness and Their Social Environment: A Semi-Systematic Review

Being mentally tough while evaluating oneself in a compassionate way is still a difficult path for performers. Self-compassion, characterized by the ability to be kind to oneself, to see one's experiences as part of the larger human experience and have a balanced awareness to one's emotions and thoughts, was recently studied as a stepping stone to performance optimization and personal development. Despite a mistrust of this concept in the sports world, various studies show its benefits within athletes. A major question remains the environment that fosters or hinders the development of self-compassion: when role models extend compassionate attitudes, does it allow performers to respond in more self-compassionate ways? The relationship between self-compassion, mental toughness, and social environment is still unclear and is an important direction for future research within performers. This semi-systematic literature review aims at proposing an overview of the state of the art regarding self-compassion, mental toughness, and the influence of performer's, and social environments. Sixteen studies were retrieved. We conclude that the number of multi-day intervention programs and longitudinal studies should be increased. The studies should also consider assessing the specific aspects of performance culture and settings. In addition, overall performance-specific measures could be developed to assess general levels of self-compassion. The development of a theoretical framework explaining how self-compassion affects a performer, the role of their entourage and its link to other psychological resources, such as mental toughness, could help to better understand this concept.

Associations Between Major Depressive Episodes and School- or Community-Based Activity Participation Among Adolescents Using Nationwide Representative Data

BACKGROUND

This study examined the association between participation in school-based and/or community-based activity and major depressive episodes (MDE) in adolescents using nationally representative data.

METHODS

This study utilized cross-sectional data from the National Survey of Drug Use and Health from 2015 to 2019. Nine screening questions determined the presence of past-year MDE in adolescents ages 12-17 (n = 67,033). Participants indicated past-year participation in school-based (eg, team sports, cheerleading, choir, band, student government, or clubs) and/or community-based activities (eg, volunteer activities, sports, clubs, or groups). Sociodemographic variables included sex, race/ethnicity, family income, and age. Descriptive statistics, univariable and multivariable regression analyses were conducted. The multivariable model included interaction terms between age and sex, and age and race/ethnicity.

RESULTS

Overall, 14% of the sample met the criteria for having MDE. The odds of MDE increased with age. Joint effects of age and sex, and age and race/ethnicity significantly influenced the association between MDE and school- or community-based activities. Participation in 1+ community-based activities was protective for MDE across all races/ethnicities.

CONCLUSIONS

Findings help illuminate the direct association of school- and community-based activity participation on MDE risk in adolescents, improving our understanding of MDE across various sociodemographic subgroups in an adolescent population. Schools should aim to facilitate equitable programming and endorse adolescent participation in multiple activities throughout the year. Schools should examine the resources available and consider partnerships that would bolster resources, access, and social capital throughout the community.

Self-compassion promotes mental help-seeking in older, not in younger, counselors

While self-compassion and mental help-seeking are two important aspects emphasized in mental health literature and counseling practice, very little research has focused on how these two are associated particularly among counseling professionals-individuals providing mental health support to others but whose mental health are often overlooked. This cross-sectional study investigated a moderated mediation model examining the role of age and attitudes in the positive influence of self-compassion on mental help-seeking intention. Using a paper-and-pencil survey, data were collected from a total of 158 Filipino counseling professionals. Results revealed that mental help-seeking attitudes significantly and partially mediated the positive association between self-compassion and mental help-seeking intention. Additionally, age significantly moderated the positive relationship between self-compassion and mental help-seeking attitudes. The significant positive influence of self-compassion on mental help-seeking attitudes was strong among older participants, weak among middle-age, and diminished among younger participants. The findings provided insights on the importance of a self-compassion-based approach to counselor training. The implications of preserving counselors' mental health in counseling practice were discussed.

Understanding help-seeking in rural counties: A serial mediation analysis

OBJECTIVE

Rural areas in the Southern United States are characterized by certain cultural values that may delay or prevent mental health service utilization. The present study examined a four-stage chain of serial mediation where higher levels of general self-reliance would be related to greater levels of public stigma, which would in turn be related to higher levels of self-stigma, followed by greater self-reliance about managing mental health problems, and finally, more negative attitudes toward seeking help from psychologists.

METHOD

Community members who lived in rural counties in the Southern United States (N = 783) completed measures of these constructs online.

RESULTS

Mediation analyses supported a direct association between general self-reliance and attitudes toward help-seeking that was explained in serial by higher levels of public stigma, self-stigma, and mental health self-reliance.

CONCLUSIONS

Clinical implications for rural practitioners are suggested including instilling policy changes, increasing provider visibility, and addressing barriers in therapy.

Men's Dropout From Mental Health Services: Results From a Survey of Australian Men Across the Life Span

While increasing numbers of Australian men are accessing mental health services, the sustainability of their therapy engagement varies significantly, with many men being lost to follow-up. The current study investigated dropout rates in a large community-based male sample to highlight the reasons for, and potential predictors of, men dropping out of mental health care services. Data were drawn from an online survey of 1907 Australian men (aged 16–85; M = 44.1 years) reflecting on their broad experiences in mental health therapy. Participants responded to bespoke items assessing their past dropout experience and reasons for dropping out, the odds of which were modeled in relation to demographics and predictors (e.g., therapist engagement strategies, alignment to traditional masculinity and pre-therapy feelings of optimism, shame, and emasculation). The overall dropout rate from therapy was 44.8% (n = 855), of which 26.6% (n = 120) accessed therapy once and did not return. The most common reasons for dropout were lack of connection with the therapist (54.9%) and the sense that therapy lacked progress (20.2%). Younger age, unemployment, self-reported identification with traditional masculinity, the presence of specific therapist engagement strategies, and whether therapy made participants feel emasculated all predicted dropout. Current depressive symptoms and suicidality were also higher amongst dropouts. Therapists should aim to have an honest discussion with all clients about the importance of therapy fit, including the real likelihood of dropout, in order to ensure this does not deter future engagement with professional services.

Fears of receiving compassion from others predict safety behaviour use in social anxiety disorder over and above fears of negative self-portrayal

Why do people with social anxiety disorder (SAD) engage in the use of safety behaviours? While past research has established that fears of negative self-portrayal are strongly associated with safety behaviour use in SAD, no research to date has investigated the potential role of fears of receiving compassion. Both types of fears could motivate those with SAD to engage in safety behaviours in order to keep others at a distance. In the present study, 150 participants with a clinical diagnosis of SAD completed measures of fears of negative self-portrayal, fears of receiving compassion, and safety behaviour use. Multiple regression analyses revealed that when controlling for self-portrayal fears, fears of receiving compassion significantly predicted increased use of safety behaviours overall, as well as the use of avoidance and impression management subtypes. Furthermore, there was a significant interaction effect in which greater fears of receiving compassion predicted greater use of impression management at lower levels of self-portrayal fears. We discuss the implications of our findings for addressing safety behaviours in the treatment of SAD.

Self-Compassion and Quality of Life in Adults Who Stutter

Purpose The purpose of this study was to identify levels of self-compassion in adults who do and do not stutter and to determine whether self-compassion predicts the impact of stuttering on quality of life in adults who stutter. Method Participants included 140 adults who do and do not stutter matched for age and gender. All participants completed the Self-Compassion Scale. Adults who stutter also completed the Overall Assessment of the Speaker's Experience of Stuttering. Data were analyzed for self-compassion differences between and within adults who do and do not stutter and to predict self-compassion on quality of life in adults who stutter. Results Adults who do and do not stutter exhibited no significant differences in total self-compassion, regardless of participant gender. A simple linear regression of the total self-compassion score and total Overall Assessment of the Speaker's Experience of Stuttering score showed a significant, negative linear relationship of self-compassion predicting the impact of stuttering on quality of life. Conclusions Data suggest that higher levels of self-kindness, mindfulness, and social connectedness (i.e., self-compassion) are related to reduced negative reactions to stuttering, an increased participation in daily communication situations, and an improved overall quality of life. Future research should replicate current findings and identify moderators of the self-compassion-quality of life relationship.

An examination of help-seeking preferences via best-worst scaling

OBJECTIVE

This study utilized best-worst scaling and latent class analysis to assess mental health treatment preferences and identify subgroups of college student help seekers.

METHOD

College students (N = 504; age: M = 20.3, 79.2% female) completed assessments of mental health treatment preferences, self-stigma, and distress.

RESULTS

Students preferred utilizing friends and family, followed by professional mental health providers, self-help, keeping concerns to themselves, physicians, and lastly religious leaders. Latent class analyses identified four classes of respondents.

CONCLUSIONS

Subgroups of student help seekers include Formal Help Seekers who prefer professional mental health providers, Informal Help Seekers who prefer friends and family, Ambivalent Help Seekers who prefer family and friends but also keeping concerns to themselves, and Help Avoiders who prefer keeping concerns to themselves. Assessing treatment preferences among different student subgroups may constitute an initial step in identifying effective ways to address university-wide mental health concerns.

Different patterns of perceived barriers to psychological treatment among Chinese depressed college students: Preliminary findings

OBJECTIVES

This study aimed to (a) identify the different patterns of perceived barriers to psychological treatment in Chinese college students with depression and (b) determine whether self-compassion and depression severity distinguished individuals with different patterns.

METHODS

This study included 338 college students with depression. The perceived barriers to psychological treatment scale were used. Latent profile analysis (LPA) was performed to identify the differential patterns.

RESULTS

Results of LPA indicated four patterns of perceived barriers, which differed with respect to levels and patterns, namely, "low barriers" (31%, n = 105), "moderate barriers" (45%, n = 153), "attitudinal and availability barriers" (18%, n = 61), and "high barriers" (6%, n = 19). Self-compassion (particularly, negative self-compassion) and depression severity distinguished participants with the four patterns.

CONCLUSIONS

A small number of participants reporting high levels across different types of barriers deserve special attention because they would be less likely to seek professional help.

Psychosocial resources and strains and health services use among adult illicit drug users from the Miami-Dade community

This study builds on previous research concerning the associations of positive and negative dimensions of the self-concept and social relationships, respectively, with medical treatment seeking actions by modeling potentially positive and negative effects simultaneously. Using data from the first wave of a large community study including adult (20-93) drug users (n = 318), multivariate linear regression analysis presents the effects of psychosocial resources on drug users' medical treatment seeking in six progressive models. Social resources such as family support, family conflict, and friend support account for variation in medical treatment seeking actions in adult drug users. Dimensions of the self-concept, including perception of powerlessness and self-esteem also influence medical treatment seeking actions in adult drug users. Moderation tests reveal that the presence of family problems related to drug use is associated with a lower likelihood of taking treatment-seeking action in the context of greater family support. This study assessed how positive and negative dimensions of social relationships and the self-concept can jointly influence medical treatment seeking actions. Implications for medical treatment seeking action research are discussed.

Collegian help seeking: the role of self-compassion and self-coldness

BACKGROUND

Researchers have identified a two-factor structure of self-compassion (i.e. self-compassion and self-coldness). To date, no research has examined each of these constructs' role in collegian professional help-seeking intention.

AIM

The current study sought to assess the role of self-compassion and self-coldness in collegian professional help-seeking intention, accounting for other theoretically and empirically-supported help-seeking constructs.

METHOD

Participants included 9349 collegians recruited as part of the national 2015-2016 Healthy Minds Study archival dataset. A logistic regression was conducted to examine the unique contributions of self-compassion and self-coldness in predicting professional help-seeking intention, controlling for key help-seeking variables.

RESULTS

A test of the full model against a constant only model was statistically significant, which indicated that the predictors collectively distinguished between collegians who intended to seek help from a professional clinician compared to those who did not. The Wald criterion indicated that both self-compassion and self-coldness were uniquely associated with intention to seek professional help. Self-compassion increased and self-coldness decreased the probability of seeking professional help.

CONCLUSIONS

The study highlights the importance of self-compassion and self-coldness in collegian help-seeking intention. These findings can inform specific outreach efforts targeting both self-compassion and self-coldness.

The association between health conditions and cannabis use in patients with opioid use disorder receiving methadone maintenance treatment

BACKGROUND

Cannabis is the most commonly used substance among patients in methadone maintenance treatment (MMT) for opioid use disorder. Current treatment programmes neither screen nor manage cannabis use. The recent legalisation of cannabis in Canada incites consideration into how this may affect the current opioid crisis.

AIMS

Investigate the health status of cannabis users in MMT.

METHOD

Patients were recruited from addiction clinics in Ontario, Canada. Regression analyses were used to assess the association between adverse health conditions and cannabis use. Further analyses were used to assess sex differences and heaviness of cannabis use.

RESULTS

We included 672 patients (49.9% cannabis users). Cannabis users were more likely to consume alcohol (odds ratio 1.46, 95% CI 1.04-2.06, P = 0.029) and have anxiety disorders (odds ratio 1.75, 95% CI 1.02-3.02, P = 0.043), but were less likely to use heroin (odds ratio 0.45, 95% CI 0.24-0.86, P = 0.016). There was no association between cannabis use and pain (odds ratio 0.98, 95% CI 0.94-1.03, P = 0.463). A significant association was seen between alcohol and cannabis use in women (odds ratio 1.79, 95% CI 1.06-3.02, P = 0.028), and anxiety disorders and cannabis use in men (odds ratio 2.59, 95% CI 1.21-5.53, P = 0.014). Heaviness of cannabis use was not associated with health outcomes.

CONCLUSIONS

Our results suggest that cannabis use is common and associated with psychiatric comorbidities and substance use among patients in MMT, advocating for screening of cannabis use in this population.

DECLARATION OF INTEREST

None.

The Relationships Among Self-Compassion, Stigma, and Attitudes Toward Counseling in Student-Athletes

Although factors involved with help-seeking have been widely studied in the general college population, college student-athletes have received less attention. The purpose of this study was to examine the moderating role of self-compassion on the relationship between public and self-stigma, and how self-stigma was associated with attitudes toward seeking counseling. A sample of 243 student-athletes from NCAA Divisions I and III participated in the study. Using structural equation modeling, self-compassion was not found to moderate the relationship between public and self-stigma. However, public stigma was positively associated with self-stigma, and self-stigma was negatively associated with attitudes toward counseling. A multigroup analysis did not find differences between males and females for the model. The results of this study have implications for professionals who work with college student-athletes and suggest that efforts should aim to reduce stigma and examine alternative factors that might improve attitudes toward mental health help-seeking.

Self-Compassion and Subjective Well-Being Mediate the Impact of Mindfulness on Balanced Time Perspective in Chinese College Students

Balanced time perspective is associated with optimal social functioning and provides psychological benefits in times of stress. Previous studies have found that mindfulness is positively associated with balanced time perspective and might promote it. However, the mechanism through which mindfulness affects balanced time perspective remains unexplored. The purpose of the present study was to investigate the mediating role of self-compassion and subjective well-being in the relationship between mindfulness and balanced time perspective. A total of 754 Chinese college students, aged 17-27 years, completed the Chinese versions of the Five-Facet Mindfulness Questionnaire, Self-Compassion Scale, Subjective Well-Being Scale, and Zimbardo Time Perspective Inventory. There were significant positive correlations between mindfulness, self-compassion, subjective well-being, and balanced time perspective. Structural equation modeling indicated that in addition to the direct influence of mindfulness on balanced time perspective, self-compassion and subjective well-being played a partial mediating role. On the basis of these findings, we conclude that mindfulness has an important positive influence on balanced time perspective, and highlights the crucial role of the self-compassion in cultivating a balanced time perspective. Limitations of the present study are also discussed.

Understanding health care avoidance and initial help-seeking behavior in German veterans: a theory of planned behavior

Objective

To gain initial insights into salient beliefs of former German soldiers (veterans) about the use of mental health services.

Data source

Narrative interviews with former German soldiers (veterans) were conducted in 2016.

Data collection/extraction method

Forty-three interviews were transcribed and analyzed thematically based on the theoretical framework of the theory of planned behavior. From within the behavorial, normative, and control beliefs, the salient beliefs were identified.

Principal findings

Four groups of salient beliefs were identified, described, and named: "Autarky", "Ineffectiveness", "Heteronomy", and "Incapacity".

Conclusion

Interventions and campaigns addressing these four specific groups of beliefs may lead to higher health service use rates. However, as a result of methodological limitations of the study design, the conclusion remains tentative.

The impact of self-stigmatization on medication attitude in schizophrenia patients

Negative attitudes towards medication in schizophrenia patients are one major factor contributing to non-adherence behavior. Besides, self-stigmatization represents another frequent and important obstacle in patients suffering from psychotic disorders. Here, we investigated possible associations between medication adherence attitude and the extent of self-stigmatization, while also exploring factors related to self-stigmatization. Sociodemographic characteristics, clinical variables, medication attitude and self-stigmatization were assessed among 81 subjects with schizophrenia or schizoaffective disorder. The cross-sectional data was then analyzed by multivariate analyses. A more positive attitude towards medication was predicted by better insight into illness, lower degree of self-stigmatization and good subjective knowledge about medication (adjusted R² = 0.23). Furthermore, a higher level of self-stigmatization was associated with lower subjective wellbeing, more severe depressive symptoms and male gender (adjusted R² = 0.58). Other clinical variables had no additional predictive value for medication adherence attitude or the extent of self-stigmatization. Our findings support the notion that self-stigmatization is an influential factor on medication attitude that should therefore be appreciated in clinical practice. Besides this, special emphasis should be taken on depressive symptoms and reduced wellbeing, especially in male patients, to lower the extent of self-stigmatization.

Variability in self-rated health trajectories from adolescence to young adulthood by demographic factors

Self-rated health (SRH) is a robust measure of general health status and an indicator of where and when to target disease prevention efforts-especially in adolescent populations when clinical endpoints are rare. This study's purpose was to model SRH trajectories from ages 13 to 31 and identify whether and when differences between demographic groups emerge. We employed a conditional latent growth model of SRH in December 2016 using a nationally representative sample of 11,512 adolescents from the National Longitudinal Study of Adolescent to Adult Health data collected in 1994-2008. The average SRH trajectory is curvilinear: SRH increases until age 21 and then decreases. This trajectory contains significant between-individual variability in the intercept and linear slope. Males and self-identified non-Hispanic Blacks had higher SRH at age 13 but experienced steeper linear declines than their demographic counterparts. Individuals who grew up in households without two parents and whose parents did not graduate college had consistently lower SRH compared to those living in households with two parents and whose parents graduated college. Self-rated health is not stable over the span of early adolescence to young adulthood; demographic factors account for differences in individual variability around the starting point and overtime changes in SRH. Because these differences are apparent as early as age 13years, prevention efforts targeting demographic-based disparities should occur early in life.