THE CONCORDANCE BETWEEN SELF-RATINGS OF CHILDHOOD AND CURRENT SYMPTOMS OF ATTENTION DEFICIT HYPERACTIVITY DISORDER

For the past 40 years, researchers have attempted to explain why some people with mental illness seek services while others do not. Researchers have hypothesized that the negative effects of stigmatizing attitudes may dissuade people from seeking care because they do not want to suffer the corresponding label of “mental patient. ” Fairly compelling literature shows that people who may benefit from mental health services do not seek them. Research from two nationwide epidemiologic studies suggested that 50% to 60% of people who would benefit from treatment do not seek it (Kessler et al., 2001; Regier et al., 1993). Subsequent analyses of these data have shown that respondents with psychiatric diagnoses were more likely to avoid services if they were unreceptive to treatment (e.g., agreeing that people should not seek care if they have a mental or emotional problem) or believed that family members and others would have a negative reaction to these services (Leaf et al., 1986, 1987; Kessler et al., 2001). The negative attitudes regarding mental health that were assessed in the aforementioned studies, however, are not necessarily equivalent to stigma. Subsequent studies have shown a direct relationship between stigmatizing attitudes and treatment adherence (Deane and Todd, 1996; Kelly and Achter, 1995; Sirey et al., 2001). In a prototypic example of this ilk (Sirey et al., 2001), stigma was measured using the Scale of Perceived Stigma (Link et al., 1989); scores on the Scale of Perceived Stigma were associated with the compliance of 134 adults with their antidepressant medication regimen 3 months later. Link and colleagues’ 1989) measure of perceived stigma provides a one-dimensional model of stigma. Other studies have examined the component attitudes that compose stigma. Two models, in particular, have strong empirical support. The first examines the public perspective of people with mental illness as responsible for their disorder (Corrigan et al., in press; Weiner et al., 1988). Members of the general public who blame people for their psychiatric disorders are likely to react to them angrily and to withhold help. A second model of mental illness stigma that highlights dangerousness has similar empirical support (Angermeyer and Matschinger, 1995; Corrigan et al., in press; Link et al., 1999; Penn et al., 1999). Members of the general public who view people with mental illness as dangerous report fear of them, try to avoid them, and endorse coercive services for them. Given the inverse relationship between causal attributions and help, we expect people who endorse responsibility to be less likely to seek care when in need. Care seeking should be viewed as a multidimensional concept because domains of care providers vary significantly. As indicated by other research, people may alternatively seek care from members of the medical profession (including primary care physicians, nurses, and mental health specialists, such as psychiatrists, psychologists, or mental health counselors) or from a generic group of community mentors (including the clergy, elder friends, and teachers; Cockerham, 1996). Hence, proxies of these two constructs will be included in our analyses. We expect to show that stigma predicts care seeking across the various domains of care.