Psychological Help-Seeking Intention Among College Students Across Three Problem Areas

The issue of underutilization of mental health services is a common and growing concern in the mental health field (e.g., Duncan & Johnson, 2007; Eisenberg, Golberstein, & Gollust, 2007; Sheu & Sedlacek, 2004; Vogel, Wester, & Larson, 2007; Wilson, Rickwood, & Deane, 2007), and studying psychological help seeking enables psychologists to uncover the dynamics behind people's decision to seek help and to use psychological services. There are two general approaches used in examining psychological help seeking: a global approach in which all help seeking is viewed similarly (e.g., Cepeda-Benito & Short, 1998) and a specific approach in which help seeking is viewed as a distinct process for each type of problem (e.g., Di Fabio & Bernaud, 2008). Little research has directly compared differences among specific concerns from a theoretical perspective, and there seems to be none using the theory of planned behavior (TPB). The application of TPB will allow this area of research to be more directly compared with other areas of research outside psychology. Additionally, the application of TPB will allow for comparison across research studies within psychology and help-seeking research. The current study used TPB as the underlying model to examine help seeking in three different areas of presenting concerns (anxiety or depression, career choice concerns, and alcohol or drug use) to see if differences exist. * TPB TPB (Ajzen, 1985, 1991; see Figure 1) is an extension of the theory of reasoned action (TRA) proposed by Fishbein and Ajzen (1975). Both models predict behavioral engagement based on antecedent variables. The model posits that the direct antecedent to behavior is intention (Ajzen & Fishbein, 2005). Intention is directly preceded by three variables: attitude, subjective norm, and perceived behavioral control. An individual's attitude toward a behavior will directly affect his or her intention to engage in the behavior. Subjective norms are the perceived social expectations regarding the behavior and directly affect intention as well. Perceived behavioral control is the variable added to the model leading to the change from TRA to TPB. It allows for the prediction of nonvolitional behavior. This variable is composed of efficacy and control beliefs regarding engaging in the behavior. In the current study, this variable assessed the level of efficacy and control that students felt in their ability to seek psychological help. Perceived behavioral control also directly affects intention and directly affects behavior itself. The inclusion of perceived behavioral control in this study also allowed for a test of whether university students view psychological help seeking as volitional. Attitude, subjective norm, and perceived behavioral control are all preceded by beliefs that are based on individual difference variables (e.g., gender, age, ethnicity, experience). The model's parsimony has made it popular in a variety of fields, but little has been done in the area of psychological help seeking with this model. Much of the work that has been done has focused on TRA, which is the previous version of the model. TPB has a strong empirical history and is appropriate for help-seeking research. Some of the more relevant applications include exercise (Madden, Ellen, & Ajzen, 1992; Rhodes & Courneya, 2005), mammography (Tolma, Reininger, Evans, & Ureda, 2006), and alcohol treatment (Codd & Cohen, 2003). TRA has also had recent application and success in psychological help seeking in the work by Vogel (Pederson & Vogel, 2007; Vogel, Wade, & Hackler, 2007; Vogel, Wade, Wester, Larson, & Hackler, 2007; Vogel & Wei, 2005). The validity of TPB makes it a strong theoretical framework to test model differences for a variety of presenting concerns. TPB includes perceived behavioral controls, which relate to the individual's efficacy and control to engage in a specific behavior. …