Attitudes toward Seeking Professional Help for an Eating Disorder: The Role of Stigma and Anticipated Outcomes.

Although between 5% and 17% of college students have an eating disorder such as anorexia nervosa or bulimia nervosa (Becker, Franko, Nussbaum, & Herzog, 2004; Prouty, Protinsky, & Canady, 2002), little is known about the determinants of help-seeking decisions for people experiencing or at risk for an eating disorder. This is a significant omission in the literature because only a small percentage of people seek professional help for eating-related issues (Becker et al., 2004; Cachelin & Striegel-Moore, 2006; Striegel-Moore, Leslie, Petrill, Garvin, & Rosenheck, 2000). For example, researchers have reported that less than 45% of individuals with a diagnosed eating disorder ever receive treatment (Cachelin & Striegel-Moore, 2006; Striegel-Moore et al., 2000), and only 17% of those identified as at risk for an eating disorder report seeking help for the problem (Becker et al., 2004). The substantial number of individuals who do not receive treatment indicates a need to better understand the factors involved in the help-seeking decisions of those experiencing and at risk for an eating disorder. This need is also important because researchers have found that eating disorders often are associated with a severe and chronic course of illness, including numerous psychological (e.g., depression, anxiety, alcohol and substance abuse) and medical comorbidities (e.g., reproductive problems, osteoporosis, cardiovascular problems) (Fairburn & Brownell, 2002; Pike & Striegel-Moore, 1997). Not surprisingly, researchers have noted the need to explore specifically the barriers to seeking help among those at risk for disordered eating attitudes and behaviors to implement effective interventions for these barriers (Meyer, 2001). The current study examines the roles of self-stigma and the anticipated risks and benefits of counseling in predicting attitudes toward counseling among a sample of individuals currently at risk for an eating disorder. This study also explores the role of gender in moderating these effects. * Help Seeking Among Individuals At Risk for an Eating Disorder In the last decade, researchers have started to examine the barriers to seeking help for individuals with unhealthy eating attitudes and behaviors. One of the barriers noted by researchers is the desire to keep the symptoms of the disorder a secret. For example, in a sample of high school students, Meyer (2001) found that the desire to keep eating issues private was an important reason for not seeking help. Similarly, college students who exhibit patterns of disordered eating tend to hide such problems from most of the people in their life and report that, initially, not seeking help is an attempt to hide their disorder (Oliver, Reed, Katz, & Haugh, 1999; Schwitzer, Rodriguez, Thomas, & Salimi, 2001). One reason individuals may try to hide their symptoms is fear of being labeled as having a mental illness and the stigmatization resulting from this label (Corrigan, 2004). Stigmatization can lead to negative reactions from others and, what is even more insidious, to self-stigmatization: the internalization of the negative beliefs held by society that can lead to the individual viewing himself or herself in a negative manner (Corrigan, 2004). The self-stigma associated with being labeled as having a mental illness has been linked to decreased self-esteem (Link, Strnening, Neese-Todd, Asmussen, & Phelan, 2001), and in the general help-seeking literature, self-stigma has been found to be negatively related to attitudes toward seeking counseling (Vogel, Wade, & Haake, 2006; Vogel, Wade, & Hackler, 2007). Although self-stigma has not yet been studied in relation to eating disorders, one study found that individuals experiencing symptoms of an eating disorder might have negative attitudes about seeking help because of a fear of being labeled (Cachelin & Striegel-Moore, 2006). Similarly, three studies have found that the shame associated with seeking counseling may be crucial in the formation of attitudes about seeking counseling for people with disordered eating (Cachelin & Striegel-Moore, 2006; Meyer, 2001; Pike & Striegel-Moore, 1997). …