Abstract:Objective To investigate the factors influencing the levels of fear regarding psychotherapy in adolescents with depression. Methods A prospective study was conducted among 258 adolescents with depression who were treated in the outpatient service and inpatient department of the First Affiliated Hospital of Nanchang University from September 2023 to March 2024. A questionnaire survey was performed. The questionnaires used included General Information Questionnaire, Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, Self-Compassion Scale, Self-Concealment Scale, Depression Self-Stigma Scale, and Thoughts About Psychotherapy Survey. The factors influencing the levels of fear regarding psychotherapy were analyzed among the adolescents with depression. Results The levels of fear regarding psychotherapy in the adolescents with depression were positively associated with the scores on the Patient Health Questionnaire-9, Self-Concealment Scale, and Depression Self-Stigma Scale (P<0.05), and were negatively associated with the score on the Self-Compassion Scale (P<0.05). Concerns about therapist responsiveness were negatively associated with the score on the Self-Compassion Scale (P<0.05), and were positively associated with the scores on the Generalized Anxiety Disorder-7 and Depression Self-Stigma Scale (P<0.05). The adolescents from one-child families had significantly higher levels of concerns about therapist responsiveness than those from non-one-child families (P<0.05). The levels of image concerns were positively associated with the scores on Patient Health Questionnaire-9, Self-Concealment Scale, and Depression Self-Stigma Scale (P<0.05); the levels of coercion concerns were positively associated with the scores of the Patient Health Questionnaire-9 and Self-Concealment Scale (P<0.05) and were negatively associated with the score on the Self-Compassion Scale (P<0.05). Middle school students had a significantly higher risk of coercion concerns than university students (P<0.05). Conclusions In adolescents with depression, the levels of fear regarding psychotherapy are associated with educational levels, only-child status, depression symptoms, anxiety symptoms, self-compassion, self-concealment, and depression self-stigma.
CHEN Zhao-Qi,TIAN Yang-Li,LIU Chuan-Jian et al. Factors influencing the levels of fear regarding psychotherapy in adolescents with depression[J]. CJCP, 2024, 26(12): 1315-1321.
Kovacs M, Obrosky S, George C. The course of major depressive disorder from childhood to young adulthood: recovery and recurrence in a longitudinal observational study[J]. J Affect Disord, 2016, 203: 374-381. PMID: 27347807. PMCID: PMC4975998. DOI: 10.1016/j.jad.2016.05.042.
Krause KR, Calderón A, Pino VG, et al. What treatment outcomes matter in adolescent depression? A Q-study of priority profiles among mental health practitioners in the UK and Chile[J]. Eur Child Adolesc Psychiatry, 2024, 33(1): 151-166. PMID: 36719524. PMCID: PMC10806045. DOI: 10.1007/s00787-023-02140-9.
Wright I, Mughal F, Bowers G, et al. Dropout from randomised controlled trials of psychological treatments for depression in children and youth: a systematic review and meta-analyses[J]. J Affect Disord, 2021, 281: 880-890. PMID: 33248810. DOI: 10.1016/j.jad.2020.11.039.
6 Kushner MG, Sher KJ. Fear of psychological treatment and its relation to mental health service avoidance[J]. Psychiatry Behav Sci, 1989, 20(4): 251-257. DOI: 10.1037/0735-7028.20.4.251.
8 Chung YYH, Shek DTL. Treatment fears: barriers to young psychotropic substance abusers receiving residential drug rehabilitation treatment[J]. Int J Ment Health Addict, 2018, 16(6): 1322-1342. DOI: 10.1007/s11469-018-9884-x.
Lienemann BA, Siegel JT. State psychological reactance to depression public service announcements among people with varying levels of depressive symptomatology[J]. Health Commun, 2016, 31(1): 102-116. PMID: 26086674. DOI: 10.1080/10410236.2014.940668.
Clement S, Schauman O, Graham T, et al. What is the impact of mental health-related stigma on help-seeking? A systematic review of quantitative and qualitative studies[J]. Psychol Med, 2015, 45(1): 11-27. PMID: 24569086. DOI: 10.1017/S0033291714000129.
Zhu L, Wei L, Xiaomin Y, et al. Self-compassion and fear of cancer recurrence in Chinese breast cancer patients: the mediating role of maladaptive cognitive styles[J]. Psychooncology, 2022, 31(12): 2185-2192. PMID: 36420681. DOI: 10.1002/pon.6070.
24 Shinde S, Khandeparkar P, Pereira B, et al. A qualitative study of understanding depression and help-seeking behavior among rural school-going adolescents in India[J]. J Indian Assoc Child Adolesc Ment Health, 2021, 17(1): 8-24. DOI: 10.1177/0973134220210102.
Wu S, Cai S, Xiong G, et al. The only-child effect in the neural and behavioral signatures of trust revealed by fNIRS hyperscanning[J]. Brain Cogn, 2021, 149: 105692. PMID: 33540359. DOI: 10.1016/j.bandc.2021.105692.
Morishita C, Masuya J, Ishii Y, et al. Interpersonal sensitivity as a mediator of the effect of childhood parenting quality on depressive symptoms[J]. J Nerv Ment Dis, 2024, 212(5): 241-250. PMID: 38198691. DOI: 10.1097/NMD.0000000000001756.
29 Thomas Tobin CS, Erving CL, Barve A. Race and SES differences in psychosocial resources: implications for social stress theory[J]. Soc Psychol Q, 2021, 84(1): 1-25. DOI: 10.1177/0190272520961379.
Rowa K, Gifford S, McCabe R, et al. Treatment fears in anxiety disorders: development and validation of the treatment ambivalence questionnaire[J]. J Clin Psychol, 2014, 70(10): 979-993. PMID: 24719267. DOI: 10.1002/jclp.22096.
Komlenac N, Lamp E, Maresch F, et al. Not always a "buffer": self-compassion as moderator of the link between masculinity ideologies and help-seeking intentions after experiences of intimate partner violence[J]. J Interpers Violence, 2023, 38(17-18): 10055-10081. PMID: 37096972. PMCID: PMC10580665. DOI: 10.1177/08862605231169766.
Egan SJ, Rees CS, Delalande J, et al. A review of self-compassion as an active ingredient in the prevention and treatment of anxiety and depression in young people[J]. Adm Policy Ment Health, 2022, 49(3): 385-403. PMID: 34559347. PMCID: PMC9005396. DOI: 10.1007/s10488-021-01170-2.
33 Chinweuba DC, Ifeagwazi CM, Chinweuba AU, et al. Does self-concealment and self-compassion differentially influence substance use for male versus female adolescents?[J]. J Subst Use, 2023, 28(1): 117-122. DOI: 10.1080/14659891.2021.2018726.
Love M, Farber BA. Honesty in psychotherapy: results of an online survey comparing high vs. low self-concealers[J]. Psychother Res, 2019, 29(5): 607-620. PMID: 29292664. DOI: 10.1080/10503307.2017.1417652.