Predictors of psychological difficulties and professional psychological help-seeking in Serbian youth

Abstract

The aim of this study is to explore the predictors of psychological difficulties (PD) of youth from the general population in Serbia, and to investigate the predictors of professional psychological help-seeking (PPHS) in the sub-sample of youth with clinically indicative symptoms of at least one mental disorder measured. A total sample consisted of 231 participants from 18 to 30 years of age (Mage=24.48, SDage=3.37, 47% males) recruited by a market research agency. Symptoms of ten disorders were measured – depression (Patient Health Questionnaire-9), anxiety (Generalized Anxiety Disorder Screener-7), suicidal ideation (Suicidal Ideation Attributes Scale), mania (Altman SelfRating Mania Scale), obsessive-compulsive symptoms (OCD; Obsessive-Compulsive Inventory-Revised), somatization (Somatic Symptom – Adult Patient), eating disorders (The Eating Disorder Examination Questionnaire), post-traumatic stress disorder (PTSD; Posttraumatic Stress Disorder Checklist and Life Events Checklist for DSM-5), dissociation (Brief Dissociative Experiences Scale), and prodromal symptoms (The Prodromal Questionnaire – Brief Version). Moreover, variables depicting demographic (gender, age), economic (socio-economic status), neighborhood (urbanity of settlement), environmental (traumatic experiences – Life Events Checklist for DSM-5), and social/cultural (social support – Multidimensional Scale of Perceived Social Support, education) domains, along with personal factors (coping strategies – Brief COPE, resilience – The Brief Resilience Scale) were collected. To explore PPHS, common barriers to care (Perceived Stigma and Barriers to Care) and experience with persons with mental health (MH) difficulties (The Reported and Intended Behaviour Scale) were assessed, while PPHS was measured by a single item (Have you ever sought professional psychological help?). A joint variable was computed, encompassing the PD experienced by each participant (i.e. a total number of screen-positive scores on measures of symptoms of mental disorders). The first regression model explained 44% of the variance of PD (R2adj=.44, F(7,223)=26.410, p=.000), with significant predictors being rural settlement (β=-.12, p=.017), previous traumatic experiences (β=.26, p=.000), lack of social support (β=-.32, p=.000), avoidant coping (β=.17, p=.021), and less pronounced resilience (β=-.17, p=.003). The second regression model was tested on a sub-sample of youth with clinically indicative symptoms of at least one mental disorder measured (N=94), with the criteria being lifetime PPHS. The model explained 26% of PPHS (R2adj=.26, F(4,89)=9.143, p=.000), showing that PPHS is less likely sought by males (β=- .30, p=.002), those having less experience with persons with MH difficulties (β=-.24, p=.019) and lacking information on where to get help (β=.25, p=.020). This study adds to the understanding of the MH of youth in Serbia and is discussed in terms of implications for comprehensive service provision.