Parental perceptions of child mental health symptoms, causes and responses among cambodian and its correlation with their children mental health

VIETNAM NATIONAL UNIVERSITY HA NOI
UNIVERSITY OF EDUCATION

PHAN RATHA

“PARENTAL PERCEPTIONS OF CHILD MENTAL
HEALTH: SYMPTOMS, CAUSES AND RESPONSES
AMONG CAMBODIAN AND ITS CORRELATION
WITH THEIR CHILDREN MENTAL HEALTH”

MASTER’S THESIS IN PSYCOLOGY

HANOI, VIETNAM: April, 2016


VIETNAM NATIONAL UNIVERSITY HA NOI
UNIVERSITY OF EDUCATION

PHAN RATHA

“PARENTAL PERCEPTIONS OF CHILD MENTAL
HEALTH: SYMPTOMS, CAUSES AND RESPONSES
AMONG CAMBODIAN AND ITS CORRELATION
WITH THEIR CHILDREN MENTAL HEALTH”
MASTER’S THESIS IN PSYCOLOGY
Major: Clinical psychology of children and adolescents
Code: Pilot

Supervisor:

Dr. Amie Pollack

Dr. Dang Hoang Minh

HANOI, VIETNAM: April, 2016


SUPERVISOR’S RESEARCH SUPERVISION STATEMENT
TO WHOM IT MAY CONCERN
Name of program: Master’s degree of Art in Clinical Psychology, specializing in
Child and Adolescent Clinical Psychology.
Name of candidate: Phan Ratha
Title of research: ―PARENTAL PERCEPTIONS OF CHILD MENTAL HEALTH:
SYMPTOMS, CAUSES AND RESPONSES AMONG CAMBODIANS AND ITS
CORRELATION WITH THEIR CHILDREN MENTAL HEALTH‖
This is to certify that the research carried out for the above titled master’s thesis was
completed by the above named candidate under my direct supervision. This thesis
material has not been used for any other degree. I played the following part in the
preparation of this thesis:

Supervisor (s)…………………………….
Date………………………………………


CANDIDATE’S STATEMENT
TO WHOM IT MAY CONCERN:
This is to certify that the thesis that I (Phan Ratha) am submitting, hereby entitled
Parental Perception of Child Mental Health (Symptoms, Cause and Treatment
Options) among Cambodians and its correlation with their children’s mental health,
for the degree of Master of Arts in Clinical Psychology at the University of
Education, Vietnam National University-Hanoi is entirely my own work and,
furthermore, that it has not been used to fulfill the requirements of any other

qualification in whole or in part, at this or any other University or equivalent
institution. No reference to, or quotes from this document, may be made without the
written approval of the author.
Signed by: ………………………………
Date: …………………………………….
Countersigned by the Chief Supervisor ………………………………………
Date: ………………………………….
Second supervisor (if any) ……………………………………………………
Date: ………………………………….


ACKNOWLEDGEMENTS
This thesis could not have been completed without the help of many people
who gave their support, advice, encouragement, and understanding. I would like to
show my deepest gratitude to the following people whom I will never forget.
First of all, I would like to give many thanks to my respectful mother, Sous
Lon, and grandparents, who have always financially and emotionally supported me.
Secondly, my appreciation is extended to Associate Professors Dr. Bahr Weiss and
Dr. Dang Hoang Minh for initiating and approving to release the first English
classes for master’s level psychology courses in Vietnam National University,
Hanoi to Cambodian students.
Additionally, I would like to express my sincerest thanks to Dr. Amie
Pollack and Dr. Cindy J Lahar, Dr. Poch Bunnak and Dr. Tran Thanh Nam who are
my kind and intelligent supervisors for their advice, encouragement, and
consultation so that I would be able to successfully complete the thesis writing
process from beginning to end. Without their technical support and professional
guidance, constructing the thesis could not have been done properly.
Furthermore, I would like to convey my thanks to lecturer Mr. Sareth Khann
and Mr. Bunna Peoun who assisted me by frequently providing feedback to enhance
this report. Moreover, my sincere thanks are delivered to all professors in the

master’s program, who tried their best to provide me with valuable knowledge and
useful skills to conduct research and write the thesis.
Finally, I cannot forget to say thanks to my classmates who provided warm
learning environment as well as Vietnamese and Cambodian friends who frequently
pushed me to focus on thesis tasks and provided a lot of feedback.


TABLE OF CONTENTS
PART I - BACKGROUND .......................................................................................8
1.1. Background of the Study......................................................................................8
1.2. Problem Statement ...............................................................................................9
1.3. Importance of the study and policy implications ...............................................10
1.4. Purposes of the study / The Aim of Research (Research Questions): ...............11
1.5. Objectives of the study: ......................................................................................11
1.6. Hypotheses for the study: ...................................................................................12
1.7. Scope and Limitation ........................................................................................12
PART II - LITERATURE REVIEW ....................................................................12
2.1. Introduction to mental health and mental disorders. ..........................................12
2.1.1. Worldwide epidemiological research regarding prevalence of mental
disorders .............................................................................................................12
2.1.2. Impact of mental health problems ............................................................12
2.1.3. Common causes of mental health problems .............................................12
2.2. Mental Health Literacy ......................................................................................12
2.2.1. What is mental health literacy? ................................................................12
2.2.2. Mental health literacy regarding help-seeking behaviors ........................12
2.2.3. Factors influencing mental health literacy and help-seeking behavior. ...12
2.3. Parental influences on child mental health development and treatment ............12
2.3.1. How parental factors put children at risk or help them recover from
mental health problems ......................................................................................12
2.3.2. How parental mental health literacy affects identification, help seeking,

and recovery from childhood mental health problems. ......................................12
2.4. Cambodian Mental Health Perceptions ..............................................................12
2.4.1. Rates of child and adult mental health in Cambodia ................................12
2.4.2. Cambodian mental health literacy and seeking-help behavior ................12


PART III - RESEARCH METHODOLOGY ......................................................12
3.1. Participants .........................................................................................................12
3.2. Sampling procedure ...........................................................................................12
3.3. Data Collection and Procedures .........................................................................12
3.4. Measurements (Scale) ........................................................................................12
3.5. Statistical Data Analysis ....................................................................................12
3.6. Ethical Considerations .......................................................................................12
PART IV – RESULTS AND DISCUSSION .........................................................12
4.1. Descriptive Results.............................................................................................12
4.2. Perceptions of the cause and consequences of specific child mental health
problems ....................................................................................................................12
4.3. Health-seeking behavior for mental health issues in children ...........................12
4.4. Analysis of parental perceptions ........................................................................12
4.5. Exploratory Factor Analysis ..............................................................................12
4.6 Explore the factors may influence parental perceptions of child mental health. 12
PART V - CONCLUSION AND FURTURE RECOMMENDATION ..............12
5.1. Conclusion ..........................................................................................................12
5.2. Recommendations ..............................................................................................12
REFERENCES ........................................................................................................13


LIST OF TABLES
Tables

Page

Table 1. Demographics by location (percentages reported for urban versus rural) ............ 12
Table 2. Responses to vignette of child with somatoform disorder ..................................... 12
Table 3. Responses to vignette of child with separation anxiety disorder ........................... 12
Table 4. Responses to vignette of child with Attention Deficit Hyper-active Disorder (ADHD) 12
Table 5. Responses to vignette of child with tic disorder .................................................... 12
Table 6. Responses to vignette of child with aggressive behavior ...................................... 12
Table 7. Responses to vignette of child with depressive disorder ....................................... 12
Table 8. Responses to vignette of child with Posttraumatic Stress Disorder (PTSD) ......... 12
Table 9. Parental perception of causes of child mental health by demographic info ......... 12
Table 10. Factorial analysis of cause of children mental health .......................................... 12
Table 11.Correlations between parent perception factors, and demographic characteristics. ... 12


LIST OF FIGURES
FIGURE

Page

Figure 1. Level of education completed by mothers by residential area ............................. 12
Figure 2: Level of education for fathers .............................................................................. 12
Figure 3. Household’s income by location .......................................................................... 12


PART I - BACKGROUND
1.1. Background of the Study
The healthy development of children is an important concern for families and
societies around the world. Given a nurturing environment, children have the
opportunity to grow into successful and productive members of society. Raising

children to be physically and mentally healthy requires much effort and serious care
from parents or caregivers. Mental health problems in children are a crucial
influence on child development. Understanding the symptoms and causes of mental
health problems will help parents effectively support their children and promote
their cognitive, social and emotional development (MoH, 2005; TPO 2005).
―There is no health without mental health‖ said Ban Ki Moon on October 10th
World Mental Health Day, 2011. This message encouraged public and private
sectors to take into account citizens’ mental health care, children included.
Improving people’s quality of life and mental health is a priority for the World
Health Organization (WHO). Worldwide epidemiological data indicate that about
20% of children and adolescents suffer from mental disorders with types of
disorders varying by cultural context. This finding is alarming and suggests that
early intervention for mental health care is needed (Saxena, Thornicroft, Knapp;
Whiteford, 2007). Another global study focused solely on children, conducted both
in developing and developed nations, and showed that 10% to 15% of children
suffer from mental health disorders with 3% to 4% of children having significant
developmental delays or mental retardation (Dom Nokteok, 2010). This finding was
very similar to a study (WHO, 2007) conducted by Seven Nation Collaborative
Study on children aged 0-12 in the Philippines which found that 16% of children in
the Philippines had mental disorders.
Regionally, a recent study (Weiss, Dang, & Nguyen, 2013) revealed that 1213% of Vietnamese children (aged 6-16) suffer from mental health problems,
indicating that 2.7 million of Vietnamese children need access to mental health
services. Studies have also looked at what factors place children at risk for mental
health problems. Weiss and colleagues (2013) found that parental income and
education play an important role as risk factors for Vietnamese child behavioral and


emotional problems. Another evidenced-based study of Spanish National Health
Survey (SNHS) with Spanish representative found a strong correlation between
parental education and child mental health among 4 to 10 year olds. This finding

was not seen among children aged from 12 to 15 years olds. Parental education was
a much greater risk factor for child mental health than family’s income or social
status (Songego, Llacer, and Galan, 2013). Therefore, parental education appears to
be a strong risk factor for parent-reported child mental health.
Parenting behavior appears to be an important factor in the development of
child mental health disorders. One study demonstrated that parenting style plays a
crucial role in child mental health; parents with strong interpersonal relationships
with their children had children with fewer mental health problems (Bolghan-Abadi,
Kimiaee & Amie, 2011). Furthermore, research has shown that family interventions
that use specific parenting skills are the most effective strategy to reduce child
behavioral problems (Hutching & Lane, 2005).
Research on child mental health is complicated by cultural variability in
perceptions of mental health, parenting behaviors, and parent reporting styles. A
study of Vietnamese parents living in Australia indicates that these parents
identified psychotic symptoms, disorientation, and suicidal thoughts and behavior as
psychopathological for their child’s mental illness. Additionally, parents in the
study believe that the most likely causes of child mental illnesses were metaphysical
and

supernatural,

biological/chemical

unrest,

and

traumatic

experiences.

(McKelvey, Baldassar, Sang, & Roberts 1999). Another study (Shanley, 2008) was
conducted in New Zealand to better understand multiple perspectives of parent’s
report of child mental health symptoms. As a result, a parent-report measure was
developed that is designed to be consistent with the cultural setting.
1.2. Problem Statement
Professionals and experts have a deep understanding of the causal,
developmental and maintaining factors of children's mental health problems.
Research on psychopathology indicates the following: 1) the interaction between
multiple biological, psychological and social factors cause children's mental health
problems (Shirk, Talmi, & Olds, 2000), 2) "One disorder can result from multiple


pathways and one pathway can have multiple results" (Hudson, Kendall, Coles,
Robin, & Webb, 2002), 3) child psychopathology can be also developed from the
increase of risk factors, especially exposure to risk factors during critical
developmental periods which can accelerate the chance of developing mental health
disorders (Shirk et al., 2000), and 4) risk and protective factors can be nonlinear, bidirectional, or reciprocal. Children and their environments are not mutually
disconnected; they constantly have reciprocal interactions and continually evolve
over time (Shirk et al., 2000; Kazdin, Kraemer, Kessler, Kupfer, & Offord, 1997).
It is ambiguous whether Cambodian parents are able to understand this
complicated picture of the cause, development and maintaining factors of children's
mental health problems. The first mental health literacy study in Australia (Jorm,
Barney, Christensen; Highet, Kelly, 2006) (by using vignettes) on depression and
schizophrenia indicated that many people cannot correctly describe psychiatric
symptoms for a disorder and various evidence also reveals that changing perception
and beliefs about mental disorders will influence behavior. Parents are more likely
to endorse a disease model when conceptualizing child mental health problems. A
disease model, which first originated in medicine, describes maladaptive
functioning as a syndrome that is either present or absent (Shirk et al., 2000; Sroufe,

1997). For example, a parent who views their child's depression as either present or
absent would likely endorse the disease model, negating the notion that mental
health problems exist on a continuum of severity.
Importantly, other literature shows that one key factor involved in parental
help-seeking for child mental health services is misperceptions of child mental
health symptoms or disagreement between parents regarding child mental health
(Shanley, 2008). Although there is an emerging literature on perceptions of mental
health disorders in Cambodia (See Chapter 2.2), there is no current literature on
review of child mental health disorders yet in Cambodia. Hence, scientific research
on Cambodian parental views of child mental disorders must be further explored.
1.3. Importance of the study and policy implications
It is expected that this empirical study will generate many significant scientific
findings relevant to child mental health, family functioning and social development.


First, the study intends to further our understanding of parent’s perceptions of child
mental problem across a variety of demographic areas. Additionally, it will inform
key health and education professionals, including child psychotherapists, school
counselors, and child-focused government offices, NGOs and social organizations
working to promote child health. Finally, it will help improve efforts to educate
parents about mental health problems and improve their ability to seek appropriate
services for children with mental health concerns.
1.4. Purposes of the study / The Aim of Research (Research Questions):
The purpose of this study is to explore parental perceptions of child mental
disorders. This research will address the following three main questions:
1. What are the common Cambodian parental perceptions of common
symptoms, causes and effective responses to child psychopathological
problems?
2. What are the factors (education, socio-economic, demographic, family
situation, etc) that influence the Cambodian parental perceptions of child

mental health?
3. Is there any existing association between parental perceptions of child
mental disorders and their child’s mental health?
1.5. Objectives of the study:
To specifically address the primary study research questions, the primary
goals of the study are the following:
1. Understand the general Cambodian parents’ perceptions of symptoms and
causes of child’s mental health problems and about how parents in Cambodia
commonly respond to children with mental health problems.
2. Explore the factors that may influence Cambodian parents’ perceptions of
child mental health.
3. To explore significant differences between Cambodian parents from urban
areas compared to parents from rural areas on their perceptions of child
mental health.
4. To explore how Cambodian parents’ perceptions of child mental health
problems may be associated with their own child’s mental health symptoms.


1.6. Hypotheses for the study:
In response to above objectives, the author has pre-determinedly provided
the following hypotheses:
Hypothesis 1: A significant number of Cambodian parents will have inaccurate
beliefs regarding the common symptoms, causes and effective responses to common
child psychopathological problems.
Hypothesis 2: Cambodian parental socio-demographic factors, including age,
education, and income will be significantly correlated with their perceptions of
child mental health symptoms, causes and appropriate parental responses.
Hypothesis 3: There will be a significant difference between parents from urban
areas in Cambodia compared to parents from rural areas on perceptions of child
mental health.

Hypothesis 4: Cambodian parents’ reported responses to common mental health
problems and perception of causes of child mental health will be correlated with
their own child’s mental health.
Hypothesis 5: High rates of mental health in children will be correlated with
Cambodian parental demographic information.
1.7. Scope and Limitation
The time frame for the study requires the author to strictly maintain a narrow
focus for the project. Therefore, the study will mainly concentrate on parents’
perceptions of children’s mental health and how these understandings correlate
with their child’s mental health status. Additionally, the target group will be
Cambodian parents of school age children who currently study in grades 1, and 2.
The sample will include parents from 2 schools in an urban area (Phnom Penh)
and from 2 schools in a rural area (Kampong Speu province, about 80 kms away
from Phnom Penh).


REFERENCES
1.

Aloud, N. (2004). Factors affecting attitudes toward seeking and using formal
mental

health

and

psychological

services

among

Arab-Muslims

population (Order No. AAI3124971).
2.

Adewuya, A., & Makanjuola, R. (2009). Preferred treatment for mental illness
among southwestern Nigerians. Psychiatric Services, 60(1), 121-124

3.

Aggarwal, N. R. (2012). Attitudes of students towards people with mental ill
health and impact on learning and well‐being. Journal of Research in Special
Educational Needs, 12(1), 37-44.

4.

Alonso, J., Chatterji, S., He, Y., & Kessler, R. C. (2013). Burdens of mental
disorders: The approach of the world mental health (WMH) surveys. The
burdens of mental disorders: Global perspectives from the WHO world mental
health surveys. (pp. 1-6) Cambridge University Press, New York, NY

5.

Bandura, A. (2012). Social cognitive theory. Handbook of theories of social
psychology (vol 1). (pp. 349-373) Sage Publications Ltd, Thousand Oaks, CA.

6.

Barksdale, C. L. (2008). Correlates of mental health help seeking behavior among african
american college students (Order No. AAI3275133). Available from PsycINFO. (621717723;
2008-99040-020).

7.

Buckner, J. D., Zvolensky, M. J., Jeffries, E. R., & Schmidt, N. B. (2014). Robust impact of
social anxiety in relation to coping motives and expectancies, barriers to quitting, and
cessation-related problems. Experimental and Clinical Psychopharmacology, 22(4), 341-347.

8.

Benjet, C., Borges, G., Stein, D. J., Méndez, E., & Medina-Mora, M. (2012). Epidemiology of
fears and specific phobia in adolescence: Results from the mexican adolescent mental health
survey. Journal of Clinical Psychiatry, 73(2), 152-158.

9.

Chinese Women's Research Network Xinhua: UN Chief Says "No Health
without Mental Health" on International Day.
3396.

10. Chinese Women's Research Network Xinhua: UN Chief Says "No Health

without Mental Health" on International Day.
3396.
11. Conner, K. O. (2009). Mental health treatment seeking among older adults with

depression: The impact of stigma and race (Order No. AAI3335741).

12. Conner, K. O., Copeland, V. C., Grote, N. K., Koeske, G., Rosen, D.,

Reynolds,Charles F., I.,II, & Brown, C. (2010). Mental health treatment
seeking among older adults with depression: The impact of stigma and
race. The American Journal of Geriatric Psychiatry, 18(6), 531-543.
13. Ding, Z., Wang, G., Pei, G., Guan, R., He, R., Phillips, M. R., . . . Wang, J. (2010).

Epidemiological survey of mental disorders in people aged 18 and older in tianshui
city of gansu province. Chinese Mental Health Journal, 24(3), 183-190.
14. Deswal, B., & Pawar, A. (2012). An epidemiological study of mental disorders

at pune, maharashtra. Indian Journal of Community Medicine, 37(2), 116-121.
15. De Almeida, J.,Miguel Caldas, Aguilar-Gaxiola, S., & Loera, G. (2013). The

burdens of mental disorders: Implications for policy. The burdens of mental
disorders: Global perspectives from the WHO world mental health
surveys. (pp. 230-243) Cambridge University Press, New York, NY.
16. De Anstiss, H., & Ziaian, T. (2010). Mental health help-seeking and refugee

adolescents:

Qualitative

findings

from

a

mixed-methods

investigation. Australian Psychologist, 45(1), 29-37.
17. Esan, O. B., Kola, L., & Gureje, O. (2012). Mental disorders and earnings:

Results from the nigerian national survey of mental health and well-being
(NSMHW). Journal of Mental Health Policy and Economics, 15(2), 77-82.
18. Fleming, M. L. (2013). Help seeking attitudes toward mental health issues

among military men who have been in combat (Order No. AAI3507990).
19. Huang, Z. J., Wong, F. Y., Ronzio, C. R., & Yu, S. M. (2007). Depressive

symptomatology and mental health help-seeking patterns of U.S.- and foreignborn mothers. Maternal and Child Health Journal, 11(3), 257-267.
20. Huang, Z. J., Wong, F. Y., Ronzio, C. R., & Yu, S. M. (2007). Depressive

symptomatology and mental health help-seeking patterns of U.S.- and foreignborn mothers. Maternal and Child Health Journal, 11(3), 257-267.
21. Hysenbegasi, A., Hass, S. L., & Rowland, C. R. (2005). The impact of

depression on the academic productivity of university students. Journal of
Mental Health Policy and Economics, 8(3), 145-151.


22. Honey, A., Emerson, E., & Llewellyn, G. (2011). The mental health of young

people with disabilities: Impact of social conditions. Social Psychiatry and
Psychiatric Epidemiology, 46(1), 1-10.
23. Isacson, D., Bingefors, K., & von Knorring, L. (2005). The impact of

depression

is

unevenly

distributed

in

the

population. European

Psychiatry, 20(3), 205-212.
24. Judd, F., Jackson, H., Komiti, A., Murray, G., Fraser, C., Grieve, A., & Gomez,

R. (2006). Help-seeking by rural residents for mental health problems: The
importance of agrarian values. Australian and New Zealand Journal of
Psychiatry, 40(9), 769-776.
25. Jorm, A. F., Blewitt, K. A., Griffiths, K. M., Kitchener, B. A., & Parslow, R. A.

(2005). Mental health first aid responses of the public: Results from an
australian national survey. BMC Psychiatry, 5.
26. Johnson, R. J. (2014). Impact of mental health research in sociology: Nearly

four decades of scholarship (1975-2011). Sociology of mental health: Selected
topics from forty years, 1970s-2010s. (pp. 141-159) Springer Science +
Business Media, New York, NY.
27. Jaycox, L. H., Stein, B. D., Paddock, S., Miles, J. N. V., Chandra, A., Meredith,

L. S., . . . Burnam, M. A. (2009). Impact of teen depression on academic,

social, and physical functioning. Pediatrics, 124(4), e596-e605.
28. Jordan, N. N., Hoge, C. W., Tobler, S. K., Wells, J., Dydek, G. J., & Egerton, W.

E. (2004). Mental health impact of 9/11 pentagon attack: Validation of a rapid
assessment tool. American Journal of Preventive Medicine, 26(4), 284-293.
29. Kessler, R. C., Aguilar-Gaxiola, S., Alonso, J., Chatterji, S., Lee, S., Ormel, J.,

. . . Wang, P. S. (2009). The global burden of mental disorders: An update from
the WHO world mental health (WMH) surveys. Epidemiologia e Psichiatria
Sociale, 18(1), 23-33.
30. Karam, E. G., Mneimneh, Z. N., Karam, A. N., Fayyad, J. A., Nasser, S. C.,

Chatterji, S., & Kessler, R. C. (2006). Prevalence and treatment of mental
disorders

in

lebanon:

A

Lancet, 367(9515), 1000-1006.

national

epidemiological

survey. The

31. Keqing, L., Ze, C., Lijun, C., Qinpu, J., Guang, S., Haoran, W., . . . Enyi, Z.

(2008). Epidemiological survey of mental disorders in the people aged 18 and
older in hebei province. Asian Journal of Psychiatry, 1(2), 51-55.
32. Knipscheer, J. W., & Kleber, R. J. (2005). Help-seeking behaviour regarding

mental health problems of mediterranean migrants in the netherlands:
Familiarity with care, consultation attitude and use of services. International
Journal of Social Psychiatry,51(4), 372-382.
33. Kovess-Masfety, V., Dezetter, A., de Graaf, R., Haro, J. M., Bruffaerts, R.,

Briffault, X., . . . Alonso, J. (2010). Religious advisors’ role in mental health
care in the european study of the epidemiology of mental disorders
survey. Social Psychiatry and Psychiatric Epidemiology, 45(10), 989-998.
34. Lu, C., Frank, R. G., Liu, Y., & Shen, J. (2009). The impact of mental health on

labour market outcomes in china. Journal of Mental Health Policy and
Economics, 12(3), 157-166.
35. Luitel, N. P., Jordans, M. J. D., Sapkota, R. P., Tol, W. A., Kohrt, B. A., Thapa,

S. B., . . . Sharma, B. (2013). Conflict and mental health: A cross-sectional
epidemiological

study

in

nepal. Social

Psychiatry

and

Psychiatric

Epidemiology, 48(2), 183-193.
36. LaBounty, J. C. (2009). Social cognition and its effects on young children's

social and mental health outcomes (Order No. AAI3343125). Available from
PsycINFO. (622073071; 2009-99140-085).
37. Mathers C.D., Loncar D. (2005): Update projects of global mortality and global

burden of disease, 2020: Global Burden of Disease Study. In: The lancet, P.
1498-1504
38. McDaid D., Knapp M., Raja S. (2008): Barriers in the mind: promoting an

economic case for mental health in low-income and middle-income countries.
In: World Psychiatry, P. 79-86
39. Mackenzie, C. S., Pagura, J., & Sareen, J. (2010). Correlates of perceived need

for and use of mental health services by older adults in the collaborative
psychiatric epidemiology surveys. The American Journal of Geriatric
Psychiatry, 18(12), 1103-1115.


40. Mariu, K. R., Merry, S. N., Robinson, E. M., & Watson, P. D. (2012). Seeking

professional help for mental health problems, among new zealand secondary
school students. Clinical Child Psychology and Psychiatry, 17(2), 284-297.
41. Miller, J. R. (2005). Attitudes and beliefs lawyers have about seeking

professional mental health services (Order No. AAI3141098).
42. McDaid D., Knapp M., Raja S. (2008): Barriers in the mind: promoting an

economic case for mental health in low-income and middle-income countries.
In: World Psychiatry, P. 79-86
43. Nguyen, Q. X. (2000). Vietnamese individuals' attitudes toward seeking mental

health services: Influence of cultural variables(Order No. AAI9967270).
44. Overby, S. E. (2009). A survey of treatment options and provider preferences

for those diagnosed with co-occurring conditions of mental illness and
substance use disorders in minnesota (Order No. AAI3359211).
45. Pandalangat, N. (2012). Cultural influences on help-seeking, treatment and

support for mental health problems - a comparative study using a gender
perspective (Order No. AAINR78080).
46. Pabst, S. R., Negriff, S., Dorn, L. D., Susman, E. J., & Huang, B. (2009).

Depression and anxiety in adolescent females: The impact of sleep preference
and body mass index. Journal of Adolescent Health, 44(6), 554-560.
47. Pang, S., Wang, G., Kong, L., Zhang, Y., Sun, B., Yin, S., . . . Phillips, M. R.

(2010). Epidemiological survey of mental illnesses in persons aged 18 years
and older in qingdao city. Chinese Mental Health Journal, 24(3), 175-182.
48. Phillips, M. R., Zhang, J., Shi, Q., Song, Z., Ding, Z., Pang, S., . . . Wang, Z.

(2009). Prevalence, treatment, and associated disability of mental disorders in
four provinces in china during 2001–05: An epidemiological survey. The
Lancet, 373(9680), 2041-2053.

49. Reavley, N. J., McCann, T. V., & Jorm, A. F. (2012). Mental health literacy in

higher education students. Early Intervention in Psychiatry, 6(1), 45-52.
Rutherford, J.

L.

(2004). Impact of

behavior (Order No. AAI3134211).

parental anxiety

on

parenting


50. Randolph, M. E. (2003). The role of depression, relationship support, and child

sexual abuse in predicting the impact of chronic pelvic pain on women's sexual
functioning (Order No. AAI3075474).
51. Ravens-Sieberer, U., Wille, N., Erhart, M., Bettge, S., Wittchen, H.,

Rothenberger, A., . . . Döpfner, M. (2008). Prevalence of mental health
problems among children and adolescents in germany: Results of the BELLA
study within the national health interview and examination survey. European
Child & Adolescent Psychiatry, 17, 22-33.
52. Rabasquinho, C., & Pereira, H. (2014). Epidemiology of mental disorders in the

south of beira interior (portugal). African Journal of Psychiatry, 17(3), 1-8.
53. Saxena S., Thornicroft G., Knapp M., Whiteford H., (2008): Resources for

mental health: scarcity, inequity, and inefficiency. In: The Lancet 370 (9590),
P. 878-889.
54. Stewart J., Tsong Y., Peou P.C. (2010): Mental Health in Cambodia: A

qualitative Evaluation. In: unpublished.
55. Slade, T., Johnston, A., Browne, M. A. O., Andrews, G., & Whiteford, H.

(2009). 2007 national survey of mental health and wellbeing: Methods and key
findings. Australian and New Zealand Journal of Psychiatry, 43(7), 594-605.
56. Srinath, S., Kandasamy, P., & Golhar, T. S. (2010). Epidemiology of child and

adolescent

mental

health

disorders

in

asia. Current

Opinion

in

Psychiatry, 23(4), 330-336.
57. Song, Z., Du, X., Han, G., Jian, Y., Liu, C., Phillips, M. R., . . . E, H. (2010).

Epidemiological survey of mental disorders in persons aged 18 and older in
qinghai province. Chinese Mental Health Journal, 24(3), 168-174, 190.
58. Sharac, J., McCrone, P., Clement, S., & Thornicroft, G. (2010). The economic

impact

of

mental

health

stigma

and

discrimination:

A

systematic

review. Epidemiology and Psychiatric Sciences, 19(3), 223-232.
59. Sareen, J., Cox, B. J., Afifi, T. O., Yu, B. N., & Stein, M. B. (2005). Mental

health service use in a nationally representative canadian survey. The Canadian
Journal of Psychiatry / La Revue Canadienne De Psychiatrie, 50(12), 753-761.

60. Tempier, R., Meadows, G. N., Vasiliadis, H., Mosier, K. E., Lesage, A., Stiller,

A., . . . Lepnurm, M. (2009). Mental disorders and mental health care in canada
and australia: Comparative epidemiological findings. Social Psychiatry and
Psychiatric Epidemiology, 44(1), 63-72.
61. Trollor, J. N., Anderson, T. M., Sachdev, P. S., Brodaty, H., & Andrews, G.

(2007). Prevalence of mental disorders in the elderly: The australian national
mental health and well-being survey. The American Journal of Geriatric
Psychiatry, 15(6), 455-466.
62. Transcultural

Psychosocial Organization, (2005): Where there is no

psychiatrist?
63. The burdens of mental disorders: Global perspectives from the WHO world

mental health surveys (2013). Cambridge University Press, New York, NY.
64. Unsal, A., M.D., & Ayranci, U., M.D. (2008). Prevalence of students with

symptoms of depression among high school students in a district of western
turkey: An epidemiological study. The Journal of School Health, 78(5), 287-93.
65. Urrutia, I., Aguirre, U., Pascual, S., Esteban, C., Ballaz, A., Arrizubieta, I., &

Larrea, I. (2012). Impact of anxiety and depression on disease control and
quality of life in asthma patients. Journal of Asthma, 49(2), 201-208.
66. Viana, M. C., Teixeira, M. G., Beraldi, F., de, S. B., & Andrade, L. H. (2009).

São

paulo

megacity

mental

health

Survey—A

population-based

epidemiological study of psychiatric morbidity in the são paulo metropolitan
area: Aims, design and field implementation. Revista Brasileira De
Psiquiatria, 31(4), 375-386.
67. Vicente, B., de, l. B., Saldivia, S., Kohn, R., Rioseco, P., & Melipillan, R.

(2012). Prevalence of child and adolescent psychiatric disorders in santiago,
chile: A community epidemiological study. Social Psychiatry and Psychiatric
Epidemiology, 47(7), 1099-1109.
68. Von Leupoldt, A., Chan, P. S., Bradley, M. M., Lang, P. J., & Davenport, P. W.

(2011). The impact of anxiety on the neural processing of respiratory
sensations. NeuroImage, 55(1), 247-252.


69. Van Hal, G. (2015). The true cost of the economic crisis on psychological well-

being: A review. Psychology Research and Behavior Management, 8.
70. Vera, M., Alegría, M., Freeman, D. H., Jr., Robles, R., Pescosolido, B., & Peña,

M. (1998). Help seeking for mental health care among poor puerto ricans:
Problem recognition, service use, and type of provider. Medical Care, 36(7),
1047-1056.
71. Van, d. H., Wright, P., Van, T. V., Doan, V. D. K., & Broerse, J. E. W. (2011).

Perceptions of mental health and help-seeking behavior in an urban community
in vietnam: An explorative study. Community Mental Health Journal, 47(5),
574-582.
72. Vega, W. A., Kolody, B., & Aguilar-Gaxiola, S. (2001). Help seeking for

mental health problems among mexican americans. Journal of Immigrant
Health, 3(3), 133-140.
73. Ward, E. C., & Heidrich, S. M. (2009). African american women's beliefs about

mental illness, stigma, and preferred coping behaviors. Research in Nursing &
Health, 32(5), 480-492.
74. Warner-Cohen, J. (2013). What factors are related to seeking mental health

treatment? a study of mental health help-seeking in youth with emotional or
physical illness (Order No. AAI3539314).
75. Wang, M. (2011). The cultural beliefs and mental health help-seeking

behaviors of people with schizophrenia in taiwan (Order No. AAI3439984).
Available from PsycINFO. (909293692; 2011-99190-257).
76. Williams, K. A. (2010). Help-seeking, service use, and unmet health and

mental health need among sexual minority youth: Findings from add health, a

national school-based study (Order No. AAI3366444).
77. Wu, T., Luo, Y., Broster, L. S., Gu, R., & Luo, Y. (2013). The impact of

anxiety

on

social

decision-making:

Behavioral

and

electrodermal

findings. Social Neuroscience, 8(1), 11-21.
78. Whiteford, H. A., & Ferrari, A. J. (2013). The burdens of mental disorders in

the global burden of disease study 2010 and the world mental health surveys:
Similarities, differences, and implications for mental health research. The


burdens of mental disorders: Global perspectives from the WHO world mental
health surveys. (pp. 221-229) Cambridge University Press, New York, NY.
79. Wong, D. F. K., Pui, H. T. K., Pearson, V., Chen, E., & Chiu, S. N. (2003).

Changing health beliefs on causations of mental illness and their impacts on
family burdens and the mental health of chinese caregivers in hong

kong. International Journal of Mental Health, 32(2), 84-98.
80. Wong, D. F. K., Tsui, H. K. P., Pearson, V., Chen, E. Y. H. C., & Chiu, S. N.

(2006). Erratum: "family burdens, chinese health beliefs, and the mental health
of chinese caregivers in hong kong". Transcultural Psychiatry, 43(1), 157.
81. Whiteford, H. A., & Ferrari, A. J. (2013). The burdens of mental disorders in

the global burden of disease study 2010 and the world mental health surveys:
Similarities, differences, and implications for mental health research. The
burdens of mental disorders: Global perspectives from the WHO world mental
health surveys. (pp. 221-229) Cambridge University Press, New York, NY.
82. Yoshimasu, K., & Kawakami, N. (2011). Epidemiological aspects of

intermittent explosive disorder in japan; prevalence and psychosocial
comorbidity: Findings from the world mental health japan survey 20022006. Psychiatry Research, 186(2-3), 384-389.
83. Yang, Z., Li, X., Wan, G., Su, L., & Luo, X. (1997). An epidemiological survey

of mental disorders in children and adolescents in china's hunan province:
Prevalence and model of interference. Chinese Mental Health Journal, 11(5),
260-263.
84. Zhou, X., Studart, C., & Shi, Q. (2010). Mental health problems, coping

mechanisms and professional help-seeking attitude in medical college
students. Chinese Mental Health Journal, 24(10), 790-795.
85. Zuvekas, S. H., & Selden, T. M. (2010). Mental health and family out-of-pocket

expenditure burdens. Medical Care Research and Review, 67(2), 194-212.
86. Zhang, J., Lu, C., Tang, J., Qiu, H., Liu, L., Wang, S., . . . Gao, C. (2010).

Epidemiological survey of mental disorders in persons aged 18 years and older

in shandong province. Chinese Mental Health Journal, 24(3), 161-167, 182.