Predictors of treatment-seeking in women with subthreshold and full-syndrome bulimia.

Despite the fact that a variety of treatments for psychological disorders have been shown to be effective, a significant proportion of individuals who experience psychological problems do not seek professional help. Women with bulimia are particularly unlikely to seek help, with lower help seeking rates than those of individuals with other common psychological disorders (Smalec & Klingle, 2000). In the current study, qualitative interviews of 11 women with bulimic symptoms and 17 clinicians with expertise in the treatment of bulimia resulted in the development of a 53-item self-report measure of bulimic exclusive treatment fears. In a second quantitative stage of study, 354 women completed a series of self-report measures, and were categorized into four groups: (1) distressed non-bulimic non-help seekers, (2) distressed non-bulimic help seekers, (3) distressed non-help seekers with bulimic symptoms, and (4) distressed help seekers with bulimic symptoms. The above mentioned measure was subjected to principal component analysis and revealed a one-factor solution. Construct validity for the measure was supported as the factor scores significantly discriminated bulimic help-seekers from non-seekers but could not discriminate non-bulimic help seekers from non-seekers. Further examination of help seeking correlates revealed the following: While high social pressure to seek help and low familial social support predicted non-bulimic treatment seeking, treatment seeking dynamics in women with bulimic symptoms were more complicated. High social pressure to seek help, positive attitudes toward help seeking, image concerns, and identified bulimic treatment fears predicted bulimic treatment seeking. Kushner and Sher\u27s (1991) conceptualization of the decision to seek help as an approach-avoidance conflict may be particularly fitting for women with bulimic patterns, as they hold ambivalent attitudes regarding help seeking, likely due to high levels of distress (approach tendency) and high levels of self-concealment and certain dimensions of treatment fearfulness (avoidance tendencies). Limitations to the present study include potential sampling bias (i.e., based on geography and level of education), and a slightly less than ideal sample size. These data suggest that researchers should begin to explore predictors of treatment seeking in different pathologies, as the decision to seek psychological help appears to be influenced by pathology-specific factors.Dept. of Psychology. Paper copy at Leddy Library: Theses & Major Papers - Basement, West Bldg. / Call Number: Thesis2003 .F73. Source: Dissertation Abstracts International, Volume: 65-07, Section: B, page: 3705. Adviser: Cheryl D. Thomas. Thesis (Ph.D.)--University of Windsor (Canada), 2004