Older adults are especially unlikely to seek mental health services, and internalized stigma is a key reason why. However, little research has investigated which older adults are particularly likely to have stigma influence help-seeking. To address this, we tested whether perceived control (PC) moderates an internalized stigma model in which public stigma is internalized as self-stigma, which negatively predicts help-seeking attitudes and help-seeking intentions. We employed moderated mediation analysis of cross-sectional, secondary data from 348 psychologically distressed Canadian adults aged 65 years and older. Participants completed an online survey that included measures of public stigma of help-seeking, self-stigma of help-seeking, help-seeking attitudes, conditional help-seeking intentions, psychological distress, and PC. PC emerged as a moderator of the internalized stigma model. Those lower in PC were more likely to have public stigma negatively predict help-seeking intentions through the serial mediation of (a) self-stigma and (b) help-seeking attitudes. Further, those lower in PC were more likely to have public stigma internalized as self-stigma and more likely to have negative help-seeking attitudes predict lower help-seeking intentions. Finally, those lower in PC also had lower help-seeking intentions in the face of low levels of self-stigma. These results contribute to a nuanced understanding of which older adults are unlikely to seek help. Identifying PC as a moderator of the internalized stigma model suggests that interventions that enhance PC should protect against public stigma's internalization and improve help-seeking behaviors for older adults who need such help. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

中文翻译：

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感知控制缓和了在痛苦的老年人中寻求心理健康服务的内化耻辱模型。


老年人特别不太可能寻求心理健康服务，而内化的耻辱感是一个关键原因。然而，很少有研究调查哪些老年人特别容易受到耻辱感影响寻求帮助。为了解决这个问题，我们测试了感知控制 （PC） 是否调节了内化的耻辱模型，在该模型中，公共耻辱被内化为自我耻辱，这负面地预测了寻求帮助的态度和寻求帮助的意图。我们对 348 名 65 岁及以上的心理困扰加拿大成年人的横断面、二手数据进行了有调节的中介分析。参与者完成了一项在线调查，其中包括寻求帮助的公众耻辱感、寻求帮助的自我耻辱感、寻求帮助的态度、有条件的寻求帮助意图、心理困扰和 PC 的测量。PC 成为内化污名模型的调节者。那些在 PC 中排名较低的人更有可能通过 （a） 自我耻辱和 （b） 寻求帮助态度的一系列中介，对寻求帮助的意图产生负面影响。此外，那些 PC 较低的人更有可能将公共耻辱内化为自我耻辱，并且更有可能有消极的寻求帮助态度预示着较低的寻求帮助意图。最后，面对低水平的自我耻辱感，PC 排名较低的人寻求帮助的意图也较低。这些结果有助于细致入微地了解哪些老年人不太可能寻求帮助。将 PC 确定为内化污名模型的调节因素表明，增强 PC 的干预措施应该可以防止公众污名的内化，并改善需要此类帮助的老年人寻求帮助的行为。（PsycInfo 数据库记录 （c） 2024 APA，保留所有权利）。