Research reports

76 BIOLOGINĖ PSICHIATRIJA IR PSICHOFARMAKOLOGIJA T. 18, Nr. 2, 2016 m. gruodis

Attitudes toward professional psychological help-seeking, perceived emotional intelligence, and prior help-seeking

experience among students in Lithuania

SuMMARyIntroduction. Previous research has widely explored various factors and barriers that effect an individual’s decision to seek professional psychological help. The main goal of those studies was to recognize and eliminate barriers, which get in a way of reaching psychological help and create favorable conditions for the help seekers. However, in Lithuania, this area is little researched, even though the issue of not seeking help is even more relevant than in some other countries. Aim of the study. The current study examined the gender differences in and relationships between psychological Help-Seeking Attitudes (HSA), perceived Emotional Intelligence (EI) and prior psychological Help-Seeking Experience (HSE) among students in Lithuania.Materials and methods. The study involved 222 students from two universities in Klaipėda, Lithuania. The research employed the Inventory of Attitudes toward Seeking Mental Health Services (IASMHS) [6]; Emotional Skills and Competence Questionnaire (ESCQ-45) [17] and the sociodemographic questionnaire (including HSE). Gender differences were examined using Independent t-test analysis, while the relationships between HSA, EI and HSE were assessed using Multivariate Regression Analysis. Results. We found that (1) females showed significantly more positive HSA toward professional psychological help, meaning they were more Psychologically Open (PO) , demonstrated higher Help-Seeking Propensity (HSP) in the future and were more Indifferent to Stigma (IS); (2) females also demonstrated higher EI: they were better at Perceiving and Understanding (PU) emotions as well as Expressing and Labeling (EL) them. Thirdly, (3) there was a significant relationship between HSA and EI. (4) Finally, there were significant associations between HSE and HSP.Conclusion. Females tend to have more positive HSA than males and scored higher on EI. Further, after controlling for gender, age, and university, affirmative HSA toward professional psychological help are positively associated with higher EI, while HSP is positively associated with HSE. Key words: psychological help, help-seeking attitudes, emotional intelligence, help-seeking experience.

Požiūris į profesionalią psichologinę pagalbą, suvoktas emocinis intelektas ir ankstesnė pagalbos ieškojimo patirtis tarp studentų

LietuvojeJulija GECAITE1, Gina LEvICKIENE2, Narseta MICKuvIENE1

1Behavioral Medicine Institute, Lithuanian university of Health Sciences, Palanga, Lithuania2LCC International university, Klaipėda, Lithuania

SANTRAuKAĮvadas. Per pastarąjį dešimtmetį buvo atlikta mokslinių darbų, tiriančių įvairius veiksnius ir kliūtis, lemiančius žmogaus sprendimą kreiptis profesionalios psichologinės pagalbos. Taip siekiama atpažinti ir pašalinti kuo daugiau kliūčių, trukdančių kreiptis psichologinės pagalbos, sukurti kuo palankesnes sąlygas klientams ir laiku sulaukti pagalbos. Vis dėlto Lietuvoje ši tematika tyrinėta mažai, nors žmonių nesikreipimas pagalbos yra gana aktuali ir opi problema šalyje. Tyrimo tikslas. Nustatyti lyčių skirtumus ir sąsajas tarp požiūrio psichologinės pagalbos atžvilgiu, suvokto emocinio intelekto ir ankstesnės pagalbos ieškojimo patirties tarp studentų Lietuvoje.Tyrimo medžiaga ir metodai. Tyrime dalyvavo 222 dalyviai iš dviejų Klaipėdos aukštųjų mokyklų. Tyrime naudotas Nuostatų psichinės sveikatos paslaugų siekimo atžvilgiu inventorius (IASMHS) [6]; Emocinių įgūdžių ir kompetencijos klausimynas (ESCQ-45) [17] ir sociodemografinė anketa. Rezultatai. Tyrimo metu paaiškėjo, kad (1) moterų požiūris psichologinės pagalbos atžvilgiu yra palankesnis nei vyrų; (2) moterų suvoktas emocinis intelektas aukštesnis negu vyrų; (3) nustatytas teigiamas ryšys tarp požiūrio psichologinės pagalbos atžvilgiu bei suvokto emocinio intelekto, t.y. kuo aukštesnis asmens suvoktas intelektas, tuo palankesnis jo požiūris psichologinės pagalbos atžvilgiu; (4) asmenys, kurie anksčiau yra kreipęsi profesionalios psichologinės pagalbos yra labiau linkę kreiptis pagalbos ir ateityje.Išvados. Moterys yra linkusios turėti pozityvesnį požiūrį į psichologinės pagalbos siekimą ir aukštesnį suvoktą emocinį intelektą. Taip pat nepriklausomai nuo lyties, amžiaus ir universiteto, požiūris į profesionalios psichologinės pagalbos siekimą yra tegiamai reikšmingai susijęs su aukštesniu suvoktu emociniu intelektu, o polinkis kreiptis į profesionalią psichologinę pagalbą teigiamai reikšmingai susijęs su ankstesne pagalbos siekimo patirtimi.

Raktiniai žodžiai: psichologinė pagalba, požiūris į psichologinę pagalbą, emocinis intelektas, ankstesnė pagalbos ieškojimo patirtis.

Corresponding author: Julija Gečaitė, e-mail: julija.gecaite@lsmuni.lt, tel. +370 699 91667

vol. 18, No 2, 2016, december BIOLOGICAL PSyCHIATRy ANd PSyCHOPHARMACOLOGy 77

INTROduCTION

Lithuania is one of the top countries in terms of alcohol abuse and divorce rates [1] and still the first European country by suicide rates [2]. Considering these facts, not seeking psychological help in time may cause psychosocial and mental health problems [3]. However, there is a gap between these people who experience psychological problems and do not seek help and people who actually get adequate psychological/psychotherapeutic treatment [4]. Thus, there is a great importance to recognize and eliminate the barriers in Lithuania, which lead an individual to isolate oneself from seeking psychological help when they are in need.

Based on previous studies, negative Help-Seeking Attitudes (HSA) towards seeking psychological help are considered to be a major barrier to seek psychological help [5]. HSA toward professional psychological help refer to the extent to which an individual (1) is open to acknowledge psychological problems and seek professional help (measured as Psychological Openness [PO]) (2) believes he is willing and able to seek professional help (measured as Help-Seeking Propensity [HSP]), and (3) is concerned about what others might think should they find out that the individual is seeking professional help for psychological problems (measured as Indifference to Stigma [IS]) [6].

Furthermore, since there are links between HSA and fear of emotions [7; 8], restricted emotional expression [9], alexithymia [10] and emotional competence [11], there might be a significant relationship between HSA and perceived Emotional Intelligence (EI). Consequently, low EI could be related to decision not to seek help in case of a need. In addition, research claims that people, who have prior Help Seeking Experience (HSE) for psychological problems, are more willing to seek help in the future [12]. Overall, to the best of our knowledge, there are no studies in Lithuania analyzing the reasons of not seeking help for psychological problems.

Considering gender differences, previous research in other countries showed that males tend to hold negative HSA in comparison to females [13], yet due to higher rates of alcohol abuse and suicidal ideation, they are not less in need of professional help than their counterparts [14]. In terms of EI and gender, Žukauskienė et al. [15] found that females are better than males in understanding, expressing, labeling, and controlling emotions in Lithuania. To understand whether mentioned psychological factors inhibit help-seeking behavior in Lithuania, males require further investigation. For mental health professionals it is important to continue to take these complicated factors into account if they are to further understand the reasons that people do not seek help.

Based on the previous research [7-13, 15] the current study hypothesized that (1) females will have more positive HSA than males; (2) females will score higher on EI than males; (3) there will be a positive associations between HSA and EI; (4) subjects with HSE will have more positive HSA towards professional psychological help than subjects without HSE.

The aim of the current study was to investigate the gender differences in and the relationship between HSA, EI and HSE among students in Lithuania.

METHOdS

222 participants from LCC International University and Klaipėda University participated in this study. 16 participants were excluded from further analysis due to incomplete data. The final sample consisted of 206 students.

Participation was voluntary, based on convenience sampling. To be selected for the study, participants had to be fluent in Lithuanian language and had to have Lithuanian citizenship. Study program was not considered as a selection criteria due to limitations of participant‘s recruitment.

Participants were approached at the university in their regular lectures during three weeks period on February, 2014. Students enrolled in several study programs: Business administration (n=61), Engineering (n=73), Educology and Pedagogy (n=18), Psychology (n=18), English philology (n=15), Techonological studies (n=10), Theology (n=2). 9 participants did not specify their major. Subjects had to fill in informed consent form, the socio-demographic information form indicating their age, gender, HSE, and university. Individuals also filled in the Inventory of Attitudes toward Seeking Mental Health Services (IASMHS) as well as Emotional Skills and Competence Questionnaire (ESCQ-45). The permissions to operate the scales were obtained from the authors [6; 16; 15].

The study protocol was approved by Institutional Review Board of LCC International University, and created according to requirements of Declaration of Helsinki

IASMHS was employed to measure HSA. IASMHS involved three subscales: Psychological Openness (PO), Help-Seeking Propensity (HSP), and Indifference to Stigma (IS) [6]. The inventory had 24 items with maximum sum of point 120. The questionnaire was self-report, based on 5-point Likert scale (1 = never, 5 = always) and showed high validity [6]. Internal consistency measured by Cronbach alpha coefficient was eligible: for total IASMHS 0.783, for subscales: PO=0.663, HSP=0.677, and IS=0.706.

ESCQ-45 was used to analyse different aspects of subjects‘ emotional skills and competence including general EI (final sum of points) and three subscales: Perception and Understanding (PU) of emotion, Expression and Labeling (EL) of emotion, and Management and Regulation (MR) of emotion [17]. The questionnaire consisted of 45 items with maximum sum of point 225. The questionnaire was self-report, based on 5-point Likert scale (1 = never, 5 = always) and was proved to be valid [16, 17]. Cronbach alphas showed high internal consistency: for total ESCQ-45: EI=0.897, for subscales: PU=0.871, EL=0.832, MR=0.716.

Statistical analysis

Analysis was performed using The Statistical Package for Social Sciences (SPSS 16). Shapiro-Wilk’s test was employed to test the normality assumption for each variable. The study data was normally distributed, except for the overall score of HSA scale. However, since the sample size of the study was relatively large, parametric tests were employed to compute statistical analysis [18]. Independent t-test was selected to measure gender and HSE differences on HSA (as well as PO; HSP and IS subscales), and EI (as well as PU, EL, and MR subscales). Analogically, Multivariate regression analysis was

GECAITE, LEvICKIENE, MICKuvIENE Help-seeking attitudes, prior experience and emotional intelligence

Research reports

78 BIOLOGINĖ PSICHIATRIJA IR PSICHOFARMAKOLOGIJA T. 18, Nr. 2, 2016 m. gruodis

employed to investigate the associations between HSA and EI, as well as associations between HSA and HSE. Statistical significance was assumed when the p-value was < 0.05.

RESuLTS

222 participants were approached. 16 participants were excluded from further analysis due to incomplete data. The final sample consisted of 206 students. There were slightly more female participants n=108 (52.4%) than males n=98 (47.6%), with a mean age of 20.3±1.33. Most of the participants were without help-seeking experience: 179 (86.9%). Baseline socio-demographic characteristics as well as scores on IASMHS and ESCQ-45 scales are presented in Table 1. Study data was normally distributed, except for the overall score of help-seeking attitudes scale. However, since the sample size of the study was relatively large, parametric tests were employed to compute statistical analysis [18].

The study detected significant gender differences (Table 2). Females scored significantly higher than males on psychological openness (24.5±6.11 vs 21.5±5.27, t=-3.71, p<0.001), help-seeking propensity (27.2±6.04 vs 24.9±5.04, t=-3.07, p=0.002) and indifference to stigma subscales (28.2±6.07 vs 25.0±5.11, t=-4.08, p<0.001). Consequently, females demonstrated significantly higher score than males on overall help-seeking attitudes (79.9±14.2 vs 71.4±9.63, t=-5.01, p<0.001). Females also scored higher than males on perception and understanding of emotion (58.3±8.84 vs 53.4±7.30, t=-4.34, p<0.001), and expression and labeling emotion (53.5±8.37 vs 48.9±7.70, t=-4.13 , p<0.001) subscales. There were no significant difference between females and males in terms of management and regulation of emotion subscale (p>0.05). Overall, females scored higher than males on final emotional intelligence score (171.1±19.7 vs 161.0±18.7, t=-3.76, p<0.001).

Multivariate regression analysis indicated that after controlling for gender, age, help-seeking experience, and

Age 20.3±1.33Gender:

Male 98(47.6%)Female 108(52.4%)

Nationality:Lithuanian 190(92.2%)Russian 16(7.8%)

Prior Help seeking:Yes 27(13.1%)No 179(86.9%)

University:LCC University 94(45.6%)Klaipeda University 112(54.4%)

Psychological Openness 23.1±5.90Help-Seeking Propensity 26.1±5.70Indifference to Stigma 26.7±5.84Final Help-seeking Attitudes 75.9±12.9Perception and Understanding of emotion 55.9±8.49Expression and Labeling of emotion 51.3±8.36Management and Regulation of emotion 59.1±6.96Final perceived Emotional Intelligence 166.3±19.8

Table 1. Baseline sociodemographic and psychological characteristics of 206 study participants

Males Females p

Nationality 0.401Lithuanian 92(93.9%) 98(90.7%)Russian 6(6.1%) 10(9.3%)

Prior Help seeking 0.005Yes 6(6.1%) 21(19.4%)No 92(93.9%) 87(80.6%)

University <0.001LCC University 23(23.5%) 71(65.7%)Klaipeda University 75(76.5%) 37(34.3%)

Age 20.0±1.32 20.6±1.30 0.003Psychological Openness 21.5±5.27 24.5±6.11 <0.001Help-Seeking Propensity 24.9±5.04 27.2±6.04 0.002Indifference to Stigma 25.0±5.11 28.2±6.07 <0.001Final Help-seeking Attitudes 71.4±9.63 79.9±14.16 <0.001Perception and Understanding of emotion

53.4±7.30 58.3±8.84 <0.001

Expression and Labeling of emotion

48.9±7.70 53.5±8.37 <0.001

Management and Regulation of emotion

58.8±7.36 59.3±6.61 0.568

Final perceived Emotional Intelligence

161.0±18.7 171.1±19.7 <0.001

Table 2. Baseline sociodemographic and psychological characteristics of 206 study participants according to gender

Table 3. Baseline characteristics of 206 study participants according to prior Help-Seeking Experience (HSE)

Yes No pGender 0.005

Male 6(22.2%) 92(51.4%)Female 21(77.8%) 87(48.6%)

Nationality 0.142Lithuanian 23(85.2%) 167(93.3%)Russian 4(14.8%) 12(6.7%)

University 0.052LCC University 17(63.0%) 77(43.0%)Klaipeda University 10(37.0%) 102(57.0%)

Age 20.5±1.19 20.3±1.35 0.345Psychological Openness 22.2±5.43 23.2±5.96 0.350Help-Seeking Propensity 28.7±5.98 25.7±5.57 0.022Indifference to Stigma 26.1±6.05 26.7±5.82 0.638Final Help-seeking Attitudes 77.0±14.40 75.7±12.71 0.657Perception and Understanding of emotion

57.1±9.50 55.8±8.34 0.501

Expression and Labeling of emotion

51.2±8.53 51.3±8.36 0.921

Management and Regulation of emotion

57.4±6.50 59.3±7.01 0.161

Final perceived Emotional Intelligence

165.6±19.9 166.40±19.9 0.846

vol. 18, No 2, 2016, december BIOLOGICAL PSyCHIATRy ANd PSyCHOPHARMACOLOGy 79

GECAITE, LEvICKIENE, MICKuvIENE Help-seeking attitudes, prior experience and emotional intelligence

university, help-seeking attitudes were significantly associated with emotional intelligence (β=0.193, p=0.004). Specifically, emotional intelligence predicted help-seeking propensity (β=0.154, p=0.027) and indifference to stigma (β=0.227, p=0.001), that was the subscale of help-seeking attitudes (Table 3).

The independents Student’s t-test showed that those with help-seeking experience demonstrated significantly higher help-seeking propensity (28.7±5.98 vs. 25.7±5.57, t=2.40, p=0.022) (Table 4). After controlling for gender, age, university and emotional intelligence, help-seeking propensity was still significantly associated with help-seeking experience (Table 3).

dISCuSSION

The current study revealed that females have significantly more positive HSA toward professional psychological help than males, which corresponds with the previous research [19]. Females revealed having significantly higher PO towards mental health services, were less affected by social stigma (had higher IS) and were more willing to seek professional psychological help in case the need is recognized (were higher on HSP). These are the factors that may increase the possibility, that females will seek professional psychological help once they are in need.

Even though our study shows women’s advantages in positive HSA, it is essential to pay a closer attention to males because they may be less likely to seek psychological help due to more negative HSA. According to previous studies, men’s negative HSA can be determined by fear of losing control and independence, discomfort to disclose distress, shame to accept their failure to be strong and deal with the problems independently, identifying oneself with traditional male norms, feeling stereotyped as tough as well as emotionally inexpressive, and having stronger tendency to enroll in destructive behavior like substance abuse or suicide to cope with life problems [20-23, 19, 3]. These are the other, yet essential reasons for men not to seek help, which were not an object of our study but can be studied as controlled factors for HSA and EI in the future studies.

Furthermore, the current study supported the prediction that gender differences exist on EI, meaning that females have overall higher EI, are higher at PU and EL of emotions. These findings partially correspond with Žukauskienė et al. [15] research results. The results can be explained based on gender stereotypes: males are supposed to be strong, aggressive

and inexpressive, while females are allowed to be sensitive and emotional [25]. This may lead females to develop more expressive character features like empathy, which is related to EI [26]. Secondly, parents can be described as taking emotion-coaching or emotion-dismissing approach depending on how they communicate with their children [27]. Since females are seen as more emotional due to gender stereotypes, possibly, emotion-coaching approach is employed with daughters more so than with sons that may influence their further EI development. Thirdly, there is great evidence that social relationships and their quality is of a greater importance to girls than to boys during adolescence [15]. Hence, females recognize the need to learn social skills, such as PU of emotions in order to develop more quality friendships.

Based on the results, practitioners may pay closer attention to HSA and EI as possible barriers to seek psychological help in males patients and address negative HSA and lower EI with standard techniques of Cognitive Behavioral Therapy [28-29] as well as practice Gender based Motivational Interview to tackle the area of self-stigmatization, which may increase IS in men [30]. Further, Mindfulness based Practices in therapeutic setting is another effective and scientifically proven therapy to deal with EI issues that contribute to lower HSP toward professional psychological help in distressing situation and create negative effects on their life quality [31-32].

Further, the present study revealed that there is a significant relationship between HSA and EI. Even though there is no analogical study done previously, the results partially correspond with Ciarrochi et al. [11] study claiming that identifying, describing and managing emotions forecast help-seeking intentions. There can be several explanations to this relationship. First, a person who is competent in regulating, expressing and understanding of his/her emotions, may also have less fear of revealing his/her emotions, which otherwise serve as the avoidance factor to seek professional psychological help [8]. Particularly, this skill of regulating, expressing and understanding emotions may give him/her a sense of control and self-esteem that otherwise would stop one from seeking help [33, 20]. Secondly, professional psychological help engages a person‘s emotions and aims at understanding their importance. Anticipated utility and risk of mental services is one of the most influential factors for holding positive or negative HSA towards professional psychological help [22]. Therefore, people who have higher EI may understand the role of emotions in psychotherapy and see value in it more so than their counterparts. Finally, fear of treatment and fear of self-

Table 4. Associations between Help-Seeking Attitudes and its subscales (Psychological Openness, Help-Seeking Propensity, Indifference to Stigma) and gender, age, prior Help-Seeking Experience, university, and final perceived Emotional Intelligence score (n=206)

R2(p) Gender Age Help-Seeking Experience

University Final Emotional Intelligence score

VIF

Psychological Openness

0.157 (<0.001) 0.157 (0.035) 0.204 (0.005) 0.124 (0.063) -0.147 0.063) 0.047 (0.483) 1.05–1.46

Help-Seeking Propensity

0.124 (<0.001) 0.128 (0.093) 0.225 (0.003) 0.149 (0.029) 0.081 (0.315) 0.154 (0.027) 1.05–1.46

Indifference to Stigma 0.135 (<0.001) 0.215 (0.005) 0.036 (0.628) 0.079 (0.244) -0.023 (0.771) 0.227 (0.001) 1.05–1.46Final Help-seeking Attitudes score

0.197 (<0.001) 0.226 (0.002) 0.208 (0.004) 0.026 (0.693) -0.041 (0.590) 0.193 (0.004) 1.05–1.46

Research reports

80 BIOLOGINĖ PSICHIATRIJA IR PSICHOFARMAKOLOGIJA T. 18, Nr. 2, 2016 m. gruodis

disclosure are recognized as the barriers to seeking help [22]. However, the very essence of these barriers is the emotion of fear. Therefore, there is a possibility that an emotionally competent person will experience lower effect of those barriers due to his skill in recognizing and managing emotion of fear.

Considering future research, the present study detected associations, thus additional research is needed to investigate the cause and effect relationships between HSA and EI. Secondly, it would be beneficial to lead an EI training program, and measure the difference in HSA before and after the training in order to detect how EI can affect HSA.

Finally, the current results show that participants, who have HSE also have higher HSP to turn to mental health specialist in the future in case the need of help is acknowledged. The results correspond to previous findings in other countries [7, 12]. Our findings lead to the interest of conducting experimental research, where people‘s HSA can be tested before and after the therapy sessions. This would allow recognizing how therapy experience may affect HSA and would give a greater value of one-time psychological consultation in various clinics.

LIMITATIONS

The research was based on convenience sampling, which may have resulted in selection bias. Also, self-reported EI scale may not have been as representative as ability based

EI inventories and might have been affected by self-serving bias. Finally, the sample was not even between those with and without HSE, thus the results about difference between two groups can only be interpreted as a tendency.

CONCLuSIONS

The current study aimed to broaden the knowledge about young adults’ Help-Seeking Attitudes and thus, to contribute to dealing with life distressing situations in Lithuania. The study provided valuable information by tapping into unexplored area of relationship between Help-Seeking Attitudes and perceived Emotional Intelligence in Lithuania. The study revealed that females tend to hold more positive attitudes toward professional psychological help and have higher perceived Emotional Intelligence. Our findings also suggest that after controlling for gender, age and university, there are positive significant associations between Help-Seeking Attitudes and perceived Emotional Intelligence, while Help-Seeking Propensity is positively associated with prior Help-Seeking Experience.

Conflicts of interestAuthors declare no conflicts of interest.

REFERENCES

1. Lithuanian Statistics Departament; 2013. [ cited 20 October, 2016]. Available from: http://www.stat.gov.lt/]

2. Health Information Centre of Institute of Hygiene, Causes of death 2015 [Cited 28 October, 2016]. Available from: http://www.hi.lt/uploads/pdf/leidiniai/Statistikos/Isankstiniai%20duomenys_2015.pdf>

3. Eisenberg, D., Hunt, J., Speer, N. Help seeking for mental health on college campuses: review of evidence and next steps for research and practice. Harvard review of psychiatry. 2012; 20(4), 222-232.

4. Mackenzie, C. S., Erickson, J., Deane, F. P., Wright, M. Changes in attitudes toward seeking mental health services: a 40-year cross-temporal meta-analysis. Clinical Psychology Review, 2014. 34(2), 99-106.

5. Mojtabai, R., Evans-Lacko, S., Schomerus, G., & Thornicroft, G. Attitudes toward mental health help seeking as predictors of future help-seeking behavior and use of mental health treatments. Psychiatric Services. 2016.

6. Mackenzie, C. S., Knox, V., Gekoski, W. L., MacAulay, H. L. An adaptation and extension of the attitudes toward seeking professional psychological help scale. Journal Of Applied Social Psychology. 2004; 34(11), 2410-2435.

7. Vogel et al., D. L., Wester, S. R. To seek help or not to seek help: The risks of self-disclosure. Journal of Counseling Psychology. 2003; 50(3), 351-361.

8. Komiya, N., Good, G. E., & Sherrod, N. B. Emotional openness as a predictor of college students’ attitudes toward seeking psychological help. Journal of Counseling Psychology. 2000. 47(1), 138-43.

9. Yousaf B., Grunfeld O, Hunter E.A., A systematic review of the factors associated with delays in medical and psychological help-seeking among men. Health psychology review. 2015a. 9(2), 264-276.

10. Sullivan, L., Camic, P. M., Brown, J. S. Masculinity, alexithymia, and fear of intimacy as predictors of UK men’s attitudes towards seeking professional psychological help. British journal of health psychology. 2015; 20(1), 194-211.

11. Ciarrochi, J., Wilson, C. J., Deane, F. P., Rickwood, D. Do difficulties with emotions inhibit help-seeking in adolescence? The role of age and emotional competence in predicting help-seeking intentions. Counselling Psychology Quarterly. 2003; 16(2), 103-120.

12. Gulliver, A., Griffiths, K. M., & Christensen, H. Perceived barriers and facilitators to mental health help-seeking in young people: a systematic review. BMC psychiatry. 2010; 10(1), 1.

13. Powell, W., Adams, L. B., Cole-Lewis, Y., Agyemang, A., & Upton, R. D. Masculinity and race-related factors as barriers to health help-seeking among African American men. Behavioral Medicine. 2016; 42(3), 150-163.

14. National Mental Health Centre. Suicide rates according to gender and age groups 2015 [Cited 28 October, 2016]. Available from: http://www.vpsc.lt/index.php?option=com_content&view=article&id=333%3Asaviudybi-danis-pagal-lyt-ir-amiaus-grupes-2013-m&catid=14%3Asaviudybi-statistika&Itemid=24&lang=lt

15. Žukauskienė, R., Erentaitė, R., & Malinauskienė, O. Tėvų auklėjimo stiliaus ir emocinio intelekto sąsajos su vyresniųjų paauglių saviveiksmingumu bei saviverte pagal lytį. Psichologija / Psychology. 2011. 4422-41. Lithuanian.

16. Takšić, V., Mohorić, T., Duran, M. Emotional Skills and Competence Questionnaire (ESCQ) as a self-report measure of emotional intelligence. Horizons of Psychology. 2009; 18(3), 7-21.

17. Faria, L., Lima Santos, N., Takšić, V., Räty, H., Molander, B., Holmström et al. Cross-cultural validation of the Emotional Skills and Competence Questionnaire (ESCQ). Psicologia. 2006; 20(2), 95-127.

18. Field, A. Discovering statistics using IMB SPPS statistics. 4th edition., ISBN 978-1-4462-4917-8; 2013.

19. Yousaf A., O., Popat, A., Hunter, M. S. An investigation of masculinity attitudes, gender, and attitudes toward psychological help-seeking. 2015b; Psychology of Men & Masculinity, 16(2), 234.

20. Addis, M. E., & Mahalik, J. R. Men, masculinity, and the contexts of help-seeking. American Counselor. 2003; 58, 5–14.

21. Pederson, E. L., & Vogel, D. L. Male gender role conflict and willingness to seek counseling: testing a mediation model on college-aged men. Journal of Counseling Psychology. 2007; 54(4), 373.

22. Nam, S. K., Choi, S. I., Lee, J. H., Lee, M. K., Kim, A. R., Lee, S. M. Psychological factors in college students’ attitudes toward seeking professional psychological help: A meta-analysis. Professional Psychology: Research and Practice. 2013. 44(1), 37.

23. Martin, S. B., Wrisberg, C. A., Beitel, P. A., Lounsbury, J. NCAA division I athletes’ attitudes toward seeking sport psychology consultation: The development of an objective instrument. Sport Counselor. 1997; 11, 201–218.

24. Mahalik, J. R., Good, G. E., & Englar-Carlson, M. Masculinity scripts, presenting concerns, and help seeking: implications for practice and training. Professional Psychology: Research and Practice. 2003. 34(2), 123.

25. Blakemore J.E. O., Berenbaum S. A., Liben L. S. Gender development. New York, London: Psychology Press: Taylor & Francis Group. 2009.

26. Lafferty J. The relationships between gender, empathy, and aggressive behaviors among early adolescents. The Sciences and Engineering. 2004; 64 (12-B), p. 6377.

27. Gottman J.M., DeClaire J. Raising an emotionally intelligent child. ISBN 0684838656. 1998.

28. Ng, W. Effects of culturally adapted treatment on help-seeking attitudes. Doctoral dissertation, University of La Verne, 2014.

29. Joshi, R., Yadav, K. Gender difference on emotional competence in reference to CBT intervention among depressed subjects. Indian Journal of Positive Psychology. 2016; 7(1), 93.

30. Syzdek, M. R., Addis, M. E., Green, J. D., Whorley, M. R., Berger, J. L. A pilot trial of gender-based motivational interviewing for help-seeking and internalizing symptoms in men. Psychology of men & masculinity, 2014; 15(1), 90.

31. Jennings, P. A. CARE for Teachers: A Mindfulness-Based Approach to promoting teachers’ social and emotional competence and well-being. Handbook of Mindfulness in Education. Springer New York. 2016; p. 133-148.

32. Gueldner, B. A., & Feuerborn, L. L. Integrating mindfulness-based practices into social and emotional learning: a case application. Mindfulness. 2016; 7(1), 164-175.

33. Nadler, A. Help-seeking behavior: psychological costs and instrumental benefits. 1991.

Received 28 October 2016, accepted 12 December 2016Straipsnis gautas 2016-10-28, priimtas 2016-12-12