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Collaborating with her psychology professor and mentor, a Hollins alumna has published an article in a national, peer-reviewed journal that sheds new light on the connection between self-concept and mental illness stigma.

“Predictors of Help-Seeking: Self-Concept Clarity, Stigma, and Psychological Distress” by Hinza Malik ’21 (with coauthor Caroline Mann, assistant professor of psychology) appears in the Summer 2022 issue of Psi Chi: Journal of Psychological Research. Malik, who is currently pursuing a master’s degree in psychology at the University of North Carolina – Wilmington, based the article on her honors thesis at Hollins.

“Mental health stigma and psychological distress have been shown to be a barrier in help-seeking*,” Malik said. “The topic of help-seeking and its predictors in addition to stigma remains essential in an effort toward improving mental health campaigns.”

One predictor that has received little investigation, Malik noted, is self-concept clarity (SCC). “The broad definition of self-concept is the perception of oneself, influenced by the interaction between the environment and subsequent experiences,” she explained. “SCC is the extent to which self-beliefs are clearly and confidently defined, internally consistent, and stable over time. A lower SCC is associated with mental health illnesses such as depression and anxiety, resulting in psychological distress.”

Malik stated that mental health stigma “can be further classified into personal stigma and perceived public stigma. Personal stigma has been shown to be negatively associated with help-seeking, but perceived public stigma was not found to be associated with help-seeking in previous studies**. The current study altered the perceived stigma reference group from ‘public’ to ‘peer’ to investigate whether this change would influence the association with help-seeking.”

Mann added, “Social norms typically influence health behaviors, so we wondered whether a more precise variable of perceived peer-group stigma would show more relevance.”

With 111 Hollins University undergraduate study participants, Malik and Mann sought “to develop a better understanding of the relationship between SCC, stigma, and help-seeking behavior,” Malik said. “To our knowledge, this was the first study to explore the concept of SCC and help-seeking together.”

The researchers developed four hypotheses. “The first hypothesis predicted a positive correlation between SCC and help-seeking,” Malik stated, “and the results showed that individuals who have a higher SCC have a more positive attitude toward seeking mental health services.

“A negative correlation between SCC and psychological distress was the second hypothesis. We found that as SCC increased, psychological distress decreased.

“The third hypothesis predicted a positive correlation between personal and peer-group stigma. This was the first study to investigate peer-group stigma.  We did find that higher perceived stigma in the peer group corresponded with higher personal stigma. As perceptions help shape personal beliefs, the direction of respondents’ personal stigma matched their perceived peer group stigma.

“The fourth hypothesis predicted no correlation between perceived public stigma and help-seeking, but a negative correlation between both personal and peer stigma with help-seeking behavior. Consistent with previous literature, personal stigma continued to be associated with help-seeking, whereas perceived public stigma was not associated with help-seeking; however, perceived peer stigma was associated.***”

“Sometimes when you’re not finding an expected effect, it’s because you’re not measuring it precisely enough,” Mann said. “It makes sense that the reference group for young college students is not ‘the public’ at large but their own sociodemographic group.”

Because the data was collected during the COVID-19 pandemic, and the research “utilized a convenience sample, which greatly limits the generalizability of our results,” the authors stressed caution in interpreting their findings. However, “One of the major strengths of the current study is that we investigated the relationship between variables that have not been studied before to help fill in the gaps in the literature. Being the first study that we know of to explore SCC with help-seeking, replication is highly recommended.” They also noted that “this is a population, young people with lower SCC and higher distress, that needs to be targeted by not only mental health help-seeking intervention programs, but also anti-stigma campaigns. Youth mental health was categorized as a crisis by U.S. Surgeon General Vivek Murthy at the 2022 American Psychological Association convention.”

“Predictors of Help-Seeking” became one of the first recipients of the Psi Chi: Journal of Psychological Research’s new Diversity Badge. According to Psi Chi Editor Steven V. Rouse, the badge recognizes projects that “examine whether psychological phenomena differ as a function of human diversity, highlight psychological characteristics within a historically marginalized group, or identify factors that are related to diversity-based prejudice or discrimination.”

For Malik, the publication is gratifying in a number of ways. “By disseminating our research to mental health professionals and the public at large, we can start removing barriers to treatment.” On a personal level, inclusion in a peer-reviewed journal reflects the degree of scholarship that Malik has achieved, a key factor in earning acceptance into a Ph.D. program. “Doctoral programs in clinical psychology are very competitive. It’s important for them to see your experience in the research cycle: Formulating your hypothesis, collecting and analyzing the data, and writing up and disseminating the results. If you’re not prepared, you won’t succeed.”

Malik praised Mann for her guidance with “Predictors of Help-Seeking,” which she completed as part of the first cohort of students in the psychology department’s clinical and counseling concentration. “Dr. Mann inspired me to explore my interests. I learned theory and got to apply my skills in a real-world clinical setting,” performing a supervised field placement at Blue Ridge Autism and Achievement Center in Roanoke. “She also encouraged me to apply for grants that made it possible for me to present my research at various conferences.” Notably, the Janet L. MacDonald and Beatrice E. Gushee Award ensured Malik could attend the National Conference on Undergraduate Research, the L. Starling Reid Psychology Research Conference at the University of Virginia, and UCLA’s Psychology Undergraduate Research Showcase.

In addition, Malik credits Mann for urging her to submit her research for publication and go beyond simply completing it as a requirement for her thesis. Mann, she said, directed her to the Psi Chi Journal as a good fit for undergraduate research.

“What sets Hollins apart from other schools is that you build these very strong relationships with your mentor. You get a lot of chances for one-on-one direction.”

Eventually, Malik hopes to specialize in clinical neuropsychology. Her ideal work environment, she said, would be in an academic medical center. “I want to incorporate my equal affinity for research, teaching, and clinical practice. I could have a research lab, and I could train future psychologists and mentor them as research assistants. A clinical practice would inform my research and vice versa. I like that integration.”

“I know Hinza will continue to make great contributions to the science and treatment of mental illness and brain diseases,” Mann stated. “She arrived at Hollins with a passion for psychology, which was a joy to witness, but what blew me away was her focused determination and her willingness to put that into practice, even during the hardships of the pandemic. Hinza expanded her research and clinical skills every single year. I’m not just proud of her work, but I’m inspired by working with her.”

*Thornicroft, G. (2007). Most people with mental illness are not treated. The Lancet, 370 (9590), 807–808. https://doi.org/10.1016/s0140-6736(07)61392-0.

**Boerema, A. M., Kleiboer, A., Beekman, A. T., van Zoonen, K., Dijkshoorn, H., & Cuijpers, P. (2016). Determinants of help-seeking behavior in depression: A cross-sectional study. BMC Psychiatry, 16(1).

Eisenberg, D., Downs, M. F., Golberstein, E., & Zivin, K. (2009). Stigma and help seeking for mental health among college students. Medical Care Research and Review, 66(5), 522–541. https://doi.org/10.1177/1077558709335173.

***Golberstein, E., Eisenberg, D., & Gollust, S. E. (2009). Perceived stigma and helpseeking behavior: Longitudinal evidence from the healthy minds study. Psychiatric Services, 60(9), 1254–1256. https://doi.org/10.1176/ps.2009.60.9.1254.