從求助污名到求助行為：自我依靠、求助意圖與身心困擾的平行中介角色

Abstract

本研究旨在探討成年初顯期青年求助行為的影響機制，聚焦於求助污名、自我依靠、身心困擾與求助意圖等變項之關係，並建構平行多重中介模型加以驗證。研究採橫斷式問卷調查法，以立意抽樣方式邀請244名年齡介於18至35歲的青年樣本，施測包含求助時的自我污名、感知他人污名、自我依靠、身心困擾、求助意圖與求助行為量表。研究結果顯示，不同背景變項（性別、身分、教育程度與經濟狀況）在主要變項上呈現部分顯著差異。各主要變項間求助污名程度愈高者，其自我依靠與身心困擾程度亦相對提高，進一步影響其求助意圖與實際行為。中介模型驗證成立，「求助污名→自我依靠→求助意圖→求助行為」路徑具統計支持的序列中介路徑；此外「求助污名→身心困擾→求助行為」路徑亦具統計支持，顯示自我依靠為個體由內化污名轉向求助意圖的重要心理轉折點，影響初顯期青年之求助行為；而身心困擾亦可在高求助污名情境下，正向預測求助行為，呈現驅動求助行動的動機作用。中介模型進一步顯示，求助時的自我污名對求助行為呈現完全中介效果，而感知他人污名則為部分中介，顯示兩種污名型態在求助歷程中扮演不同角色。研究建議降低求助污名，須同時關注青年自我依靠背後的心理需求，進而協助個體保有自主性，亦能維持對外求助的正向意圖，以促進有效地尋求外部協助；心理健康服務方面可強化身心困擾的初步篩檢；最後，需思考如何從社會層面營造一個開放、接納心理求助的支持性環境與文化氛圍，亦須實務介入與倡導個體層次的去污名化，方能有效促進初顯期青年更為健康與自主的求助歷程。This study aimed to explore the mechanisms influencing help-seeking behavior among emerging adults, with a focus on the relationships among help-seeking stigma, self-reliance, psychological distress, help-seeking intention, and actual help-seeking behavior. A cross-sectional survey was conducted using purposive sampling, and data were collected from 244 participants aged 18 to 35. The measures included self-stigma of help-seeking, perceived public stigma, self-reliance, psychological distress, help-seeking intention, and help-seeking behavior. The results revealed that background variables (gender, student status, education level, and economic status) showed partial significant differences across the main variables. Higher levels of help-seeking stigma were associated with increased self-reliance and psychological distress, which in turn negatively influenced help-seeking intention and actual behavior. The parallel multiple mediation models were supported. Specifically, the path “help-seeking stigma→self-reliance→help-seeking intention → help-seeking behavior” showed a statistically significant sequential mediation effect. Additionally, the path“help-seeking stigma→psychological distress→help-seeking behavior”was also supported, indicating that self-reliance serves as a key psychological turning point in transforming internalized stigma into help-seeking intention, while psychological distress may act as a motivational force that drives help-seeking behavior in the context of high stigma. Furthermore, the mediation analysis revealed that self-stigma had a full mediation effect on help-seeking behavior, whereas perceived public stigma showed a partial mediation effect, suggesting that these two forms of stigma play distinct roles in the help-seeking process. This study recommends that efforts to reduce help-seeking stigma should simultaneously address the underlying psychological needs associated with emerging adults’ self-reliance. Such efforts can support individuals in maintaining their sense of autonomy while also fostering a positive intention to seek external help, thereby promoting more effective help-seeking behaviors. In terms of mental health services, it is recommended to enhance early screening mechanisms for psychological distress to enable timely support. Lastly, it is important to consider how to cultivate a socially supportive and accepting environment for psychological help-seeking at the societal level. Practical interventions and advocacy aimed at individual-level destigmatization are also essential to facilitate a healthier and more autonomous help-seeking process among emerging adults.