Psychological and cultural influences on Koreans' help-seeking attitudes.

This study examined the influence of gender, cultural variables (i.e., horizontal and vertical individualism), and personal psychological variables (i.e., psychological distress, social-network orientation, and self-concealment) on attitudes toward seeking counseling in Korea. For the 142 college student participants, gender, social network orientation, and self-concealment significantly influenced attitudes toward seeking professional help. Hierarchical multiple regression analysis suggested that higher scores on negative social network orientation and self-concealment were associated with lower attitudes toward seeking professional help. Men showed more negative help-seeking attitudes than women. Implications of the findings for developing and delivering counseling services in Korea are discussed.

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With about 50 years of history, the profession of counseling and psychotherapy in Korea has been growing rapidly in recent years and the numbers of counselors and counseling centers have been increasing (Kim, 1997; Kim et al., 2000). To enhance the accountability of the counseling services, national licensure for professional counselors was introduced in 2001. However, in spite of increased counseling services, many Koreans with mental health issues still do not consider seeking professional psychological help as a way of resolving their problems. For instance, Yoo (2001), investigating referral patterns of youths with problems, found that Koreans were not inclined to use professional counseling services, regardless of the nature of their problems. Because attitudes have been found to predict actual help-seeking (Cramer, 1999), a better understanding of Koreans' help-seeking attitudes may impact the way counseling services are designed and delivered in Korea and may improve the access and delivery of such services to those needing counseling services. Therefore, the purpose of this study was to examine the influence of gender, psychological variables, and cultural variables on attitudes toward seeking professional psychological help in Korea.

PERSONAL FACTORS INFLUENCING HELP-SEEKING ATTITUDES

Earlier studies on help-seeking attitudes focused on the influence of (a) demographic variables such as gender, race, education, socioeconomic status (SES), and religion (Cramer, 1999), and (b) personal and psychological factors. Women (Fisher & Turner, 1970) and people who have a higher SES (Tessler & Schwarts, 1972) and educational level (Leaf, Bruce, Tischler, & Holzer, 1987) have had more positive attitudes toward seeking professional help than men and people with a lower SES and educational level. In addition, Cramer's reanalysis of data from Kelly and Achter (1995) and Cepeda-Benito and Short (1998) revealed that higher psychological discomfort (Rickwood & Braithwaite, 1994), more positive social network orientation (Tata & Leong, 1994), and a higher level of self-concealment (Larson & Chastain, 1990) predicted more positive attitudes toward seeking professional psychological help.

With regard to psychological discomfort, using Australian adolescents, Rickwood & Braithwaite (1994) examined the relationship between gender, social network, openness to mental health service, psychological discomfort, and general (i.e., informal networks, such as friends or family and professional) as well as professional (e.g., mental health or educational) help-seeking. They found that being female and willing to disclose mental health issues were significantly related to general help-seeking but that only psychological discomfort was related to professional help-seeking. Similarly, a study conducted with Korean college students (Jang, 1999) revealed that the personal perception of the seriousness of a problem, rather than the nature of a problem, influenced attitudes toward seeking counseling service. This result suggests that people seek professional psychological help when they experience great psychological discomfort. Not everyone experiencing psychological discomfort, however, seeks professional psychological help (Lopez, Meledez, Sauer, Berger, & Wyssmann, 1998). For instance, adolescents and minorities in the United States, despite having greater emotional stress as compared with non-minority groups, have higher resistance toward utilizing and receiving counseling services (Akutsu, Snowden, & Organista, 1996).

Social network orientation, which may influence help-seeking, refers to the beliefs, attitudes, and expectation that individuals have about the utility of their social support system in a problem situation. This personal perception of the utility of social support systems is reported to be stable over time (Sarason, Pierce, Sherin, Sarason, & Waltz, 1991). A negative social network orientation results from experiencing ineffective and punitive social support and leads to low trust, independence, and low social skills (Vaux, 1985). Negative social network orientation also reflects the belief that the social support system's intervention is undesirable, impossible, or potentially dangerous. This result, in turn, may lead to negative attitudes toward seeking psychological services (Tata & Leong, 1994).

The level of a person's self-concealment is also thought to influence attitudes toward seeking psychological help (Cepeda-Benito & Short 1998; Cramer, 1999; Kelly & Achter, 1995). Self-concealment denotes one's predisposed refusal to share personally distressing information with others (Larson & Chastain, 1990). The findings from studies on self-concealment are, however, inconsistent. According to Kelly and Achter (1995), high self-concealers reported more negative attitudes toward professional help-seeking than low self-concealers, but high self-concealers reported a higher probability of actually requesting counseling. These findings indicated that, even though high self-concealers were afraid of counseling because it requires disclosing personal information, they were more likely to request counseling because of their greater perception of the need for counseling. In contrast, Cepeda-Benito and Short (1998) argued that high self-concealers tended to avoid counseling and that there was no evidence of these individuals in comparison to low self-concealers showing a higher probability of seeking counseling. Therefore, individuals who report a greater perceived need for counseling may not actually seek counseling.

CULTURAL FACTORS INFLUENCING HELP-SEEKING ATTITUDES

In two studies that explored the relationship between adherence to Asian cultural values and attitudes toward seeking help, Asian-American students' level of acculturation was significantly correlated with their tolerance of stigma associated with psychological help and their willingness to see a counselor (Kim & Omizo, 2003; Zhang & Dixon, 2003). These findings support other cultural comparative studies that suggested that Asian Americans tend not to utilize Western counseling services (Yamashiro & Matsuoka, 1997; Ying & Miller, 1992). In another study, Tata and Leong (1994), using Chinese-Americans, discovered that the more acculturated persons were, the more positive their attitude toward seeking psychological services.

Yeh (2002), studying interdependent self-construal (i.e., relying on and being obligated in close social relationships), independent self-construal (i.e., a distinct, stable, and decontextualized self), and collective self-esteem (i.e., group membership) of Taiwanese, found that being female and having higher scores on interdependent self-construal were related to positive attitudes toward seeking psychological help. Collective self-esteem was inversely related to attitudes toward seeking professional psychological help; that is, negativity about and being less connected to one's social group was associated with lower levels of help-seeking attitudes. This finding is consistent with another research (Tata & Leong, 1994) finding that Chinese-American persons with a higher level of individualism showed more negative help-seeking attitudes.

To explore the relationship between individualism-collectivism and help-seeking attitudes of Korean and U.S. college students, Yoo (1997) divided individualism and collectivism into vertical collectivism (i.e., interdependent and perceive themselves different from others), horizontal collectivism (i.e., interdependent and perceive themselves similar to others), vertical individualism (i.e., independent and perceiving themselves to be different from others), and horizontal individualism (i.e., independent and perceiving themselves as similar to others) (Singelis et al., 1995). Yoo found that U.S. students had more positive attitudes toward professional psychological help-seeking than Korean students. Specifically, the vertical versus horizontal dimensions of individualism and collectivism rather than the individualistic versus collectivistic tendencies contributed the difference. These results were replicated in Yoo and Yoo's (2000) study which found that, for Korean adults and Korean college students, the higher their vertical tendency of individualism (i.e., the higher their perception of independence and being different from others), the more negative their attitudes were toward counseling.

To better understand the negative relationship between Koreans' vertical individualism and attitudes toward counseling requires a reflection on the nature of modern Korean society. Traditional Korean culture has been considered collectivistic (Hofstede, 1991) with deference to authority figures and filial piety being key cultural characteristics (Kim, Atkinson, & Yang, 1999). However, Korea's rapid economic development since the Korean War has resulted in an increasingly prevalent atmosphere of individual competition. An example is Korean college students: Now, more than ever, they experience tremendous academic and peer pressure to score well on the national college entrance exam, thereby creating highly competitive tendencies among the students. A recent study in Korea, for instance, revealed that intense competition was the top complaint of university students (Ewha Student Counseling Center, 2003). An increased pressure for competition in modern Korean society suggests that vertical individualistic tendencies may be prevalent among the younger generation. We, therefore, decided to focus on vertical and horizontal individualism. In the current study, we hypothesized that: (a) women would show more positive attitudes toward counseling than men, (b) higher vertical individualism would be related to negative attitudes toward counseling, and (c) higher levels of psychological discomfort, greater self-concealment, and a more negative social-network orientation would be related to negative attitudes toward counseling.

METHOD

Participants

Participants in this study were 162 male and female undergraduate college students attending five mid- to high-level academic competitive universities in the South Korean cities and areas of Seoul, Incheon, Kyeonggi, and Kwangju. The mean age of participants was 20.67 (SD = 3.27), and the age range was 18 to 43. The number of male students was 64 (39.5%), and the number of female students was 98 (60.5%). The mean age of male students was 21.03 (SD = 4.40), and the mean age of female students was 20.44 (SD = 2.24).

Instruments

Measuring help-seeking attitudes. The Attitudes Toward Seeking Professional Psychological Help Scale (ATSPPHS; Fisher & Turner, 1970) was used to measure help-seeking attitudes. The ATSPPHS consists of 29 items and has 4 subscales: Perception of Need for Help (e.g., At some near future, I might want to have psychological counseling.), Tolerance to Stigma (e.g., I would feel uneasy going to a counselor because of what some people would think), Openness in Interpersonal Relationship (e.g., There are some experiences in my life I would no discuss with anyone), and Trust in Experts (e.g., If a good friend asked my advice about a mental problem, I might recommend that he see a counselor). Only the total score of attitudes toward counseling was used for this study. Items are rated on a 4-point Likert type scale (1 = strongly disagree, 4 = strongly agree); the range of total scores range from 29 to 116. When this instrument was implemented with predominantly Westerners, the internal consistency was .83-.84, and it was evaluated as a relatively reliable instrument (Fisher & Turner, 1970). For this Korean sample, the Cronbach a reliability was .80.

Measuring psychological discomfort. The Symptom Checklist (SCL-90) is a 90-item questionnaire (Derogatis, Rickels, & Rock, 1976). We used the SCL-90-R version that Kim and Won (1984) revised and standardized to fit the Korean context. This instrument consists of 90 items; 83 items (e.g., I feel distressed) are scored according to 9 symptom dimensions, and the other 7 items are not scored but are used for clinical purposes. Respondents indicated their psychological discomfort over the past 7 days by using a 5-point Likert scale (1 = strongly disagree, 5 = strongly agree). The range of total scores is 83-415. A lower score for each item indicates lower psychological discomfort. The Cronbach [alpha] reliability for the scores on the Korean version, calculated with the participants of this study, was .97.

Measuring self-concealment. The Self Concealment Scale (SCS, Larson & Chastain, 1990) consists of 10 items (e.g., I have an important secret that I haven't shared with anyone) and uses a 5-point Likert scale. Participants indicate their willingness to conceal aspects of themselves by using a 5-point Likert scale (1 = strongly disagree, 5 = strongly agree). The SCS has a range of total scores from 10 to 50, and higher scores indicate a higher tendency toward self-concealment. Larson and Chastain (1990) reported a Cronbach [alpha] reliability of .83 and a four-week test-retest reliability of .81. The Cronbach [alpha] reliability for the scores from this study was .86.

Measuring social network orientation. The Network Orientation Scale (NOS, Vaux, 1985) is a 20-item (e.g., It's easy for me to talk about personal and private matters) instrument that utilizes a 5-point Likert scale (1 = strongly agree, 5 = strongly disagree) to elicit one's orientation toward social networks. The range of total scores is 20-100, and all positive responses on this instrument are reverse scored. Accordingly, higher scores indicate a more negative orientation toward social networks. The Cronbach [alpha] reliability of the NOS is .88 (Vaux, 1985). The Cronbach [alpha] reliability calculated for the scores from this study was .76.

Measuring individualism. A Korean-translated version of The Scale of Individualism-Collectivism (Singelis, Triandis, Bhawuk, & Gelfand, 1995) has 32 items and 4 subscales: Horizontal Individualism (e.g., I often do my own thing), Vertical Individualism (e.g., Winning is everything), Horizontal Collectivism (e.g., I feel good when I cooperate with others), and Vertical Collectivism (e.g., It is important to me that I respect decisions made by my groups). Only the Vertical individualism and Horizontal Individualism subscales were used in this study. Responses are given on a 9-point Likert scale, with higher scores indicating greater levels of the variable. The Cronbach [alpha] reliability from the original study (Singelis, et al., 1995) was .70 for Vertical Individualism and .83 for Horizontal Individualism. Reliabilities for this study were .74 and .67, respectively.

Procedure

We sent 200 survey packages to the five universities, and 171 responses were returned. The response rate was 85.8%. Nine responses were excluded because they were incomplete, resulting in 162 responses used for data analyses. All the instruments, except the SCL-90, were initially translated into Korean by two of the researchers. The translated instruments were cross-validated using back translation by two other individuals (i.e., an educational linguistics doctoral student and an engineering doctorate) who were bilingual in English and Korean. The translated instruments were given to them without any information about the original instrument. The primary researcher then joined the translators in a consensual process that compared the original items with the translated items, with minor revisions being made to the Korean version until it more accurately matched the original version. This procedure was to ensure that the items of each scale were properly worded for the Korean context so as not to lose their original meaning.

RESULTS

Preliminary Analysis

Table 1 presents the correlations, means, standard deviations, skewness, and kurtosis indices for all the variables. Skewness and kurtosis indices ranged from -.25 to .76 and from -.27 to .53, respectively. These low numbers reveal that the distributions of the variables are approximate to a normal distribution (Tabachnik & Fidell, 2001). Correlation analyses were conducted to examine the overall relationship between help-seeking attitudes and other variables. To guard against possible alpha inflation problems, we used a Bonferroni correction by dividing the .05 by the number of variables, which resulted in a new alpha level of .01. According to the results, psychological discomfort, self-concealment, and social network orientation were found to be negatively related to professional help seeking attitudes at statistically significant levels.

Influence of Personal Variables and Cultural Variables on Help-Seeking Attitudes

A hierarchical multiple regression analysis was conducted to examine the relative influence of personal psychological variables (i.e., psychological discomfort, self-concealment, and social network orientation) and cultural variables (i.e., vertical individualism and horizontal individualism) on professional help-seeking attitudes. Gender was entered in the first step, because gender differences in help-seeking have been reported in previous studies (e.g., Fisher & Turner, 1970; Atkinson & Gim, 1989) and because we wanted to partial out its influence. Vertical individualism and horizontal individualism were entered second, and psychological discomfort, negative social network orientation and self-concealment were entered in the third step. We entered the cultural variables before the personal variables because we were most interested in the influence of individualism as a cultural behavioral pattern, given the younger Korean generation's apparent tendency toward individual competitiveness. Further, we assumed that cultural factors would have greater influence on attitudes toward seeking help. To assess for the presence of multicollinearity, the variation inflation factor (VIF) statistic was first examined across the predictor variables. Myers (1990) indicated that a VIF value greater that 10 is "cause for at least some concern" (p. 369). The highest VIF statistic was 1.32, suggesting that multicollinearity was not present. The result of the hierarchical multiple regression analyses (see Table 2) revealed a significant relative effect for social network and self-concealment on attitudes toward seeking help. Gender had no influence in step 1 or 2, but had a significant effect on help-seeking attitudes in step 3, when all other variables had been entered into the regression equation. This pattern for gender is called a suppression effect.

DISCUSSION

The results of this study found that a positive orientation toward social networks and less self-concealment along with gender, were associated with higher help-seeking attitudes. There was no relationship discovered between vertical and horizontal individualism and help-seeking attitudes. Even though Yoo (1997) and Yoo and Yoo (2000) found that vertical individualism was negatively related to help-seeking attitudes, it is too early, given the few studies conducted in this area, to develop any clear conclusions. We had surmised that individualism, especially with regards to academic competitiveness, was increasing in Korea. However, it could be argued that our sample of college students had already successfully cleared the major hurdle of the national entrance exam in order to be in college, and, therefore, a lower level of competitiveness may exist than we had expected. Future studies may want to explore this hypothesis.

Similarly, our hypothesis about a positive relationship between psychological discomfort and attitudes toward seeking professional psychological help was not supported. Although it may appear puzzling that individuals who experience psychological discomfort would not want to seek counseling, it is important to remember that the ATSPPHS (Fisher & Turner, 1970) only measures attitude and not behavior. That is, it is plausible that individuals experiencing psychological discomfort do indeed seek professional help but do not necessarily hold positive attitudes about doing so. Our findings mirror the results of earlier studies that revealed that individuals who experience psychological distress do not simply avoid counseling but may in fact exhibit greater resistance toward seeking professional psychological help (Akutsu, et. al., 1996; Lopez, et. al., 1998).

The results also indicated that the higher the level of negative social network orientation and self-concealment individuals exhibited, the more negative their attitudes toward seeking professional psychological help. This finding suggests that Korean individuals who have a tendency towards self-concealment are likely to have difficulty revealing their problems. Consequently, counseling or therapeutic processes in which self-disclosure is a prerequisite may be a deterrent toward seeking professional help. In addition, individuals, who have negative social network orientations and so appear to have negative perceptions about the utility of social resources, also have negative attitudes toward seeking professional help. The fact that these results appear consistent with earlier studies (Cramer, 1999; Tata & Leong, 1994) leads us to consider whether this is indeed an etic or universal phenomena. More importantly, what this means for providers of counseling services is that individuals who are reluctant to self-disclose or are basically mistrustful of social support services may also resist seeking professional psychological help. For Koreans with a tendency towards high self-concealment, efforts to counter such resistance may need to focus on how they perceive and conceptualize both mental health counseling as well as mental health counselors. For example, it may be important for mental health counselors in Korea to spend time acknowledging and exploring such resistance and discomfort with clients in the initial sessions in order to make any further progress with counseling.

What is perhaps the most interesting result from our study is the influence of gender on help-seeking attitude. The influence of gender was significant when considered in conjunction with personal and cultural factors. This gender effect on help-seeking attitudes is consistent with recent studies presented at an international symposium on help-seeking attitudes (Ang, Lim, Tan, & Yau, 2004; Goh, Ghazi-Moghadam, Kato, & Hansen, 2004; Lim, Tan, Ang, & Yau, 2004; Tan, Lim, Ang, & Yau, 2004; Xie, Goh, Wahl, Romano, & Zhang, 2004; Yoo, 2004) in which women displayed more positive attitudes toward seeking counseling services than men. In fact, Goh et al., in a meta-analysis of studies on attitudes toward seeking help found that gender was the only variable allowing for a meaningful calculation of effect size. Similarly, Good, Dell, and Mintz (1989) found a significant relationship between the traditional male gender role (e.g., provider, protector) and patterns of avoiding or ignoring sources of professional help. They suggested that "as men's values regarding the male role became less traditional, their view of psychological help seeking become more positive" (p. 209). It is unclear whether Korean men share similar gender role expectations as those in Good et al.'s study, but one can easily find anecdotal evidence suggesting a strong masculine tendency among Korean men, as well as claims of pervasive male dominance and sexism. We believe that counselors in Korea should consider McCarthy and Holliday's (2004) recommendations when working with Korean men: (a) adequately prepare men for the process they are about to enter and undertake, (b) be aware of unfounded negative beliefs and stereotypes that may interfere with treatment, (c) uncover the important and valuable strengths that masculinity provides for men in the daily experience, (d) be aware of how names and labels can affect perceptions, and (e) tailor the change-enhancing component of treatment to better fit with the male culture.

The current study is not without its limits. Participants in this study were college students from four major cities and areas in South Korea and as a result did not represent a wide range of ages, socioeconomic status, or other demographic variables. This limits the generalizability of our findings. Additionally, the validity of this study may be threatened because of the use of self-report measures, which may have resulted in a tendency toward socially desirable responses. Finally, as with other previous studies on help-seeking attitudes, there is a distinction between help-seeking attitudes and help-seeking behaviors. Will Koreans' positive attitudes toward help-seeking result in their actually seeking help? Do Koreans' negative help-seeking attitudes mean that they will never seek help? These questions remain unanswered.

Implications for Mental Health Counselors

Based on our findings, it appears that Koreans may need to be educated about the role and usefulness of receiving professional psychological help. Furthermore, the existing stigma surrounding psychological help seeking needs to be reduced. The Seoul National University in Korea recently changed the name of their counseling services center from The Center for Counseling and Student Services to The Center for Campus Life and Culture. This change is just one example of administrators' attempts to avoid the effects of labeling and the stigma that Koreans have toward counseling, thus making counseling services more inviting and accessible. To further reduce the negative effects of labeling and stigma on seeking counseling services, procedures need to be developed to introduce counseling as a viable source for help. This may be achieved by introducing counseling and a variety of psychoeducational and career development services from a young age. Currently, mental health counseling does not exist in many Korean schools. Efforts in Korea to educate and train career counseling teachers to meet the increasing career development needs of secondary school students (Jin, 2002) should, therefore, be applauded, encouraged, and expanded. A possible preference for informal social support systems could also lead to the development of peer counseling and support networks in and outside of schools in addition to educating and involving parents in promoting the mental health of their school-aged children. It is also worthwhile to seek the collaboration of Korea's extensive religious institutions (e.g., temples and churches) to which many Koreans belong.

As we consider how to apply our findings to the Korean context, we are aware that counseling in Korea has had a considerably short history and a brief introduction (Kim, 1997; Kim et al., 2000). Despite the fact that counseling centers, particularly in Korean higher education settings, are growing at a rapid pace (Goh & Lee, 2003), Lee (2001) noted that in a study of six 4-year universities in Korea only 40% of the students reported ever utilizing these services. This small percentage reflects the cautious attitude toward seeking help as is suggested in our results. Although our study attempted to clarify the role of personal and cultural factors in influencing help-seeking attitudes, the results do not allow us to be conclusive. Efforts to study and gain a better understanding of help-seeking and the delivery mental health counseling services to Koreans are only just emerging (e.g., J. Jang, 2001; Y. Jang, 1999; Yoo, 1997; Yoo & Lee, 2000; Yoo & Yoo, 2000). There is, therefore, very little literature from which to draw about Koreans and counseling that adds to our present discussion about Korean culture and help-seeking attitudes. Much of our expectation thus far, has its roots in anecdotal and professional experiences within the Korean counseling community and these speculations need to be investigated.

Sue (1998, 1999), emphasizing the need to consider within-group differences in research and practice with culturally different clients, highlighted the importance of designing and delivering culturally appropriate mental health counseling services to individuals who are unlikely to seek such services. Our study suggests that mental health counselors, particularly those working with culturally different clients, should not assume that the general public holds positive attitudes toward seeking professional counseling. Specifically, Korean women reported more favorably toward seeking psychological help than men. It is, therefore, important to consider the suggestions (McCarthy & Holliday, 2004) we outlined earlier in this article for working with men. Additionally, U.S. mental health counselors should take into consideration the influence of personal, psychological and cultural factors on their clients' attitudes toward help-seeking (e.g., gender, social network orientation, and self-concealment). This consideration may be especially important in order to overcome the discrepancies reported in the delivery of mental health services to ethnic minority populations in the United States (U.S. Department of Health and Human Services, 2001). This report found that "major disparities exist in the access, utility and quality of mental health services for racial minorities" (p.163). In addition, as Sue (1999) contended, both Korean and U.S. counselors need to be careful when research is inconclusive in order not to stereotype clients' help-seeking attitudes based purely on their racial or ethnic background. That is, U.S. and Korean counselors need to recognize within group differences as much as between group differences and know when to individualize and when to generalize research findings.

Future studies are needed using a more diverse sample as well as actual clients who have sought help. Studies on help-seeking attitudes of Koreans also need to examine if and how prior help-seeking experiences relate to counseling attitudes. We also encourage cross-cultural comparative studies with other countries that are hypothesized to have similar or different psychological and cultural characteristics as Korea. The use of qualitative research methods, in addition to quantitative ones will add richer information to the current knowledge base.

In conclusion, there is an increasing emphasis in the United States for mental health counselors to realize the international scope and context of mental health counseling theory and practice (Leong & Blustein, 2001; Marsella, 1998; Pedersen & Leong, 1997). It is important for studies such as ours to be replicated within Korea as well as in other countries in Asia, the United States, and around the world. Such studies will enrich the knowledge and understanding of the factors that influence attitudes towards mental health counseling and may increase the utilization and improve mental health counseling delivery.

Table 1
Correlations, Means, Standard Deviations, Skewness, and Kurtosis
Indices for Studv Variables

                         Help         Pschological        Self-
                        Seeking        Discomfort      Concealment

Help Seeking               --

Psychological
Discomfort                .19             --

Self-
Concealment               .08            .37 **           --

Negative
Social network
Orientation               .20            .23 *           .38 **

Vertical
Individualism            0.09            .19             .08

Horizontal
Individualism             .02            .05             .19

M                        2.85           1.88            3.07

SD                        .37            .50             .81

Skewness                 -.25            .76            -.15

Kurtosis                  .03            .04            -.15

                    Negative Social     Vertical       Horizontal
                        Network       Individualism   Individualism
                      Orientation

Help Seeking

Psychological
Discomfort

Self-
Concealment

Negative
Social network
Orientation              --

Vertical
Individualism             .20 **          --

Horizontal
Individualism             .05              .30 **        --

M                        2.70             5.58           8.8.8

SD                        .44             1.15           5.92

Skewness                 -.05             -.25           -.33

Kurtosis                 -.27              .03           -.18

Note. N = 162

** p<01.

Table 2
Cultural and Personal Variables Regressed on Help-Seeking Attitudes

Variables                      [beta]       t       [R.sup.2]

Step 1
  Gender                         .12      1.50          .01
Step 2
  Gender                         .14      1.70
  Vertical Individualism        -.13     -1.52          .01
  Horizontal Individualism       .05       .55
Step 3                           .17      2.33 *
  Vertical Individualism        -.06      -.74
  Horizontal Individualism       .08      1.08          .20
  Psychological Discomfort      -.02      -.29
  Negative Social Network       -.32     -3.90 ***
  Self -Concealment             -.20     -2.65 **

                                           [DELTA]
Variables                         F       [R.sup.2]

Step 1
  Gender                      2.26           .01
Step 2
  Gender
  Vertical Individualism      1.53           .01
  Horizontal Individualism
Step 3
  Vertical Individualism
  Horizontal Individualism    7.28 ***       .20 *
  Psychological Discomfort
  Negative Social Network
  Self -Concealment

Note: (N = 162)

* p <.05. ** p < .01. *** p < .001.

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AUTHOR NOTE

Portions of this article were presented at the 111th Annual Convention of the American Psychological Association, in Toronto, Canada, August 2003.

Correspondence concerning this article should be addressed to Sung-Kyung Yoo, Department of Psychology, Ewha Woman's University, 11-1 Daehyun-dong, Seodaemoon-ku, Seoul, Korea 120-745. Email: [e-mail].

Sung-Kyung Yoo, Ph.D., and Eunju Yoon, Ph.D. are with the Department of Psychology, Ewha Woman's. University, Seoul, Korea. Michael Goh, Ph.D., is with the University of Minnesota, Minneapolis, MN. E-mail: [e-mail].