Traditional masculinity ideology and resistance to psychotherapy.

Levant, McCurdy, Keum, Cox, Halter & Stefanov. (2022) published “Mediation and Moderation of the Relationship Between Men’s Endorsement of Traditional Masculinity Ideology and Intentions to Seek Psychotherapy” in Professional Psychology: Research and Practice. Their study is interesting in that low levels of depression and endorsement of traditional masculinity ideology reduced the intention to seek therapy, whereas at high levels of depression, men who endorsed traditional masculinity ideology held more favorable attitudes toward therapy. Here’s the abstract:

The present study used data from 1,602 men collected online to assess the relationship between men’s endorsement of traditional masculinity ideology (TMI) and their intentions to seek psychotherapy, as mediated by attitudes toward seeking professional psychological help and self-stigma of seeking help and moderated by the men’s levels of depression and precontemplation. Also assessed was whether the model was conditional on race and ethnicity (comparing White men to men of color) and sexual partner preferences (comparing men who always partnered with women to those who did not). The relationship between TMI and help-seeking intentions was fully mediated through help-seeking attitudes and partially mediated through self-stigma and was moderated by depression. At higher levels of depression, a given level of endorsement of TMI was associated with more favorable attitudes toward seeking help than they were at lower levels of depression. Furthermore, the negative relationship between TMI and help-seeking intentions seen at lower levels of depression (where increases in TMI were associated with reductions in intentions) changed to a positive relationship at higher levels of depression (where increases in TMI were associated with increases in intentions). The mediation moderation model was not conditional on race and ethnicity or sexual partner preferences. An implication for practice is that depression appears to play a key role in limiting or even reversing the negative relationships between TMI and intentions to seek therapy, and that this role applies broadly across the male population, irrespective of race, ethnicity, and sexual partner preferences. 

Self-stigma refers to holding negative attitudes toward one’s own mental distress, including shame. It makes sense that, at low levels of depression, self-stigma gets in the way of help-seeking. What is interesting is identifying the tipping point – when level of depression overrides self-stigma and shifts toward greater help-seeking. One obvious problem is that the study was done online. It would also be interesting to see whether the same pattern applies when men are asked about anxiety.