Honors Program


Document Type


Date of this Version

Spring 4-7-2023


Ranjbari-Sisan, Jasmine, William Spaulding, and Tierney Lorenz. 2023. Healthcare Service Use, Help-seeking Behaviors, and Health and Wellbeing in Attenuated Psychosis. Undergraduate Honors Thesis. University of Nebraska-Lincoln.


Copyright Jasmine Ranjbari-Sisan, William Spaulding, and Tierney Lorenz 2023.


Persons with serious mental illness (SMI) receive poorer-than-standard healthcare, contributing to a 20-year reduction in the average life expectancy of persons with SMI. While extant literature describes the health disparities experienced by persons with SMI, little research examines the relationship between attenuated psychotic symptoms, healthcare service use, and help-seeking behaviors that may contribute to the disparities in this vulnerable population. This study explores the relationships between attenuated psychotic symptoms, physical health symptoms and related distress, healthcare service use, and help-seeking intentions to better understand health disparities in vulnerable and marginalized populations, such as individuals with SMI. Only a portion of individuals exhibiting symptoms meet criteria for a psychiatric illness based on the psychosis continuum. Subjects with Attenuated Psychotic Symptoms (APS; symptoms that are qualitatively similar to those of frank psychosis but attenuated in severity) were studied to examine hypotheses related to the health disparities and healthcare service inequities present in the SMI population because they often have analogous health disparities, comparable psychological and social characteristics as persons with SMI, and represent roughly 2% of college samples, which approximates the epidemiological risk of psychosis. Data was collected from one hundred and twenty-five undergraduate and graduate students attending the University of Nebraska-Lincoln. Selected measures examined individuals’ demographics, physical health symptoms, medical provider-diagnosed severe/chronic health conditions, healthcare service use, help-seeking intentions, attenuated psychotic symptoms, and psychological wellbeing. Analyses included descriptive statistics, Pearson’s correlation coefficients, and T-tests. The study’s findings indicate that physical and attenuated psychotic symptoms are inversely correlated with help-seeking intentions, with healthcare service use correlated only with physical symptoms. These findings suggest that as symptoms and corresponding distress increase, people are less likely to engage in help-seeking behaviors, possibly related to barriers associated with symptoms such as decreased or low energy, avolition, or other challenges related to physical and mental health. Findings also indicate a need for further analysis of healthcare service use engagement and help-seeking behavior, including life- style and other health-related behaviors, to identify intervention targets to improve mental and physical health.

Keywords: serious mental illness, help-seeking behaviors, attenuated psychosis