Coping Strategies, Personality Type, and Help-seeking behavior for Mental Health Problems

. Individual dispositions and personal factors play a role in determining the strategy to cope with mental health problems. Individuals with type A personality often show greater effort to improve their condition when experiencing stress. The study used 75 participants all gained through convenience sample ages 18-35 years old most of whom were university students in Kupang. The study used General Help-Seeking Questionnaire (GHSQ), Ways of Coping, and stress-prone type A personality test to investigate different coping strategies of individuals with type A personality when seeking help for mental health problems. Data analysis using Pearson's product moment correlation shows significant findings to support hypotheses that coping strategies are related to certain help-seeking behavior in individuals with type A personality (p=<0.05; 2-tailed). The awareness of important roles of personality tendencies when seeking help for mental health problems will impact on matters related to stress-reduction efforts to achieve mental health and well-being. problems in type A personality. Emotion-focused coping of distancing also shows moderate negative siginificant correlation with seeking help from semiformal sources ( (r = - 0.344, p=<0.05). The negative correlation shows that coping strategy of distancing is related to not seeking help from semiformal sources for mental problems in type A personality. Therefore, the null hypothesis is rejected. All these results support our hypothesis that coping strategy is related to help-seeking behavior for mental health problems in individuals with type A personality.


Introduction
Physical and mental well-being is the goal that everyone wants to achieve in life. Stress is a reaction to the stressors that come from within and outside the person. Excessive stress level is a factor that play a role in the development of mental disorders (Mrazek & Haggerty, 1994). One pattern of behavior that emerge as a result of mental health problems is seeking help and social support. Help-seeking behavior in the field of mental health is the process of adaptation to mental health problems through individual coping strategies to seek help from other parties (Rickwood, Thomas, & Bradford, 2012). Various factors are known to influence help-seeking behavior for mental health problems, such as attitude, motivation, mental health literacy, social support, and stigma (Novianty & Rochman Hadjam, 2017;Fathiyah, 2016;Bonabi, Müller, Ajdacic-Gross, Eisele, Rodgers, Seifritz, Rössler, & Rüsch, 2016;Nurhayati, 2013;Pradhan, Sharma, Malla, & Sharma, 2013). These factors can be categorized as individual factors and environmental factors that influence a person in help-seeking behavior for mental health problems. In this current research, individual factors are considered as important factors to be studied more deeply for the reason that the greater the influence of individual factors on help-seeking behavior then the less impact is the inhibiting effect of stigma on the emergence of help-seeking behavior when experiencing mental health problems.
According to Cornally & McCarthy (2011), there are 3 main components of help seeking behavior, i.e: focusing on issues, intentional behavior, and social interaction with third parties. These three elements of behavior show that seeking professional help when experiencing mental problems is one form of individual coping of the problem (Chai & Low, 2015;Rickwood, Thomas, & Bradford, 2012). Lazarus & Folkman (1984) defined coping as an individual attempt to make certain changes regarding the emotional and situational stress conditions that are considered to be pressing for him. There are 2 coping mechanisms in response to stress, namely problem-focused coping and emotional-focused coping (Lazarus & Folkman, 1984;Lazarus, 1993). Problem-oriented coping is done with the aim of changing the pressing situation for the individual, while emotionally focused coping is aimed at changing the emotional experience that is the result of stressful conditions (Lazarus, 1993).
Differences in coping between individuals led to differences in daily emotional experiences (Kim & Duda, 2003;Lu, 1996). For example, Bolger (1990) found that high level of neuroticism is related to ineffective coping that leads to more distress. In this current research, it is assumed that differences in personality dimensions have an influence on the external behavior of individuals in the face of daily problems including problems in the field of mental health. Therefore, this current study will be looking at the mediating role of personality type on help-seeking behavior in overcoming mental health problems.
In this study, researchers chose to look at the relationship of coping strategies and the behavior of seeking help for mental health problems. Discussions about stress and stress coping mechanisms are needed to understand the dynamics of mental disorders (Sawang, Oei, Goh, Mansoer, Markhum, & Ranawake, 2010). Common mental disorders have the same characteristics as the emotional impact of stress in the form of negative emotions such as anger, fear, guilt, anxiety, or depression (Lazarus & Folkman, 1984). Thus, mental health problems have the potential to be experienced by anyone who judges themselves to be under psychological stress.
This study will use classification based on typology A and B (Friedman, 1996).
According to Friedman, this classification is caused by differences in neurochemical mechanisms that cause individuals with type A personality and individuals with type B personality to have different responses to the situation in the environment (Friedman, 1996). Individuals with type A personality, among others, like to compete, have a strong thrust, have limited sense of time, always want to be successful, are aggressive, hostile, impatient, and more concerned with quantity than quality (Winn 2001). The behavior of individuals with type A personality is symptomatic because it is often associated with cardiovascular psychophysiology. In individuals who have type B personality there are no similar indicators that they are often considered to have different and more normal personality traits than individuals with type A personality (Winn, 2001;King, 2010).
Individual dispositions and personal factors play a role in determining the strategy for coping (Ntoumanis, Edmunds, & Duda, 2009). According to Graziano, Hill, Johnson, Rodibaugh, Sexton, & Whittaker (2017), the competitive and resilient personality tendency depict individuals who are reluctant to seek help when faced with adversity. Individuals with type A personality often shows greater effort to improve their condition when experiencing stress (Moqaddam & Hatami, 2017). In addition, individuals with type A personality who have ambitious and dominant characteristics in fact will benefit more from visits made to professionals when experiencing psychological stress (Moqaddam & Hatami, 2017). Thus, it can be concluded that although at risk of experiencing physical problems of cardiovascular disorders, individuals with Type A personality have resilience characteristics in their personality traits related to coping strategies for stress. The purpose of the study is to find the relationship of coping strategies and help-seeking behavior for mental health problems in individuals with type A personality. We hypothesize that coping strategy is related to help-seeking behavior for mental health problems in type A personality. This study aims to seek answers to the following questions: (a) what is the relationship of coping strategies and help-seeking behavior for mental health problems in individuals with type A personality? and (b) what coping strategy, if any, is employed by individuals with type A personality with regard to help-seeking behavior for mental health problems ?

Methodology
The current study is a field study to gather data on the mediating effect of personality type on coping strategy and help-seeking behavior. The sample were 75 participants all gained through convenience sample consists of male= 22, female=53) between the ages of 18-35 (mean age=21,13). Participants were students and workers in Nusa Cendana University in Kupang at the time of participation.
The study used the General Help-Seeking Questionnaire (GHSQ) that have been developed in Australia to measure future oriented help-seeking behavior. The questionaire were measuring intentions to seek help by asking participants to choose among 1 to 7 point of scale on how likely it is that they would seek help from the sources listed. Some of the choices are psychologist, teachers at school, self-help books, parents, etc. The scale that was used to measure coping strategies on this current study is an adaptation from Ways of Coping by Folkman & Lazarus that measures problemoriented coping and emotion-based coping. The scale was made of 50 items samples of which included "talked to someone to find out more about the situation" (Berbicara dengan seseorang membuat saya mengetahui lebih lanjut tentang apa yang harus saya lakukan) for problem-focused coping and "I made a promise to myself that things would be different next time" ( Saya berjanji pada diri sendiri bahwa keadaan akan berbeda pada waktu ke depannya ) for emotion-focused coping. The scale used Likert scale with 4 alternatives, not used / sangat tidak sesuai (1), used somewhat / tidak sesuai (2), used quite a bit / sesuai (3), used a great deal / sangat sesuai (4). The instrument that was used to measure type A personality is a questionaire developed by Howard Glazer, Stress-prone type A Personality test. The test contrasted type A behavior from type B behaviors and put the contrasting behavior in a continuum range from 1 to 7 (i.e., "doesn't mind leaving things temporarily versus must get things finished once started" (Saya tidak keberatan apabila pekerjaan saya ditunda untuk sementara waktu >< setiap pekerjaan yang sedang saya lakukan harus diselesaikan). To respond, participants were asked to check the number that best describing their position between the two extremes. The criteria that is used for the classification of type A and type B was the total score of each individuals taking part in the study. The criteria score that were ranged from 80 to 110 was categorized as type A personality,whereas participants that were scored below 59 were categorized to have type B personality.
A correlational analysis of data was used to find the relationship between problem-focused and emotion-focused coping strategies and help-seeking behavior in people with type A and type B personality.

Results
Based on the criteria used to classifiy people into type A and type B personality, the data collect 42 participants that were categorized to have type A personality, 7 participants with type B personality, while the rest falls between these two category.
The analysis is then carried out to find the relationship of coping strategies and helpseeking behavior in participants who scored high in type A personality dimension. The data is examined using Pearson's correlation that was run to test the hypotheses that there would be a significant relationship between coping strategy and help-seeking bahavior in type A personality.
The effect of these sub divisions with regard to help-seeking behavior for individuals type A personality is investigated using Pearson's correlation.
There is only one sub category of problem focused coping that shows significant result with the help-seeking behavior for mental problems in type A personality. A Pearson's correlation coefficient shows that there is a moderate positive significant relationship between problem-focused coping to seek social support and informal help-seeking behavior (r = 0.333, p=<0.05). The positive correlation shows that coping strategy to seek for social support is related to seeking support from informal sources to deal with mental health problems in type A personality.
Help-seeking behavior for mental health problems in type A personality also has significant correlations with sub categories of emotion-focused coping. A Pearson's correlation coefficient shows that there is a moderate negative significant relationship between emotion-focused coping of self-controlling and seeking help from other sources related to self-help (r = -0.401, p=<0.05). The negative correlation shows that coping strategy to show self-control is related to not seeking for help from other sources related to self-help. There is also a moderate negative significant relationship between emotion-focused coping escape-avoidance and seeking help from informal sources (r = -0.465, p=<0.05). The negative correlation shows that coping strategy to show escape-avoidance is related to not seeking for help from informal sources for mental problems in type A personality. Significant positive correlation is also found between emotion-focused coping of accepting responsibility and seeking help from formal sources with r = 0.378, p=<0.05. The positive correlation shows that coping strategy to accept responsibility is related to seeking help from formal sources for mental problems in type A personality. Emotion-focused coping of distancing also shows moderate negative siginificant correlation with seeking help from semiformal sources ( (r = -0.344, p=<0.05). The negative correlation shows that coping strategy of distancing is related to not seeking help from semiformal sources for mental problems in type A personality. Therefore, the null hypothesis is rejected. All these results support our hypothesis that coping strategy is related to help-seeking behavior for mental health problems in individuals with type A personality.

Discussion
The purpose of this study is to investigate coping strategies in relation to help seeking behavior in individuals with type A personality. The results from this study have highlighted the characteristics of coping strategies in dealing with mental health problems and seeking help in individuals with type A personality. The results of this study indicate that the tendency to use problem-focused and emotion-focused coping strategies is related to the behaviors of individuals with type A personality in seeking help for mental health problems. The results of this study are in accordance with the opinion of Moqaddam & Hatami (2017) who stated that individuals with type A personality will show greater efforts to improve their condition when experiencing stress which can be observed in seeking help from informal sources to deal with mental health problems. Furthermore, individuals with type A personality in daily life show high competitiveness. This is different when they encounter mental health problems because the attitude shown is just the opposite, namely the invigoration to establish affiliation with others to gain emotional support for the problem (Rickwood et al, 2012).
The tendency to prioritize on obtaining emotional support is apparent in the lack of interest to use sources of help that rely on one's ability to deal with emotional problems which are clearly not the main forte of individuals with type A personality.
This tendency is reinforced by the urge to approach informal sources of help such as parents, friends, spouse, or other family members; instead of avoiding them when experiencing mental health problems.
Individuals with type A personality also respond to activity of finding information for their problems as an activity that aims to entertain themselves. In doing this, they are more relaxed to engage in activities that risking them to lose more time provided that they usually have difficulties to feel at ease whenever they consider that there are still many things to think about other than relaxing and reading to find information about themselves.
Individuals with type A personality were also reported to be willing to seek help from mental health professionals rather than looking for help in those without adequate competence in the field of mental health (Friedman, 1996;Rickwood et al., 2012). This means that during stress, individuals with type A personality would go against stigma about help-seeking behavior once experience firsthand the need and responsibility to have adequate emotional competence (Novianty & Rochman Hadjam, 2017;Fathiyah, 2016;Bonabi, Müller, Ajdacic-Gross, Eisele, Rodgers, Seifritz, Rössler, & Rüsch, 2016;Nurhayati, 2013;Pradhan, Sharma, Malla, & Sharma, 2013).

Conclusion
From the study it can be concluded that the behavior of seeking help in dealing with mental health problems is mediated by personality tendencies in using coping strategies. Not only for individuals with type A personality, awareness about the importance of finding solutions for mental health problems needs to be cultivated because efforts to maintain mental health are not only a matter of reducing the impact of stress but also in order to achieve physical and mental well being.