Date of Award
Summer 2000
Document Type
Dissertation - Restricted
Degree Name
Doctor of Philosophy (PhD)
Department
Psychology
First Advisor
Lueger, Robert
Second Advisor
Saunders, Stephen
Third Advisor
Sheikh, Anees
Abstract
In response to the need for a screening system that would help primary care practitioners identify patients whose psychological status makes them likely candidates for excessive health care utilization, this study screened patients at a university student health center. Several need-related variables, such as depressive symptoms, anxiety symptoms, distress, and functioning, had been shown in past research to be predictors of patients' medical care utilization, even when level of physical illness was controlled. This study hypothesized that two variables, somatization and persistent interpersonal problems, would moderate the relationship between need variables and level of health service use in a college student sample. Participants included 187 undergraduate and graduate students who were enrolled in a private midwestern university and visited the campus clinic on one of the screening days. Students were asked to complete several screening instruments while they awaited their visit with a medical practitioner. Results indicated that the hypotheses about the prediction of health care use received very little support. Multiple regression analysis revealed that gender, number of physiological symptoms, and psychological need variables made little contribution to the prediction of variance in health care use. This could be explained by (a) insufficient power to detect a small effect size, (b) redundant predictor variables, and (c) restriction of range in the criterion variable. A partial correlation revealed a weak, positive correlation between anxiety symptoms and health care use when level of physical symptoms was controlled. Somatization and interpersonal problems did not make a significant contribution to the prediction of utilization. The prevalence rates of psychological disorders in this setting were equivalent to those in primary care settings overall. Students who screened positive for depression or anxiety made more health visits in the twelve months preceding their research participation than students who did not screen positive. Post-hoc analyses revealed that high- and low-user groups were similar on all variables measured in this study. The clinical, theoretical, and research implications of the findings are discussed along with suggestions for future research.