A cognitively-sensitized stigma model of help-seeking inhibition in generalized anxiety disorder: A conceptual framework illustrated in the Chinese cultural context

Although previous studies have established the crucial role of stigma in inhibiting psychological help-seeking, little is known about how distinct mental disorders shape this process through their specific cognitive characteristics. To address this gap, the present study takes Generalized Anxiety Disorder (GAD) as an illustrative case to explore how its core cognitive traits amplify stigma effects and suppress help-seeking intention. This study is a conceptual investigation that proposes the Cognitively-Sensitized Stigma Model, integrating the Theory of Planned Behavior (TPB) to elucidate how stigma influences help-seeking through the pathways of attitude, subjective norm, and perceived behavioural control. The model posits that three core cognitive traits of GAD-fear of negative evaluation, meta-worry, and intolerance of uncertainty-function as cognitive amplifiers that intensify the inhibitory impact of stigma. Attachment styles are further incorporated as moderating mechanisms, highlighting how different interpersonal regulation patterns may either magnify or buffer the "cognition-stigma-help-seeking" chain. Using Chinese culture as an illustrative context, the study demonstrates how collectivism, face concerns, and emotional restraint systematically heighten sensitivity to social evaluation and construct a cultural context of shame surrounding help-seeking. This conceptual framework bridges cognitive, cultural, and stigma theories, offering a foundation for future cross-cultural validation and culturally sensitive interventions.