Adolescent Self-Efficacy in Relation to Illness Perception and Treatment Compliance: An Inpatient Study




treatment compliance, psychotropic treatment, illness perception, self-efficacy, adolescents


Non-compliance with psychotropic treatment appears to be a growing problem among adolescent mental healthcare users. Treatment is frequently initiated during hospitalisation periods; however, at discharge a change in the primary administrator of the treatment poses a risk that the discharged patient may become non-compliant. In this study, we investigate factors influencing psychotropic treatment compliance of adolescent inpatients admitted to a psychiatric facility. A quantitative, non-experimental, cross-sectional, survey-type research design was employed. Approximately 170 participants were selected through a non-probability convenience sampling method. The data were gathered using self-reporting measures, namely the Drug Attitude Inventory, the Brief Illness Perception Questionnaire and the Decision Self-Efficacy Scale. The data were analysed using a Pearson product–moment correlation coefficient and a moderated hierarchical regression analysis. The results indicated a significant relationship between illness perception and self-efficacy where self-efficacy was identified as a moderator between illness perception and treatment compliance of male adolescent inpatients. The findings of the study and the gender differences which surfaced may contribute to a better understanding of the intricate processes related to treatment compliance in adolescents. These findings may help to direct intervention aimed at promoting treatment compliance.


Metrics Loading ...


AACAP (American Academy of Child and Adolescent Psychiatry). 2012. “A Guide for Public Child Serving Agencies on Psychotropic Medications for Children and Adolescents.” Accessed 10 January 2022.

Acar, G., K. Bademli, and N. Lök. 2017. “Medication Non-Adherence in Chronic Mental Illness: Management Strategies.” ARC Journal of Psychiatry 2 (1): 23–25.

APA. 2013. Diagnostic and Statistical Manual of Mental Disorders: DSM-5. 5th ed. Washington: APA.

Atorkey, P., P. N. Doku, S. A. Danquah, C. Owiredua, and M. Akwei. 2017. “Illness Perceptions and Medication Adherence in Adolescents with Sickle Cell Disease in Two Selected Hospitals in Greater Accra.” IFE Psychologia 25 (2): 180–94.

Averous, P., E. Charbonnier, M. C. Lagouanelle-Simeoni, A. Prosperi, and L. Dany. 2018. “Illness Perceptions and Adherence in Bipolar Disorder: An Exploratory Study.” Comprehensive Psychiatry 80: 109–15. DOI:

Bandura, A. 2004. “Health Promotion by Social Cognitive Means.” Health Education and Behavior 31 (2): 143–64. DOI:

Bikaako-Kajura, W., E. Luyirika, D. W. Purcell, J. Downing, F. Kaharuza, J. Mermin, S. Malamba, and R. Bunnell. 2006. “Disclosure of HIV Status and Adherence to Daily Drug Regimens among HIV-Infected Children in Uganda.” AIDS and Behavior 10 (4): S85–S93. DOI:

Bobier, C., and M. Warwick. 2005. “Factors Associated with Readmission to Adolescent Psychiatric Care.” Australian and New Zealand Journal of Psychiatry 39: 600–6. DOI:

Broadbent, E. n.d. “Scoring the Brief – IPQ.”

Broadbent, E., K. J. Petrie, J. Main, and J. Weinman. 2006. “The Brief Illness Perception Questionnaire.” Journal of Psychosomatic Research 60: 631–7. DOI:

Broadbent, E., C. Wilkes, H. Koschwanez, J. Weinman, S. Norton, and K. J. Petrie. 2015. “A Systematic Review and Meta-Analysis of the Brief Illness Perception Questionnaire.” Psychology & Health 30 (11): 1361–85. DOI:

Bulloch, A. M., and S. B. Patten. 2010. “Non-Adherence with Psychotropic Medications in the General Population.” Social Psychiatry & Psychiatric Epidemiology 45 (1): 47–56. DOI:

Bunn, H., and A. M. O’Connor. 1996. “Validation of Client Decision-Making Instruments in the Context of Psychiatry.” Canadian Journal of Nursing Research 28: 13–27.

Casey, B. J., R. M. Jones, and T. A. Hare. 2008. “The Adolescent Brain.” Annals of the New York Academy of Sciences 1124: 111–126. DOI:

Chapman, S. E., and R. Horne. 2013. “Medication Nonadherence and Psychiatry.” Current Opinion in Psychiatry 26 (5): 446–52. DOI:

Charach, A., T. Volpe, K. M. Boydell, and R. E. Gearing. 2008. “A Theoretical Approach to Medication Adherence for Children and Youth with Psychiatric Disorders.” Harvard Review of Psychiatry 16 (2): 126–35. DOI:

De las Cuevas, C., and W. Peñate. 2014. “To What Extent Psychiatric Patients Feel Involved in Decision Making About Their Mental Health Care? Relationships with Socio-Demographic, Clinical, and Psychological Variables.” Acta Neuropsychiatrica 26 (6): 372–81. DOI:

Dean, A. J., J. Walters, and A. Hall. 2010. “A Systematic Review of Interventions to Enhance Medication Adherence in Children and Adolescents with Chronic Illness.” Archives of Disease in Childhood 95 (9): 717–23. DOI:

DiBonaventura, M., S. Gabriel, L. Dupclay, S. Gupta, and E. Kim. 2012. “A Patient Perspective of the Impact of Medication Side Effects on Adherence: Results of a Cross-Sectional Nationwide Survey of Patients with Schizophrenia.” BMC Psychiatry 12 (20): 1–7. DOI:

Dilallo, J. J., and G. Weiss. 2009. “Motivational Interviewing and Adolescent Psychopharmacology.” Journal of American Academy of Child and Adolescent Psychiatry 48 (2): 108–13. DOI:

Dixon, L. B., Y. Holoshitz, and I. Nossel. 2016. “Treatment Engagement of Individuals Experiencing Mental Illness: Review and Update.” World Psychiatry 15 (1): 13–20. DOI:

Farooq, S., and F. Naeem. 2014. “Tackling Nonadherence in Psychiatric Disorders: Current Opinion.” Neuropsychiatric Disease and Treatment 10: 1069–77. DOI:

Flisher, A. J., and A. Gevers. 2010. “Mental Health and Risk Behaviour.” In South African Child Gauge 2009/2010, edited by M. Kibel, L. Lake, S. Pendlebury and C. Smith, 53–57. Cape Town: Children’s Institute.

Floersch, J., L. Townsend, J. Longhofer, M. Munson, V. Winbush, D. Kranke, R. Faber, J. Thomas, H. Janis, R. Jenkins, and R. L. Findling. 2009. “Adolescent Experience of Psychotropic Treatment.” Transcultural Psychiatry 46 (1): 157–79. DOI:

Fontanella, C. A. 2008. “The Influence of Clinical, Treatment, and Healthcare System Characteristics on Psychiatric Readmission of Adolescents.” American Journal of Orthopsychiatry 78 (2): 187–98. DOI:

Frank, M. R., E. M. Heiby, and J. H. Lee. 2007. “Assessment of Determinants of Compliance to Twelve Health Behaviors: Psychometric Evaluation of the Health Behavior Schedule II.” Psychological Reports 100 (3): 1281–97. DOI:

Garrido, P., and C. Saraiva. 2012. “Understanding the Revolving Door Syndrome.” European Psychiatry 27: 1. DOI:

Hagell, A., J. Coleman, and F. Brooks. 2015. Key Data on Adolescence. London: Association for Young People’s Health.

Hamrin, V., E. M. McCarthy, and V. Tyson. 2010. “Pediatric Psychotropic Medication Initiation and Adherence: A Literature Review Based on Social Exchange Theory.” Journal of Child and Adolescent Psychiatric Nursing 23 (5): 151–72. DOI:

Hodes, R., L. Cluver, P. Barron, N. R. Dlamini, L. Madisha, N. Mazibuko, H. Q. Nenzhelele, F. M. Motshwane, Y. Pillay, L. Kamugisha, and L. Schultz. 2017. National Adolescent and Youth Health Policy. National Department of Health.

Hogan, T. P., A. G. Awad, and R. Eastwood. 1983. “A Self-Report Scale Predictive of Drug Compliance in Schizophrenics: Reliability and Discriminative Validity.” Psychological Medicine 13: 177–83. DOI:

Huefner, J. C., and A. K. Griffith. 2014. “Psychotropic Medication Use with Troubled Children and Youth.” Journal of Child and Family Studies 23: 613–6. DOI:

Imran, N., M. W. Azeem, M. R. Chaudhry, and Z. Butt. 2015. “Illness Perceptions in Adolescents with a Psychiatric Diagnosis in Pakistan.” BJPsych Bulletin 39 (4): 174–8. DOI:

James, J. 2013. “Health Policy Brief: Patient Engagement.” Health Affairs 1–6. DOI:

Jensen, P. S., J. Buitelaar, G. J. Pandina, C. Binder, and M. Haas. 2007. “Management of Psychiatric Disorders in Children and Adolescents with Atypical Antipsychotics: A Systematic Review of Published Clinical Trials.” European Child and Adolescent Psychiatry 16: 104–20. DOI:

Jin, J., G. E. Sklar, V. M. Oh, and S. C. Li. 2008. “Factors Affecting Therapeutic Compliance: A Review from the Patients’ Perspective.” Therapeutic and Clinical Risk Management 4: 269–86. DOI:

Kampman, O., K. Lehtinen, V. Lassila, E. Leinonen, O. Poutanen, and A. M. Koivisto. 2000. “Attitudes Towards Neuroleptic Treatment: Reliability and Validity of the Attitudes towards Neuroleptic Treatment (ANT) Questionnaire.” Schizophrenic Research 45: 223–34. DOI:

Knapp, P., D. K. Raynor, J. E. Thistlethwaite, and M. B. Jones. 2009. “A Questionnaire to Measure Health Practitioners’ Attitudes to Partnership in Medicine Taking: LATCon II.” Health Expectations 12 (2): 175–86. DOI:

Kapphahn, C., M. Morreale, V. Rickert, and L. Walker. 2006. “Financing Mental Health Services for Adolescents: A Position Paper of the Society for Adolescent Medicine.” Journal of Adolescent Health 39: 456–8. DOI:

Laurier, C., D. Lafortune, and J. Collin. 2010. “Compliance with Psychotropic Medication Treatment among Adolescents Living in Youth Care Centres.” Children and Youth Services Review 32: 67–73. DOI:

Longhofer, J., and J. Floersch. 2010. “Desire and Disappointment: Adolescent Psychotropic Treatment and Adherence.” Anthropology & Medicine 17 (2): 159–72. DOI:

Maree, K., J. W. Creswell, L. Ebersohn, I. Eloff, R. Ferreira, N. V. Ivankova, J. D. Jansen, J. Pietersen, V. L. Plano Clark, and C. van der Westhuizen. 2013. First Steps in Research. Pretoria: Van Schaik.

Martin, L. R., S. L. Williams, K. B. Haskard, and M. R. DiMatteo. 2005. “The Challenge of Patient Adherence.” Therapeutics and Clinical Risk Management 1 (3): 189–99.

Moeini, B., F. Shafii, A. Hidarnia, G. R. Babaii, B. Birashk, and H. Allahverdipour. 2008. “Perceived Stress, Self-Efficacy and Its Relations to Psychological Well-Being Status in Iranian Male High School Students.” Social Behavior and Personality: An International Journal 36 (2): 257–66. DOI:

Molteni, S., G. Giaroli, G. Rossi, M. Comelli, M. Rajendraprasad, and U. Balottin. 2014. “Drug Attitude in Adolescents: A Key Factor for a Comprehensive Assessment.” Journal of Clinical Psychopharmacology 34: 99–108. DOI:

Moncrieff, J., K. Azam, S. Johnson, L. Marston, N. Morant, K. Darton, and N. Wood. 2016. “Results of a Pilot Cluster Randomised Trial of the Use of a Medication Review Tool for People Taking Antipsychotic Medication.” BMC Psychiatry 16 (1): 205. DOI:

Moses, T. 2011. “Adolescents’ Commitment to Continuing Psychotropic Medication: A Preliminary Investigation of Considerations, Contradictions, and Correlates.” Child Psychiatry and Human Development 42: 93–117. DOI:

Munson, M., J. Floersch, and L. Townsend. 2009. “Attitudes Toward Mental Health Services and Illness Perceptions Among Adolescents with Mood Disorders.” Child & Adolescent Social Work Journal 26 (5): 447–66. DOI:

Nagae, M., H. Nakane, S. Honda, H. Ozawa, and H. Hanada. 2015. “Factors Affecting Medication Adherence in Children Receiving Outpatient Pharmacotherapy and Parental Adherence.” Journal of Child and Adolescent Psychiatric Nursing 28: 109–17. DOI:

Nielsen, R. E., E. Linström, J. Nielsen, and S. Levander. 2012. “DAI-10 as Good as DAI-30 in Schizophrenia.” European Neuropsychopharmacology 22: 747–70. DOI:

Nunnally, J. C., and I. H. Bernstein. 1994. Psychometric Theory. 3rd ed. New York: McGraw-Hill.

O’Connor, A. M. 2002. User manual: Decision Self Efficacy Scale. Ottawa Hospital Research Institute. Accessed 15 March 2022.

Osterberg, L., and T. Blaschke. 2005. “Adherence to Medication.” New England Journal of Medicine 353 (5): 487–97. DOI:

Peat, J., and B. Barton. 2008. Medical Statistics: A Guide to Data Analysis and Critical Appraisal. New Jersey: John Wiley & Sons.

Pesut, D., S. Raskovic, S. V. Tomic, M. Bulajic, M. Bogic, B. Bursuc, and P. A. Peric. 2014. “Gender Differences Revealed by the Brief Illness Perception Questionnaire in Allergic Rhinitis.” Clinical Respiratory Journal 8 (3): 364–8. DOI:

Petrie, K. J., and J. Weinman. 2012. “Patients’ Perceptions of Their Illness: The Dynamo of Volition in Health Care.” Current Directions in Psychological Science 21 (1): 60–65. DOI:

Polanczyk, G. V., G. A. Salum, L. S. Sugaya, A. Caye, and L. A. Rohde. 2015. “Annual Research Review: A Meta-Analysis of the Worldwide Prevalence of Mental Disorders in Children and Adolescents.” Journal of Child Psychology & Psychiatry 56 (3): 345–65. DOI:

Seal, F., A. J. Cave, and L. L. Atkinson. 2017. “Primary Non-Adherence of Prescribed Pharmaceutical Treatments and Interventions: An Investigative Review to Improve Quality in Primary Care.” Quality in Primary Care 25 (5): 344–59.

Semahegn, A., K. Torpey, A. Manu, N. Assefa, G. Tesfaye, and A. Ankomah. 2018. “Psychotropic Medication Non-Adherence and Associated Factors Among Adult Patients with Major Psychiatric Disorders: A Protocol for a Systematic Review.” Systematic Reviews 7 (10): 1–5. DOI:

Stangor, C. 2015. Research Methods for the Behavioral Sciences. 5th ed. Stamford: Wadsworth Cengage Learning.

Steca, P., A. Greco, D. Monzani, A. Politi, R. Gestra, R. G. Ferrari, G. Malfatto, and G. Parati. 2013. “How Does Illness Severity Influence Depression, Health Satisfaction and Life Satisfaction in Patients with Cardiovascular Disease? The Mediating Role of Illness Perception and Self-Efficacy Beliefs.” Psychology and Health 28 (7): 765–83. DOI:

Steinhausen, H. C. 2015. “Recent International Trends in Psychotropic Medication Prescriptions for Children and Adolescents.” European Child and Adolescent Psychiatry 24: 635–40. DOI:

Taj, F., M. Tanwir, Z. Aly, A. A. Khowajah, A. Tariq, F. K. Syed, F. Waqar., and K. Shahzada. 2008. “Factors Associated with Non-Adherence Among Psychiatric Patients at a Tertiary Care Hospital, Karachi, Pakistan: A Questionnaire Based Cross-Sectional Study.” Journal of Pakistan Medical Association 58 (8): 432–6.

Tan, J. O., and J. M. Fegert. 2004. “Capacity and Competence in Child and Adolescent Psychiatry.” Health Care Analysis 12 (4): 285–94. DOI:

Tavakol, M., and R. Dennick. 2011. “Making Sense of Cronbach’s Alpha.” International Journal of Medical Education Correspondence 2: 53–55. DOI:

Thunander Sundbom, L., and K. Bingefors. 2012. “Women and Men Report Different Behaviours in and Reasons for Medication Non-Adherence: A Nationwide Swedish Survey.” Pharmacy Practice 10 (4): 207–21. DOI:

Timlin, U., K. Riala, and H. Kyngäs. 2013. “Adherence to Treatment among Adolescents in a Psychiatric Ward.” Journal of Clinical Nursing 22: 1332–42. DOI:

Townsend, L., J. Floersch, and R. L. Findling. 2009. “Adolescent Attitudes toward Psychiatric Medication: The Utility of the Drug Attitude Inventory.” Journal of Child Psychology and Psychiatry 50 (12): 1523–31. DOI:

Townsend, L., J. Floersch, and R. L. Findling. 2010. “The Conceptual Adequacy of the Drug Attitude Inventory for Measuring Youth Attitudes toward Psychotropic Medications: A Mixed Methods Evaluation.” Journal of Mixed Methods Research 4 (1): 32–55. DOI:

WHO (World Health Organization). 2003. “Adherence to Long-Term Therapies: Evidence for Action.” Geneva: WHO. Accessed 6 January 2022.;jsessionid=BE882455CFC9CF3547E3BEE05F7F226C?sequence=1.

WHO (World Health Organization). 2013. “Comprehensive Mental Health Action Plan 2013–2020.” Geneva: WHO. Accessed 6 January 2022.



How to Cite

George, Ancel Andrew, and Anneke Louise Franken. 2022. “Adolescent Self-Efficacy in Relation to Illness Perception and Treatment Compliance: An Inpatient Study”. Southern African Journal of Social Work and Social Development 34:20 pages.
Received 2022-04-20
Accepted 2022-09-15
Published 2022-12-22