Help-seeking perceived norm is a frequently studied help-seeking perception construct and is incorporated into certain medical/health/social scientific theories used to studying health services treatment access. When studying the behavior of seeking help from a mental health professional, “perceived norm” is shorthand for “perceived norm related to seeking help from a mental health professional.”
A variety of ad hoc measures of help-seeking perceived norm have been used by scholars over time. See Dr. Hammer’s Publications page for such articles (e.g., Hammer, Perrin, & Spiker, 2021; Spiker, Berney, Hammer, & Jensen, 2020; Spiker, Hammer & Parnell, 2019, Hammer, Spiker, & Perrin, 2019, Hammer, Parent, & Spiker, 2018; Hammer & Vogel, 2013). These measures vary in the degree to which they assess injunctive versus descriptive elements of perceived norm. These measures are generally adapted from Ajzen’s (2006; revised 2019) subjective norms measure template for scholars wanting to construct direct measures for a Theory of Planned Behavior Questionnaire.
In October 2024, Hammer and colleagues (2024) published psychometric evidence of reliability and validity for a battery of mental health help seeking measures, including measures of the constructs of perceived norm: injunctive and perceived norm: descriptive.
Most recently, Hammer and colleagues (2026) synchronized the language of six measures (i.e., Mental Help Seeking Attitude Scale [MHSAS], Perceived Norm: Injunctive Scale [PN:IS], Perceived Norm: Descriptive Scale [PN:DS], Personal Agency: Autonomy Scale [PA:AS], and Personal Agency: Capacity Scale [PA:CS], Mental Help Seeking Intention Scale [MHSIS]) to a shared definition of mental health help-seeking behavior and provided evidence of reliability and validity for these six synchronized measures. This battery of measures – known as the Integrated Behavioral Model of Mental Health Help Seeking Questionnaire (IBM-HS-Q) – assesses central constructs of the Integrated Behavioral Model of Mental Health Help Seeking (IBM-HS), including the three mechanisms (attitude, perceived norm, personal agency) and intention.
This 2026 IBM-HS-Q battery includes a 3-item measure of perceived norm: injunctive called the Perceived Norm: Injunctive Scale (PN:IS). The PN:IS measures perceived norm: injunctive in a conditional manner by incorporating a hypothetical mental health concern vignette scenario into the instrument instructions.
This 2026 IBM-HS-Q battery also includes a 3-item measure of perceived norm: descriptive called the Perceived Norm: Descriptive Scale (PN:DS). The PN:DS measures perceived norm: descriptive in a conditional manner by incorporating a hypothetical mental health concern vignette scenario into the instrument instructions.
Here is the APA-style citation for the 2026 paper that psychometrically evaluated the IBM-HS-Q measurement battery including the PN:IS and PN:DS:
Hammer, J. H., Dueber, D. M., Toland, M. D., & Weng, W.* (2026). The Integrated Behavioral Model of Mental Health Help Seeking Questionnaire (IBM-HS-Q): Development and validity evidence. Current Psychology, 45, 553. https://doi.org/10.1007/s12144-026-09132-3
These Perceived Norm Scales assesses perceived norm in a manner consistent with the definition of perceived norm specified by the Integrated Behavioral Model of Mental Health Help Seeking (IBM-HS).
Because the earlier reasoned action tradition theories (i.e., Theory of Reasoned Action, Theory of Planned Behavior) use the term “subjective norm” and do not provide strict guidance on the degree to which subjective norm items must assess injunctive versus descriptive norm elements, these Perceived Norm Measures are also appropriate for measuring “subjective norm”. However, we recommend that help seeking researchers use the IBM-HS and operationalize this measured construct as “perceived norm” and explicitly measure both elements with the two measures.
The two elements (i.e., injunctive and descriptive) of perceived norm may be best operationalized as either (a) two separate latent factors or (b) two inseparable facets of the same latent factor, depending on the measure, population, and sample in question. Thus, users are encouraged to use factor analysis to verify the dimensionality (and reliability) of this six-item set (the 3 items of the PN:IS and 3 items of the PN:DS) in their sample before committing to a given modeling and scoring strategy. In other words, it may be best to create one mean score that averages the scores across all six items to measure overall perceived norm, or it may be best to create two mean scores, one that averages the scores across the three PN:IS items to measure perceived norm: injunctive and one that averages the scores across the three PN:DS items to measure perceived norm: descriptive. When in doubt, the default is to treat them as separate measures.
How do I obtain a copy of the PN:IS and PN:DS?
Before using the PN:IS and/or PN:DS, we ask that you obtain permission by filling out the online Hammer Instrument Permission Form.
These measures are free for use in nonprofit academic research by those who have (or are being supervised by a professor who has) an advanced professional degree in a mental health profession and relevant training in the use of assessment instruments. Those seeking permission to use the measures for other purposes (e.g., commercial, profit, clinical, republication) may be charged a fee. The authors retain the copyright for the instrument.
Please note that any modifications/adaptations to these measures may affect the reliability and/or validity of results. For this reason, modification of these measures should be done with caution, is the sole responsibility of the researcher, and must be clearly described in any published or printed materials mentioning the modified version of these measures.
Download the PN:IS and PN:DS: You may download a copy of the 2026 versions using the following links:
Click here to download a copy of the PN:IS in .pdf format
Click here to download a copy of the PN:IS in .doc format
Click here to download a copy of the PN:DS in .pdf format
Click here to download a copy of the PN:DS in .doc format
Sample SPSS and Mplus syntax is forthcoming, as is a Qualtrics .qsf file to permit importing a copy of these measures directly into Qualtrics.com.
What language translations of the PN:IS and/or PN:DS exist?
Here is a list of translated versions from professionals who consented to having their translation made available for future public use, provided the user cites the published source that utilized the translated version.
- Coming soon.
May I translate the PN:IS and/or PN:DS into another language?
Yes, you may translate them. If you develop a translated version and publish findings using the translated version, please consider providing me with a copy, so that I may share the translated version with others (see above section) who can cite you as the developer.
When translating the PN:IS and/or PN:DS, please follow published best practices for translating self-report instruments. A poor translation can lead to a translated instrument that fails to measure what it is supposed to measure. Here are some helpful resources on this topic:
- A review of guidelines for cross-cultural adaptation of questionnaires could not bring out a consensus (Epstein et al., 2015) – read this article first.
- Cross cultural adaptation & psychometric validation of research instruments: A methodological review (Arafat et al., 2016) – read this article second.
- Translation, adaptation and validation of instruments or scales for use in cross-cultural health care research: a clear and user-friendly guideline (Sousa & Rojjanasrirat, 2011)
- Cross cultural adaptation & psychometric validation of instruments: Step-wise (Yasir, 2016)
- Cross-cultural adaptation and validation of psychological instruments: Some considerations (Borsa et al., 2012)
- Cross-cultural adaptation of research instruments: language, setting, time and statistical considerations (Gjersing et al., 2010)
- Operationalizing the cross-cultural adaptation of epidemiological measurement instruments (Reichenheim & Moraes, 2007)
- Guidelines for the process of cross-cultural adaptation of self-report measures (Beaton et a., 2000)
- Cross-cultural adaptation of health-related quality of life measures: literature review and proposed guidelines (Guillemin et al., 1993)