Health locus of control and health behaviour

Individual characteristics associated with perceptions of control over mortality risk and determinants of health effort

People who believe they have greater control over health and longevity are typically more likely to invest in their long-term health. Investigating individual differences in perceived control over risk and exploring different determinants of health effort may help to tailor health promotion programs to more effectively encourage healthy behaviors. From a sample of 1500 adults, we measured perceived control over 20 causes of death, overall perceived uncontrollable mortality risk (PUMR), state-level optimism, self-reported health effort, and the accuracy of estimations of avoidable deaths. We found individual differences in perceptions of control over specific causes of death based on age, gender, and income. PUMR was predicted by socioeconomic variables expected to influence exposure to risk and resource availability. Higher levels of PUMR, not perceptions of control over specific causes of death, predicted self-reported health effort. The strength of relationship between PUMR and lower health effort was not moderated by state-level optimism. Age and education both positively predicted greater accuracy in assessing the prevalence of avoidable deaths. We suggest that PUMR may capture people's "general sense" of mortality risk, influenced by both exposure to hazards and the availability of resources to avoid threats. Conversely, perceived control over specific risks may involve more deliberate, considered appraisals of risk. This general sense of risk is thought to play a more notable role in determining health behaviors than specific assessments of control over risk. Further study is needed to investigate the degree to which PUMR accurately reflects objective measures of individual risk.

Social capital and health beliefs: Exploring the effect of bridging and bonding social capital on health locus of control among women in Dhaka

This cross-sectional study examined if social capital affects women's health attributions. The study used the Internet Social Capital Scale (ISCS) and Multidimensional Health Locus of Control (MHLC) Scale to measure Social Capital and Health Locus of Control. A predefined 38-item questionnaire was used to survey 485 purposively selected women. A bidirectional reciprocal structural equation model was used to measure the covariance between Social Capital and Health Locus of Control. We hypothesized that women with strong social capital, particularly those rich in bridging ties, would exhibit a greater sense of agency and empowerment over their health, attributing their health outcomes less to internal factors like fate and more to external influences like powerful others and broader social support. However, we found that when women have higher social capital, their external health locus of control increases. Bridging and bonding social capital lower women's internal health control, but bridging social capital leads to higher attributes to powerful others. Likewise, we expected women with more social capital would exhibit a lower perception of uncontrollability over their health, but is not the case. The findings underscore the necessity for women to have more social capital.

Social cognition, personality and social-political correlates of health behaviors: Application of an integrated theoretical model

OBJECTIVE

Dispositional, intra-personal constructs such as personality traits and generalized beliefs are consistently related to health behaviors, but relatively few studies have tested the theory-based mechanisms by which these constructs relate to health behaviors and compared them across behavior type. In the current study we tested an integrated theoretical model in which belief-based social cognition constructs (attitudes, subjective norms, perceived behavioral control) were proposed to mediate effects of personality traits (conscientiousness, extroversion) and socio-political beliefs (political beliefs, locus of control, free will beliefs) on participation in three health-related behaviors: physical activity, COVID-19 vaccination, and sugar-sweetened beverage restriction.

METHODS

Proposed integrated model effects were tested in a five-week prospective correlational study. Finnish residents completed measures of personality, socio-political, and social cognition constructs with respect to physical activity participation (N = 557), COVID-19 vaccination uptake (N = 1,115), and sugar-sweetened beverage restriction (N = 558) and self-reported their behavior at follow-up.

RESULTS

Structural equation models revealed direct effects of intention on behavior, and of social-cognition constructs on intention, across all behaviors. We also found indirect effects of political beliefs on behavior mediated by social cognition constructs and intentions for COVID-19 vaccination and sugar-sweetened beverage restriction behaviors, indirect effects of conscientiousness on behavior mediated by social cognition constructs and intentions for physical activity and sugar-sweetened beverage restriction behaviors, and indirect effects of health locus of control on behavior mediated by social cognition constructs and intentions for physical activity behavior. Finally, we found a negative total effect of populist beliefs on behavior for COVID-19 vaccination behavior.

CONCLUSION

Findings contribute to an evidence base for the effects of dispositional and social cognition constructs of health behaviors, point to a possible mechanism by which these generalized constructs relate to health behavior, and outline how the pattern of effects varies across the different behaviors.

Explaining differences in self-focused and other-involved public health preventive behaviors between the US and China: the role of self- construal and health locus of control

Background

This study examined national similarities and differences in people's engagement in health preventive behaviors during a public health crisis, as well as investigated the underlying individual-level psychological mechanisms. A conceptual distinction was made between self-focused and other-involved preventive behaviors in response to public health crises.

Method

Two cross-sectional surveys were conducted in the United States (N = 888) and China (N = 844) during the early stage of the COVID-19 pandemic. Hayes' PROCESS was utilized to assess national differences in seven preventive behaviors, along with the mediating effects of self-construal and health locus of control.

Results

The results showed that American participants reported greater engagement in self-focused preventive behaviors than Chinese, whereas Chinese participants reported greater engagement in other-involved preventive behaviors than Americans. Chinese participants also engaged more in other-involved than self-focused preventive behaviors. Self-construal and health locus of control partially explained the observed differences in engagement in preventive behaviors.

Discussion

This study introduces a culture-sensitive approach to provide insights for crafting communication interventions that can enhance the effectiveness of health campaigns in the context of a public health crisis.

An examination of health locus of control in relation to antibiotic resistance perceptions and antibiotic use behaviors among college students

Objective: The aim of the present study was to examine the role of health locus of control (HLOC; internal, chance, powerful others) in antibiotic resistance perceptions and antibiotic use behaviors among college students. Participants: Participants were 366 students recruited from the introductory psychology pool at a university in the northeastern United States. Methods: Participants completed the study via Qualtrics in 2015 (October-December). They completed the Multidimensional Health Locus of Control Scale (measuring internal, chance, powerful others HLOC) and questions about their antibiotic use and antibiotic resistance perceptions. Results: Linear regression analyses were employed to examine the role of the HLOC in antibiotic use behaviors and antibiotic resistance perceptions. With the exception of the regression with antibiotic resistance concern as an outcome, powerful others HLOC was the strongest predictor across all models. Conclusions: Antibiotic misuse was prevalent in our sample and powerful others HLOC was associated with problematic antibiotic use.

Interactive Health Messages Work Better for Those Who Feel Less in Control: The Role of External Health Locus of Control and Risk Perception

Interactive websites, which provide greater user control over a site's interface, are commonly employed in health communication campaigns to deliver risk information in more vivid and engaging ways. The present study explored whether interactive health websites could increase risk perception and encourage systematic processing (i.e. analytical review of persuasive arguments based on prior knowledge and experience) and information seeking and sharing intentions of anti-sugar consumption content. We further investigated whether the effect of interactivity could be moderated by individuals' beliefs in the role of external factors such as sheer luck in determining their health outcomes. A between-subjects design experiment compared a high interactive website (n = 94) to a low interactive website (n = 73). Results showed that interactivity increased risk perception regarding sugar consumption, especially for the individuals who reported a higher level of external health locus of control. Risk perception was a positive predictor of systematic processing, as well as information seeking and sharing intentions. Theoretical and practical implications of this study are discussed.

What is the burden of tinnitus?

Introduction

Tinnitus is a complex experience that often occurs alongside other health conditions, including hearing loss. In the UK, as in other western countries, patterns of health are changing with a rise in multi-morbidity and complexity of health conditions. As we age, we can expect to live with multiple health conditions. Burden of illness has long been recognised. Less well recognised is the burden that accumulates from the treatment of health conditions.

Methods

This qualitative thematic analysis of patient accounts described the cumulative burdens of tinnitus, both the experience of hearing the tinnitus and from the treatments undertaken. Between 2017-8 we conducted interviews with 38 participants who were help-seekers in a range of contrasting UK clinical services (Physician led, Audiology led and Hearing Therapy led). We examined these interview data using reflexive thematic analysis methods to identify and explore the cumulative burdens for those who live with and seek help for their tinnitus. Specifically, we used six phased approach to determine and group themes.

Results

The themes provide a coherent description of the nature of the burden that people with tinnitus experience.

Discussion

In tinnitus, as with most chronic health conditions, the largest treatment workload is devolved to the patient. Patients are required to implement treatments, learn about tinnitus and find new ways of coping. Yet this work happens invisibly, without recognition from clinicians who measure outcomes but not the efforts made to achieve outcomes. Patient-centred care depends upon the recognition of the cumulative burdens that patients experience.

Personality and weight management in adults with type 2 diabetes: A systematic review

Aims

Managing weight in the context of type 2 diabetes presents unique hormonal, medicinal, behavioural and psychological challenges. The relationship between weight management and personality has previously been reviewed for general and cardiovascular disease populations but is less well understood in diabetes. This systematic review investigated the relationship between personality constructs and weight management outcomes and behaviours among adults with type 2 diabetes.

Methods

Medline, PubMed, Embase, PsycINFO and SPORTDiscus databases were searched to July 2021. Eligibility: empirical quantitative studies; English language; adults with type 2 diabetes; investigation of personality-weight management association. Search terms included variants of: diabetes, physical activity, diet, body mass index (BMI), adiposity, personality constructs and validated scales. A narrative synthesis, with quality assessment, was conducted.

Results

Seventeen studies were identified: nine cross-sectional, six cohort and two randomised controlled trials (N=6,672 participants, range: 30-1,553). Three studies had a low risk of bias. Personality measurement varied. The Big Five and Type D personality constructs were the most common measures. Higher emotional instability (neuroticism, negative affect, anxiety, unmitigated communion and external locus of control) was negatively associated with healthy diet and physical activity, and positively associated with BMI. Conscientiousness had positive associations with healthy diet and physical activity and negative associations with BMI and anthropometric indices.

Conclusions

Among adults with type 2 diabetes, evidence exists of a relationship between weight management and personality, specifically, negative emotionality and conscientiousness. Consideration of personality may be important for optimising weight management and further research is warranted.

Systematic review registration

www.crd.york.ac.uk/prospero/, identifier CRD42019111002.

Is Neoliberalism Killing Us? A Cross Sectional Study of the Impact of Neoliberal Beliefs on Health and Social Wellbeing in the Midst of the COVID-19 Pandemic

Neoliberal ideology is linked to poorer collective health and well-being. At the individual level, however, neoliberal beliefs may actually promote self-efficacy, self-esteem, and self-reliance. We examined the effects of three beliefs underlying neoliberalism—(a) Personal Wherewithal, (b) Natural Competition, and (c) Anti-Government Interference—to understand the unique pathways by which neoliberalism affects health and well-being at the individual level. Participants were recruited using paid advertisements on social media in May/June 2020. Multivariable regression identified associations between each of the three identified neoliberal beliefs and participants’ (a) self-rated physical health, (b) number of health diagnoses, (c) life satisfaction, (d) loneliness, and (e) social trust of family, close friends/partners, coworkers, neighbors, and strangers. Among 2632 respondents, personal wherewithal was associated with better health, life satisfaction, and social well-being (perhaps by promoting self-efficacy and self-reliance to undertake healthy behaviors), while anti-government beliefs were associated with worse life satisfaction and social well-being (perhaps by reducing benefits inherent in collective action and social connection). Those hoping to reduce the negative effects of neoliberalism on collective well-being must contend with the reinforcing effect that personal wherewithal might have in shaping the perceived benefits of neoliberalism among those with these beliefs.

The Relationship Between Meaning in Life and Health Behaviors in Adults Aged 55 Years and Over During the COVID-19 Pandemic: the Mediating Role of Risk Perception and the Moderating Role of Powerful Others Health Locus of Control

BACKGROUND

Coronavirus disease 2019 (COVID-19) has impacted many people's meaning in life and health behaviors. This study aimed to verify the relationship among meaning in life (MIL), epidemic risk perception, health locus of control (HLC), and preventive health behaviors among older adults after the COVID-19 outbreak was declared a pandemic.

METHOD

In this longitudinal study, 164 participants aged 55 years and above completed the following measures at time 1 (February 19, 2021) and one month later at time 2 (March 19, 2021): Meaning in Life in the Epidemic Questionnaire, Epidemic Risk Perception Questionnaire, Multidimensional Health Locus of Control Scale, and Health Behaviors Before and After the Epidemic Survey. Hayes' SPSS Process Macro was used to analyze the mediating effect of epidemic risk perception (model 4) and the moderating role of powerful others HLC in the mediation model (model 14).

RESULTS

The results showed that after controlling for gender, age, education level, and health behaviors at the baseline, risk perception had a significant mediating effect on the relationship between MIL and preventive health behaviors (β = .02, SE = .01, 95% CI [.00, .04]). In addition, powerful others HLC had a moderating effect on the second half of the mediating effect (β = .02, p = .02, 95% CI [.00, .03]). Specifically, compared to the older adults with low powerful others HLC, the risk perception of older adults with high powerful others HLC increased preventive health behaviors.

CONCLUSION

Practitioners should adequately cultivate older adults' risk awareness and reinforce the importance of advice from doctors and professionals, thereby effectively enhancing the preventive health behaviors of older adults in China during the COVID-19 pandemic.

Patterns of social mixing in England changed in line with restrictions during the COVID-19 pandemic (September 2020 to April 2022)

Social mixing contributes to the transmission of SARS-CoV-2. We developed a composite measure for risky social mixing, investigating changes during the pandemic and factors associated with risky mixing. Forty-five waves of online cross-sectional surveys were used (n = 78,917 responses; 14 September 2020 to 13 April 2022). We investigated socio-demographic, contextual and psychological factors associated with engaging in highest risk social mixing in England at seven timepoints. Patterns of social mixing varied over time, broadly in line with changes in restrictions. Engaging in highest risk social mixing was associated with being younger, less worried about COVID-19, perceiving a lower risk of COVID-19, perceiving COVID-19 to be a less severe illness, thinking the risks of COVID-19 were being exaggerated, not agreeing that one’s personal behaviour had an impact on how COVID-19 spreads, and not agreeing that information from the UK Government about COVID-19 can be trusted. Our composite measure for risky social mixing varied in line with restrictions in place at the time of data collection, providing some validation of the measure. While messages targeting psychological factors may reduce higher risk social mixing, achieving a large change in risky social mixing in a short space of time may necessitate a reimposition of restrictions.

Development of a text message-based intervention for follow-up colposcopy among predominately underserved Black and Hispanic/Latinx women

PURPOSE

Underserved Black and Hispanic/Latinx women show low rates of follow-up care after an abnormal Pap test, despite the fact that cervical cancer is one of the few preventable cancers if detected early. However, extant literature falls short on efficacious interventions to increase follow-up for this population. A concurrent mixed methods study was completed to evaluate the acceptability of a text message-based intervention and identify perceived barriers and facilitators to follow-up after an abnormal Pap test among underserved predominantly Black and Hispanic/Latinx women.

METHODS

Patients who completed follow-up for an abnormal Pap test were recruited to complete a cross-sectional survey, qualitative interview assessing barriers and facilitators to follow-up, and text message content evaluation (N = 28). Descriptive statistics were performed to describe background variables and to evaluate the acceptability of text messages. A directed content analysis was completed for the qualitative interviews.

RESULTS

Participants expressed interest in a text message-based intervention to increase abnormal Pap test follow-up. In the qualitative interviews, low knowledge about cervical risk and negative affect toward colposcopy/test results were identified as barriers to follow-up. Facilitators of follow-up included feeling relieved after the colposcopy and adequate social support. Participants rated the text messages as understandable, personally relevant, and culturally appropriate.

CONCLUSION

The findings suggest that underserved Black and Hispanic/Latinx women experience cognitive and emotional barriers that undermine their ability to obtain follow-up care and a text message-based intervention may help women overcome these barriers. Future research should develop and evaluate text message-based interventions to enhance follow-up after an abnormal Pap test.

Health locus of control in a pandemic situation: cross-cultural differences between European and Asian respondents

Background

The present cross-cultural study examined the health locus of control construct during the COVID-19 pandemic. The scien-tific purpose of the study was to determine whether, during the pandemic situation, cultural and sex differences influence the health locus of control construct and change the internal health locus of control (IHLC), powerful others health locus of control (PHLC), and chance health locus of control (CHLC).

Participants and procedure

A total of 2617 recipients aged 18-70 years from Asia (China, India, and Indonesia), and Europe (Bulgaria, Germany, and Hungary) completed a questionnaire about their health. The participants completed an online version of the Multidimen-sional Health Locus of Control Scale – Form A.

Results

The survey shows that in a pandemic life-threatening situation, most individuals strive to rely on IHLC and/or PHLC, and fewer of them tend to rely on CHLC. However, there are differences (p < .001) between the two cultural samples: the rep-resentatives of Asian collectivistic culture are more dominated by PHLC, compared to the representatives of the European individualistic culture. When the comparison is between individuals from different cultures, sex differentiation affects the health locus of control, and as a result, significant differences in relation to IHLC, PHLC, and CHLC levels (р < .05) appear.

Conclusions

In conclusion, the study indicates that cultural differences influence both the IHLC and PHLC levels, and that Asian partici-pants are dominated by PHLC more than European respondents. Asian females are more likely to seek support from pow-erful others (PHLC) compared to European women, who perceive themselves as more independent. Asian male partici-pants are prepared to rely on powerful others (doctors or medical institutions), while European male respondents are prone to rely on themselves mainly (IHLC). The results show that sex differences do not significantly affect the health locus of control within the same cultural group.

Health locus of control in a pandemic situation: cross-cultural differences between European and Asian respondents

Background

The present cross-cultural study examined the health locus of control construct during the COVID-19 pandemic. The scien-tific purpose of the study was to determine whether, during the pandemic situation, cultural and sex differences influence the health locus of control construct and change the internal health locus of control (IHLC), powerful others health locus of control (PHLC), and chance health locus of control (CHLC).

Participants and procedure

A total of 2617 recipients aged 18-70 years from Asia (China, India, and Indonesia), and Europe (Bulgaria, Germany, and Hungary) completed a questionnaire about their health. The participants completed an online version of the Multidimen-sional Health Locus of Control Scale – Form A.

Results

The survey shows that in a pandemic life-threatening situation, most individuals strive to rely on IHLC and/or PHLC, and fewer of them tend to rely on CHLC. However, there are differences (p < .001) between the two cultural samples: the rep-resentatives of Asian collectivistic culture are more dominated by PHLC, compared to the representatives of the European individualistic culture. When the comparison is between individuals from different cultures, sex differentiation affects the health locus of control, and as a result, significant differences in relation to IHLC, PHLC, and CHLC levels (р < .05) appear.

Conclusions

In conclusion, the study indicates that cultural differences influence both the IHLC and PHLC levels, and that Asian partici-pants are dominated by PHLC more than European respondents. Asian females are more likely to seek support from pow-erful others (PHLC) compared to European women, who perceive themselves as more independent. Asian male partici-pants are prepared to rely on powerful others (doctors or medical institutions), while European male respondents are prone to rely on themselves mainly (IHLC). The results show that sex differences do not significantly affect the health locus of control within the same cultural group.

The Lived Experiences of Depression in Huntington's Disease: A Qualitative Study

BACKGROUND

Depression is a common neuropsychiatric syndrome in Huntington's disease (HD) and has debilitating consequences, including poorer sleep, exacerbation of cognitive and functional decline, and suicidality. To date, no published studies have documented the lived experience of depression in HD, despite clinical evidence that depression may be experienced differently in HD compared to the general population.

OBJECTIVE

The aim of this study was to investigate the lived experiences of depression in people with the CAG expansion for HD using qualitative methods.

METHODS

We conducted semi-structured interviews with HD CAG expansion carriers who had current or previous experiences of depression, until data saturation was achieved. This resulted in interviews from 17 HD CAG expansion carriers (11 premanifest, 6 manifest) which were analyzed using thematic analysis.

RESULTS

The four key themes that emerged related to the temporal characteristics of depression in HD, the qualitative changes associated with depression, psychosocial stressors perceived to contribute to depression, and the perception of depression as an endogenous feature of HD.

CONCLUSION

This study provides an enriched understanding of the unique characteristics of depression in HD, and the attributions that CAG expansion carriers make for their depression symptoms. The themes identified in this study can be used to guide more targeted assessment and treatment of depression in HD.

Health Locus of Control and Neurocognitive Function in Latinx and Non-Latinx White People Living With HIV: A Cross-sectional Study

ABSTRACT

Research suggests that health locus of control (HLOC) is related to important health and neurocognitive outcomes in people living with HIV. However, the role of ethnicity in these relationships remains poorly understood. This study explored the role of HLOC on neurocognition in a diverse sample of 134 people living with HIV (Latinx: n = 96; non-Latinx White: n = 38) who completed comprehensive neurocognitive evaluations and the Multidimensional HLOC Scale-Form C. Results indicate no ethnocultural differences in HLOC beliefs (ps > .05). External HLOC (i.e., chance and powerful others) related to worse neurocognition in the Latinx group and contributed to significant variance in global neurocognition and learning, memory, and verbal fluency, underscoring the role of external HLOC beliefs on neurocognition, particularly for Latinx individuals. Additional research is needed to better characterize the mechanistic relationship between HLOC beliefs and neurocognitive function and to further explore this relationship among other underrepresented populations also disproportionately affected by HIV.

The Psychology of Coronavirus Behavioral Health Mindset, Vaccination Receptivity, Customer Orientation and Community Public Service

Three studies were conducted to explore the psychological determinants of COVID-deterrent behaviors. In Study 1, using data collected and analyzed both before and after the release of COVID-19 vaccines, mask-wearing, other preventative behaviors like social distancing, and vaccination intentions were positively related to assessments of the Coronavirus Behavioral Health Mindset (CVBHM); belief in the credibility of science; progressive political orientation; less use of repressive and more use of sensitization coping; and the attribution of COVID-19 safety to effort rather than ability, powerful forces, fate, or luck. In Study 2, favorable COVID-19 vaccination intentions were related to greater willingness to work, lower emotional distress, and greater customer experience mindset. Study 3 examined the personality and motives of individuals who volunteered to help deliver COVID-19 inoculations to the local community. The vaccine-giving volunteers, especially those with prosocial motives, had high CVBHM scores, belief in the credibility of science, low use of repressive coping, greater attribution of COVID-19 protection to effort, low likelihood of voting conservative, were older, and had more education than others. The majority of public health volunteers expressed prosocial motives to help people or join a cause (60.7%), but many (39.3%) expressed the personal motives of getting the COVID-19 vaccination for themselves, conveying a public image of compassion, or structuring time. Based on the three research studies, a COVID-19 Mindset Hierarchy model is proposed to integrate the results.

Subjective Socioeconomic Status, Cognitive Abilities, and Personal Control: Associations With Health Behaviours

Objective

To examine subjective and objective socioeconomic status (SSES and OSES, respectively) as predictors, cognitive abilities as confounders, and personal control perceptions as mediators of health behaviours.

Design

A cross-sectional study including 197 participants aged 30–50 years, recruited from the crowd-working platform, Prolific.

Main Outcome Measure

The Good Health Practices Scale, a 16-item inventory of health behaviours.

Results

SSES was the most important predictor of health behaviours (beta = 0.19, p &lt; 0.01). Among the OSES indicators, education (beta = 0.16, p &lt; 0.05), but not income, predicted health behaviours. Intelligence (r = −0.16, p &lt; 0.05) and memory (r = −0.22, p &lt; 0.01) were negatively correlated with health-promoting behaviours, and the effect of memory was upheld in the multivariate model (beta = −0.17, p &lt; 0.05). Personal control perceptions (mastery and constraints) did not act as mediators.

Conclusion

SSES predicted health behaviours beyond OSES. The effect of socioeconomic indicators was not confounded by cognitive abilities. Surprisingly, cognitive abilities were negatively associated with health-promoting behaviours. Future research should emphasise SSES as a predictor of health behaviours. Delineating the psychological mechanisms linking SSES with health behaviours would be a valuable contribution toward improved understanding of socioeconomic disparities in health behaviours.

Intention to adhere to test, trace, and isolate during the COVID-19 pandemic (the COVID-19 Rapid Survey of Adherence to Interventions and Responses study)

Objectives

(1) To investigate factors associated with intention to self‐isolate, request a test, and share details of close contacts when required. (2) To determine whether associations were stronger during periods when less stringent national COVID‐19 restrictions were in place.

Design

Series of cross‐sectional nationally representative surveys. We selected survey waves where different national restrictions were in place in England (first lockdown, summer release, second lockdown, third lockdown).

Methods

We investigated whether psychological factors and increased out‐of‐home activity in the last week were associated with intention to self‐isolate and request a test if you were to develop COVID‐19 symptoms, and intention to share details of contacts if you were to test positive. We also investigated whether the strength of associations differed by timepoint in the pandemic.

Results

Intention to self‐isolate, request a test and share details of contacts were associated with greater perceived risk of COVID‐19 to people in the United Kingdom, knowing that COVID‐19 transmission can be asymptomatic, and agreeing that personal behaviour has an impact on COVID‐19 transmission. There were few differences in strength of associations by timepoint suggesting these effects are broadly stable over time.

Conclusions

Psychological factors were associated with intention to adhere to key components of the contact tracing system; there was no evidence for an association with increased out‐of‐home activity. Messages that increase knowledge that COVID‐19 can be transmitted even if someone does not have symptoms and that an individual’s actions can contribute to the spread of the virus may promote engagement with the test, trace, and isolate system.

Relationships among the Internal Health Locus of Control, Mental Health Problems, and Subjective Well-Being of Adults in South Korea

The purpose of this study was to confirm the relationship between internal health locus of control, mental health problems, and subjective well-being in adults during the prolonged COVID-19 pandemic. In particular, the mediating effect of mental health problems on the relationship between internal health locus of control and subjective well-being was examined. A cross-sectional descriptive design was conducted via online survey. The participants were 600 adults over 20 years of age living in South Korea. The collected data were analyzed using hierarchical regression analysis and SPSS Process Macro (Model 4). As a result of the study, the internal health locus of control had a significant negative effect on mental health problems. In addition, in the process of the internal health locus of control affecting subjective well-being, the mediating effect of mental health problems was significantly shown. In the period of an infectious disease pandemic such as COVID-19, it is necessary to establish a strong internal health locus of control of individuals and to promote monitoring and treatment introduction for those with a low internal health locus of control. In addition, it was discussed that controlling mental health problems can improve subjective well-being, which is life satisfaction and happiness.

Psychological and Socio-Economical Determinants of Health: The Case of Inner German Migration

A substantial body of research has shown worse health conditions for East- vs. West-Germany in the wake of reunification. In the present study, we investigate how these differences between the two formerly divided regions developed and what maintains them. Specifically, we consider the associations between health status, income satisfaction, and health-related locus of control. In a quasi-experimental and longitudinal study design, we are particularly interested in the differences between individuals who stayed in East-Germany and those who were born in the East but migrated to West-Germany. To this end, we examined data from seven waves of the Saxony Longitudinal Study (2003-2009). Specifically, we tested a cross-lagged panel model with random effects, which evinced very good model fit. Most parameters and processes were equivalent between individuals who stayed in East-Germany vs. moved to West-Germany. Crucially, there was the expected pattern of positive correlations between health, income, and locus of control. In addition, we found substantially lower values for all three of these variables for the individuals who stayed in East-Germany (vs. moved to West-Germany). A possible explanation is the increase in socio-economic status that the internal migrants experienced. These findings present an important contribution of research in order to foster a better understanding on the social dynamics in Germany related to internal/domestic migrants and implications in the context of health outcomes (e.g., significantly more unemployment in East vs. West-Germany), especially since almost 20-25% of East-German citizens migrated to West-Germany. Until now, there are no similar studies to the Saxony longitudinal project, since the data collection started in 1987 and almost every year an identical panel has been surveyed; which can be particularly useful for health authorities. The study mainly focuses on social science research and deals with the phenomenon of reunification, approaching several subjects such as mental and physical health, quality of life and the evaluation of the political system. Yet even though many people have experienced such a migration process, there has been little research on the subjects we approach. With our research we deepen the understanding of the health consequences of internal migration.

Explaining socioeconomic disparities in health behaviours: A review of biopsychological pathways involving stress and inflammation

The purpose of this article was to explore how individuals' position in a socioeconomic hierarchy is related to health behaviours that are related to socioeconomic disparities in health. We identified research which shows that: (a) low socioeconomic status (SES) is associated with living in harsh environments, (b) harsh environments are related to increased levels of stress and inflammation, (c) stress and inflammation impact neural systems involved in self-control by sensitising the impulsive system and desensitising the reflective system, (d) the effects are inflated valuations of small immediate rewards and deflated valuations of larger delayed rewards, (e) these effects are observed as increased delay discounting, and (f) delay discounting is positively associated with practicing more unhealthy behaviours. The results are discussed within an adaptive evolutionary framework which lays out how the stress response system, and its interaction with the immune system and brain systems for decision-making and behaviours, provides the biopsychological mechanisms and regulatory shifts that make widespread conditional adaptability possible. Consequences for policy work, interventions, and future research are discussed.

The association between childhood socioeconomic status and adult health behavior: The role of locus of control

The socioeconomic environment in childhood is a powerful determinant for health behavior in adulthood, subsequently influencing health outcomes. However, the underlying mechanisms are insufficiently understood. This study assesses locus of control (LOC) as a mediator linking childhood socioeconomic status (SES) with health behavior (smoking, regular alcohol consumption, unhealthy diet and low physical activity). Drawing on a representative sample from Germany (SOEP), we investigated these relations using structural equations modelling. Results show that externally oriented LOC explains up to 6% of the relationship between childhood SES and health behavior in adulthood, independently from adult SES. Stratification indicates that these results hold in women but not in men, in younger and middle-aged individuals but not in older ones. Hence, control beliefs play a modest yet significant role in shaping the socioeconomic gradient in health behavior and might have far-reaching consequences on how morbidity and mortality arise and persist across generations.

Harnessing Neuroimaging to Reduce Socioeconomic Disparities in Chronic Disease: A Conceptual Framework for Improving Health Messaging

Socioeconomic status (SES)-related health disparities persist for numerous chronic diseases, with lower-SES individuals exhibiting greater risk of morbidity and mortality compared to their higher-SES counterparts. One likely contributor is disparities in health messaging efforts, which are currently less effective for motivating health behavior change among those lower in SES. Drawing on communication neuroscience and social neuroscience research, we describe a conceptual framework to improve health messaging effectiveness in lower SES communities. The framework is based on evidence that health-message-induced activity in the ventral striatum (VS) and subdivisions of the medial pre-frontal cortex (MPFC) predicts behavior change. Additionally, we draw from social neuroscience work showing that activity in these regions during valuation and the processing of self-related vs. social information, differs as a function of SES. Bringing together these previously disparate lines of work, we argue that health messages emphasizing the benefits to close others (vs. the self) of engaging in behavior change will be more effective among lower SES individuals. We also outline a research agenda based on our framework. Ultimately, we hope that this framework utilizing a “brain-as-predictor” approach generates novel insights about the neural underpinnings of message-induced behavior change among lower SES individuals, and helps to close the gap in SES-based health disparities by harnessing the power of neuroimaging.

Psychological factors associated with self-management in multiple sclerosis

OBJECTIVE

Patient's engagement in their own treatment has been shown to improve clinical outcomes. A better understanding of the association between self-management in multiple sclerosis (MS) and potentially modifiable psychological factors may provide clinicians with strategies to design and stimulate better patient activation for self-managing health. Therefore, in this study, we examined whether cognitive factors, namely self-efficacy, acceptance of illness, optimism, and health locus of control (HLC), are associated with self-management in MS.

METHODS

This is a cross-sectional study. A total of 382 patients with MS who completed the MS Self-Management Scale-Revised and the questionnaires that measure self-efficacy, optimism, illness acceptance, and HLC were included in the study.

RESULTS

A hierarchical multiple regression revealed that power of others' HLC (b = 0.42, P ≤ .001), optimism (b = 0.27, P ≤ .01), internal HLC (b = -0.11, P = .017), and self-efficacy (b = 0.11, P = .031), together with control variables (longer disease duration and higher disability), explained 30% of the variance in the dependent variable.

CONCLUSIONS

In the case of MS, self-management is associated with patient's perception that healthcare professionals control their health, higher self-efficacy, optimism, and, surprisingly, lower internal HLC. The results of this study indicate the vital role of the healthcare staff in encouraging the patients with MS toward activities related to self-management and provide new insights on the psychological intervention aimed at improving self-management by patients.

Adhering to antiretroviral therapy: A qualitative analysis of motivations for and obstacles to consistent use of antiretroviral therapy in people living with HIV

Objectives:

Based on the 2015 U.S. Centers for Disease Control and Prevention data, 40% of people living with HIV in the United States with an HIV diagnosis and 18.5% of people living with HIV in HIV care in the United States are not virally suppressed. Many HIV care clinics have implemented recommendations to improve the percentage of people living with HIV on antiretroviral therapy. To understand what more could be done, we examine patients’ motivations and obstacles to maintaining adherence to antiretroviral therapy.

Methods:

We conducted qualitative analysis using a qualitative description framework of in-depth interviews with people living with HIV receiving care at an urban HIV care clinic in the midwestern United States.

Results:

We found that while many traditional barriers to care have been addressed by existing programs, there are key differences between those consistent with antiretroviral therapy and those inconsistent with antiretroviral therapy. In particular, self-motivation, diagnosis acceptance, treatment for depression, spiritual beliefs, perceived value of the HIV care team, and prior experience with health care distinguish these two groups. Most significantly, we found that people living with HIV consistent with antiretroviral therapy describe their main motivation as coming from themselves, whereas people living with HIV inconsistent with antiretroviral therapy more often describe their main motivation as coming from the HIV care team.

Conclusion:

Our results highlight the importance of the HIV care team’s encouragement of maintaining antiretroviral adherence, as well as encouraging treatment for depression.

Individual and social predictors of smoking and obesity: A panel study in Germany

This is a longitudinal study of changes in smoking behaviour as well as becoming overweight/obese (OW/OB) and the strength of their association with personal factors such as self-control, mental health, and socioeconomic status (SES) versus their connection with the behaviour of other household members. Furthermore, we investigate that in terms of roles within a household, who is more vulnerable towards the behaviour of others. We used a hybrid model that followed individual adults (person-level fixed-effect) who participated in a national representative panel survey in Germany, SOEP, between 2008 and 2016 and answered all SF-12 items (N = 6874). The count of members in a household showing the associated adverse health behaviour was the nested random-effect. Compared with other predictors, the likelihood of a person becoming OW/OB had the strongest association with the number of cohabits who were also OW/OB and it became worse as this number increased (OR 7.18, 95% CI: 2.10-24.54 and 12.44, 95% CI: 1.53-100.85, for men and women respectively, e.g. compared with being married 2.83, 95% CI: 2.28-3.53 and 1.82, 95% CI: 1.42-2.34). However, for smoking the same rapid trend was not observed. Particularly, becoming OW/OB in female (adult) children was strongly associated with the behaviour of others (compared with household head or partner). For smoking the strongest link with others was among women who were head of the household. For both behaviours, we found neither mental health nor self-control to be strong predictors. Our findings indicate that various factors do not play equal roles in changes in health behaviour and particularly for women, becoming OW/OB is strongly connected with the behaviour of others. We further discuss the potential importance of social norms that might be helpful in developing more effective policies incorporating social connections as well as norms.

Smoker profiles and their influence on smokers' intention to use a digital decision aid aimed at the uptake of evidence-based smoking cessation tools: An explorative study

OBJECTIVES

Evidence-based smoking cessation support tools (EBSTs) can double the quitting chances, but uptake among smokers is low. A digital decision aid (DA) could help smokers choose an EBST in concordance with their values and preferences, but it is unclear which type of smokers are interested in a digital DA. We hypothesized that smokers' general decision-making style (GDMS) could be used to identify early adopters. This study therefore aimed to identify smoker profiles based on smokers' GDMS and investigate these profiles' association with intention to use a digital DA.

DESIGN

A cross-sectional dataset (N = 200 smokers intending to quit) was used to perform a hierarchical cluster analysis based on smokers' GDMS scores.

METHODS

Clusters were compared on demographic and socio-cognitive variables. Mediation analyses were conducted to see if the relationship between cluster membership and intention was mediated through socio-cognitive variables (e.g., attitude).

RESULTS

Two clusters were identified; " Avoidant Regretters " (n = 134) were more avoidant, more regretful and tended to depend more on others in their decision making, while " Intuitive Non-regretters " (n = 66) were more spontaneous and intuitive in their decision making. Cluster membership was significantly related to intention to use a DA, with " Avoidant Regretters " being more interested. Yet, this association ceased to be significant when corrected for socio-cognitive variables (e.g., attitude). This indicates that cluster membership affected intention via socio-cognitive variables.

CONCLUSIONS

The GDMS can be used to identify smokers who are interested in a digital DA early on. As such, the GDMS can be used to tailor recruitment and DA content.

The Effectiveness of an Educational Intervention Based on Theories and Models on Diabetes Outcomes: A Systematic Review

Background & Introduction: Patient's self-management behaviors are essential to control diabetes. Studies have demonstrated that health educational interventions can improve some aspects of glycemic control and clinical outcomes, however, it is unclear which education theories underlying these interventions improve effectiveness. In this review of the literature, we aimed to assess the efficacy of health education and promotion theories, or models, to improve self-care and self- management behaviors among patients with type 2 diabetes (T2D). Methods & Results: Eight scientific databases (Web of Science, PubMed, Scopus, Magiran, Google Scholar, Medlib, ProQuest and Scientific Information Database) were searched to identify a published academic article from 2010 to 2019. We included quasi-experimental, clinical trial and randomized clinical trial studies. A total of 26 studies including data from 3879 patients with T2D met the inclusion criteria. We found that the PRECEDE (7/26, 26.92%) and Health Belief Models (7/26, 26.92%) were the most common models used to assess the efficacy of health education and health promotion models. Conclusion: Overall, health promotion and education theories and models have been used as a useful instrument for improving the self-care behaviors and self-management behaviors among patients with T2D.

Health Locus of Control Is Associated With Physical Activity and Other Health Behaviors in Cardiac Patients

PURPOSE

Physical inactivity, smoking, and excessive alcohol use are well-recognized modifiable risk factors for cardiovascular disease (CVD), yet uptake of strategies to mitigate these poor health behaviors varies widely among patients with cardiovascular disease. Part of this variation may be explained by health locus of control (HLOC), defined as the extent to which individuals believe their health is a consequence of their own actions, chance, or the influence of others (eg, physicians).

METHODS

A total of 599 cardiac outpatients (30% female, 61.4 ± 9.4 y of age) completed the Multidimensional Health Locus of Control questionnaire and a structured health behavior questionnaire assessing physical activity, smoking, and alcohol use, at baseline and a 4-y follow-up. Relationships between health behaviors and HLOC were assessed cross-sectionally and longitudinally using general linear models and logistic regression models adjusting for medical and sociodemographic factors.

RESULTS

Higher Internal HLOC was found to be associated with higher levels of leisure time physical activity (LTPA) (β = .21, P = .0008), while lower Internal HLOC was associated with decreasing levels of alcohol consumption over time (β = .26, P = .03). Increasing Chance HLOC was related to lower levels of leisure time physical activity (β = -.15, P = .047) and increased likelihood of being a smoker (β = .10, P = .01), and increasing physician HLOC was associated with decreased likelihood of being a smoker (β = -.17, P = .01).

CONCLUSIONS

Associations between HLOC and multiple health behaviors were observed in a large sample of cardiac outpatients. Results suggest that assessing and targeting HLOC beliefs of cardiac patients may be clinically relevant for behavior change in settings, such as in rehabilitation programs where behavior change is a goal.

Healthy Leaders: Core Self-Evaluations Affect Leaders' Health Behavior Through Reduced Exhaustion

Leaders’ self-directed health behavior (i.e., SelfCare behavior) plays an important role in the health and well-being of both leaders and employees but has been neglected in research so far. This study was aimed at investigating the antecedents of SelfCare behavior in terms of the personal characteristics of the leaders. In a sample of 150 (98 male, 52 female) German leaders from a wide range of organizations, we examined the direct and indirect effects of core self-evaluations (i.e., CSEs) on leaders’ SelfCare behavior. We predicted that CSEs would be positively related to SelfCare behavior with reduced exhaustion as a mediator, and organizational health climate (i.e., OHC) as a moderator of this relationship. Results showed that CSEs were positively related to SelfCare behavior and that the reduced exhaustion mediated this relationship. There was no evidence that OHC moderated the positive relationship between CSEs and SelfCare behavior. Theoretical and practical implications of the study are discussed.

Medical Drama Viewing and Healthy Lifestyle Behaviors: Understanding the Role of Health Locus of Control Beliefs and Education Level

The present study advances the understanding of how medical drama viewing influences healthy lifestyle behaviors (e.g., smoking, exercising, and consuming vegetables) by examining the role of the health locus of control (HLOC) beliefs and education level. An analysis of nationally representative data reveals that watching medical dramas is positively associated with chance and powerful others' HLOC beliefs. In addition, healthy lifestyle behaviors are positively associated with the internal HLOC belief and are negatively associated with the chance and powerful others' HLOC beliefs. Research findings demonstrate that there are indirect effects of medical drama viewing on these behaviors via chance and powerful others' HLOC beliefs. The indirect effect through the powerful others' HLOC belief is also contingent on the education level. The implications for the role of HLOC beliefs and education level in terms of the effects of medical dramas on health-promoting behaviors are discussed.

Paradoxical Effects of Perceived Control on Survival

Objectives

Appraising health as controllable is typically thought to be adaptive, but recent evidence suggests the paradoxical possibility that perceived control (PC) can be detrimental. We considered the premise that high PC should have a survival benefit when it is part of an adaptive mindset involving high value (importance) for health, but it might be detrimental when it is part of a mindset comprised of low health value (HV). In addition, we examined whether the survival consequences of PC and HV vary with advancing age.

Method

Interviews were conducted with a heterogeneous sample of community-dwelling adults (n = 341; 72-99 years) to assess appraisals of control and value in the domain of health. Mortality data were obtained over 12 years from a provincial health registry.

Results

Both age and HV moderated the PC effect on mortality. The predicted beneficial and detrimental PC effects emerged at younger ages: higher PC predicted longer survival times when health was highly valued but shorter survival times when health was less highly valued.

Discussion

These findings deepen the knowledge regarding the conditions under which PC is or is not adaptive, suggesting the consequences depend on age and the extent to which health is valued.

A path analysis model suggesting the association between health locus of control and compliance with childhood vaccinations

Despite vaccines benefits, parent's vaccine hesitancy is growing. Health locus of control (HLOC) may affect decision making regarding child vaccinations. The aim of this study was to investigate the relationship between parents' HLOC and compliance with routine childhood immunization programs. A cross-sectional survey was conducted among 731 parents of children aged 3-4 years. Internal HLOC, powerful others and chance HLOC (dimensions of external HLOC), reliability of information sources, and attitudes towards vaccines were measured. Path analysis was conducted to explore direct and indirect associations between HLOC and vaccination's compliance. The results show that High powerful others HLOC has a direct association with vaccination compliance (ß = 0.23, p < 0.001). High internal and chance HLOC have indirect associations through parents' attitudes regarding vaccines. Perceived reliability of information sources was associated with not complying with vaccines (ß = -0.07, p < 0.05). For conclusions, Interaction between internal and external HLOC may explain vaccination compliance. Decreasing levels of chance HLOC and increasing powerful others HLOC may increase levels of compliance with childhood vaccinations.

Randomized Controlled Trial: 4 Month versus 6 Month Monitoring of HIV-infected Patients on Highly Active Antiretroviral Therapy

As HIV treatment becomes more widely available and efficacious, and persons with HIV live longer, considerations for the financial and healthcare impact are of important. The best interval for routine HIV monitoring has been identified as area in which gaps in knowledge exist. The goal of this study is to determine the impact of changing scheduled follow up care for persons with HIV from a 4 to 6 months interval. HIV infected adults with a CD4 count ≥250 cells/μl, and an undetectable HIV viral load (VL) by an ultrasensitive assay for at least 1 year were randomized to routine HIV care at either a 4 or 6 months interval. Subjects were monitored for virological failure, adherence and quality of life (QOL). 142 subjects were enrolled and completed study protocol. Two subjects in the 6 months arm developed virological failure, p value = 0.5. There was no difference in adherence, or QOL scores. Subjects in the 4 months arm had higher rates of HIV visits (8.5/100 vs. 5.2/100 person months, p = 0.01) and non-HIV related visits (9.4/100 vs. 6.0/100 person months, p = 0.01) and were more likely to change antiretroviral regimen (34.8 vs. 15.8 %, p = 0.01). Despite strict inclusion criteria in this relatively short follow up time, 2/142 (1.4 %) subjects developed virological failure and many more had transient detectable VL. While not statistically significant a larger study with longer follow up is needed.

Health locus of control: Its relationship with medication adherence and medication wastage

BACKGROUND

Non-adherence is a significant factor contributing to medication wastage. Whilst there is some evidence on the influence of patients' health locus of control in relation to adherence, there has been little inquiry into its relationship with mediation wastage.

OBJECTIVES

To determine the relationship between medication adherence and health locus of control as well as medication wastage and health locus of control in patients with chronic conditions.

METHODS

Outpatients having a diagnosis of asthma, cardiovascular conditions, or diabetes participated in a cross-sectional study employing a self-administered questionnaire. The questionnaire determined presence of unused medication (wastage), adherence using 'Tool for Adherence Behaviour Screening' (TABS), and health locus of control using 'Multidimensional Health Locus of Control' (MHLC) scale Form C. Logistic regression was performed to ascertain the effects of MHLC and demographics in relation to adherence and wastage. MHLC beliefs were divided into 8 types of health locus of control. One-Way ANOVA was used to assess differences between conditions and belief types. P-values ≤ .05 were considered significant.

RESULTS

There were 330 patients recruited (58% male; age, mean±(SD): 61 ± 15 years; 110 asthma, 110 cardiovascular, 110 diabetes). In terms of health locus of control, females had higher 'doctors' beliefs (p = .054) and significantly lower 'other people' beliefs (p = < .0005). Lower 'chance' beliefs (p = .016) were associated with adherence. Lower 'doctors' beliefs and higher 'other people' beliefs were significantly associated with wastage (p = < .0005). There was a significant difference in adherence (p = < .0005) and in wastage (p = .002) between the eight types of health control. 'Yea-sayers' had the least presence of unused medication, followed by 'pure internal' believers. 'Pure powerful others external' had the highest presence of unused medication.

CONCLUSIONS

Healthcare professionals should take into account patients' health locus of control beliefs whilst conducting an intervention with patients; this can impact positively medication adherence and minimisation of medication wastage.

Depression, Metabolic Syndrome, and Locus of Control in Arab Americans Living in the DC Metropolitan Area: A Structural Equation Model

Arab Americans have high prevalences of metabolic syndrome (MetS) and depression. Depression and external locus of control (LOC) may worsen MetS. We examined the relationship between depression and MetS with a convenience sample of 136 Arab Americans living in the Washington, DC, metropolitan area. Participants were surveyed with the Multidimensional Health Locus of Control questionnaire and the Center of Epidemiological Studies-Depression scale. Laboratory measurements were collected based on the components of MetS. A structural equation model was used to explore the relationship between MetS and depression through analysis of LOC. MetS was significantly correlated with external LOC (powerful others and chance), and depression was correlated with a weak internal LOC. Future study of the effect of LOC on health outcomes in Arab Americans may be used to mitigate MetS and depression in this population.

Children's Sense of Control as a Determinant of Adult Health: Causation, Mediation, and Spuriousness

Previous research suggests higher levels of education instill a greater sense of internal control that promotes health in adulthood. We propose that the sense of control has its origins in early childhood and that prior research has possibly misattributed a mediational role to sense of control in adulthood. Using a conceptual framework that includes these early influences, we employ data from the 1970 British Cohort Study ( N = 9,855), examining the extent to which the association between education and adult health is spurious due to these early childhood factors. We find that the internal sense of control as assessed in childhood and adolescence has profound influences on both education and health in early adulthood and that a substantial portion of the latter association is spurious. We conclude that the sense of control is an important health-related factor originating early in life, influencing both health and education later in adulthood.

Perception towards Regular Health Check-ups

The aim of this case study is to explore the perception of the rural people for regular health check-ups. A survey was conducted in 500 households in a village in Telangana in March 2012 to get an overview about the inhabitants’ health and their willingness to go for regular check-ups. Since majority of the respondents reported not visiting doctors or hospitals regularly, the key determinants for avoidance of such health check-ups was examined. The objective was to discover factors that may be addressed in future when healthcare facilities would be made available to these villages. The major determinants for avoidance of regular health check-ups were estimated through a logit model. The health locus of control index was constructed using five questions related to attitude and perception on regular health check-up. The results indicate that demographic factors like gender and age, economic factors such as family income and family health expenditure, distance, cost of availing a doctor and health locus of control are the key determinants for avoiding regular health check-up in rural India. However, due to increasing awareness among the rural population over the years, majority of the respondents are willing to pay a minimal amount of money and ready to use the electronic device which can monitor their health.

Health Psychological Constructs as Predictors of Doping Susceptibility in Adolescent Athletes

BACKGROUND

Doping is a highly relevant problem in sport, even in adolescent athletes. Knowledge of the psychological factors that influence doping susceptibility in young elite athletes remains sparse.

OBJECTIVES

This study investigated the predictive potential of different health-psychological constructs and well-being on doping susceptibility. The main hypotheses to be tested were positive associations of fear of failure, external locus of control, and ego-oriented goal orientation as well as negative associations of confidence of success, task orientation, internal locus of control, and performance motivation with doping susceptibility. Low levels of well-being are furthermore expected to be associated with doping susceptibility.

METHODS

Within this cross-sectional study, 1,265 Austrian junior athletes aged between 14 and 19 years responded to a paper-pencil questionnaire.

RESULTS

Performance motivation was a negative, while depressive mood, self-esteem, fear of failure and ego-oriented goal orientation were positive predictors of doping susceptibility. In addition, participants who were offered performance enhancing substances in the past were particularly susceptible to doping.

CONCLUSIONS

The study corroborates the predictive value of classical psychological constructs in doping research, initially analyzed in view of adult athletes, also for adolescents' doping susceptibility.

The health locus of control concept: Factorial structure, psychometric properties and form equivalence of the Multidimensional Health Locus of Control scales

Contradictory evidence exists on the Multidimensional Health Locus of Control scale’s factor structure and the psychometric equivalence between Form A and Form B. University students (N = 359) completed the Multidimensional Health Locus of Control and General Self-Efficacy scales. The three-factor model had better fit and parsimony in both Forms. ‘Internal’ scale negatively correlated with ‘chance’ but positively with ‘others’. The two external scales positively correlated. The scales’ reliability was satisfactory, but the two Forms were not psychometrically equivalent. Convergent validity was confirmed. The evidence suggests a three-factor structure and psychometric non-equivalence of the two Forms. Researchers should make an informed choice on which Form to use.

Control Constructs: Do They Mediate the Relation between Educational Attainment and Health Behaviour?

Health promoting behaviours seem to be more prevalent among people with higher socio-economic status (SES). The main purpose of this article was to study (a) the relationship between education (as a dimension of SES) and intention and health behaviour (fruit/vegetable consumption), (b) the relationship between education and control conceptualizations (health locus of control (HLC), responseefficacy and self-efficacy) and (c) to what extent the relationship between education and intention/health behaviour (fruit/vegetable consumption) was mediated through different control beliefs. The results showed that women with higher education had higher intentions to consume fruit/vegetables and consumed fruit/vegetables more frequently. Higher education was associated with higher selfefficacy and response-efficacy beliefs and less belief in HLCchance. These control beliefs partly mediated the education–intention/behaviour relationship.

Personal determinants of acceptance of drinking and driving among Polish drivers

<b>Background</b><br /> <br /> The aim of the study was to explore a number of personal predictors that increase one’s approval of driving under the influence (DUI). In keeping with the previous studies, we assumed this approval will more often be expressed by unmarried young men with a lower level of education, who are additionally characterized by a higher need for stimulation, risk acceptance, sensation seeking, and a preference for hedonic values.<br /> <br /> <b>Participants and procedure</b><br /> <br /> After examining more than 1000 drivers, we selected a group of 254 individuals (97 men, 157 women) who formed our study group. In our survey, these drivers admitted to driving while intoxicated in the past, but at the same time declared that small doses of alcohol did not limit their driving skills. We used a set of research tools in order to verify the assumptions. The following tools measured temperamental and personality variables: Formal Characteristics of Behavior-Temperament Inventory, Risk Acceptance Scale, Stimulating-Instrumental Risk Inventory, Scheler Value Scale, Rotter’s Locus of Control Scale, and Zuckerman’s Sensation Seeking Scale.<br /> <br /> <b>Results</b><br /> Driving under the influence of alcohol is most often approved of by unmarried men who have a higher level of education and are characterized by low levels of sensory sensitivity, low levels of emotional reactivity, an internal locus of control, a high need for risks, high sensation-seeking tendencies, and who prefer vital and aesthetic values.<br /> <br /> <b>Conclusions</b><br /> It is well justified to examine personal predictors of various dangerous road behaviors, such as driving under the influence of intoxicating substances. These studies could aid both creating effective social prevention programs and conducting psychological screening tests.

The Paradoxical Role of Perceived Control in Late Life Health Behavior

Research has established the health benefits of psychological factors, including the way individuals appraise outcomes. Although many studies confirm that appraising outcomes as controllable is adaptive for health, a paradoxical possibility is largely ignored: Perceived control may be detrimental under some conditions. Our premise was that appraising health as controllable but at the same time ascribing little value to it might signal a dysfunctional psychological mindset that fosters a mistaken sense of invincibility. During face-to-face interviews with a representative sample of older adults (age range = 72–99), we identified individuals with such a potentially maladaptive “invincible” mindset (high perceived control and low health value) and compared them to their counterparts on several outcomes. The findings were consistent with our hypotheses. The invincibles denied future risks, they lacked the activating emotion of fear, and they visited their physicians less often over a subsequent five-year period. Moreover, in contrast to their counterparts, the invincibles did not appear strategic in their approach to seeking care: Even poor health did not prompt them to seek the counsel of a physician. The recognition that psychological appraisals are modifiable highlights the promise of remedial methods to alter maladaptive mindsets, potentially improving quality of life.

Mental Fitness for patients with acute coronary syndrome: A randomized clinical trial

OBJECTIVES

The aim of this study was to verify the efficacy of a manualized, cognitively oriented psychological intervention, called Mental Fitness, in improving the mental and physical health of patients with acute coronary syndrome (ACS). Mental Fitness is a small-group four-session treatment aimed at increasing awareness of one's own bodily perceptions, emotions, and thoughts and is overall tailored on participants' perception of control over their health.

DESIGN

Prospective randomized controlled single-blind trial.

METHODS

Patients with ACS were recruited within a week from their acute cardiac event. Patients in the intervention group underwent one of two variants of Mental Fitness, depending on their perceived (internal or external) control over their health. Patients in the control group underwent standard treatment. All the patients were submitted to a clinical and psychological follow-up for 8 months.

RESULTS

The patients who underwent the Mental Fitness intervention (N = 31) showed, compared to the control patients (N = 34), increased quality of life in its physical, psychological, social and environmental domains, more functional emotional and problem-centred coping strategies, and higher emotional awareness. They also showed improved high-density lipoprotein cholesterol, triglycerides, heart rate, and left ventricular ejection fraction compared to the controls. In addition, they were more successful in maintaining physical exercise.

CONCLUSIONS

This study demonstrates the efficacy of Mental Fitness in modifying specific psychological and physical variables conditioning cardiological patients' prognosis. It also confirms the importance of differentiating psychological interventions based on the psychological characteristics of the patients. Statement of contribution What is already known on this subject? Traditional symptom-based interventions in heart disease are aimed at diagnosing and reducing psychological symptomatology (e.g., depression), but recent work has shown the usefulness of orienting psychological interventions to patients' representations of themselves and of the world and to how such representations influence their thoughts, feelings, and behaviours (e.g., Chiavarino et al., ). What does this study add? Mental Fitness, by working on awareness of bodily perceptions, emotions, and thoughts, leads to positive changes in physical and psychological health. Mental Fitness is a cost-effective psychological intervention that adds significantly to the effectiveness of standard medical care.