Beliefs about Control and Health Behavior

  • Richard R. Lau


The desire to control one’s environment and the events in one’s life is a very general human motive. It plays a central role in several basic (although very different) theories of personality and social psychology (e.g., Bandura, 1977; de Charms, 1968; Fromm, 1941; Kelley, 1967; White, 1959). Because the desire for control is such a general motivation, beliefs about whether one has control over one’s life have attracted much research interest. The research that is relevant to health falls into three main categories. The first addresses the question of the extent to which control reduces the stressfulness of an aversive event. The second type of research looks at the results of an attributional style known as “learned helplessness.” The third category of research includes those studies that look at more generalized beliefs about control as an individual difference or personality factor. This chapter will briefly review the first two of these theoretical orientations before delving more deeply into the third individual difference or “locus of control” approach. A brief summary at the end of this chapter will attempt to tie these three orientations together again.


Health Behavior Health Locus Attributional Style Control Belief Control Scale 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Abramowitz, C. V., Abramowitz, S. I., Roback, H. B., & Jackson, C. (1974). Differential effectiveness of directive and nondirective group therapies as a function of client internal-external control. Journal of Consulting and Clinical Psychology, 42, 849–853.PubMedCrossRefGoogle Scholar
  2. Abramson, L. Y., Seligman, M. E. P., & Teasdale, J. D. (1978). Learned helplessness in humans: Critique and reformulation. Journal of Abnormal Psychology, 87, 49–74.PubMedCrossRefGoogle Scholar
  3. Alloy, L. B., & Abramson, L. Y. (1982). Learned helplessness, depression, and the illusion of control. Journal of Personality and Social Psychology, 42, 1114–1126.PubMedCrossRefGoogle Scholar
  4. Andersen, R., Kravits, J., & Anderson, O. W. (1971). The public’s view of the crisis in medical care: An impetus for changing delivery systems? Economics and Business Bulletin, 24, 44–49.Google Scholar
  5. Averill, H. R. (1973). Personal control over aversive stimuli and its relationship to stress. Psychological Bulletin, 80, 286–303.CrossRefGoogle Scholar
  6. Bandura, A. (1977). Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review, 84, 191–215.PubMedCrossRefGoogle Scholar
  7. Best, J. A. (1975). Tailoring smoking withdrawal procedures to personality and motivational differences. Journal of Consulting and Clinical Psychology, 43, 1–8.PubMedCrossRefGoogle Scholar
  8. Best, J. A., & Steffy, R. A. (1975). Smoking modification procedures for internal and external locus of control clients. Canadian Journal of Behavioral Science, 7, 155–165.CrossRefGoogle Scholar
  9. Balch, P., & Ross, A. W. (1975). Predicting success in weight reduction as a function of locus of control: A unidimensional and multidimensional approach. Journal of Consulting and Clinical Psychology, 43, 119.PubMedCrossRefGoogle Scholar
  10. Borthe, D. G., & Hammen, C. L. (1981). The attributional model of depression. Personality and Social Psychology Bulletin, 7, 53–58.CrossRefGoogle Scholar
  11. Cohen, S. (1980). Aftereffects of stress on human performance and social behavior: A review of research and theory. Psychological Bulletin, 88, 82–108.PubMedCrossRefGoogle Scholar
  12. Cohen, S., Rothbart, M., & Phillips, S. (1976). Locus of control and the generality of learned helplessness in humans. Journal of Personality and Social Psychology, 34, 1049–1056.CrossRefGoogle Scholar
  13. Collins, B. E. (1974). Four components of the Rotter internal-external scale: Belief in a difficult world, a just world, a predictable world, and a politically responsive world. Journal of Personality and Social Psychology, 29, 381–391.PubMedCrossRefGoogle Scholar
  14. Cromwell, R. L., Butterfield, E. C. Brayfield, F. M., & Curry, J. L. (1977). Acute myocardial infarction: Reaction and recovery. St. Louis: Mosby.Google Scholar
  15. Dabbs, J. M., & Kirscht, J. P. (1971). Internal control and the taking of influenza shots. Psychological Reports, 28, 959–962.PubMedCrossRefGoogle Scholar
  16. de Charms, R. (1968). Personal causation: The internal affective determinants of behavior. New York: Academic Press.Google Scholar
  17. Depue, R. A., & Monroe, S. M. (1978). Learned helplessness in the perspective of the depressive disorders: Conceptual and definitional issues. Journal of Abnormal Psychology, 87, 3–20.PubMedCrossRefGoogle Scholar
  18. DiMatteo, M. R., & DiNicola, D. D. (1982). Achieving patient compliance. Elmsford, NY: Pergamon Press.Google Scholar
  19. Friedman, M. L., & Dies, R. R. (1974). Reactions of internal and external test-anxious students to counseling and behavior therapies. Journal of Consulting and Clinical Psychology, 42, 921.PubMedCrossRefGoogle Scholar
  20. Fromm, E. (1941). Escape from freedom. New York: Farrar & Rinehart.Google Scholar
  21. Giles, S. L. (1984). Relationship between locus of control expectancies and disease-related learning and disease control in diabetics. Unpublished manuscript, Oregon Health Sciences University.Google Scholar
  22. Gottlieb, N. H., & Baker, J. A. (1985). Health beliefs, health locus of control and other cognitive factors in alcohol use, physical activity and smoking: Differences by university fitness program participation. Unpublished manuscript, University of Texas, Austin.Google Scholar
  23. Hiroto, D. S. (1974). Locus of control and learned helplessness. Journal of Experimental Psychology, 31, 311–327.Google Scholar
  24. Jacobs, M. L., & Lau, R. R. (1988). The effect of locus of control beliefs on the success of health-related communications. Manuscript in preparation, Carnegie-Mellon University.Google Scholar
  25. James, W. H., Woodruff, A. B., & Werner, W. (1965). Effect of internal and external control upon changes in smoking behavior. Journal of Consulting Psychology, 29, 184–186.PubMedCrossRefGoogle Scholar
  26. Johnson, S. E. D. (1983). Internal-external control as one factor in the maternity client’s choice of midwife/home birth versus obstetrician/hospital birth. Unpublished master’s thesis, University of Pittsburgh.Google Scholar
  27. Joreskog, K. G., & Sorbom, D. (1984). LISREL VI: Analysis of linear structural relationships by the method of maximum likelihood. Chicago: National Educational Resources.Google Scholar
  28. Kaplan, G. D., & Cowles, A. (1978). Health locus of control and health value in the prediction of smoking reduction. Health Education Monographs, 6, 129–137.PubMedCrossRefGoogle Scholar
  29. Kelley, H. H. (1967). Attribution theory in social psychology. In D. Levine (Ed.), Nebraska symposium on motivation, (Vol. 15, pp. 192–240). Lincoln: Nebraska University Press.Google Scholar
  30. Kilmann, P. R. (1974). Direct and nondirect marathon group therapy and internal-external control. Journal of Counseling Psychology, 21, 380–384.CrossRefGoogle Scholar
  31. Kilmann, P. R., Albert, B. M., & Sotile, W. M. (1975). Relationships between locus of control, structure of therapy, and outcome. Journal of Consulting and Clinical Psychology, 43, 588.PubMedCrossRefGoogle Scholar
  32. Kirscht, J. P. (1972). Perceptions of control and health beliefs. Canadian Journal of Behavioral Science, 4, 225–237.CrossRefGoogle Scholar
  33. Klein, D. C., Fencil-Morse, E., & Seligman, M. E. P. (1976). Learned helplessness, depression, and the attribution of failure. Journal of Personality and Social Psychology, 33, 508–516.PubMedCrossRefGoogle Scholar
  34. Krantz, D., Baum, A., & Wideman, M. (1980). Assessment of preferences of self-treatment and information in health care. Journal of Personality and Social Psychology, 39, 977–990.PubMedCrossRefGoogle Scholar
  35. Lau, R. R. (1982). Origins of health locus of control beliefs. Journal of Personality and Social Psychology, 42, 322–334.PubMedCrossRefGoogle Scholar
  36. Lau, R. R., & Hartman, K. A. (1983). Common sense representations of common illnesses. Health Psychology, 2, 167–185.CrossRefGoogle Scholar
  37. Lau, R. R., Hartman, K. A., & Ware, J. E., Jr. (1986). Health as a value: Methodological and theoretical considerations. Health Psychology, 5, 25–43.PubMedCrossRefGoogle Scholar
  38. Lau, R. R., & Ware, J. E., Jr. (1981). Refinements in the measurement of health-specific locus-of-control beliefs. Medical Care, 19, 1147–1158.PubMedCrossRefGoogle Scholar
  39. Lazarus, R. S. (1966). Psychological stress and the coping process. New York: McGraw-Hill.Google Scholar
  40. Lefcourt, H. M. (1976). Locus of control: Current trends in theory and research. Hillsdale, NJ: Erlbaum.Google Scholar
  41. Lundy, J. R. (1972). Some personality correlates of contraceptive use among unmarried female college students. Journal of Psychology, 80, 9–14.PubMedCrossRefGoogle Scholar
  42. MacDonald, A. P. (1970). Internal-external locus of control and the practice of birth control. Psychological Reports, 27, 206.PubMedCrossRefGoogle Scholar
  43. Maier, S. F., & Seligman, M. E. P. (1976). Learned helplessness: Theory and evidence. Journal of Experimental Psychology: General, 105, 3–46.CrossRefGoogle Scholar
  44. Martin, D. J., Abramson, L. Y., & Alloy, L. B. (1984). Illusion of control for self and others in depressed and nondepressed college students. Journal of Personality and Social Psychology, 46, 125–136.PubMedCrossRefGoogle Scholar
  45. Miller, S. M. (1979). Controllability and human stress: Method, evidence and theory. Behaviour Research and Therapy, 17, 287–304.PubMedCrossRefGoogle Scholar
  46. Peterson, C. (1982). Learned helplessness and health psychology. Health Psychology, 1, 153–168.CrossRefGoogle Scholar
  47. Peterson, C., & Seligman, M. E. P. (1984). Causal explanations as a risk factor for depression: Theory and evidence. Psychological Review, 91, 347–374.PubMedCrossRefGoogle Scholar
  48. Raps, C. S., Peterson, C., Jonas, M., & Seligman, M. E. P. (1982). Patient behavior in hospitals: Helplessness, reactance, or both? Journal of Personality and Social Psychology, 42, 1036–1041.PubMedCrossRefGoogle Scholar
  49. Rotter, J. B. (1954). Social learning and clinical psychology. Englewood Cliffs, NJ: Prentice-Hall.CrossRefGoogle Scholar
  50. Rotter, J. B. (1975). Some problems and misconceptions related to the construct of internal vs. external control of reinforcement. Journal of Consulting and Clinical Psychology, 43, 56–67.CrossRefGoogle Scholar
  51. Sackett, D. L., & Haynes, R. B. (Eds.). (1976). Compliance with therapeutic regimens. Baltimore, MD: Johns Hopkins University Press.Google Scholar
  52. Seeman, M., & Evans, J. W. (1962). Alienation and learning in a hospital setting. American Sociological Review, 27, 772–783.CrossRefGoogle Scholar
  53. Seligman, M. E. P. (1975). Helplessness: On depression, development, and death. San Francisco: Freeman.Google Scholar
  54. Sells, S. B. (1970). On the nature of stress. In J. E. McGrath (Ed.) Social and psychological factors in stress. New York: Holt, Rinehart & Winston.Google Scholar
  55. Sonstroem, R. J., & Walker, M. I. (1973). Relationship of attitude and locus of control to exercise and physical fitness. Perceptual and Motor Skills, 36, 1031–1034.PubMedCrossRefGoogle Scholar
  56. Steffy, R. A., Meichenbaum, D., & Best, J. A. (1970). Aversive and cognitive factors in the modification of smoking behavior. Behaviour Research and Therapy, 8, 115–125.PubMedCrossRefGoogle Scholar
  57. Strickland, B. R. (1978). Internal-external expectancies and health-related behaviors. Journal of Consulting and Clinical Psychology, 46, 1192–1211.PubMedCrossRefGoogle Scholar
  58. Sweeney, P. D., Anderson, K., & Bailey, S. (1986). Attributional style in depression: A meta-analytic review. Journal of Personality and Social Psychology, 50, 974–991.PubMedCrossRefGoogle Scholar
  59. Taylor, S. E. (1979). Hospital patient behavior: Reactance, helplessness, or control? Journal of Social Issues, 35, 156–184.CrossRefGoogle Scholar
  60. Thompson, S. C. (1981). Will it hurt less if I can control it? A complex answer to a simple question. Psychological Bulletin, 90, 89–101.PubMedCrossRefGoogle Scholar
  61. Toner, J. B., & Manuck, S. B. (1979). Health locus of control and health-related information seeking at a hypertension screening. Social Science and Medicine, 13A, 823.Google Scholar
  62. Wallston, B. S., & Wallston, K. A. (1978). Locus of control and health: A review of the literature. Health Education Monographs, 6, 107–117.PubMedCrossRefGoogle Scholar
  63. Wallston, B. S., & Wallston, K. A. (1984). Social psychological models of health behavior: An examination and integration. In A. Baum, S. E. Taylor, & J. E. Singer (Eds.), Handbook of psychology and health (Vol. 4, pp. 23–53). Hillsdale, NJ: Erlbaum.Google Scholar
  64. Wallston, B. S., Wallston, K. A., Kaplan, G. D., & Maides, S. A. (1976). Development and validation of the health locus of control scale. Journal of Consulting and Clinical Psychology, 44, 580–585.PubMedCrossRefGoogle Scholar
  65. Wallston, K. A., Maides, S., & Wallston, B. S. (1976). Health-related information seeking as a function of health-related locus of control and health value. Journal of Research in Personality, 10, 215–222.CrossRefGoogle Scholar
  66. Wallston, K. A., & Wallston, B. S. (1981). Health locus of control scales. In H. M. Lefcourt (Ed.), Research with the locus of control construct, (Vol. 1, pp. 189–243). New York: Academic Press.Google Scholar
  67. Wallston, K. A., & Wallston, B. S. (1982). Who is responsible for your health? The construct of health locus of control. In G. S. Sanders & J. Suls (Eds.), Social psychology of health and illness (pp. 65–95). Hillsdale, NJ: Erlbaum.Google Scholar
  68. Wallston, K. A., Wallston, B. S., & DeVellis, R. (1978). Development of the multidimensional health locus of control (MHLC) scales. Health Education Monographs, 6, 160–170.PubMedCrossRefGoogle Scholar
  69. Ware, J. E., Jr. (1978). Effects of acquiescent response set on patient satisfaction ratings. Medical Care, 16, 327–336.PubMedCrossRefGoogle Scholar
  70. Weaver, R. (1972). Internality, externality, and compliance as related to chronic home dialysis patients. Unpublished master’s thesis, Emory University (cited in Strickland, 1978).Google Scholar
  71. White, R. W. (1959). Motivation reconsidered: The concept of competence. Psychological Review, 66, 297–333.PubMedCrossRefGoogle Scholar
  72. Wildman, H. E., Rosenbaum, M. N. S., Framer, E. M., Keane, T. M., & Johnson, W. G. (1979). Smoking cessation: Predicting success with the health locus of control scale. Paper presented at the Association for the Advancement of Behavior Therapy, San Francisco.Google Scholar
  73. Williams, A. F. (1972a). Factors associated with seat belt use in families. Journal of Safety Research, 4, 133–138.Google Scholar
  74. Williams, A. F. (1972b). Personality characteristics associated with preventive dental health practices. Journal of American College of Dentists, 39, 225–234.Google Scholar
  75. Wolff, H. G. (1953). Stress and disease. Springfield, IL: Thomas.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1988

Authors and Affiliations

  • Richard R. Lau
    • 1
  1. 1.Department of Social and Decision SciencesCarnegie-Mellon UniversityPittsburghUSA

Personalised recommendations