Rotter J.B.

Locus of control is how people measure and understand how people relate their health to their behavior, health status and how long it may take to recover from a disease.^[8] Locus of control can influence how people think and react towards their health and health decisions. Each day we are exposed to potential diseases that may affect our health. The way we approach that reality has a lot to do with our locus of control. Sometimes it is expected to see older adults experience progressive declines in their health, for this reason it is believed that their health locus of control will be affected.^[8] However, this does not necessarily mean that their locus of control will be affected negatively but older adults may experience decline in their health and this can show lower levels of internal locus of control. Age plays an important role in one’s internal and external locus of control. When comparing a young child and an older adult with their levels of locus of control in regards to health, the older person will have more control over their attitude and approach to the situation. As people age they become aware of the fact that events outside of their own control happen and that other individuals can have control of their health outcomes.^[8]

A study published in the journal Psychosomatic Medicine examined the health effect of childhood locus of control. 7,500 British adults (followed from birth), who had shown an internal locus of control at age 10, were less likely to be overweight at age 30. The children who had an internal locus of control also appeared to have higher levels of self-esteem.^[38]

Gender-based differences

As Schultz and Schultz (2005) point out, significant gender differences in locus of control have not been found for adults in the U.S. population. However, these authors also note that there may be specific sex-based differences for specific categories of items to assess locus of control; for example, they cite evidence that men may have a greater internal locus for questions related to academic achievement.^[39]

A study made by Takaki and colleagues (2006), focused on the gender differences with relationship to internal locus of control and self-efficacy in hemodialysis patients and their compliance.^[40] This study showed that females that had high internal locus of control were less compliant in regards to their health and medical advices compared to the men that participated in this study. Compliance is known to be the degree in which a person’s behavior, in this case the patient, has a relationship with the medical advice. For example, a person that is compliant with correctly follow his/her doctor’s advice.

Cross-cultural issues

The question of whether people from different cultures vary in locus of control has long been of interest to social psychologists. Japanese people tend to be more external in locus-of-control orientation than people in the U.S.; however, differences in locus of control between different countries within Europe (and between the U.S. and Europe) tend to be small.^[41] As Berry et al. pointed out in 1992, ethnic groups within the United States have been compared on locus of control; African Americans in the U.S. are more external than whites, even when socioeconomic status is controlled.^[42] Berry et al. also pointed out in 1992 how research on other ethnic minorities in the U.S. (such as Hispanics) has been ambiguous. More on cross-cultural variations in locus of control can be found in Shiraev and Levy (2004). Research in this area indicates that locus of control has been a useful concept for researchers in cross-cultural psychology.

Self-efficacy

Self-efficacy, a related concept introduced by Albert Bandura, has been measured by means of a psychometric scale.^[43] It differs from locus of control by relating to competence in circumscribed situations and activities (rather than more general cross-situational beliefs about control). Bandura has also emphasised differences between self-efficacy and self-esteem, using examples where low self-efficacy (for instance, in ballroom dancing) are unlikely to result in low self-esteem because competence in that domain is not very important to an individual. Although individuals may have a high internal health locus of control and feel in control of their own health, they may not feel efficacious in performing a specific treatment regimen that is essential to maintaining their own health.^[44] Self-efficacy plays an important role in one’s health because when people feel that they have self-efficacy over their health conditions, the effects of their health becomes less of a stressor.

Smith (1989) has argued that locus of control only weakly measures self-efficacy; "only a subset of items refer directly to the subject's capabilities".^[45] Smith noted that training in coping skills led to increases in self-efficacy, but did not affect locus of control as measured by Rotter's 1966 scale.

Stress

At first,^[when?] stress was not considered to play a part in a person’s health and/or illness. In the previous section we^[who?] saw how self-efficacy can be related to a person’s locus of control, and stress also has a relationship in these areas. Self-efficacy can be something that people use to deal with the stress that they are faced with on their everyday life. Some findings suggest that external health-related locus of control combined with self-efficacy moderates illness-related psychological distress.^[44] In previous section, it was mentioned the different types of locus of control, internal and external. Based on the definition on people that have an external locus of control, we can see that this can be associated with higher levels of stress. A study conducted by Bollini and others reveals that individuals who have a high external locus of control tend to have higher levels of psychological and physical problems. These people are also more vulnerable to external influences and as a result they become more responsive to stress.^[44]

Veterans that have spinal cord injuries and post-traumatic stress are a good group to look at in regards to locus of control and stress. Aging shows to be a very important factor that can be related to the severity of the symptoms of PTSD experienced by the patients following the trauma of the war.^[46] Research suggest that patients that suffered a spinal cord injury will benefit from knowing that they have control over their health problems and they disability, which reflex the characteristics of having internal locus of control. A study made by Chung et Al. 2006 focused on how the responses of spinal cord injury post-traumatic stress will vary depending on age. The researchers tested different age groups including young adults, middle-aged and elderly; the average age was 25, 48 and 65 for each group respectively. After the study, they concluded that age does not make a difference on how spinal cord injury patients respond to the traumatic events that happened.^[46] However, they did mention that age did play a role in the extent by which the external locus of control was used, concluding that the young adults group showed to be using more external locus of control characteristics than the other age groups that they were being compared to.