PART 1
Health Locus of Control
PART 2
CONCLUSIONS
METHODS
DISCUSSION
APPENDIXES
Part I; Belief and Health
HLC and Psychosomaticism
HLC, as a belief structure, provides a strategy for viewing the world. I suggested earlier that
HLC may have an influence on health behavior, as indicated by Rotter's Social Learning Theory.
This might equate with better health for individuals with an internal HLC, because they tend to
adopt strategies to maintain or improve the state of their health (ie. abstaining from smoking/
drinking, getting exercise). Duffy (1997), in support of this, found an internal HLC in Mexican
American women to predict health promoting behaviors. Given the fact that cognition may
actually alter immunity, however, one's HLC may have more immediate effects on health
demonstrated by the presence or absence of psychosomatic symptoms. Indeed, an individual's
perception of control may actually elicit or prevent a physiological stress reaction from occurring:
"One of the most important variables that determines whether an aversive stimulus will cause a
stress reaction is the degree to which the situation can be controlled" (Comer, 1998).
Control and immunity:
Anecdote: |
This is certainly not empirical evidence, but non-anecdotal evidence supports the fact that one's
perception of control does have an impact on health. Vandervoot, Luis, and Hamilton (1997) cite a study
wherein subjects who were given control improved their condition, whereas withdrawing control had the
opposite effect. They also cite that internals have an advantage over externals in their mental and
physical health in relatively healthy populations. Camille Chatterjee, in the most recent issue of
Psychology Today (1999), note a study in which Heike Mahler, PhD., et al., found that watching a video
of survivors or of recovery exercises prior to coronary bypass surgery altered patients' appraisal of their
healing process; the patients' belief that they were in charge of their recuperation translated into a
'speedy recovery'. The placebo effect is simply the name given to this phenomenon when researchers
find improvements in health not claimed by treatment:
. . . it is now clear from PNI [psychoimmunology] that an expectation of recovery can alter subjective feelings of well-being, and result in autonomic activation as well as the production of pituitary hormones. Thus there are specific testable pathways by which expectation (the placebo effect) can alter immunity. -Watkins, 1996, p. 59.These studies are evidence for the ability of cognition, specifically the perception of control, to alter immunity.
Bates and Rankin-Hill (1995) discovered that an internal Locus of Control was associated with better
self-reported health in chronic pain sufferers across mainstream and Latino populations. Internals were
more likely to consider themselves healthy/ less likely to consider themselves unhealthy, and externals
were less likely to consider themselves healthy/ more likely to consider themselves unhealthy in the
populations studied (see below).
| Puerto Rico | New England | ||
|---|---|---|---|
| population | all | all | Latino |
| Internal | 58% Healthy | 61% Healthy | 40% Healthy |
| External | 8% Healthy | 30% Healthy | 100% Healthy |
-adapted from Bates & Rankin-Hill, 1995.They found that internals demonstrated less expressiveness to pain; lower depression, fear, tension and worry; and a determination to overcome pain. Externals were more likely demonstrate emotional response to pain; to report daily routine and work interference due to pain; less likely to find activities to keep them busy; and more likely to agree with the following: "As long as I have pain, I will never have a fulfilling, happy life". In addition, internals were found to forgo seeking immediate care, while externals were more likely to seek the advise of a physician, psychiatrist, friend or family member. This study concluded that while internals go about life in attempt to regain control, pleasure and purpose, externals develop drug dependancies or continue on in a fruitless search for some outside force. It marks the difference between an endless devotion to life, and an endless search for a cure.
From this study and the studies discussed regarding the influence of control over immunity, it follows
logically that a measure of generalized health expectancy like the HLC would alter health and self-report
measures reflecting health. Vandervoot, et al. (1997) found: "When controlling for a variety of health risk
factors, CHLC [chance Health Locus of Control] was associated with increases in recent and chronic physical
health symptoms, as well as major health problems"(p. 174). (CHLC is a subscale on a multidimensional
measure of HLC, and high scores on this indicate externality). This finding supports a psychosomatic
influence of HLC.
In order to test the same hypothesis in the current study, psychosomatic symptoms will be
operationalized as one's score on Greller and Parson's (1988) self-report health questionnaire: the
Psychosomatic Complaints Scale of Stress (PCS). This scale includes a number of psychosomatic symptoms
which subjects rate on a likert scale (see materials), including items such as 'Have headaches', 'Stomach
bothers me', and 'High blood pressure'. It is conceptualized as a way to measure stress, as compatible with
the definition of psychosomaticism used throughout the current study. I am hoping to replicate the findings
of Vandervoot, et al. (1997)- an external HLC is associated with a higher degree of physical symptoms-
using the HLC as a measure of perceived control over health and PCS as a measure of psychosomaticism.
