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Health locus of control and psychological distress in cancer patients: Interactive effects of context

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Abstract

Delineation of the relationship between health locus of control (HLOC) and psychological adjustment in chronic disease has been hampered by the failure to consider the moderating effect of contextual factors. The extent to which HLOC beliefs match the control realities in a situation (Reality Matching hypothesis) as well as the degree of threat (Threat hypothesis) posed by the situation were hypothesized to moderate the HLOC-distress relationship. Distress, diesease severity (i. e., threat), and HLOC were assessed in 69 individuals with malignant disease undergoing evaluation for bone marrow transplantation. Hierarchical regression analyses indicated that the HLOC-distress relationship was moderated by disease severity and treatment history (i. e., whether an individual had failed prior cancer therapy). However, in some instances, the specific interaction relationships obtained differed from those evident in previous research with ESRD patients. It was concluded that there is no simple main effect relationship between HLOC beliefs and psychological adjustment. Rather. this relationship is best described by joint consideration of factors descriptive of the context in which the individual is embedded.

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References

  • Affleck, G., Tennen, H., Pfleiffer, C., and Fifield, J. (1987). Appraisals of control and predicatability in adapting to a chronic disease.J. Person. Soc. Psychol. 53: 273–279.

    Google Scholar 

  • Andersen, B. L., Anderson, B., and DeProsse, C. (1989). Controlled prospective longitudinal study of women with cancer. II. Psychologuical outcomes.J. Consult. Clin. Psychol. 57: 692–697.

    PubMed  Google Scholar 

  • Anderson, K. O., Bradley, L. A., Young, L. D., McDaniel, L. K., and Wise, C. M. (1985). Rheumatoid arthritis: Review of psychological factors related to etiology, effects, and treatment.Psychol. Bull. 98: 358–387.

    PubMed  Google Scholar 

  • Andrykowski, M. A., Altmaier, E. M., Barnett, R. L., Otis, M. L., Gingrich, R., and Henslee-Downey, P. J. (1990). The quality of life in adult survivors of allogeneic bone marrow transplantation: Correlates and comparison with matched renal transplant recipients.Transplantation 50: 399–406.

    PubMed  Google Scholar 

  • Andrykowski, M. A., Brady, M. J., and Hunt, J. W. (1993). Positive psychosocial ajustment in potential bone marrow transplant recipients: Cancer as a psychosocial transition.Psycho-Oncology 2: 261–276.

    Google Scholar 

  • Bergner, M., Bobbit, R. A., Carter, W. B., and Gilson, B. S. (1981). The Sickness Impact Profile: Development and final revision of a health status measure.Med. Care 191: 787–805.

    Google Scholar 

  • Burish, T., Carey, M., Wallston, K., Stein, M., Jamison, R., and Lyles, J. (1984). Healthy locus of control and chronic disease: An external orinetation may be advantageous.J. Soc. Clin. Psychol. 2: 326–332.

    Google Scholar 

  • Cantril, H. (1965).The Patterns of Human Concern, Rutgers University Press, New Brunswick, NJ.

    Google Scholar 

  • Cella, D. F., Tross, S., Orav, E. J., Holland, J. C., Silverfarb, P. M., and Rafla, S. (1989). Mood states of patients after the diagnosis of cancer.J. Psychosoc. Oncol. 7: 45–54.

    Google Scholar 

  • Cella, D. F., Mahon, S. M., and Donovan, M. I. (1990). Cancer recurrence as a traumatic event.Behav. Med. 16: 15–22.

    PubMed  Google Scholar 

  • Christensen, A. J., Turner, C. S. Smith, T. W., Holman, J. M. Jr., and Gregory, M. C. (1991). Health locus of control and depression in end-stage renal diesease.J. Consult. Clin. Psychol. 59: 419–424.

    PubMed  Google Scholar 

  • Cohen, F., and Lazarus, R. S. (1983),. Coping and adaptation in health and illness. In Mechanic, D. (ed.),Handbook of Health, Health Care, and the Health Professions, Free Press, New York, pp. 608–631.

    Google Scholar 

  • Cohen, J., and Cohen, P. (1983).Applied Multiple Regression for the Behavioral Sciences, 2nd ed., Lawrence Earlbaum, Hillsdale, NJ.

    Google Scholar 

  • Derogatis, L. R. (1986). The psychosocial adjustment to illness scale (PAIS).J. Psychosom. Res. 30: 77–91.

    PubMed  Google Scholar 

  • Devins, G. M., Binik, Y. M. Gorman, P., Dattel, M., McCloskey, B., Oscar, G., and Briggs, J. (1982). Perceived self-efficacy outcome expectancies, and negative mood states in end-stage renal disease.J. Abnorm. Psychol. 91: 241–244.

    PubMed  Google Scholar 

  • Farber, J. M., Weinerman, B. H., and Kuypers, J. A. (1984). Psychosocial distress in oncology outpatients.J. Psychosoc. Oncol. 2(3/4): 109–117.

    Google Scholar 

  • Folkman, S. (1984). Personal Control and stress and coping processes: A theoretical analysis.J. Person. Soc. Psychol. 46: 839–852.

    Google Scholar 

  • Frank, R. G., and Elliott, T. R. (1989). Spinal cord injury and health locus of control beliefs.Paraplegia 27: 250–256.

    PubMed  Google Scholar 

  • Gold, D. T., Smith, S. D., Bales, C. W., Lyles, K. W. Westlund, R. E., and Drezner, M. K. (1991). Osteoporosis in late life: Does health locus of control affect psychosocial adaptation?J. Am. Geriatr. Soc. 39: 670–675.

    PubMed  Google Scholar 

  • Helgeson, V. S. (1992). Moderators of the relation between perceived control and adjustment to chronic illness.J. Person. Soc. Psychol. 63: 656–666.

    Google Scholar 

  • Hughson, A. V. M., Cooper, A. F., McArdle, C. S., and Smith, D. C. (1988). Psychosocial consequences of mastectomy: Levels of morbidity and associated factors.J. Psychosom. Res. 32: 383–391.

    PubMed  Google Scholar 

  • Jaccard, J., Turrisi, R., and Wan, C. K. (1990).Interation Effects in Multiple Regression, Sage, London.

    Google Scholar 

  • Jamieson, K. R., Wellisch, D. K., and Pasnau, R. O. (1978). Psychosocial aspects of mastectomy. I. The woman's perspective.Am. J. Psychiat. 135: 432–436.

    PubMed  Google Scholar 

  • Marshall, G. N. (1991). A multidimensional analysis of internal health locus of control beliefs: Separating the wheat from the chaff?J. Person. Soc. Psychol. 61: 483–491.

    Google Scholar 

  • McNair, P. M., Lorr, M., and Droppelman, L. (1981).POMS Manual (2nd): Education and Industrial Testing Service, San Diego, CA.

    Google Scholar 

  • Phares, E. J. (1976).Locus of Control in Personality, General Learning Press, Morristown, NJ.

    Google Scholar 

  • Poll, I. B., & Kaplan De-Nour, A. (1980). Locus of control and adjustment to chronic hemodialysis.Psychol. Med. 10: 153–157.

    PubMed  Google Scholar 

  • Reid, D. (1984). Participatory control and the chronic illness adjustment process. In Lefcourt, H. (eds.),Research with the Locus of Control Construct: Extensions and Limitations, Vol. 3, Academic Press, New York, pp. 361–389.

    Google Scholar 

  • Rothbaum, F., Weisz, J. R., and Snyder, S. S. (1982). Chaning the world and changing the self: A two process model of perceived control.J. Person. Soc. Psychol. 42: 5–37.

    Google Scholar 

  • Rotter, J. B. (1966). Generalized expectancies for internal versus external control of reinforcement.Psychol. Monogr. 80(1): No. 609.

    Google Scholar 

  • Shadish, W. R., Jr., Hickman, D., and Arrick, M. C. (1981). Psychological problems of spinal cord injury patients: Emotional distress as a function of time and locus of control.J. Consult. Clin. Psychol. 49: 297.

    PubMed  Google Scholar 

  • Strickland, B. R. (1978). Internal-external expectancies and health-related behaviors.J. Consult. Clin. Psychol. 46: 1192–1211.

    PubMed  Google Scholar 

  • Strickland, B. R. (1989). Internal-external control expeetancies: From contingency to creativity,Am. Psychol. 44: 1–12.

    Google Scholar 

  • Taylor, S. E., Kemney, M. E., Reed, G. M., and Aspinwall, L. G. (1991). Assault on the self: Positive illusions and adjustment to threatening events. In Goethals, G. A., and Strauss, J. A. (eds.),The Self: An Interdisciplinary Perspective, Springer, New York, pp. 239–254.

    Google Scholar 

  • Wallston, B. S., Wallston, K. A., Kaplan, G. D., and Maides, S. A. (1976). Development and validation of the Health Locus of Control (HLC) scale.J. Consult. Clin. Psychol. 44: 580–585.

    PubMed  Google Scholar 

  • Wallston, K. A. (1991). The importance of placing measures of health locus of control beliefs in a theoretical context.Health Educ. Res. 6: 251–252.

    Google Scholar 

  • Wallston, K. A., Wallston, B. S. (1982). Health locus of control scales. In Lefcourt, H. M. ed.),Research with the Locus of Control Construct, Vol. 1, Academic Press, New York, pp. 189–243.

    Google Scholar 

  • Wallston, K. A., Wallston, B. S., and DeVellis, R. (1978). Development of the Multidimensional Health Locus of Control (MHLC) scales.Health Educ. Monogr. 6: 160–170.

    PubMed  Google Scholar 

  • Watson, M., Greer, S., Pruyn, J., and Van den Borne, B. (1990). Locus of control and adjustment to cancer.Psychol. Rep. 66: 39–48.

    PubMed  Google Scholar 

  • Wortman, C. B., and Brehm, J. (1975). Responses to uncontrollable outcomes: An integration of reactance therapy and the learned helplessness model. In L. Berkowitz (eds.),Advances in Experimental Social Psychology, Vol. 8, Academic Press, New York, pp. 277–336.

    Google Scholar 

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Andrykowski, M.A., Brady, M.J. Health locus of control and psychological distress in cancer patients: Interactive effects of context. J Behav Med 17, 439–458 (1994). https://doi.org/10.1007/BF01857919

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