Low Control Beliefs Research Articles

Do poor psychosocial resources mediate health inequalities in type 2 diabetes? The Maastricht Study

Abstract Low socioeconomic position (SEP) has been identified as a risk factor for type 2 diabetes mellitus (T2DM). A potential pathway of this association is psychosocial resources. Disadvantageous environmental conditions result in low control beliefs through adverse resources and inferiority beliefs through social comparison for people with a low SEP. We examined two poor psychosocial resources, low control beliefs and inferiority beliefs, to explain socioeconomic inequalities in T2DM. We analysed mediating roles of low control beliefs and inferiority beliefs by using counterfactual mediation analysis. 8293 participants aged 40-75 living in Limburg, the Netherlands participated in The Maastricht Study starting from September 2010 to October 2020 and were followed up to 10 years with annual questionnaires with a median follow-up time of 7.18 years. SEP (education, income, occupation), control and inferiority beliefs, and (pre)diabetes by oral glucose tolerance test were measured at baseline. Incident T2DM was self-reported per annum. 3.2%(N = 203) of the participants without T2DM at baseline reported incident T2DM. People with low SEP had more often prevalent and incident T2DM (e.g., low education:HR=2.13, 95%CI:1.53-2.97). Lower control beliefs and higher inferiority beliefs were more common among people with low SEP than people with high SEP. Moreover, lower control beliefs and higher inferiority beliefs were risk factors for T2DM (e.g., low control beliefs: HR = 1.50, 95%CI:1.08-2.09). The relationship between SEP and T2DM was partially mediated by control beliefs (7.98-13.56%) and inferiority beliefs (2.16-4.53%). Poor psychosocial resources are important in socioeconomic inequalities in diabetes. Researchers and practitioners should consider the psychosocial profile of people with lower SEP might differ from those with higher SEP and this might interfere with the development, treatment, and prevention of T2DM. We should aim to work with such beliefs, instead of against it. Key messages • Socioeconomic health inequalities in diabetes has many underlying mechanism including psychosocial pathways. • Interventions and research should consider the different environment of low SEP and psychosocial profiles of people. We should aim to work with it, instead of against it.

Do poor psychosocial resources mediate health inequalities in type 2 diabetes mellitus? Findings from the Maastricht study.

Low socioeconomic position (SEP) has been identified as a risk factor for type 2 diabetes mellitus (T2DM), and psychosocial resources might be on the pathway in this association. We examined two poor psychosocial resources, low control beliefs and inferiority beliefs, that might link low SEP with T2DM. 8292 participants aged 40-75 living in Southern Netherlands participated in The Maastricht Study starting from September 2010 to October 2020 and were followed up to 10 years with annual questionnaires. SEP (education, income, occupation), low control beliefs, inferiority beliefs, and (pre)diabetes by oral glucose tolerance test were measured at baseline. Incident T2DM was self-reported per annum. We analysed the mediating roles of poor psychosocial resources by using counterfactual mediation analysis. People with low SEP had more often prevalent and incident T2DM (e.g. low education: HR = 2.13, 95%CI: 1.53-2.97). Low control beliefs and high inferiority beliefs were more common among people with low SEP. Moreover, low control beliefs and high inferiority beliefs were risk factors for T2DM (e.g. low control beliefs: HR = 1.50, 95%CI: 1.08-2.09). The relationship between SEP and T2DM was partially mediated by control beliefs (8.0-13.6%) and inferiority beliefs (2.2-4.5%). We conclude that poor psychosocial resources are important in socioeconomic inequalities in diabetes. Researchers and practitioners should consider the psychosocial profile of people with lower SEP, as such a profile might interfere with the development, treatment, and prevention of T2DM. Further research should explore how poor psychosocial resources interact with chronic stress in relation to socioeconomic health inequalities.

DECLINES IN CONTROL BELIEFS OVER TIME: THE ROLE OF PERCEIVED DISCRIMINATION AND INEQUALITY

Abstract Higher control beliefs represent a key protective factor for healthy aging, broadly defined. If the benefits of control beliefs are well documented, fewer studies have focused on the antecedents of changes in control. There is empirical evidence that social stress, such as being treated unfairly or discriminated against, may erode personal control. The goal of this study was to examine perceived discrimination and inequality in relation to long-term change in control beliefs, in a national sample, using data from the Midlife in the United States (MIDUS) longitudinal study (Waves II and III, N = 2540, MIDUS II age range: 30-84, Mean=55.53, SD=11.21). Perceived discrimination was quantified as the sum of 9 items capturing experiences of daily discrimination. Perceived inequality was measured in three settings: work, family (relationship with children), and home. Both mastery and perceived constraints were used as indicators of control beliefs. The results revealed a significant decline in control between the two waves. Controlling for age, gender, education, self-rated physical health, and baseline control beliefs, higher daily discrimination and perceived inequality were significantly associated with lower control beliefs, 8 to 10 years later. There were not significant interactions with age and the patterns of results persisted when other relevant factors, such as cognitive performance and physical activity, were considered. The findings suggest that interventional programs should target (sources of) perceived discrimination and inequality and that changes in control beliefs could be considered a potential mechanism of the association between social stress and trajectories of healthy aging.

Awareness of Aging Mediates the Relationship Between Health and Control Beliefs: A Micro-Longitudinal Study

Objective: Control beliefs are bidirectionally related to physical and cognitive health, but it is unclear how health influences control beliefs. Health-related experiences (physical symptoms and memory failures) on a particular day can make older adults more aware of their aging, and may subsequently lead to lower control beliefs. We propose that awareness of aging constructs (subjective age and awareness of age-related change [AARC]) could function as mediating mechanisms between health and control beliefs, and examine this relationship from both between- and within-person perspectives separately for domain-general and domain-specific control beliefs. Methods: Older adults (n=116) ranging in age from 60 to 90 (M=64.71) completed a nine-day daily diary study online, resulting in 743 total days. Participants reported their physical symptoms, memory failures, felt age, daily AARC gain and loss experiences, and control beliefs on Days 2-9. Results: Multilevel mediation results showed that between-person AARC losses mediated the relationship between physical symptoms and both domain-general and domain-specific control over physical symptoms. Between-person AARC losses also mediated the relationship between memory failures and both domain-general and domain-specific control over memory. AARC gains and subjective age did not mediate the relationship between health and control beliefs. Discussion: Our findings suggest that between-person differences in AARC losses function as underlying mechanisms linking health and control beliefs. Efforts to reduce AARC losses may lessen the negative impact of health problems on control beliefs for older adults.

Control diversity: How across-domain control beliefs are associated with daily negative affect and differ with age.

Domain-specific control beliefs typically buffer the influence stressors have on people's negative affect (affective stressor reactivity). However, little is known about the extent to which individuals' control beliefs vary across stressor types and whether such stressor-related control diversity is adaptive for affective well-being. We thus introduce a control diversity construct (a person-level summary of across-domain control beliefs) and examine how control diversity differs with age and relates to negative affect and affective stressor reactivity. We apply a multilevel model to daily diary data from the National Study of Daily Experiences (NSDE; N = 2,022; mean age = 56 years; 33-84; 57% women). Our findings indicate that above and beyond average control beliefs, people whose control is spread over fewer stressor domains (less control diversity) have lower negative affect and less affective stressor reactivity. Older adults are more likely than younger adults to have their control beliefs concentrated in one domain. Additionally, associations between control diversity and negative affect and affective stressor reactivity were age invariant. Moderation effects indicated that when people with low average control beliefs are faced with stressors, having control beliefs focused on fewer domains rather than spread broadly across many domains is associated with less negative affect. Our findings suggest that control diversity provides unique insights into how control beliefs differ across adulthood and contribute to affective well-being. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

What is the evidence that differences in ‘control over destiny’ lead to socioeconomic inequalities in health? A theory-led systematic review of high-quality longitudinal studies on pathways in the living environment

BackgroundLow control and high demand in the places where people work has been shown to partially explain why those in lower socioeconomic positions experience poorer health than their counterparts in...

Control beliefs and susceptibility to the promises of memory improvement

SummaryBrain training is increasingly popular, and many believe in the efficacy of such programs without empirical evidence. We examined whether instructions promising memory improvement would influence subjective and objective cognition. Participants (n = 145; age: M = 50.64) were randomly assigned to a memory improvement or memory task condition. Participants completed demographic and perceived control over cognition measures, in addition to cognitive tasks and subjective cognition items for 7 days. Participants in the improvement condition reported significantly greater memory increases than those in the memory task condition. This effect was moderated by perceived control over cognition; participants in the improvement condition with high control beliefs were significantly more likely than those with low control beliefs or those in the task condition to report better memory. Individuals with higher control beliefs may be more susceptible to the claims of brain training programs, which is significant given that such programs are increasingly popular and commercially available.

Posttraumatic stress disorder symptom severity and control beliefs as the predictors of academic burnout amongst adolescents following the Wenchuan Earthquake

ABSTRACTBackground: Previous studies indicate that posttraumatic stress disorder (PTSD) and control beliefs can affect burnout and their unique role in this situation has been examined, but fewer studies have examined their combined role in adolescent’s academic burnout following traumatic events.Objective: This study examined the combined effect of PTSD symptom severity and control beliefs on academic burnout among adolescents, and assessed the moderating role of primary and secondary control beliefs in the relation between PTSD symptom severity and academic burnout.Methods: Seven hundred and forty-five adolescents were investigated using self-report questionnaires, and a series of regression equations examined the impact of PTSD severity and control beliefs on academic burnout.Results: PTSD symptom severity is associated positively with academic burnout, while primary and secondary control beliefs have a negative relation with academic burnout. In addition, primary control beliefs buffer the positive effects of PTSD symptom severity on academic burnout. We found that the positive relation between PTSD symptom severity and academic burnout in the low primary control beliefs group is more intense than that found in the high primary control beliefs group.Conclusions: PTSD symptom severity is a risk factor, whereas primary and secondary control beliefs are protective factors in academic burnout. In addition, PTSD symptom severity and primary control beliefs have a combined effect on academic burnout in adolescents following natural disasters.

The Relationships of Health Behaviour and Psychological Characteristics with Spontaneous Preterm Birth in Nulliparous Women

Objectives Preterm birth is the leading pregnancy outcome associated with perinatal morbidity and mortality and remains difficult to prevent. There is evidence that some modifiable maternal health characteristics may influence the risk of preterm birth. Our aim was to investigate the relationships of self-reported maternal health behaviour and psychological characteristics in nulliparous women with spontaneous preterm birth in prenatal primary care. Methods The data of our prospective study was obtained from the nationwide DELIVER multicentre cohort study (September 2009–March 2011), which was designed to examine perinatal primary care in the Netherlands. In our study, consisting of 2768 nulliparous women, we estimated the relationships of various self-reported health behaviours (smoking, alcohol consumption, folic acid supplementation, daily fruit, daily fresh vegetables, daily hot meal and daily breakfast consumption) and psychological characteristics (anxious/depressed mood and health control beliefs) with spontaneous preterm birth as a dichotomous outcome. Due to the clustering of clients within midwife practices, Generalized Estimating Equations was used for these analyses. Results Low health control beliefs was the sole characteristic significantly associated with spontaneous preterm birth (odds ratio 2.26; 95 % confidence interval 1.51, 3.39) after being adjusted for socio-demographics, anthropometrics and the remaining health behaviour and psychological characteristics. The other characteristics were not significantly associated with spontaneous preterm birth. Conclusions for Practice Maternal low health control beliefs need to be explored further as a possible marker for women at risk for preterm birth, and as a potentially modifiable characteristic to be used in interventions which are designed to reduce the risk of spontaneous preterm birth.

Enhancing the academic success of competitive student athletes using a motivation treatment intervention (Attributional Retraining)

Competitive student athletes who experience the typical challenges inherent in high school-to-university transitions must also overcome sport-related difficulties which can undermine their academic motivation and class attendance due to competitions, fatigue, injuries, identity issues, and novel training environments (MacNamara & Collins, 2010; Simons et al., 1999). In an eight-month quasi-experimental, randomized treatment field study, an attribution-based motivation treatment (Attributional Retraining: AR) was administered to student athletes (n = 185) and non-athletes (n = 281) who differed in perceived control beliefs (±1 SD) in a two-semester, online course. Simple slope regression analyses revealed the AR (vs. no-AR) treatment assisted competitive student athletes who had low control beliefs by increasing perceived success in the course (b = 0.84, p = 0.038), post-treatment test performance (b = 11.68, p = 0.001), year-end course grades (b = 6.32, p = 0.017), and by reducing course withdrawals (b = −1.00, p = 0.034, OR = 0.37). These results demonstrate the benefits of an attribution-based motivation treatment for vulnerable student-athletes in terms of perceived course success, performance, and persistence in making the transition from high school to college.

Socio-demographic inequalities across a range of health status indicators and health behaviours among pregnant women in prenatal primary care: a cross-sectional study

BackgroundSuboptimal maternal health conditions (such as obesity, underweight, depression and stress) and health behaviours (such as smoking, alcohol consumption and unhealthy nutrition) during pregnancy have been associated with negative pregnancy outcomes. Our first aim was to give an overview of the self-reported health status and health behaviours of pregnant women under midwife-led primary care in the Netherlands. Our second aim was to identify potential differences in these health status indicators and behaviours according to educational level (as a proxy for socio-economic status) and ethnicity (as a proxy for immigration status).MethodsOur cross-sectional study (data obtained from the DELIVER multicentre prospective cohort study conducted from September 2009 to March 2011) was based on questionnaires about maternal health and prenatal care, which were completed by 6711 pregnant women. The relationships of education and ethnicity with 13 health status indicators and 10 health behaviours during pregnancy were examined using multilevel multiple logistic regression analyses, adjusted for age, parity, number of weeks pregnant and either education or ethnicity.ResultsLower educated women were especially more likely to smoke (Odds Ratio (OR) 11.3; 95 % confidence interval (CI) 7.6– 16.8); have passive smoking exposure (OR 6.9; 95 % CI 4.4–11.0); have low health control beliefs (OR 10.4; 95 % CI 8.5–12.8); not attend antenatal classes (OR 4.5; 95 % CI 3.5–5.8) and not take folic acid supplementation (OR 3.4; 95 % CI 2.7–4.4). They were also somewhat more likely to skip breakfast daily, be obese, underweight and depressed or anxious. Non-western women were especially more likely not to take folic acid supplementation (OR 4.5; 95 % CI 3.5–5.7); have low health control beliefs (OR 4.1; 95 % CI 3.1–5.2) and not to attend antenatal classes (OR 3.3; 95 % CI 2.0–5.4). They were also somewhat more likely to have nausea, back pains and passive smoking exposure.ConclusionsSubstantial socio-demographic inequalities persist with respect to many health-related issues in medically low risk pregnancies in the Netherlands. Improved strategies are needed to address the specific needs of socio-demographic groups at higher risk and the structures underlying social inequalities in pregnant women.

Control beliefs level and change as predictors of subjective memory complaints

Objective: Low control beliefs (CB) are related to objective cognitive functions, but the link between CB and subjective memory complaints (SMC) is unclear. The aim of this study was to investigate the associations between CB (level and change) and SMC over a 10-year span.Methods: The study utilized a large national sample of participants (N = 3272, M = 56.52, SD = 11.84) from the Midlife in the US Study (MIDUS) to examine if both level (mean of Time 1 and Time 2) and change (Time 2 minus Time 1) of CB (personal mastery and perceived constraints) longitudinally predict SMC.Result: Both the level of personal mastery and perceived constraints predicted SMC. Long-term changes in perceived constraints, but not in personal mastery, also predicted SMC. No age difference was found for the effects of CB (age × CB) on SMC.Conclusion: The findings support the notion that the risk of SMC is related to low CB, and full consideration of CB level and change is needed for intervention development to combat memory loss.

Self-esteem is relatively stable late in life: the role of resources in the health, self-regulation, and social domains.

A large body of research has documented changes in self-esteem across adulthood and individual-difference correlates thereof. However, little is known about whether people maintain their self-esteem until the end of life and what role key risk factors in the health, cognitive, self-regulatory, and social domains play. To examine these questions, we apply growth modeling to 13-year longitudinal data obtained from by now deceased participants of the Berlin Aging Study (N = 462; age 70-103, M = 86.3 years, SD = 8.3; 51% male). Results revealed that self-esteem, on average, does decline in very old age and close to death, but the amount of typical decline is minor. Health-related constraints and disabilities as well as lower control beliefs and higher loneliness were each associated with lower self-esteem late in life. We obtained initial evidence that some of these associations were stronger among the oldest-old participants. Our results corroborate and extend initial reports that self-esteem is, on average, fairly stable into the last years of life. We discuss possible pathways by which common and often severe late-life challenges may undermine an otherwise relatively robust self-esteem system.

Low control beliefs in relation to school dropout and poor health: findings from the SIODO case-control study.

BackgroundThere is cumulating evidence that health is compromised through adverse socioeconomic conditions negatively affecting how people think, feel, and behave. Low control beliefs might be a key mechanism. The reversed possibility that low control beliefs might set people on a pathway towards adverse socioeconomic and health-related outcomes is much less examined.MethodsA case–control design was used, consisting of 330 cases who dropped out of school in the 2010–2011 school year and 330 controls who still attended school at the end of that year. The respondents, aged between 18 and 23, came from Eindhoven and surrounding areas in the south-east of The Netherlands. A questionnaire asked for current health status, recalled socioeconomic and social background, and recalled control beliefs (mastery and general self-efficacy). Logistic regression analyses were used.ResultsRecalls of low mastery and low self-efficacy were strongly related to both dropout and less than good health. Low socioeconomic background was also associated to odds of dropout, but did not confound or moderate the associations of low control beliefs with dropout and health. Odds ratios of dropout and less than good health indicated at least twice the odds of a poor outcome with recalls of low control beliefs.ConclusionsIndependent of the socioeconomic background, low control beliefs are related to heightened odds of both poor health and school dropout. Individual differences in control beliefs might thus be as fundamental as socioeconomic conditions in generating life-course socioeconomic and health-related pathways. Although the findings should first be cross-validated in prospective studies, public health professionals working with youth might already start considering early interventions in youth with all too fatalistic and powerless mind-sets.

Does a relationship with a financial service professional overcome a client’s sense of not being in control of achieving their goals?


 
 
 Although considerable evidence suggests that setting goals increases the odds of behavior changes that lead to goal attainment, less research has been conducted examining what underlying traits allow some to successfully attain their goals when others do not. This study, using the Theory of Planned Behavior, examines the affects of individual control beliefs on financial goal progress. Findings suggest that low control beliefs are significantly associated with less financial-goal progress; however, the receipt of expert financial advice can reduce this negative effect and result in higher levels of goal progress than that of individuals with high control beliefs.
 
 

Cortisol response to challenge involving low controllability: The role of control beliefs and age

Cortisol responses are typically more pronounced under low controllability conditions, yet little is known about the role of individual differences. This study examined whether cortisol response to a situation with low controllability differs as a function of preexisting control beliefs and age. We manipulated level of controllability using a driving simulator. Control beliefs were assessed prior to the lab session. Salivary cortisol was measured before and after the driving simulation. Participants were 152 adults aged 22–84 from a Boston area sample. In comparison to the normal controllability condition, those in the low controllability condition reported less perceived control over driving, supporting the effectiveness of the manipulation. In the low controllability condition those with higher control beliefs showed a greater cortisol response than those with low control beliefs. Older adults showed a greater cortisol response than younger adults during the challenge. Implications of acute cortisol responses for performance outcomes are discussed.

Preliminary evidence for relations between motivation and beliefs related to exercise dependence

Individuals engage in physical activity for a variety of reasons which are described by motivational determinants of behaviour. However, very little is known about the motivational antecedents of excessive exercise and exercise dependence. This study aimed to investigate the relationships between various motivating factors and specific beliefs characteristic for exercise dependence. Data were collected from a cross-sectional survey in a sample of volunteer recreational athletes (31 males aged 19–23 years and 54 females aged 18–34 years). Participants completed three questionnaires: Estonian 2 × 2 Achievement Goals in Sport Questionnaire was used to measure tendency to emphasize mastery and performance goals; Modified Estonian Exercise Motivation Questionnaire-2 to measure specific exercise motives; and an original Exercise Belief Scale was designed to estimate behavioural and control beliefs characteristic for exercise dependence. Results indicated that motivational orientation was a significant predictor of beliefs related to exercise dependence. Specifically, multiple regression analysis showed that perceived importance of exercise was significantly predicted by mastery approach and performance approach goals. Withdrawal effects, a hallmark for exercise dependence, could be predicted by mastery approach goals and competitive motive. Low control beliefs indicative for exercise tolerance appeared to be related with performance approach goals and competition motive. However, mastery approach also significantly predicted intentional avoidance of overtraining. Results suggest that beliefs related to exercise dependence are strongly related to various motivational aspects. Further investigation is needed to develop psychological assessment instruments to differentiate between normal and healthy exercise motivation and markers of overtraining and exercise dependence potential.

Life satisfaction and feeling in control: Indicators of successful aging predict mortality in old age

Life satisfaction and control beliefs are established indicators of successful aging and predict mortality. However, it has not yet been examined whether they independently predict mortality or interact. We examined main and interaction effects using Cox proportional hazards models in a sample of older adults (N = 1402; age range: 65-91). Only the interaction of life satisfaction and control beliefs significantly predicted mortality when controlling for socio-demographic variables and health. These findings suggest that detrimental effects of low control beliefs can be buffered by life satisfaction, and unexpectedly, that high levels of both factors are not most protective against mortality.

Quiet-eye training, perceived control and performing under pressure

ObjectivesWhile previous studies have explored how quiet-eye (QE) training optimizes objective (visual attention) control in aiming tasks, this study examined whether QE training influences perceived (psychological) control and how changes in control beliefs correspond to changes in anxiety, visual attention and performance under pressure. MethodsTwo groups of ten experienced soccer penalty takers followed either a QE training program or a practice program where penalty kicks were practiced with no instruction. Measurements of anxiety, gaze, performance and perceived control were recorded over baseline, retention and a competitive, ‘shoot-out’ transfer condition. ResultsNot only did the QE training optimize aiming behavior and performance, but these changes in visual attention were mirrored in changes in control beliefs. QE participants significantly reduced their perceptions of outcome uncertainty (contingency) and increased their perceptions of shooting ability (competence) and ability to score and cope with the pressure (control), compared to practice participants. Furthermore, there was an overall and significant relationship between high perceptions of control beliefs and aiming behavior. Specifically, those participants with high control beliefs were more likely to aim optimally and further from the goalkeeper, whereas participants with low control beliefs experienced suboptimal and more centralized aiming behavior. ConclusionThese findings are the first to highlight the relationship between control beliefs, anxiety and attentional control in sport and offer further explanations regarding the benefits of QE training for performance under pressure.

The relationship between cognitive function and life space: The potential role of personal control beliefs.

We examined the relationship of cognitive and functional measures with life space (a measure of spatial mobility examining extent of movement within a person's environment) in older adults, and investigated the potential moderating role of personal control beliefs. Internal control beliefs reflect feelings of competence and personal agency, while attributions of external control imply a more dependent or passive point of view. Participants were 2,737 adults from the ACTIVE study, with a mean age of 74 years. Females comprised 76% of the sample, with good minority representation (27% African American). In multiple regression models controlling for demographic factors, cognitive domains of memory, reasoning, and processing speed were significantly associated with life space (p < .001 for each), and reasoning ability appeared most predictive (B = .117). Measures of everyday function also showed significant associations with life space, independent from the traditional cognitive measures. Interactions between cognitive function and control beliefs were tested, and external control beliefs moderated the relationship between memory and life space, with the combination of high objective memory and low external control beliefs yielding the highest life space (t = -2.07; p = .039). In conclusion, older adults with better cognitive function have a larger overall life space. Performance-based measures of everyday function may also be useful in assessing the functional outcome of life space. Additionally, subjective external control beliefs may moderate the relationship between objective cognitive function and life space. Future studies examining the relationships between these factors longitudinally appear worthwhile to further elucidate the interrelationships of cognitive function, control beliefs, and life space.