Low Personal Control Research Articles

Moderators of occupational pressure in female health professionals—Individual differences and coping skills

Individual differences and coping skills have influential impacts on stress process by influencing the eventual outcomes of the stressors, contributing to either wellbeing, or illness and negative experiences. The aim of this paper is to explore the individual differences and coping strategies of a cohort of women with health professionals’ occupational pressure. This is a cross-sectional survey, informed by the transactional model of stress and coping framework, and carried out on women health professionals (n = 203) from the Kuala Lumpur Hospital. Multiple regressions were conducted to examine the potential moderators of stress. Women Health Professionals reported stress with six out of eight organizational sources of pressure, with relationship being a key stressor. Their individual differences (mean + SD) were characterised by low drive (7.6 + 1.9-8.2 + 2.0), low personal influence (10.8 + 2.0 to 11.7 + 2.3), moderate control (13.4 + 3.4 to 16.3 + 2.4), and high impatience behaviour (19.1 + 3.8 to 20.4 + 3.3). With Coping strategy, the Life-work-balance coping is a significant positive predictor for five out of the nine outcomes of occupational pressure [state of mind (p < 0.001), level of resilience (p = 0.01), level of confidence (p = 0.003), physical symptoms (p = 0.001) and energy level (p < 0.001)]. The findings show relationship as a key stressor, with a less favourable pattern of individual-differences and an over-reliance on lifework balance coping. Female health professionals, stressed at work, have an undesirable profile of individual difference and a coping strategies, suggestive of attempts to balance the demands of their dual work role. The increasing female into the workforce, warrants more research to inform stress management guideline to ameliorate stress amongst those vulnerable workers. Future studies to examine individual differences of these female-dominated professions across health setting are needed to better inform the pressure-at-work issues for the increasing Asian women health professionals.

Illness perception and quality of life in patients with contact dermatitis

People's subjective perceptions of illness are important determinants of their ways of coping with health threats and the ensuing physical and mental outcomes, including quality of life (QoL), which has been consistently reported to be impaired by contact dermatitis. To investigate the relationships of subjective illness perceptions and dermatological QoL in atopic, contact and occupational dermatitis patients and a comparison group of patients with other dermatological diseases. Three hundred and three patients of four diagnostic groups filled in the Brief Illness Perception Questionnaire and the Skindex-16 (+ occupational impact items) Dermatological QoL questionnaire before clinical examination and patch testing. Perceptions of serious consequences, greater symptom burden and more uncertainty and worry were associated with lower QoL (r(s) > 0.50). Overall, patients reported low personal control over their condition and low understanding of the disease (3.5 and 4.8, respectively, on a 0-10 scale). QoL was most impaired among occupational dermatitis patients (mean = 46) and least impaired among patients who were later diagnosed as suffering from conditions other than contact dermatitis (mean = 62). Identifying critical components of illness perceptions in patients with atopic, contact and occupational dermatitis may enable the design of consultations and interventions to fit patients' perceptions, which could affect their QoL.

On Social Stability and Social Change

More than a decade of research from the perspective of system-justification theory (Jost & Banaji, 1994) has demonstrated that people engage in motivated psychological processes that bolster and support the status quo. We propose that this motive is highly contextual: People do not justify their social systems at all times but are more likely to do so under certain circumstances. We describe four contexts in which people are prone to engage in system-justifying processes: (a) system threat, (b) system dependence, (c) system inescapability, and (d) low personal control. We describe how and why, in these contexts, people who wish to promote social change might expect resistance.

Illness representations and concurrent depression symptoms in haemodialysis patients

We examined the association between illness perceptions and depression symptoms in established haemodialysis patients (HD). Two hundred and fifteen patients completed the Revised Illness Perception Questionnaire and the Beck Depression Inventory-II (BDI). Patients with a BDI ≥ 16 were termed as 'depressed'. Lower personal control and illness coherence, and greater perceived consequences were all related to depression significantly increasing the explained variance over clinical factors. Our findings suggest it is not disease characteristics or co-morbidity per se that is related to mood symptoms in HD patients, rather the apparent interpretation and regulation of the illness.

Do illness perceptions predict pain-related disability and mood in chronic orofacial pain patients? A 6-month follow-up study

In our study, we investigated the predictive value of illness beliefs as measured by the revised illness perception questionnaire (IPQ-R) in the context of other clinical predictors in patients with chronic orofacial pain over a 6-month follow-up period. Consecutive patients (152) referred to the interdisciplinary orofacial pain service at the Centre for Dental and Oral Medicine and Cranio-Maxillofacial Surgery, University of Zurich received questionnaires to assess pain and pain-related disability, anxiety, depression as well as physical and mental quality of life at three time points: prior to treatment, 3 and 6 months after beginning of treatment. Results: significant improvement was found over time for all outcome measures except mental quality of life. Results of the regression analysis indicated that believing pain could have serious consequences on one’s life (IPQ subscale consequences) is one of the most important predictors for treatment outcome. The belief in low personal control and in a chronic timeline is also shown to be predictive for outcome, though explaining a smaller proportion of variance. These results provided evidence that beliefs about pain are important predictors for treatment outcome even when controlled for pain and mood. They therefore need to be considered in the management of patients with chronic orofacial pain. Assessing patients’ illness beliefs can provide essential information on these important psychological determinants of adjustment to chronic pain and may be specific targets for individualised treatment approaches.

When Rejection Sensitivity Matters: Regulating Dependence Within Daily Interactions With Family and Friends

This diary study examined situational dependence within daily interactions with family members and close friends over a 2-week period. Experiencing low personal control (high situational dependence) when interacting with family members and friends was associated with lower perceived regard and intimacy. Participants generally regulated felt dependence by derogating and withdrawing from their interaction partner (self-protective dependence regulation) and exhibiting lower levels of positive behavior, such as expressing thoughts and feelings or trying to improve the interaction (relationship-promotive dependence regulation). Furthermore, higher rejection sensitivity (but not low self-esteem) was associated with more negative evaluations of perceived regard and intimacy, greater self-protective dependence regulation, and lower relationship-promotive dependence regulation within low control interactions. These results identify dependence as a key element of rejection risk contexts and support the situation-specific nature of rejection sensitivity.

Attachment and dependence regulation within daily interactions with romantic partners

AbstractFor 2 weeks, 74 New Zealand undergraduate students recorded their reactions to two components of situational dependence during interactions with their romantic partner: low personal control and high partner impact. Lower personal control predicted lower perceived regard and intimacy, greater partner derogation and withdrawal (self‐protective dependence regulation), and reduced attempts to improve interaction quality (relationship‐promotive dependence regulation). Participants also reported greater self‐protective dependence regulation the more their partner was impacting on their thoughts, feelings, and behaviors. As expected, more anxious individuals reported higher drops in perceived regard and greater self‐protective dependence regulation when experiencing lower control, whereas more avoidant individuals reported lower regard and reduced relationship‐promotive behavior when experiencing stronger partner impact. The links between attachment and dependence are discussed.

Degree and correlates of cardiac knowledge and awareness among cardiac inpatients

Objective To investigate the degree of CHD awareness as well as symptom, risk factor, and treatment knowledge in a broad sample of cardiac inpatients, and to examine its sociodemographic, clinical and psychosocial correlates. Methods 1308 CHD inpatients (351 [27.0%] female), recruited from 11 acute care sites in Ontario, participated in this cross-sectional study. Participants were provided with a survey which included a knowledge questionnaire among other measures, and clinical data were extracted from medical charts. Results 855 (68.8%) respondents cited heart disease as the leading cause of death in men, versus only 458 (37.0%) in women. Participants with less than high school education ( p < .001), an annual family income less than $50,000CAD ( p = .022), low functional capacity ( p = .042), who were currently smoking ( p = .022), who had no family history of heart disease ( p < .001), and who had a perception of low personal control ( p = .033) had significantly lower CHD knowledge. Conclusions Awareness of CHD is not optimal, especially among women, South Asians, and those of low socioeconomic status. CHD patients have a moderate level of disease knowledge overall, but greater education is needed. Practice implications Tailored educational approaches may be necessary for those of low socioeconomic status, particularly with regard to the nature of CHD, tests and treatments.

Clinical course and prognosis of hand and wrist problems in primary care

To describe the course of a new episode of hand and wrist problems in general practice and to identify predictors that are associated with poor outcome at short-term and long-term followup. Patients consulting their general practitioner with hand or wrist problems (no prior consultation in the preceding 3 months) were sent a questionnaire at baseline and at 3, 6, and 12 months of followup. Potential predictors included sociodemographic variables, characteristics of the symptoms, physical activity, and psychosocial factors. General practitioners recorded information on symptoms, signs, and medical diagnosis. The main outcome measure was insufficient improvement of symptoms using the Symptom Severity Scale at short-term (3 months) and long-term (12 months) followup. Twenty-three percent of patients reported complete recovery after 3 months, increasing to 42% at 1 year after first presentation. Higher probability of poor outcome at 3 months was associated with being female, low pain intensity at baseline, and lower personal control at baseline; at 12 months it was associated with older age, being female, reporting symptoms for >3 months at baseline, low scores on the coping strategy "reducing demands," and a higher score on somatization. Discriminative ability of the models was moderate, with areas under the curve after bootstrapping of 0.60 and 0.69 at 3 and 12 months, respectively. More than half of all patients reported residual symptoms at 1 year. Although poor outcome was difficult to predict, age, sex, duration of symptoms, and psychosocial factors were associated with poor outcome of hand and wrist problems.

Illness perceptions in dialysis patients and their association with quality of life

The present study explored illness perceptions of end stage renal disease (ESRD) patients on both haemodialysis (HD) and peritoneal dialysis (PD) treatment, and their associations with quality of life. Leventhal's self-regulation model (SRM) was used as a theoretical framework. Illness perceptions and quality of life were assessed with the IPQ-R and the SF-36 in 91 HD and 42 PD patients participating in the NECOSAD-study. Compared to HD patients, PD patients experienced more personal control and had a better understanding of the illness. Illness perceptions explained from 17 to 51% of the variance in quality of life scores. Perception of more symptoms, more consequences and lower personal control were associated with lower well-being. The concept of illness perceptions is useful in understanding the impact of ESRD and of dialysis treatment on quality of life. Interventions aimed at providing more knowledge about ESRD and dialysis, and provision of skills to coping with the illness and its consequences may improve quality of life in dialysis patients.

Nurses’ knowledge of pain

The aim of this study was to establish if postregistration education and clinical experience influence nurses' knowledge of pain. Inadequacies in the pain management process may not be tied to myth and bias originating from general attitudes and beliefs, but reflect inadequate pain knowledge. Design. A pain knowledge survey of 20 true/false statements was used to measure the knowledge base of two groups of nurses. This was incorporated in a self-administered questionnaire that also addressed lifestyle factors of patients in pain, inferences of physical pain, general attitudes and beliefs about pain management. One hundred questionnaires were distributed; 86 nurses returned the questionnaire giving a response rate of 86%. Following selection of the sample, 72 nurses participated in the study: 35 hospice/oncology nurses (specialist) and 37 district nurses (general). Data were analysed using SPSS. The specialist nurses had a more comprehensive knowledge base than the general nurses; however, their knowledge scores did not appear to be related to their experience in terms of years within the nursing profession. Whilst educational programmes contribute to an increase in knowledge, it would appear that the working environment has an influence on the development and use of this knowledge. It is suggested that the clinical environment in which the specialist nurse works can induce feelings of reduced self-efficacy and low personal control. To ease tension, strategies are used that can result in nurses refusing to endorse their knowledge, which can increase patients' pain. Clinical supervision will serve to increase the nurses' self-awareness; however, without power and autonomy to make decisions and affect change, feelings of helplessness, reduced self-efficacy and cognitive dissonance can increase. This may explain why, despite educational efforts to increase knowledge, a concomitant change in practice has not occurred.

Reports of Abusive Experiences During Childhood and Adult Health Ratings

This study examines the relationship between reports of childhood abuse and self-rated health in adulthood, and the potential of personal control to serve as a mediator. Regression models were estimated using data from the National Survey of Midlife Development in the United States (MIDUS). Reported emotional abuse was associated with lower personal control. In addition, women who reported emotional abuse by mother or both parents were more likely than women who were not abused to report lower self-rated health. The relationship between emotional abuse by both parents and self-rated health was mediated by personal control. The findings suggest that there are long-term health consequences of early childhood abuse. The effects of childhood abusive experiences, however, operate differently for men and women and are dependent on the outcome examined. Childhood abuse compromises personal control that, in turn, leads to lower health ratings.

Public perception of scientific uncertainty in relation to food hazards

The research reported here aims to understand how people react to statements expressing risk uncertainty information in the context of a commonly experienced potential hazard, food related risks. Public perception of seriousness of risk for themselves, and for other people was examined for different types of uncertainty, for each of five different food hazards. The results indicated that participants responded to the different types of uncertainty in a uniform way, suggesting that perception of risk associated with uncertainty is not affected by the 'type' of uncertainty. The results further indicated that the seriousness of risk, in the presence of statements of uncertainty, was perceived to be greater for pesticides and genetic modification compared to BSE, high fat diets and Salmonella . It was argued that this could be due to the perceptions of low personal control, and high societal responsibility to protect people and societal control over exposure to the potential risks of pesticides and genetic modification. Under circumstances where people feel they have little personal control over their exposure to a particular hazard, and those social institutions that are perceived to be in control of protecting the public indicate that there is uncertainty associated with risk estimates, the hazard may appear to be 'out of control', which is associated with a perception of serious risk.

Envy, Resentment, Schadenfreude, and Sympathy: Reactions to Deserved and Undeserved Achievement and Subsequent Failure

This study tested the hypothesis that schadenfreude (or pleasure in another's misfortune) would be more closely related to resentment and a wish to correct a perceived injustice than to envy, and that sympathy would involve different processes. Participants were 184 undergraduates who responded to scenarios in which a student with a record of either high or average achievement that followed high or low effort subsequently suffered failure under conditions where there was either high or low personal control. Results showed that resentment about the student's prior achievement could be distinguished from envy. Schadenfreude about the student's subsequent failure was predicted by resentment and not by envy. Sympathy was not predicted by either resentment or envy. Deservingness was a key variable in the models that were tested.

Women's Work, Men's Work, and the Sense of Control

This article examines gender differences in four dimensions of work alienation—routine, nonautonomous, estranged, and isolated work—and the ways in which work alienation shapes subjective alienation, measured as the sense of powerlessness versus control. It is expected that women's work is more objectively alienating than men's, that these work characteristics shape people's sense of personal control, and that work characteristics explain the effect of employment status, especially homemaker status and part-time employment, on perceived control. These propositions are examined in a 1995 U.S. national telephone probability sample with 2,592 respondents. Nonroutine work, including task variety and problem solving; autonomous work, including decision-making autonomy and freedom from supervision; fulfilling work; and nonisolated work all significantly positively affect the sense of personal control. Women's disproportionate representation in homemaking and part-time work explains women's low personal control. Compared to full-time employees, part-time workers have a lower sense of control because their work is more routine, less enjoyable, and less autonomous. Compared to full-time employees, homemakers have a lower sense of control because their work is more routine, less enjoyable, and more isolated. However, homemakers report more autonomy than paid workers, and female paid workers report less isolated work than their male counterparts.

Learned helplessness and cocaine dependence: an investigation.

Low personal control and a sense of meaninglessness of life, attributes associated with a pattern of human learned helplessness, have also been described as contributing to the onset of adolescent drug use, as well as the maintenance of chronic substance abuse. However, despite its intuitive appeal as an etiologic factor, the absence of psychometrically sound and easily administered measures of learned helplessness has limited the ability of researchers to empirically test its role in the addiction process. Accordingly, the publication by Quinless and Nelson (1988) of a relatively brief Learned Helplessness Scale (LHS) led us to administer it to a sample of 30 consecutive cocaine dependent individuals seeking treatment for the first time at our facility. Our results indicated that the LHS was internally consistent when administered to this clinical sample and that theoretically meaningful and statistically significant relationships with other measures of psychological functioning were observed. Moreover, scores on the LHS were related to treatment retention/outcome.

When mom or dad has cancer: II. Coping, cognitive appraisals, and psychological distress in children of cancer patients.

Cognitive appraisals and coping were examined in children, adolescents, and young adults (N = 134) faced with the diagnosis of cancer in a parent. All 3 age groups perceived low personal control and high external control over their parent's illness and used relatively little problem-focused coping. Adolescents and young adults reported more emotion-focused coping and dual-focused coping (both problem- and emotion-focused in intent) than did preadolescent children. Stage and prognosis of parent's cancer were related to appraisals of greater seriousness and stressfulness, and to more avoidance; however, only appraisals of stress were related to symptoms of anxiety-depression. Emotion-focused coping was related to greater avoidance and to higher symptoms of anxiety-depression; coping and control beliefs did not interact in their association with anxiety-depression symptoms.

When mom or dad has cancer: II. Coping, cognitive appraisals, and psychological distress in children of cancer patients.

Cognitive appraisals and coping were examined in children, adolescents, and young adults (N = 134) faced with the diagnosis of cancer in a parent. All 3 age groups perceived low personal control and high external control over their parent's illness and used relatively little problem-focused coping. Adolescents and young adults reported more emotion-focused coping and dual-focused coping (both problem- and emotion-focused in intent) than did preadolescent children. Stage and prognosis of parent's cancer were related to appraisals of greater seriousness and stressfulness, and to more avoidance; however, only appraisals of stress were related to symptoms of anxiety-depression. Emotion-focused coping was related to greater avoidance and to higher symptoms of anxiety-depression; coping and control beliefs did not interact in their association with anxiety-depression symptoms.

Perfectionism, control, and components of performance anxiety in professional artists

The present study tested the hypothesis that perfectionism and personal control are associated with debilitating and facilitating performance anxiety among professional performers. A related goal was to examine how the personality variables were related to indices of performance evaluation and goal satisfaction. A sample of 87 professional performers completed the Multidimensional Perfectionism Scale, a measure of personal control, and a measure of debilitating and facilitating performance anxiety. Subjects also provided ratings of somatic performance anxiety, happiness while performing, performance evaluation, and goal satisfaction. The results showed that self-oriented perfectionism, socially prescribed perfectionism, and low personal control were associated with greater debilitating performance anxiety, somatic anxiety, and less goal satisfaction. In addition, hierarchical regression analyses indicated that higher debilitating anxiety and lower facilitating anxiety were a joint function of high self-oriented perfectionism and low personal control. Similarly, it was found that low goal satisfaction was associated jointly with high self-oriented perfectionism and low personal control. The results provide general support for self-regulation models and attest to the importance of perfectionism and personal control as joint contributors to the quality of performance anxiety and goal satisfaction

Age and Depression

In this study, the relationship between age and depression is analyzed, looking for effects of maturity, decline, life-cycle stage, survival, and historical trend. The data are from a 1990 sample of 2,031 U.S. adults and a 1985 sample of 809 Illinois adults. The results show that depression reaches its lowest level in the middle aged, at about age 45. The fall of depression in early adulthood and rise in late life mostly reflects life-cycle gains and losses in marriage, employment, and economic well-being. Depression reaches its highest level in adults 80 years old or older, because physical dysfunction and low personal control add to personal and status losses. Malaise from poor health does not create a spurious rise of measured depression in late adulthood. However, some of the differences among age groups in depression reflect higher education in younger generations, and some reflect different rates of survival across demographic groups that also vary in their levels of depression.