Low Internal Locus Of Control Research Articles

Associations among loneliness, internal locus of control and subjective accelerated ageing in older adults who received the booster vaccination.

A rise in loneliness among older adults since the COVID-19 outbreak, even after vaccination, has been highlighted. Loneliness has deleterious consequences, with specific effects on perceptions of the ageing process during the COVID-19 pandemic. Coping with stressful life events and the challenges of ageing may result in a perception of acceleration of this process. Studies have shown a buffering effect of an internal locus of control in the relationship between COVID-19 stress and mental distress. The current study examined whether loneliness predicts subjective accelerated ageing and whether internal locus of control moderates this relationship. Two waves of community-dwelling older adults (M = 70.44, s.d. = 5.95; age range 61-88 years), vaccinated three times, were sampled by a web-survey company. Participants completed the questionnaire after the beginning of the third vaccination campaign and reported again 4 months later on loneliness, internal locus of control and subjective accelerated ageing level in the second wave. Participants with higher levels of loneliness presented 4 months later with higher subjective accelerated ageing. Participants with a low level of internal locus of control presented 4 months later with high subjective accelerated ageing, regardless of their loneliness level. Participants with a high level of internal locus of control and a low level of loneliness presented with the lowest subjective accelerated ageing 4 months later. The findings emphasise the deleterious effects of loneliness and low internal locus of control on older adults' perception of their ageing process. Practitioners should focus their interventions not only on loneliness but also on improving the sense of internal locus of control to improve subjective accelerated ageing.

A Systematic Review and Classification of Factors Influencing Diabetic Foot Ulcer Treatment Adherence, in Accordance With the WHO Dimensions of Adherence to Long-Term Therapies.

Effective treatment of diabetic foot ulcers (DFUs) involves a multidisciplinary treatment plan to promote wound healing and prevent complications. Given the lack of consensus data on the factors affecting patient adherence, a systematic review was performed to identify and classify factors according to the WHO Dimensions of Adherence to Long-Term Therapies. Six hundred and forty-three articles from PubMed, Embase, and Scopus were reviewed. The inclusion criteria included qualitative and quantitative studies which discussed factors affecting patient adherence to DFU treatment, had study populations that comprised patients with either prior history of or existing DFU, and had either prior history of DFU treatment or were currently receiving treatment. Factors, and associated measures of adherence, were extracted and organized according to the WHO Dimensions of Adherence to Long-Term Therapies. Seven quantitative and eight qualitative studies were included. Eleven patient-related factors, seven condition-related factors, three therapy-related factors, five socioeconomic factors, and five health system-related factors were investigated by the included studies. The largest proportion of factors studied was patient-related, such as patient insight on DFU treatment, patient motivation, and patient perception of DFU treatment. There was notable overlap in the range of discussed factors across various domains, in the socioeconomic (including social support, income, social and cultural acceptability of DFU therapy, cost) and therapy-related domains (including duration of treatment, offloading footwear, and reminder devices). Different studies found that specific factors, such as gender and patients having a low internal locus of control, had differing effects on adherence on different cohorts. Current literature presents heterogeneous findings regarding factors affecting patient adherence. It would be useful for future studies to categorize factors as such to provide more comprehensive understanding and personalized care to patients. Further research can be done to explore how significant factors can be addressed universally across different cohort populations in different cultural and socioeconomic contexts.

Looking towards an automated future: U.S. attitudes towards future artificial intelligence instantiations and their effect

The present study explores people’s attitudes towards an assortment of occupations on high and low-likelihood of automation probability. An omnibus survey (N = 1150) was conducted to measure attitudes about various emerging technologies, as well as demographic and individual traits. The results showed that respondents were not very comfortable with AI’s management across domains. To some degree, levels of comfort corresponded with the likelihood of automation probability, though some domains diverged from this pattern. Demographic traits explained the most variance in comfort with AI revealing that men and those with higher perceived technology competence were more comfortable with AI management in every domain. With the exception of personal assistance, those with lower internal locus of control were more comfortable with AI managing in almost every domain. Age, education, and employment showed little influence on comfort levels. The present study demonstrates a more holistic approach of assessing attitudes toward AI management at work. By incorporating demographic and self-efficacy variables, our research revealed that AI systems are perceived differently compared to other recent technological innovations.

Dependence Severity, Locus of Control, and Readiness to Change in Male Alcoholic Clients: A Correlational Study

Objectives: To assess the level of dependence severity, locus of control, and readiness to change in male alcohol clients and measure the correlation between dependence with a locus of control and readiness to change.
 Methodology: A descriptive correlational design was conducted in the substance use rehabilitation centers at psychiatric teaching hospitals in Baghdad city from November /2021 to May 2022. The instrument of the study was designed by using sociodemographic, the clinical characteristics of the client, the Short-form Alcohol Dependence Data Questionnaire (SADD), Drinking Related Internal-External Locus of Control Scale: (DRIE), and the Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES). The data was collected through the use of a semi-structured form and analyzed by Social Package for Statistical Sciences SPSS version 26.0
 Results: The study showed a highly significant difference in dependence severity with an internal and external locus of control at p-value= .001, a significant reverse relationship between readiness to change among clients with regard to the duration of alcohol use at p-value= .008, and amount of alcohol use per day at p-value=.009. A significant relationship between readiness to change and clients’ level of education, and age of alcoholic clients’ is significant at p-value= .005.and significant relationship between locus of control and monthly income.
 Conclusions: Alcoholic male clients have a moderate dependence severity of alcohol and moderate external locus of control, low internal locus of control, and high readiness to change.
 Recommendations: Further research should be conducted on AUD, activating the media’s role to increase community awareness about the harmful effects of alcohol and the possible treatment methods.

Psychosocial burden of inflammatory bowel disease in adolescents and young adults.

This study examined the psychosocial burden of inflammatory bowel disease (IBD) in young people aged 15-25 years attending a tertiary specialist health centre for adolescents and young adults in Brisbane. To describe the impact of IBD on psychosocial well-being in young people and to compare well-being in the IBD cohort to well-being among young people with other chronic conditions, with a view to identifying characteristics and challenges unique to those with IBD. Young people with IBD provided demographic information and psychosocial data through a cross-sectional self-report survey. Psychosocial data included the Kessler Psychological Distress Scale, Perceived Stress Scale, Brief Illness Perception Questionnaire, World Health Organisation Well-being Index, Paediatric Quality of Life Inventory, Short Quality of Life Questionnaire for IBD, Multidimensional Scale of Perceived Social Support, Connor Davidson Resilience Scale 2 and the Multidimensional Health Locus of Control Scale. Surveys were collected from 51 young people with IBD and compared with surveys from 210 young people with juvenile rheumatic disease (n= 31), phenylketonuria (n=21), cystic fibrosis (n=33), renal transplants (n=14) and craniomaxillofacial conditions (n=111). On the psychosocial domains, 41% of young people with IBD had poor well-being and 37% were at risk of depression. When assessed against the comparison group, young people with IBD reported higher depressive symptoms (P=0.04), worse illness perceptions (P < 0.01) and lower internal locus of control (P < 0.01). Early recognition and treatment of depression and other psychosocial comorbidities within integrated pathways of care is crucial in adolescents and young adults with IBD and likely to improve the course of IBD and their overall health and well-being. Interventions aimed at enhancing self-efficacy and increasing public awareness are also likely to be helpful.

The Role of Income Volatility and Perceived Locus of Control in Financial Planning Decisions.

Two studies examine whether income volatility might lead to greater personal financial insecurity and might create a decision environment that discourages planning ahead on personal finances. In Study 1 (N = 982), participants who reported more month-to-month variability in their actual income were less likely to have planned for financial contingencies. A lower internal locus of control partially mediated the link between volatility and financial planning decisions in Study 1, and lower internal locus of economic control predicted financial planning decisions independently of volatility. In Study 2 (N = 149), participants who were randomly assigned to receive volatile (vs. stable) payments in a simulated work environment were less likely to save their compensation for this work. Again, lower internal locus of economic control predicted financial planning decisions independently of volatility. This is the first study to demonstrate a causal link between income volatility and financial decisions, specifically a heightened tendency to make short-term financial decisions. Both studies also underlined the importance of internal locus of control for financial planning decisions.

Exploring reasons for variations in anxiety after testing positive for human papillomavirus with normal cytology: a comparative qualitative study.

ObjectiveTo explore reasons for variations in anxiety in women testing positive for human papillomavirus (HPV) with normal cytology at routine HPV primary cervical cancer screening.MethodsIn‐depth interviews were conducted with 30 women who had tested HPV‐positive with normal cytology, including 15 with low‐to‐normal anxiety and 15 with high anxiety. Data were analysed using Framework Analysis to compare themes between low and high anxiety groups.ResultsSeveral HPV‐related themes were shared across anxiety groups, but only highly anxious women expressed fear and worry, fatalistic cognitions about cancer, fertility‐related cognitions, adverse physiological responses and changes in health behaviour(s). In comparison to those with low anxiety, women with high anxiety more strongly voiced cognitions about the 12‐month wait for follow‐up screening, relationship infidelity, a lower internal locus of control and HPV‐related symptom attributions.ConclusionsReceiving an HPV‐positive with normal cytology result related to various emotional, cognitive, behavioural and physiological responses; some of which were specific to, or more pronounced in, women with high anxiety. If our observations are confirmed in hypothesis‐driven quantitative studies, the identification of distinct themes relevant to women experiencing high anxiety can inform targeted patient communications and HPV primary screening implementation policy.

Greed as an adaptation to anomie: The mediating role of belief in a zero-sum game and the buffering effect of internal locus of control

Greed is associated with many negative consequences. However, knowledge regarding why and when people behave greedily is limited. Anomie is the perception of the disordering of social structures, destruction of social regulations, and breaking down of moral standards. The current study explored the relationship between anomie and greed, the underlying mechanism and the boundary condition of this relationship. A sample of 279 participants (Mage = 35.85, SD = 8.74) completed the questionnaire sets and passed the validity checks. The results indicated that anomie was positively associated with greed and that belief in a zero-sum game (BZSG) partially mediated this relationship. Moreover, the effect was moderated by internal locus of control (ILOC). Specifically, an indirect relationship was found only among people with low ILOC but not those with high ILOC. The theoretical implications of the results and future research directions are discussed.

Predicting Control Beliefs in Older Adults: A Micro-Longitudinal Study.

The present study examined potential sources of intra- and inter-individual differences in older adults' control beliefs using a micro-longitudinal design. Older adults (n = 205) ranging in age from 60 to 94 (M = 72.70, SD = 6.72) completed 8 in-person testing sessions within 3 weeks which included assessments of control beliefs (Locus of Control and Perceived Competence), physical health (physical symptoms and sleep self-efficacy), stressors, emotional well-being (Positive Affect and Negative Affect), and cognition (basic cognition tests, everyday cognition, and memory failures). Multilevel models indicated that on days when older adults had higher sleep self-efficacy, more positive affect, and less negative affect, they also had more internal locus of control and higher perceived competence. Having stressors on the previous occasion was associated with lower internal locus of control on the subsequent occasion. Physical symptoms, everyday cognition, and memory failures could be predictive of locus of control for some older adults. Our findings showed the differentiated antecedents of locus of control and perceived competence, the unique role of sleep self-efficacy, positive affect, and negative affect in understanding antecedents of both, as well as the need to study well-being and cognition antecedents of control beliefs in future studies.

Gender differences in attitudes and attributes of people using therapeutic shoes for diabetic foot complications

BackgroundTherapeutic shoes can prevent diabetic foot reulcerations but their use is complicated by the fact that shoes have psychological and social meanings, which is believed to put a larger burden on women than men. The aim was to compare attitudes and attributes of women and men using therapeutic shoes for diabetic foot complications.MethodsA questionnaire was posted to 1230 people with diabetes who had been fitted with therapeutic shoes. Women’s and men’s answers were compared using t-tests, Mann–Whitney U tests and chi-square tests with Fischer’s exact tests. P-values < 0.05 were considered statistically significant.ResultsQuestionnaires from 443 (36.0%) respondents (294 men, 149 women, mean age 69.2 years) were analyzed. More men than women (p < 0.05) had paid employment (20.4% vs 9.4%), had someone who reminded them to wear their therapeutic shoes (27.6% vs 10.0%), and had a history of foot ulcers (62.9% vs 46.3%) or minor amputation (17.7% vs 6.7%). More women than men received disability pension (18.8% vs 10.2%). Women reported worse general health, lower internal locus of control regarding ulcer prevention, and more negative attitudes to the appearance and price of therapeutic shoes and how they felt about wearing them in public. Other comparisons were non-significant: other shoe attributes, education, diabetes type, current foot ulcers, major amputations, satisfaction with shoe services, understanding of neuropathy as a risk factor, locus of control regarding ulcer healing, belief in the shoes’ efficacy to prevent and heal ulcers, worries about ulcer healing and new ulcerations, self-efficacy, depression, shoe use/adherence, paying a fee for therapeutic shoes, and social support.ConclusionsMen had worse foot complications. Women had worse general health, lower internal locus of control regarding ulcer prevention, and more negative attitudes toward therapeutic shoes. Clinicians should pay more attention to their female patients’ concerns. Future research and development should focus on improving the weight and appearance of therapeutic shoes, particularly for women. Research is also needed on how to facilitate the adaption and reevaluation process where patients change from viewing shoes purely as items of clothing to also viewing them as medical interventions.

Unemployment and Reemployment Effects on Locus of Control and Health

While unemployment compromises wellbeing and health, reemployment can mitigate some of its negative effects. Yet, we lack understanding of the underlying mechanism through which these unemployment and reemployment effects occur. In the present study, we integrate models of unemployment, stress, and trait variability to argue that changes in locus of control play a crucial role in explaining health following unemployment and reemployment. Applying propensity score matching to a longitudinal sample of 7,908 individuals from the German Socio-Economic Panel (SOEP) reveals that unemployment predicts lower internal locus of control which in turn relates to poorer subjective health. Subgroup analyses show that the decline in internal control beliefs only occurs for involuntary (as compared with voluntary) unemployment. Reemployment reverses this negative effect on health through restoring internal control beliefs. Concluding, our study adds to the extant literature as it uncovers why health changes occur after job loss and job gain.

Priming employees’ promotion focus

PurposeThe purpose of this paper is to examine the relationship between servant leadership and customer service behaviors by probing the mediating role of promotion focus and the moderating role of internal locus of control.Design/methodology/approachThe authors hypothesized an indirect relationship between servant leadership and customer service behaviors through promotion focus. Also, the authors predicted that the positive relationship between servant leadership and promotion focus would be stronger for employees with low internal locus of control. The authors tested the theoretical model with data gathered across two phases over three months from 280 supervisor-subordinate dyads.FindingsResults indicated that servant leadership was positively related to customer service behaviors via promotion focus. Results also showed that internal locus of control moderated the relationship between servant leadership and promotion focus, such that the relationship was stronger for employees low on internal locus of control. Furthermore, this moderated mediated model was supported. As predicted, the indirect effect was stronger when internal locus of control was low.Research limitations/implicationsThis study extends the regulatory focus theory to the service context to investigate how and when servant leadership enhances customer service behaviors. The authors suggested promotion focus as a key mediating mechanism and revealed internal locus of control as a boundary condition for the effectiveness of servant leadership.Originality/valueThis study highlights the importance role of promotion focus in fostering customer service behaviors and provides novel theoretical insight regarding when servant leadership enhances customer service behaviors.

Multifactorial analysis of dissatisfaction after primary total knee replacement

BackgroundThe aims of this study were to identify the prevalence and causes of dissatisfaction in a cohort of private practice patients, and to compare the psychological characteristics of dissatisfied patients to matched, satisfied controls. MethodsUnilateral TKR patients were evaluated to identify those dissatisfied with their TKR. Dissatisfied and satisfied patients were matched in terms of age, gender, follow-up duration and body mass index (BMI). Psychological evaluation was performed using the Pain Catastrophizing Scale (PCS), Depression, Anxiety and Stress Scale (DASS) and the Multidimensional Health Locus of Control (MHLC) scale. The preoperative grade of osteoarthritis, prevalence of comorbidities, and postoperative functional outcomes, were also compared. ResultsA cohort comprised 301 patients (response rate 71%), with 24 patients (eight percent) dissatisfied at a mean follow-up of 37months (range eight to 74months). Persistent pain was the most common reason for dissatisfaction (n=10). Dissatisfied patients reported a significantly higher mean PCS score (P=0.03), higher depression component of the DASS (P=0.02) and lower internal locus of control (P=0.02). The dissatisfied group exhibited reduced improvement (P<0.05) in the Oxford Knee Score (OKS) and range of motion (ROM), as well as a lower preoperative grade of osteoarthritis compared to satisfied patients. ConclusionsDissatisfied patients exhibit an altered psychological profile to matched satisfied controls. In addition, they have lesser improvements in the OKS and ROM. Thus, both physical as well as psychological factors contribute to dissatisfaction. Identification of these factors may help in planning focused interventions to address dissatisfaction.

Recognition of anxiety, depression, and PTSD in patients with COPD and CHF: Who gets missed?

This study sought to identify patient factors associated with mental health (MH) recognition and treatment in medically ill Veterans. Retrospective data from patient electronic medical records (EMR) and self-report data were reviewed for 180 Veterans with cardiopulmonary conditions who met diagnostic criteria for anxiety, depression, or posttraumatic stress disorder on the Mini-International Neuropsychiatric Interview. Multivariate logistic regression examined the association of medical record MH recognition and MH service use with patient factors, including anxiety and depression severity, self-efficacy, locus of control, coping, illness intrusiveness, and health-related quality of life (QOL). Seventy veterans (39%) had an MH diagnosis documented in their EMR, and 101 (56%) received at least one MH service (≥1 MH encounter or psychiatric medications). Greater depression (p=0.047) and adaptive coping (p=0.012) were associated with increased likelihood of EMR documentation of MH diagnoses. EMR MH diagnosis (p<0.001), higher internal locus of control (p=0.037), and poorer physical health-related QOL (p=0.014) were associated with greater likelihood of MH service use. Veterans with cardiopulmonary conditions experiencing MH problems are under-recognized. Improved MH screening is needed, particularly for patients with poor adaptive coping skills, low internal locus of control, or poor physical health-related QOL.

Multifactorial analysis of patient dissatisfaction after TKR – the influence of psychological factors

Objectives:The published rates of dissatisfaction following total knee replacement (TKR) range between 11-18%, with residual symptoms and psychological distress being important features. The aims of this study were to identify the prevalence and causes of dissatisfaction in a cohort of private practice patients, and to describe a post-operative management program which may improve satisfaction with their replaced knee in these patients.Methods:A cohort of 375 patients with unilateral TKR was evaluated to identify patients who were dissatisfied with TKR. Dissatisfied and satisfied patients were matched in terms of age, gender, follow-up duration and BMI. Psychological evaluation was performed using the pain catastrophizing scale (PCS), Depression, Anxiety and Stress Scale (DASS) and the Multidimensional Health Locus of Control (MHLC) scale. The pre and post-operative Oxford knee scores (OKS) and range of motion (ROM), preoperative grade of osteoarthritis, and prevalence of comorbidities were also compared between groups. Patients indicating dissatisfaction with their TKR were then followed up by phone on a second occasion 12months later. Those that indicated enduring dissatisfaction were invited to participate in a chronic pain program utilising cognitive behavioural therapy, desensitisation and coping strategies. Patients referred to the program were screened by the therapists for inclusion and enrolled into a flexible course of therapy. Pre- and post- intervention questionnaires will be used to determine the effect of the program on satisfaction rates (5-point Likert scale) and psychological responses to pain.Results:The final cohort consisted of 301 patients (response rate 80%), with 24 patients (6.5%) dissatisfied with the result of TKR. Persistent pain was the most common reason for dissatisfaction (n=10). Dissatisfied patients reported a significantly (P = 0.03) higher mean PCS score (mean±SD, 11.3±10.3), compared to satisfied patients (5.4±6.3) and a significantly (P = 0.02) higher depression component of the DASS (3.5±3.3 vs 1.4±1.6). In addition, dissatisfied patients returned a significantly (P = 0.02) lower internal locus of control (16.6±8.2 vs 21.3±8.2). The dissatisfied group also exhibited a reduced improvement in the OKS and ROM, as well as a lower preoperative grade of osteoarthritis compared to satisfied patients. Preliminary analysis revealed that five patients (21%) became satisfied with their knee despite no intervention occurring between measurements. Of the remaining patients, five patients (21%) did not think their ongoing issues were severe enough to warrant further intervention, and nine patients (38%) were referred directly to the program. It is expected that these results will shed new light on the potential management options for these patients that identify as dissatisfied after a primary unilateral TKR.Conclusion:Dissatisfied patients exhibit higher scores for catastrophisation and depression, with lower self confidence in managing their knee symptoms. In addition, they have lesser improvements in the OKS and ROM. Thus, both physical as well as psychological factors contribute to dissatisfaction. Identification of these factors can help in planning focused interventions to address dissatisfaction. This is the longest follow-up of such a cohort; our results so far indicate that 21% of such patients can improve spontaneously with time which challenges some conventional beliefs. The results of the 38% of patients who remain dissatisfied and will undergo the program will determine whether such an intervention will be worthwhile in this difficult clinical situation.

Good day for Leos: Horoscope's influence on perception, cognitive performances, and creativity

Do people treat horoscopes as mere entertainment, or does reading horoscopes have more substantial consequences? Building upon research on the expectancy effect as well as on literature highlighting the influence of astrology on individuals, we hypothesized that reading positive versus negative horoscopes would affect people's perceptions, emotions, cognitions, and creativity. Across three experiments, reading positive versus negative astrological forecasts increased positive interpretation of ambiguous events (Experiment 1, N=195), cognitive performance (Experiment 2, N=189), and creativity (Experiment 3, N=193). Furthermore, positive (versus negative) horoscopes decreased negative emotions among people who believe in astrology and the effects of horoscopes on cognitive performances and creativity were stronger among people with a low internal locus of control. Opening newspapers and searching for daily horoscopes have more consequences than one may initially think.

HYGIENIC ASSESSMENT OF RISK FACTORS FOR HIV-INFECTION AND NARCOMANIA PREVALENCE AMONG MEDICAL STUDENTS

Aim. The aim of the study was to carry out the hygienic assessment of risk factors for HIV-infection and narcomania prevalence among medical students. Materials and methods. Questionnaire was used to interrogate 2645 students of medical university, 1-6-year students. Socio-personal characteristics of students, level of knowledge on the problems of narcomania and HIV-infection, students’ opinion on the reasons of drug use and ways of reducing narcomania and HIV-infection threat, peculiarities of sexual behavior were studied. Subjective opinion of students on narcomania, spreading among them, was received. Results. It was established that risk factors for HIV-infection and narcomania among medical students are the following: not full family, passive leisure, low internal locus of control. The level of students’ awareness on narcomania and HIV-infection can be estimated as fragmental and insufficient. There is a relatively high level of stigma and discrimination in students’ attitude to HIV-infected persons. Conclusions. The main way for reducing the threat of narcomania and HIV-infection, singled out by students, is decrease in a risky behavior including sexual one. Students’ subjective opinion showed that there are subjects using drugs among them. It is necessary to introduce advanced technologies for preventive work both at the universities and students youth organizations.

Material Hardship and Internal Locus of Control Over the Prevention of Child Obesity in Low-Income Hispanic Pregnant Women

ObjectiveTo determine the relations between household material hardships and having a low internal locus of control over the prevention of child obesity in low-income Hispanic pregnant women. MethodsWe performed a cross-sectional analysis of baseline data collected during a third trimester prenatal visit from women participating in the Starting Early Study, a randomized controlled trial to test the efficacy of a primary care-based family-centered early child obesity prevention intervention. Using multiple logistic regression analyses, we determined whether 4 domains of material hardship (food insecurity, difficulty paying bills, housing disrepair, neighborhood stress), considered individually and also cumulatively, were associated with having a low internal locus of control over the prevention of child obesity. ResultsThe sample included 559 low-income Hispanic pregnant women, with 60% having experienced at least 1 hardship. Food insecurity was independently associated with a low internal locus of control over the prevention of child obesity (adjusted odds ratio, 2.38; 95% confidence interval, 1.50–3.77), controlling for other hardships and confounders. Experiencing a greater number of material hardships was associated in a dose-dependent relationship with an increased odds of having a low internal locus of control. ConclusionsPrenatal material hardships, in particular food insecurity, were associated with having a lower prenatal internal locus of control over the prevention of child obesity. Longitudinal follow-up of this cohort is needed to determine how relations between material hardships and having a low internal locus of control will ultimately affect infant feeding practices and child weight trajectories.

Resistance to temptation: the interaction of external and internal control on alcohol use during residential treatment for alcohol use disorder.

BackgroundThere is evidence that drinking during residential treatment is related to various factors, such as patients' general control beliefs and self‐efficacy, as well as to external control of alcohol use by program's staff and situations where there is temptation to drink. As alcohol use during treatment has been shown to be associated with the resumption of alcohol use after discharge from residential treatment, we aimed to investigate how these variables are related to alcohol use during abstinence‐oriented residential treatment programs for alcohol use disorders (AUD).MethodsIn total, 509 patients who entered 1 of 2 residential abstinence‐oriented treatment programs for AUD were included in the study. After detoxification, patients completed a standardized diagnostic procedure including interviews and questionnaires. Drinking was assessed by patients' self‐report of at least 1 standard drink or by positive breathalyzer testing. The 2 residential programs were categorized as high or low control according to the average number of tests per patient.ResultsRegression analysis revealed a significant interaction effect between internal and external control suggesting that patients with high internal locus of control and high frequency of control by staff demonstrated the least alcohol use during treatment (16.7%) while patients with low internal locus of control in programs with low external control were more likely to use alcohol during treatment (45.9%). No effects were found for self‐efficacy and temptation.ConclusionsAs alcohol use during treatment is most likely associated with poor treatment outcomes, external control may improve treatment outcomes and particularly support patients with low internal locus of control, who show the highest risk for alcohol use during treatment. High external control may complement high internal control to improve alcohol use prevention while in treatment.

Predictors of outcome of an Internet-based cognitive-behavioural therapy for post-traumatic stress disorder in older adults.

The aim of this study was to evaluate the role of resource-oriented variables such as self-efficacy, locus of control (LOC) and post-traumatic growth (PTG) in predicting treatment response in older adults with post-traumatic stress. Fifty-eight older adults with subsyndromal or greater severity of war-associated post-traumatic stress disorder (PTSD) symptoms completed a randomized controlled Internet-based cognitive-behavioural therapy (CBT) with immediate and delayed treatment groups. Assessments of PTSD severity and resource-oriented variables of self-efficacy, LOC and PTG were conducted at baseline, post-treatment and at a 6-month follow-up. Results revealed that pre-treatment scores on measures of internal LOC and PTG predicted PTSD symptom severity at post-treatment, even after controlling for initial PTSD. At a 6-month follow-up, internal LOC continued to predict PTSD symptom severity. In addition, repeated-measures analyses of variance revealed that, relative to older adults with low internal LOC and PTG, older adults with high internal LOC and PTG, respectively, did not differ with respect to initial PTSD severity, but they showed a more pronounced response to treatment. These findings suggest that greater locus of control and post-traumatic growth is associated with greater improvement in PTSD symptoms following Internet-based CBT. Assessment of these constructs may be useful in identifying trauma survivors who are most likely to respond to CBT. Greater internal locus of control and post-traumatic growth is associated with greater improvement in PTSD symptoms following Internet-based CBT. Older adults with initial high internal locus of control and post-traumatic growth, respectively, did not differ with respect to initial PTSD severity, but they showed a more pronounced response to treatment. It could be assumed that patients with initial functional appraisals could benefit easier and faster from a trauma-focused cognitive-behavioural therapy compared to individuals with lower internal locus of control and post-traumatic growth.