Low Sense Of Control Research Articles

Care recipients’ psychological well-being: The role of sense of control and caregiver type

The current study tested mediation and moderation hypotheses to examine the link between caregiver type, sense of control, and depressive symptoms in older adult care recipients. All recipients (127 older adults, aged 60–98) reported at least one instrumental activity of daily living impairment and 75% reported at least one activity of daily living limitation. Results indicated that care recipients’ depressive symptoms varied by caregiver type and level of sense of control. Recipients with low sense of control and family caregivers reported higher depressive symptoms than those with a low sense of control and non-family caregivers. The findings suggest that although some care recipients have caregivers they may yet experience poor psychological well-being. Implications for practitioners are that in addition to their medical and physical health needs, the psychological well-being of care recipients is also important to consider.

Depressive symptoms, socio-economic background, sense of control, and cultural factors in University students from 23 Countries

We measured depressive symptoms with the Beck Depression Inventory in 17,348 university students from 23 high-, middle-, and low-income countries, and assessed associations with individual level and ecological level factors using multi-level random effects regression modelling. Wide variations in depressive symptoms were observed between countries, with lower levels in Western and Southern Europe and South and North America, intermediate levels in Central and Eastern Europe, and higher levels in Pacific-Asian samples. Poorer socio-economic background and low sense of control were associated with depressive symptoms within each country. Independently of individual level effects, higher depressive symptoms were recorded in countries with greater income inequality and with less individualistic cultures. Personal circumstances, beliefs, and cultural factors may all contribute to depressive symptoms in this population.

Desire for Control, Sense of Control and Obsessive-Compulsive Symptoms

While control-related cognitions have often been implicated in discussions of Obsessive Compulsive Disorder (OCD), empirical investigations of the relationship between control-constructs and OCD symptoms have been relatively limited. In this article it was hypothesized that OCD symptoms may be linked with a higher desire to control (DC), but a lower sense of control (SC) over the self and environment, leading to motivation for compulsive symptoms. This hypothesis was investigated in an analogue population, using regression analyses controlling for depression and anxiety. Consistent with predictions, it was found that higher levels of DC and lower levels of SC were associated with higher levels of OCD-related beliefs and symptoms. While control cognitions were linked with the OCD-related beliefs of perfectionism and the over-estimation of threat, they did not relate to cognitions concerning the importance of/need to control thoughts. With respect to specific OCD-symptoms, control cognitions were most strongly related to contamination obsessions/washing compulsions. Implications for theory and treatment are discussed.

The course of severe fatigue in disease‐free breast cancer patients: a longitudinal study

We investigated whether fatigue is a persistent problem, and whether persistent fatigue is related to former treatment modalities. In addition, we studied the predictors of persistent fatigue. At baseline (n=150, mean time since cancer treatment=29 months) patients were asked to fill out several questionnaires on psychological, physical, social, cognitive and behavioral aspects (Ann. Oncol. 2002;13:589-598). During the 2 years after baseline patients were asked to fill out monthly a fatigue questionnaire (CIS-fatigue). Hundred-twenty-one patients completed the study, 10 dropped out and 19 had a disease recurrence. Twenty-four percent of the patients experienced persistent severe fatigue complaints during the 2-year observation period. Persistent fatigue seemed to be related to the duration of former treatment but unrelated to type of surgery, type of adjuvant therapy and time since treatment finished. High anxiety, high impairment in role functioning and low sense of control over fatigue symptoms at baseline were predictors of persistent fatigue. Fatigue appears to be a persistent problem for a quarter of a sample of disease-free breast cancer patients during a 2-year period. The predictors of persistent fatigue found in this study can be helpful for the development of interventions to reduce post-treatment fatigue.

Education, cumulative advantage, and health

Education’s positive effect on health gets larger as people age. The large socioeconomic differences in health among older Americans mostly accrue earlier in adulthood on gradients set by educational attainment. Education develops abilities that help individuals gain control of their own lives, encouraging and enabling a healthy life. The health-related consequences of education cumulate on many levels, from the socioeconomic (including work and income) and behavioral (including health behaviors like exercising) to the physiological and intracellular. Some accumulations influence each other. In particular, a low sense of control over one’s own life accelerates physical impairment, which in turn decreases the sense of control. That feedback progressively concentrates good physical functioning and a firm sense of personal control together in the better educated while concentrating physical impairment and a sense of powerlessness together in the less well educated, creating large differences in health in old age.

Psychosocial Stress, Personality, and the Severity of Chronic Hepatitis C

This cross-sectional study examined the association between the severity of chronic hepatitis C and the type 1 personality, which has been shown by Grossarth-Maticek to be strongly related to the incidence of cancer and mortality. Sixty-nine patients with chronic hepatitis C completed the Stress Inventory, a self-report questionnaire to measure psychosocial stress and personality, and were classified into three groups according to hepatitis severity: group A, chronic hepatitis C with a normal serum alanine aminotransferase level; group B, chronic hepatitis C with an elevated alanine aminotransferase level; and group C, liver cirrhosis. Each of four scales related to the type 1 personality--low sense of control, object dependence of loss, unfulfilled need for acceptance, and altruism--was significantly and positively associated with hepatitis severity. The type 1 score, calculated as the average of these scales, was also strongly related to hepatitis severity (p<0.0001), and adjustment for age, sex, education level, smoking, drinking, and duration brought no attenuation into the association. Chronic psychosocial stress relevant to the type 1 personality may also influence the course of chronic hepatitis C.

Associations of Intrauterine Growth Restriction Among Term Infants and Maternal Pregnancy Intendedness, Initial Happiness About Being Pregnant, and Sense of Control

Term infants (> or =37 weeks' gestation) who weigh <2500 g have intrauterine growth restriction (IUGR) and have a higher risk of mortality and morbidity. Little is known about how psychosocial factors affect the risk of IUGR. We examined the association between IUGR and maternal pregnancy intendedness, initial happiness about becoming pregnant, and maternal sense of control. We analyzed data from a survey of California mothers aged > or =15 years with term live births in 1999 and 2000 (N = 5961). Mothers were asked about pregnancy intendedness before pregnancy, initial happiness about becoming pregnant, and maternal sense of control, assessed by a standardized scale. We examined the association of having an infant with IUGR and these factors in univariate and multivariate analyses. Mothers with low sense of control (3.0%) and average sense of control (2.7%) were more likely to have an infant with IUGR than mothers with high sense of control (1.8%; odds ratio: 1.8; 95% confidence interval: 1.2-2.9; and odds ratio: 1.6; 95% confidence interval: 1.0-2.5). After multivariate analysis, we found no significant association between sense of control and IUGR. We also found no significant association between IUGR and pregnancy intendedness and happiness about becoming pregnant. We found no statistically significant association between IUGR and maternal pregnancy intendedness, initial happiness about becoming pregnant, and maternal sense of control. Although research should continue to explore associations between psychosocial factors and IUGR, prenatal care programs should focus on known risk factors for IUGR.

African American males at a crossroad.

With the recent debates regarding school drop outs, limited parental support, peer pressure, and social isolation, African American males are at a crossroad. For much too long attention has focused on factors that reflect poor self image and a lower sense of control over their destinies. Options are very limited, and it is important to consider the new public policy response to male responsibility utilizing natural support systems. Mentoring is a key variable to establishing greater community responsibility through primary prevention.

Age and the Gender Gap in the Sense of Personal Control

The theory of personal control predicts that women have a lower sense of control than men, but the evidence is equivocal. Inconsistencies in research results suggest that women's sense of control is lower than men's under some conditions, but not others. We hypothesize that the gender gap in perceived control is greater for older persons than for younger. Compared with their male counterparts, older women may face more educational, employment, economic, and health disadvantages than do younger women. To test the hypotheses that men have a higher sense of personal control than women, that the gap between men and women is larger in older age groups than in younger, and that education, work, economic conditions, and health account for the age-based effect of gender on perceived control, we use the survey of Aging, Status, and the Sense of Control (ASOC), in which a representative sample of U.S. respondents were interviewed in 1995 and again in 1998. We find support for the hypothesis that the gender gap in personal control is greater among older persons than younger, and that over time women's sense of control declines more than men's. Education, personal employment history, household income, and physical functioning account for some of the age-based effect of gender on perceived control. Work fulfillment, fairness of domestic labor, economic hardship, and self-reported health do not, however.

Retirement and mental health.

This research examines whether retirement is associated with mental health and how one's daily pursuits mediate this association. It tests two perspectives from the sociology of work and the sociology of mental health. Using data from two surveys, the 1995 Aging, Status, and Sense of Control and the 1987-1988 National Survey of Families and Households, regression analysis was used to examine retirement, activities, and well-being. In support of the view that work is alienating and retirement liberating, retirees experienced less anxiety and distress and higher positive affect. Retirees' lower anxiety and distress were explained by activity characteristics. In support of the view that work is empowering and retirement demoralizing, retirement is associated with lower sense of control in both data sets, in part because of the daily pursuits. Retirement was not associated with depressive symptomatology. Suggestions for creating opportunities that enhance well-being are discussed.

Determinants of chronic fatigue in disease-free breast cancer patients: a cross-sectional study

BackgroundQuality of life after cancer treatment becomes more important as the number of long-term survivors increases. This study aimed to investigate complaints of fatigue after treatment for breast cancer. Patients and methodsThe study patients were 150 women who had finished curative treatment for breast cancer by a mean of 29 months before commencement of this study. Measurements included computerised questionnaires and a daily Self-Observation List. ResultsThirty-eight per cent of the sample were severely fatigued, compared with 11% in a matched sample of women without a history of cancer. No association was found between fatigue and former treatment. The ‘severely fatigued disease-free breast cancer patient’ scored more ‘problematic’ on psychological well-being, functional impairment, sleep disturbance, physical activity, social support, neuropsychological and social functioning compared with the ‘non-severely fatigued disease-free breast cancer patient’. Furthermore, the severely fatigued patients had a lower sense of control with respect to their fatigue complaints and stronger breast cancer- and psychologically-related attributions with regard to the causes of fatigue compared with the non-severely fatigued patients. Regression analyses indicated that sleep disturbance, physical activity and causal attributions contributed significantly to the subjective experience of fatigue. ConclusionsSevere fatigue is a problem for almost 40% of the sample of breast cancer survivors. Severe fatigue is related to physical, psychological, social, cognitive and behavioural factors.

Establishing a Sense of Personal Control in the Transition to Adulthood

This study tests the hypothesis that the high sense of personal control enjoyed by adult Americans develops during the transition to adulthood. Analyses use data from the National Longitudinal Survey of Youth (NLSY), which interviewed respondents in 1979 who were between the ages of 14 and 22 and again in 1992 when they were between 27 and 35. Cross-sectional analyses show a positive slope of perceived control with respect to age in the range from 14 through 22. Dropping out of school dampens the increase. It further reduces perceptions of control prospectively, net of control at time 1. Getting pregnant or getting a partner pregnant does notflatten the slope and does not affect later adulthood perceptions of control, except indirectly if it leads to dropping out of school. Adolescent sense of control correlates positively with parental education and the adolescent's cognitive skill, and cognitive skill increases the trajectory for young men but not for young women. Both factors predict more positive changes in the sense of control in the period between adolescence and middle age. A low sense of control at the beginning of the follow-up period does not increase the risk of subsequently dropping out of school, but it does increase the risk of a subsequent nonmarital pregnancy,

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.

Coping Resources and Self-Reported Depressive Symptoms Among Frail Older Ethnic Women

ABSTRACT This study uses data from the 1982-84 National Long-Term Care Channeling Demonstration to model the additive and interactive effects of health-related and social stressors and coping resources on self-reported depressive symptoms of frail, elderly African American (n = 900) and Hispanic (n = 146) women. Older white women are included as a reference group. Results indicate that older African American women report fewer depressive symptoms than their white counterparts in the study and that symptom levels reported by older Hispanic and white women did not differ. Parallel regression analyses revealed that physical illnesses, perceptions of unmet need, and low sense of control were common predictors of depressive symptoms for all three groups and that there were also unique predictors for each group.

Age and the Sense of Control

Two large random-sample surveys of adults age 18 and over show high, stable mean levels of perceived control in the age range 18 through 50, followed by successive steps down in progressively older age groups. Physical impairment and low education account for much of the low sense of control-reported by older respondents. Education accounts for more of the age-group differences than does impairment. More than half of the age-group mean differences remain after adjustment. The results do not change substantially with added adjustment for other socioeconomic factors (race, sex, income, earnings, marital status, employment status) or other measures of physical aging (perceived health, malaise, aches and pains, exercise, and body weight). The relative importance of education suggests that intergenerational improvements in lifetime living and working conditions mnight account for much of the remaining association between old age and low sense of control

Key determinants of the MMPI-PTSD subscale: treatment considerations.

Seventy-five "in country" Vietnam combat psychiatric inpatients were given a battery of measures upon admission to the medical center. These included the MMPI, VETS Adjustment Scale, State-Trait Anxiety Scale, Rotter Locus of Control, Profile of Mood Scale, and a variation of the Figley Stress Scale that measures current stress. Post-traumatic stress disorder (PTSD) was determined by the MMPI-PTSD subscale. Ten of the battery variables were used as predictors for a multiple regression analysis on the MMPI-PTSD subscale. Results yielded a multiple R of .89 for two predictors, Figley Stress Scale and Rotter Locus of Control (external). Patients with PTSD, therefore, suffer most from perceived and experienced current stressors and a low sense of control. Arguments are made for more present-centered and interpersonal strategies in the treatment of PTSD combat veterans.

Preventing Child Abuse and Neglect: A Randomized Trial of Nurse Home Visitation

A program of prenatal and infancy home visitation by nurses was tested as a method of preventing a wide range of health and developmental problems in children born to primiparas who were either teenagers, unmarried, or of low socioeconomic status. Among the women at highest risk for care-giving dysfunction, those who were visited by a nurse had fewer instances of verified child abuse and neglect during the first 2 years of their children's lives (P = .07); they were observed in their homes to restrict and punish their children less frequently, and they provided more appropriate play materials; their babies were seen in the emergency room less frequently during the first year of life. During the second year of life, the babies of all nurse-visited women, regardless of the families' risk status, were seen in the emergency room fewer times, and they were seen by physicians less frequently for accidents and poisonings than comparison group babies (P less than or equal to .05 for all findings, except where indicated.) Treatment differences for child abuse and neglect and emergency room visits were more significant among women who had a lower sense of control over their lives.

Social Networks and Health Status: A Longitudinal Analysis

Panel data are employed to test the proposition that network engagement, particularly in conjunction with a high sense of control (vs. powerlessness), is associated with favorable health behavior. Field interviews were conducted with a representative sample of Los Angeles County in 1976 and again in 1977, with intervening systematic telephone call-backs to monitor self-rated health status, illness management, and preventive health activities. Two forms of network engagement (instrumental and consultation), and two powerlessness factors (personal mastery and general control) are distinguished. On the whole, (1) integration in a network is modestly associated with positive health; (2) consultation networks are less sanguine (e.g., such engagement goes with less preventive health behavior); (3) the two sense-of-control indices are independently related to favorable health; and (4) the poorest health is associated with a combination of low support and low sense of control. The findings are interpreted in their bearing on the Durkheimian thesis concerning the buffering effect of social integration and related alienation processes.