Problematic Gambling Behavior in a Sample of Gamblers: The Role of Alexithymia, Dissociation Features, and External Locus of Control.

Gambling disorder is a severe condition that significantly compromises the lives of those affected. In light of this clinical relevance, the literature on the antecedents of this form of addiction is constant and continually evolving. Consistently with this framework, the present research aimed at investigating the role of some risk factors in gambling disorder, with a specific focus on alexithymia, dissociation, and locus of control. The research involved a sample of 290 participants (183 males and 107 females; Mage = 34.43, SD = 14.65) who practice gambling at least occasionally. They completed an online survey including the South Oaks Gambling Screen, Twenty-Items Toronto Alexithymia Scale, Dissociative Experience Scale-II, and Locus of Control of Behavior. ANOVA and a moderated-mediation model were implemented to analyse the collected data. Results showed that 19.0% of the participants were At Risk and Problem Gamblers, while 27.6% fell into the category of Problematic Gamblers. Problematic Gamblers showed significantly higher levels of alexithymia, dissociation, and external locus of control. Moreover, a significant association between alexithymia and the severity of problematic gambling behaviour was found and was significantly mediated by absorption (a dissociation feature). Furthermore, the external locus of control significantly moderated this indirect effect. The role of gender as a covariate was also investigated. Such findings may offer further insights into the field of clinical research on gambling disorder and may provide useful information for effective clinical practice.

Locus of control, environment, and small-medium business performance in pilgrimage tourism: The mediating role of product innovation.

Small and medium businesses in pilgrimage tourism are one of the most vulnerable sectors in the post-pandemic due to product innovation and business activities. This study aims to investigate the impact of locus of control and environment on business performance, as well as to examine the role of product innovation. The data of this research were retrieved using a self-administered survey from small and medium businesses on Islamic pilgrimage in East Java of Indonesia. Using structural equation modeling, the findings indicate that locus of control and environment can support product innovation and small-medium business performance. Furthermore, this present research shows that there is a robust link between product innovation and performance. This research also reveals that product innovation partially mediates the link between locus of control and business performance, as well as the environment and small-medium business performance in pilgrimage tourism. These findings raise the need for small and medium enterprises to take the initiative for product innovations to escalate business performance.

Illness intrusiveness, health locus of control, and anxiety symptoms among veterans with congestive heart failure.

Disease severity, illness intrusiveness, and health locus of control (HLC) each contribute to psychosocial wellbeing in patients with congestive heart failure (CHF). To better understand the relationships between these variables regarding anxiety symptoms, we analyzed data from 116 adult male veterans with comorbid CHF and anxiety. Results suggested that illness intrusiveness significantly mediated the relation of CHF severity to anxiety symptom severity, and that the illness intrusiveness domains of physical well-being/diet, work/finances, and other aspects of life (religious/spirituality, community/civic, self-improvement/expression) were also significant mediators of that relationship. The relation of illness intrusiveness to anxiety was not moderated by internal HLC. Findings highlight the importance of assessing and treating various aspects of illness intrusiveness to manage anxiety symptoms in CHF patients.

Physical activity as a mediator in the relationship between health locus of control and health-related quality of life in multiple sclerosis patients with different disease duration.

BACKGROUND: The importance of undertaking physical activity for functioning of patients with multiple sclerosis (MS) has been repeatedly highlighted. However, the research on the role of physical activity in shaping the quality of life of patients with different disease duration is scarce. OBJECTIVE: The aim of this study was to identify the mediating role of physical activity in the relationship between health locus of control (HLoC) and health-related quality of life in MS patients with varying disease duration. METHODS: The study included 339 patients with MS from rehabilitation centers. The Multiple Sclerosis Impact Scale (MSIS-29) was used to measure health-related quality of life, physical activity was assessed by the Godin Leisure Time Exercise Questionnaire (GLTEQ) and the Health Locus of Control Questionnaire was used to measure HLoC. RESULTS: Physical activity has been shown to be a mediator in the relationship between intrinsic HLoC and health-related quality of life particularly in patients with longer disease duration. Intrinsic HLoC was positively associated with engaging in physical activity, which in turn was positively associated with the physical component of quality of life in patients with longer (indirect effect: ß = -0.077, p < 0.05) and moderate (ß = -0.040, p < 0.05) duration of illness. CONCLUSION: The results highlight the importance of psychological resources for undertaking quality-of-life-related physical activity by MS patients with long disease duration. Particularly important here is the internal HLoC, which promotes physical activity that increases the chance of a high quality of life.

Development and Validation of an Instrument for Assessing Nurses' Control Sources of Resilience in the COVID-19 Pandemic.

Background: Nurses' resilience in the care of patients with Coronavirus Disease 2019 (COVID-19) is essential. This study aimed to develop and validate an instrument for assessing nurses' resilience control resources in the COVID-19 pandemic. Methods: In this qualitative study, with a conventional content analysis based on a literature review and semi-structured interviews conducted with 20 nurses, the initial draft of the instrument was prepared in different aspects based on a 5-point scale. The instrument's face validity and content validity were examined in 15 nurses and 15 experts, and construct validity was obtained in 482 nurses using the available sampling method. Data were analyzed in SPSS software Version 24 using indexes and analytic tests. Results: Out of 54 items, 18 items were confirmed by the expert panel and the items had content validity ratio and content validity index scores higher than 0.79. According to the results of an exploratory factor analysis, this tool has 4 dimensions: God, chance, internal locus of control, and powerful others. They accounted for 48.06% of the total variance. CFA showed the indices confirmed the model fit (χ2/df = 1.846, comparative fit index = 0.921, incremental fit index = 0.923, root mean square approximation error = 059, goodness of fit index = 0.905). The reliability of the instrument was acceptable (Ω > 0.70, α > 0.7, CR >0.60, and intra-class correlation coefficients > 0.70). Conclusion: The developed tool is used to measure the control resources of nurses' resilience in caring for COVID-19 patients. It can help recognize the focus areas for developing appropriate interventions.

The Way Older Childless Women Value Their Life-A Qualitative Study.

Older women without children, like all older adults, evaluate their lives and face a conflict between despair and ego integrity as proposed by Erikson's theory of development. Their uniqueness lies in their deviation from the societal norm of parenthood prevalent in pro-natalist societies such as Israel. This study aims to explore how older childless women evaluate their lives. Using a qualitative approach, 20 semi-structured, in-depth interviews were conducted with women over 60 years of age who do not have children. Three main themes emerged from the participants' responses: their experiences as women without children in a pro-natalist society, the significance of freedom in their lives, and their life experiences from conflicting perspectives-an internal and external locus of control. The study's findings demonstrate that older childless women adeptly utilize different perspectives across various aspects of their lives, contributing to ego integrity, contrary to the prevailing societal notion that in the absence of children, women are damaged and lack identity. It is conceivable that other segments of the older adult population, diverging from mainstream societal norms, may similarly leverage these different perspectives to uphold their ego.

Self-directed learning in dental hygiene students: Impact of locus of control and personality traits.

OBJECTIVES: The purpose of this study was to identify demographic variables, the level of self-directed learning (SDL), locus of control (LOC), and personality traits in dental hygiene (DH) students and to identify predictive variables for SDL. METHODS: Cross-sectional survey research was conducted with a convenience sample of DH students (n = 229) in the United States using a web-based survey. The validated instruments used were the Self-Directed Learning Instrument (SDLI) to determine level of SDL, the Academic Locus of Control (ALC) scale for college students to evaluate LOC, and the Big Five Inventory-2-Extra Short Form (BFI-2-XS) to identify personality traits. Descriptive, correlation, and regression analyses were performed. RESULTS: The completion rate was 68.9% (n = 159). The average SDLI score of the sample was 82.59, indicating a high overall level of SDL. The average ALC score was 10.34, indicating an overall internal LOC. Internal LOC (B = -0.319, SE = 0.082, ß = -0.330, p < 0.001) and an open-minded personality trait (B = 1.156, SE = 0.363, ß = 0.233, p = 0.002) emerged as significant predictors of learning motivation (B = -0.138, SE = 0.057, ß = -0.214, p < 0.017) and self-monitoring (B = 0.553, SE = 0.253, ß = 0.167, p = 0.030) SDLI constructs. CONCLUSION: SDL among DH students can be cultivated by enhancing their learning motivation and self-monitoring skills. This may be achieved by helping learners increase their internal locus of control and open-mindedness. Future studies should explore exercises to help promote these traits.

Association between nutrition self-efficacy, health locus of control and food choice motives in consumers in nine European countries.

We investigated associations between food choice motives and psychological determinants of dietary health behaviour change (nutrition self-efficacy, NS-E, and health locus of control, HLoC) among 9381 participants (18-65 years, 49.4% females) from nine European countries. Price was the highest rated food choice motive. Higher importance of all motives was associated with higher NS-E and with higher Internal HLoC. Relationships between food choice motives and External HLoC were also in the expected direction in showing negative associations with Health, Natural Content, Weight Control, Mood and Sensory Appeal. Higher External HLoC was also associated with perceived greater importance of 'external' motives Ethical Concern, Familiarity and Convenience. Relationships between External HLoC and food choice motives were not all in the expected direction. Price was unrelated to External HLoC. Females rated the importance of all motives higher than males. People with less education ascribed greater importance to Price in motivating food choices. Together, these findings imply that self-efficacy and health locus of control should be considered along with motivations for food choice in dietary health promotion.

Health locus of control and symptom distress: The mediating role of illness acceptance and symptom severity in acute leukemia patients.

OBJECTIVE: This study aims to explore the multiple mediating roles of illness acceptance and symptom severity between health locus of control and symptom distress in acute leukemia patients. METHODS: From June 2022 to March 2023, a convenience sampling method was used to recruit 208 acute leukemia patients in the inpatient center of a hospital in Hebei. The Chinese versions of Multidimensional Health Locus of Control Scale, Illness Acceptance Scale, and Anderson Symptom Assessment Scale was used in the cross-sectional study. RESULTS: All participants reported the presence of symptom distress. Symptom distress was significantly correlated with chance health locus of control, illness acceptance, and symptom severity (P＜0.05). Illness acceptance alone played a mediating role in the relationship between chance health locus of control and symptom distress in acute leukemia patients (ß=0.087, 95%CI 0.030-0.167). The indirect role of chance health locus of control on symptom distress through symptom severity alone was also statistically significant (ß=0.131, 95%CI 0.008-0.252). Furthermore, the multiple mediating role of chance health locus of control and symptom distress through illness acceptance and symptom severity combined was verified (ß=0.027, 95%CI 0.001-0.089). The alternative model is also valid, indicating bidirectional relationships between symptom severity, illness acceptance, and chance health locus of control, collectively influencing symptom distress. CONCLUSION: There is a positive relationship between chance health locus of control and symptom distress; additionally, increasing social psychological interventions for illness acceptance and strengthening the management of core symptoms will help alleviate the impact of health chance locus of control on symptom distress in acute leukemia patients. Longitudinal studies are needed to confirm the causal relationships among the variables explored within the model. IMPACT ON NURSING PRACTICE: It is recommended that healthcare professionals pay attention to the assessment of health locus of control in patients, identify patients with health chance locus of control in a timely manner, take measures to enhance their disease acceptance, and strengthen the management of core symptoms, thereby reducing their level of symptom distress.

Blending Behavioural Theory and Narrative Analysis to Explore the Lived Experience of Obesity and Assess Potential Engagement in a UK Weight Management Service: Theory and Narrative Approaches in Weight Management.

BACKGROUND: Current treatments for people with obesity emphasise the need for person-centred approaches that consider complex biopsychosocial factors and value the lived experience of people when attempting to lose weight. METHODS: Narrative interviews (n = 20) were conducted with people living with obesity to explore the causes of their weight gain and their expectations and engagement with treatment at a Weight Management Clinic. A mixed inductive and deductive qualitative analysis identified utterances that represented psychological constructs used to understand self-appraisal and health behaviour. A narrative analysis was used to situate these findings in the context of a participant's life story. RESULTS: Locus of control was a dominant construct evidenced through a person's attributional style and self-efficacy. Transcripts represented a heightened sense of self-understanding and shifts in control, and styles of attribution and efficacy resulted in either stasis or self-actualisation. The Stages of Change model could be applied to narratives to ascertain a patient's motivation to access treatment. Importantly, narrative interviews also allowed for the consideration of how a person's systemic context influenced their weight. CONCLUSION: Narrative interaction supports both self- and shared understandings of the causes and consequences of obesity for individuals, in a non-blaming or shaming manner. It provides an opportunity to enhance engagement through tailored, person-centred treatments.

Social capital and health beliefs: Exploring the effect of bridging and bonding social capital on health locus of control among women in Dhaka.

This cross-sectional study examined if social capital affects women's health attributions. The study used the Internet Social Capital Scale (ISCS) and Multidimensional Health Locus of Control (MHLC) Scale to measure Social Capital and Health Locus of Control. A predefined 38-item questionnaire was used to survey 485 purposively selected women. A bidirectional reciprocal structural equation model was used to measure the covariance between Social Capital and Health Locus of Control. We hypothesized that women with strong social capital, particularly those rich in bridging ties, would exhibit a greater sense of agency and empowerment over their health, attributing their health outcomes less to internal factors like fate and more to external influences like powerful others and broader social support. However, we found that when women have higher social capital, their external health locus of control increases. Bridging and bonding social capital lower women's internal health control, but bridging social capital leads to higher attributes to powerful others. Likewise, we expected women with more social capital would exhibit a lower perception of uncontrollability over their health, but is not the case. The findings underscore the necessity for women to have more social capital.

Anticipatory anxiety of seizures in epilepsy: A common, complex, and underrecognized phenomenon?

The diagnosis of epilepsy is associated with loss of predictability, which invariably results in the fear of when and if future seizures will occur. For a subset of patients with epilepsy (PWE), there may be a pathological persistent fear of seizure occurrence, resulting in limitations to daily activities through avoidant behaviors. Paradoxically, the research of anticipatory anxiety of seizures (AAS; also referred to as seizure phobia) has been practically nonexistent and, not surprisingly, this condition remains underrecognized by clinicians. The available data are derived from three small case series of patients followed in tertiary epilepsy centers. In this study, we review the available data on the reported clinical manifestations of AAS in PWE, and of the potential role of variables associated with it, such as personal and family psychosocial and psychiatric history and epilepsy-related variables. In addition, we review the need for the creation of screening tools to identify patients at risk of AAS and discuss potential treatment strategies, which could be considered as part of the comprehensive management for PWE.

A Study on the Sense of Parental Competence, Health Locus of Control and Levels of Anxiety, Depression and Somatization in Parents of Children with Type 1 Diabetes: Evidence on a Possible Relationship.

Background: Parents of children with chronic conditions face challenges that go beyond basic care and parenting responsibilities. Parents' experiences can be influenced by perceived stress, emotional experiences, feelings of helplessness, low sense of self-efficacy, anxiety and depression, reducing their quality of life. It is therefore not surprising that parents of children with chronic illnesses are more likely to experience stress, anxiety and depression than parents of healthy children. A prevalent chronic condition is type 1 diabetes. Methods: Parents (31 with children with type 1 diabetes diagnosis and 71 with children without chronic illness) were recruited to complete the measures of the Brief Symptom Inventory-18 (BSI-18), the Parent Health Locus of Control (PHLOC) and Parenting Sense of Competence (PSOC). Results: Significant differences in depression and internal locus of control were found; there was a positive correlation between internal LOC and efficacy in both samples; furthermore, there was a negative correlation between somatization and satisfaction in the experimental group. Conclusions: The ongoing experiences and challenges faced daily make parents perceive themselves as capable. Active involvement in supporting and managing the needs of child with type 1 diabetes could be a source of empowerment for the parent, contributing to the maintenance of their sense of competence. It is important, therefore, to consider the well-being and perception of the parent at a personal level, regardless of the child's situation.

Exploring the relationship between personality traits and locus of control in early adolescence. Does gender play a role?

The main aim of this study was to analyse associations between the five-factor model personality traits and locus of control of successes and failures based on the theory of social learning and to assess whether gender moderated relationships between these variables in Polish early adolescents. The following instruments were used: the Picture Based Personality Survey for Children and the Locus of Control Questionnaire. A total of 1016 students participated in the study, including 49% boys and 51% girls. Both for girls and boys, the highest correlations were found between conscientiousness and locus of control in success situations. Neuroticism correlated negatively with the two types of locus of control. A moderating effect of gender was observed between openness to experience and locus of control of successes, and it was stronger in girls than in boys.

Childhood Adversity and Incident Psychotic Experiences in Early Adulthood: Cognitive and Psychopathological Mediators.

BACKGROUND AND HYPOTHESIS: Childhood adversity is often described as a potential cause of incident psychotic experiences, but the underlying mechanisms are not well understood. We aimed to examine the mediating role of cognitive and psychopathological factors in the relation between childhood adversity and incident psychotic experiences in early adulthood. STUDY DESIGN: We analyzed data from the Avon Longitudinal Study of Parents and Children, a large population-based cohort study. Childhood adversity was measured prospectively from birth to age 11 years, mediators (anxiety, depression, external locus of control [LoC], negative symptoms) were assessed at approximately 16 years of age, and incident psychotic experiences were assessed at ages 18 and 24 years. Mediation was examined via the counterfactual g-computation formula. STUDY RESULTS: In total, 7% of participants had incident suspected or definite psychotic experiences in early adulthood. Childhood adversity was related to more incident psychotic experiences (ORadjusted = 1.34, 95% CI = 1.21; 1.49), and this association was partially mediated via all mediators examined (proportion mediated: 19.9%). In separate analyses for each mediator, anxiety, depression, external LoC, and negative symptoms were all found to mediate the link between adversity and incident psychotic experiences. Accounting for potential confounders did not modify our results. CONCLUSIONS: Our study shows that cognitive biases as well as mood symptomatology may be on the causal pathway between early-life adversity and the development of psychotic experiences. Future studies should determine which mediating factors are most easily modifiable and most likely to reduce the risk of developing psychotic experiences.

Explaining differences in self-focused and other-involved public health preventive behaviors between the US and China: the role of self- construal and health locus of control.

Background: This study examined national similarities and differences in people's engagement in health preventive behaviors during a public health crisis, as well as investigated the underlying individual-level psychological mechanisms. A conceptual distinction was made between self-focused and other-involved preventive behaviors in response to public health crises. Method: Two cross-sectional surveys were conducted in the United States (N = 888) and China (N = 844) during the early stage of the COVID-19 pandemic. Hayes' PROCESS was utilized to assess national differences in seven preventive behaviors, along with the mediating effects of self-construal and health locus of control. Results: The results showed that American participants reported greater engagement in self-focused preventive behaviors than Chinese, whereas Chinese participants reported greater engagement in other-involved preventive behaviors than Americans. Chinese participants also engaged more in other-involved than self-focused preventive behaviors. Self-construal and health locus of control partially explained the observed differences in engagement in preventive behaviors. Discussion: This study introduces a culture-sensitive approach to provide insights for crafting communication interventions that can enhance the effectiveness of health campaigns in the context of a public health crisis.

Fatalism and depressive symptoms among Chinese college students: Mediation models of locus of control and positive coping.

Fatalistic voluntarism and classic fatalism have opposite effects on depression. This study attempted to measure fatalistic voluntarism with the magnanimity of Taoist values and examined the internal mechanism by which classic fatalism and magnanimity influenced depression. A total of 525 Chinese college students effectively completed self-reported questionnaires. Results showed that classic fatalism is positively correlated with depression, and magnanimity is negatively correlated with depression. Furthermore, classic fatalism and magnanimity can influence depression in Chinese college students through serial mediation by locus of control and positive coping. These findings illuminate the mediating role of locus of control and positive coping, providing specific ways to use two different belief systems, which can help reduce depressive symptoms among college students. In addition, our study may provide some ideas for the development of local culture in the promotion of mental health in different regions.

The self-management experiences of individuals who perceive health as beyond their control: An interpretive phenomenological study of individuals with ischemic heart disease.

This qualitative study aimed to gain an understanding of what it means to live with ischemic heart disease for individuals who perceive health as beyond their control and how these individuals navigate their choices regarding adhering or not adhering to self-management behavior. Participants were recruited through purposive sampling, and semi-structured interviews were conducted. Content analysis was employed to identify themes and subthemes in the interview data. The theme, "attribution of ischemic heart disease," revealed that the participants attributed their condition to lifestyle, critical events, and the natural aging process. The theme, "experiences of self-management," highlighted the different behaviors among participants who perceived health to be beyond their control. The theme, "barriers and facilitators," identified factors such as a strong sense of responsibility toward family members, the work environment, and access to medical resources. Our study showed that despite perceiving their health to be beyond their control, some individuals may still adhere to self-management practices. Understanding factors such as "attribution" and "barriers and facilitators" can provide nurses with insights into the patients' decisions to adhere or not adhere to self-management behaviors.

Psychological separation, health locus of control, and transition readiness in adolescents and young adults with type I diabetes.

PURPOSE: The purpose of this study was to examine the effects of psychological separation and health locus of control on the health care transition readiness of adolescents and young adults (AYAs) with type 1 diabetes. METHODS: Data were collected between December 2020 and October 2021. One hundred twelve AYAs with type 1 diabetes treated at a tertiary hospital and under follow-up observation as well as AYAs with type 1 diabetes nationwide who were part of the type 1 diabetes internet community were enrolled. The Psychological Separation Inventory, the Multidimensional Health Locus of Control scale from C, and the Self-management and Transition to Adulthood with Therapeutics = Rx Questionnaire were used. RESULTS: Multiple regression analysis indicated that age (ß = 0.302, p = .001), hemoglobin A1c (HbA1c) (ß = -0.174, p = .040), conflictual separation (ß = 0.242, p = .005), functional separation (ß = 0.200, p = .045) and attitudinal separation (ß = -0.240 p = .015) were significantly associated with health management transition readiness; these predictors explained 27.6% of health care transition readiness (F = 8.062, p = .000). CONCLUSIONS: AYAs with type 1 diabetes can enhance readiness for health care transition by fostering psychological separation from parents, effectively managing blood glucose levels, and taking into account age-related factors during the preparation process. At this point, it is essential for healthcare professionals to guide parents in recognizing adolescents' psychological independence and facilitating their supportive role through the process of redefining their roles. PRACTICE IMPLICATIONS: Health care providers should promote psychological separation in AYAs. Additionally, taking into account the developmental characteristics of adolescence can facilitate a successful health care transition.

Psychological well-being and factors affecting it after the COVID-19 pandemic.

Introduction: The COVID-19 pandemic has enormously impacted human activity worldwide, partly due to many governments issuing stay-at-home orders and limiting the types of social interactions citizens can engage in. Hence, this study investigated psychological well-being and factors affecting it after the COVID-19 pandemic. Methods: A total of 345 participants were recruited in the study. This research was conducted between February and May 2023 in Sarab, East Azerbaijan, Iran. To measure the data, valid and reliable instruments of Goldberg's General Health Questionnaire (GHQ-28), Multidimensional Health Locus of Control (MHLC), interpersonal support evaluation list (ISEL-SF), and health-protective behaviors checklist instrument were used. Results: According to the results, health locus of control (r = 0.227; p < 0.001), social support (r = 0.339; p < 0.001), and COVID-19 preventive behaviors (r = 0.376; p < 0.001) were positively correlated with psychological well-being. The strongest correlation was observed between psychological well-being and protective behaviors (r = 0.376; p < 0.001). In the hierarchical regression model, total, demographic characteristics along with health locus of control, social support, covid-19 preventive behaviors, and history of COVID-19 infection were able to explain 57.4% of the variation in psychological well-being. Discussion: Public healthcare providers' and policymakers' preventive and supportive actions are highly advised for promoting health locus of control and social support in adults after the COVID-19 pandemic. In addition, it is better to include a community's social and environmental changes.