The Relationship Between Perceived Uncontrollable Mortality Risk and Health Effort: Replication, Secondary Analysis, and Mini Meta-analysis.

BACKGROUND: The Uncontrollable Mortality Risk Hypothesis (UMRH) states that those who are more likely to die due to factors beyond their control should be less motivated to invest in preventative health behaviors. Greater levels of perceived uncontrollable mortality risk (PUMR) have been associated with lower health effort in previous research, but the topic remains understudied. PURPOSE: To examine the evidence for the UMRH by replicating a previous study investigating the effects of PUMR on social gradients in health effort, and conducting a mini meta-analysis of the overall relationship between PUMR and health effort. METHODS: We replicated Pepper and Nettle (2014), who reported a negative relationship between PUMR and health effort, and that the positive effect of subjective socioeconomic position on health effort was explained away by PUMR. We also compared the predictive effect of PUMR on health effort with that of dimensions from the Multidimensional Health Locus of Control scale-a well-used measure of a similar construct, which is frequently found to be associated with health behavior. Finally, we conducted a mini meta-analysis of the relationship between PUMR and health effort from the available research. RESULTS: PUMR was negatively associated with health effort, and mediated 24% of the total effect of subjective socioeconomic position on health effort, though this mediation effect was weaker than in Pepper and Nettle (2014). PUMR was shown to be a substantially stronger predictor of health effort than the relevant dimensions of the MHLC scale. Finally, our mini meta-analysis indicated a medium-sized negative relationship between PUMR and health effort. CONCLUSIONS: Our findings offer support for the role of PUMR in mediating the relationship between subjective socioeconomic position and health effort. The results highlight the importance of measuring and understanding PUMR in studying socioeconomic inequalities in health behaviors. We discuss potential areas for future research, including determining the accuracy of PUMR, investigating influential cues, examining the role of media in shaping risk perceptions, and understanding individuals' awareness of their own perceptions of mortality risk.

Previous research suggests that people who are more likely to die due to uncontrollable factors are less motivated to look after their health. This is because they are less likely to live to see the long-term benefits of a healthy lifestyle. The purpose of this study is to examine and expand upon previous research investigating the relationship between perceptions of uncontrollable mortality risk and the amount of effort people devote to their health. Our findings support past research and show that the more people feel their risk of dying is out of their control, the less effort they put into looking after their health. Our analysis suggests there is a medium-strength relationship between perceived uncontrollable mortality risk and health effort, which we argue warrants further empirical investigation. The strength of this relationship emphasizes the importance of improving the safety of people's living environments and highlights the positive impact that this can have on health behaviors.

Does effort increase or decrease reward valuation? Considerations from cognitive dissonance theory.

The present research tested the effect of manipulated perceived control (over obtaining the outcomes) and effort on reward valuation using the event-related potential known as the Reward Positivity (RewP). This test was conducted in an attempt to integrate two research literatures with opposite findings: Effort justification occurs when high effort leads to high reward valuation, whereas effort discounting occurs when high effort leads to low reward valuation. Based on an examination of past methods used in these literatures, we predicted that perceived control and effort would interactively influence RewP. Consistent with the effort justification literature (cognitive dissonance theory), when individuals have high perceived control, high effort should lead to more reward valuation than low effort should. Consistent with the effort discounting literature, when individuals have low perceived control, low effort should lead to more reward valuation than high effort should. Results supported these interactive and integrative predictions.

Physical effort paradox during reward evaluation and links to perceived control.

Effort expenditure not only prospectively discounts the reward associated with it but also retrospectively adds the subjective value of reward, which is known as the effort paradox. This study aimed to resolve the effort paradox during reward evaluation through the critical lens of neural dynamics and its potential moderators. In total, 40 participants completed an effort-reward task wherein they exerted varying physical efforts to obtain an opportunity to win monetary rewards by active or passive decision-making. We found that after-effects of physical effort expenditure during reward evaluation unfolded as an effort paradox over time, manifesting itself as an effort discounting effect during the reward positivity (RewP) period but as an effort enhancement effect during the late positive potential (LPP) interval. Then, we found a dynamic balance between the discounting effect and the enhancement effect such that the more effort discounted the RewP at the early stage, the more effort increased the LPP at the late stage. Moreover, we observed that the effort-reward relationship was modulated by perceived control such that it increased the reward sensitivity effect and decreased the effort discounting effect. Together, our findings provide new insights into the neural mechanisms underlying the after-effects of physical effort exertion during reward evaluation.

Perceived control, self-management efficacy, and quality of life in patients treated with radiation therapy for breast cancer: a longitudinal study.

OBJECTIVE: This longitudinal study aims to examine the present state of perceived control, self-management efficacy, and overall quality of life (QoL) in patients with breast cancer undergoing radiotherapy, and gain insight into the dynamic trends and factors that influence the quality of life experienced by patients during the course of radiotherapy. METHODS: Participants completed the Cancer Experience and Efficacy Scale (CEES), Strategies Used by People to Promote Health (SUPPH), and Functional Assessment of Cancer Therapy- Breast (FACT-B). The data was analyzed using the software SPSS26.0. Repeated measures analysis of variance (ANOVA) and mixed-effects linear models were used to analyze trends in perceived control, self-management efficacy, and QoL at three-time points, as well as factors affecting QoL during radiotherapy. RESULTS: Perceived control and self-management efficacy were associated with QoL over the course of the radiotherapy. Self-management efficacy (ß = 0.30, P < 0.001), presence of chemotherapy (ß = 18.33, P = 0.024), and duration of illness (ß = 2.25, P = 0.028) had a positive effect on the change in QoL, while time (ß = - 2.95, P < 0.001), cancer experience (ß = - 0.46, P < 0.001), and type of medical insurance (ß = - 2.77, P = 0.021) had the negative effect on the change in QoL. CONCLUSION: The QoL, perceived control, and self-efficacy of patients with breast cancer show dynamic changes during radiotherapy. The higher the self-efficacy, the better the QoL, and the worse the QoL when the sense of disease control is poor. At the same time, more attention should be paid to the QoL of breast cancer radiotherapy patients with a long course of the disease, receiving chemotherapy, and different medical payment methods.

Mediational roles of stress-coping factors in the relationship between patient-perceived communication quality and physical functioning: racial difference between Chinese and Non-Hispanic White American breast cancer survivors.

PURPOSE: The assumption that patient-provider communication may mediate patients' sense of control over cancer to affect health outcomes has limited evidence. This study examines whether patient-perceived cancer care communication quality (PPCQ) mediates stress appraisal and coping behavior, affecting physical functioning across different racial groups. METHODS: Two hundred and twenty Chinese American and 216 non-Hispanic White (NHW) women (ages 28-80) with stage 0-III breast cancer, 1-5 years post-diagnosis, and without recurrence, enrolled and completed a cross-sectional telephone survey. Physical functioning was measured by the NIH-PROMIS short form. Validated measures of PPCQ, patients' evaluation of their socioeconomic well-being, stress appraisal (perceived severity and control), use of coping strategies, treatment-related symptoms, and comorbidities were also assessed. Path analyses were used to examine the mediation for each racial group. RESULTS: Regardless of race, treatment-related symptoms, comorbidities, and socioeconomic well-being were all directly related to physical functioning (p < 0.05). The impact of PPCQ on physical functioning was mediated by perceived control in the Chinese American group (p < 0.05), but not in the NHW group. Perceived severity and coping were not mediators of physical functioning in either group. CONCLUSIONS: The mediational pathway from PPCQ to perceived control to physical functioning in Chinese American survivors may be partially explained by their lower socioeconomic well-being and culturally valued conformity to physicians as a medical authority. These sociocultural dynamics reinforce the importance of cancer care communication. For NHW survivors, the impact of treatment-related symptoms and socioeconomic well-being on physical functioning outweighed their PPCQ and perceived control.

Caregiver interactions, perceived control, and meaning in life of elderly: the moderating effect of the elderly-to-social worker ratio.

BACKGROUND: Meaning in life is a widely accepted aim in promoting psychosocial health in institutional care. However, how caregiver interaction and perceived control impact meaning in life among the elderly remains unclear. This study explores the effect of institutional caregiver interaction, family caregiver interaction, and perceived control on meaning in life among elderly residents in China, and the potential moderating effect of elderly-to-social worker ratio in these associations. METHODS: Multistage random sampling was used to recruit a sample of 452 elderly residents from 4 elderly care homes in urban China. A structural equation model was used to test the study hypothesis. RESULTS: Institutional caregiver interaction is positively related to meaning in life, and perceived control among elderly residents has a positive impact on meaning in life. Moreover, the elderly-to-social worker ratio moderated the relationship between institutional caregiver interaction and meaning in life, as well as between family caregiver interaction and meaning in life. CONCLUSIONS: Increase elderly's meaning in life is an important service target for the caring professions in institutional care. Social workers affect the effectiveness of interventions on elderly's meaning in life in institutional care. A higher elderly-to-social worker ratio could improve the effectiveness of interventions on meaning in life for elderly residents.

The effects of attitudes, norms, and perceived control on the adaptation of elderly individuals and individuals with chronic health conditions to heatwaves.

BACKGROUND: In this study, the theory of planned behaviour (TPB) was used to examine the determinants of the heat protection intentions and actions of elderly individuals and individuals with chronic health conditions. This is an important topic as understanding the motivations for adapting behaviours to heatwaves can inform the design of warning systems and awareness campaigns by public health authorities to mitigate the adverse effects of weather hazards on health. METHODS: Three phone surveys were conducted in 2015 and 2016 to collect data on a large sample of individuals with increased vulnerability to heatwaves in the city of Longueuil, Canada. Prospective and panel fixed effects logit models for ordinal variables were used to analyse the factors that influenced heat protection intentions and actions. RESULTS: Attitudes, norms, and perceived control have positive effects on intentions to adopt heatwave protection actions and intentions on the effective adoption of these preventive measures. The hypothesis according to which perceived control moderates the effect of attitudes and norms on intentions is rejected. In addition, the results suggest that elderly individuals are less likely than individuals in other age groups to adopt heat protection actions. Health conditions related to vulnerability to hot weather do not seem to significantly improve the adoption of heat protection behaviours. CONCLUSIONS: The adoption of heatwave protection actions can be improved by public health interventions that influence attitudes and social norms related to heat protection behaviours and facilitate their adoption.

Validation of the Spanish version of the Perceived Control Scale: Perceived Constraints on Personal Control and Perceived Mastery.

OBJECTIVES: Perceived control is a relevant variable for understanding middle and older adults' mental health. The Perceived Control Scale has two dimensions, Perceived Constraints on Personal Control and Perceived Mastery, and is a widely used instrument for assessing perceived control in adults. The aim of this study was to analyze the psychometric properties of the Spanish version of the Perceived Control Scale with data from two different studies. METHOD: In Study 1, 348 older adults between 60 and 92 years old were assessed through face-to-face assessments. In Study 2, 334 adults between 40 and 90 years completed an online survey. Perceived control, self-perceptions of aging, and anxiety and depressive symptomatology were assessed. An exploratory (Study 1) and confirmatory (Study 2) factor analysis of the Perceived Control Scale were performed, and reliability and its relationship with the other assessed variables were evaluated. RESULTS: Results from parallel, exploratory, and confirmatory factor analyses suggested that the Spanish version of the Perceived Control Scale has a bidimensional structure: Perceived Constraints on Personal Control and Perceived Mastery. Good internal consistency was found for the scale in both samples. The results revealed negative and significant associations with negative self-perceptions of aging, and anxiety and depressive symptomatology. CONCLUSION: The Spanish version of the Perceived Control Scale shows good psychometric properties which endorse its use with middle-aged and older adults assessed either face-to-face or through online surveys.

[Intercultural adaptation of the PUKSoPC in German language : A scale for perceived control in patients with Parkinson's disease]. / Interkulturelle Adaptation der PUKSoPC in deutscher Sprache : Eine Skala zur gefühlten Kontrolle von Parkinson-Patientinnen und -Patienten.

BACKGROUND: The level of perceived control in people with Parkinson's disease plays a significant role in affecting their quality of life. Simpson et al. developed a scale of perceived control specific to Parkinson's disease called the Parkinson's UK Scale of Perceived Control (PUKSoPC). In this work, we present a cross-culturally adapted German translation of the original English version. METHODS: After receiving approval by the original authors, an internationally established procedure was used for cross-cultural adaptation. Firstly, the original English version was translated into German independently by two bilingual neuroscientists, who then agreed on a consensus version. This was tested on 10 people with Parkinson's disease and independently back translated into English by two different neuroscientists. After forming a consensus version, this English version was compared with the original version by all four translators. Differences between the versions resulted in modifications to the German translation so that the back translation matched the original as closely as possible. The final version was approved by two of the original authors and clinically tested on 50 people with Parkinson's disease. RESULTS: During the translation process, the four translators agreed on a culturally adapted German version of the PUKSoPC. Testing of the final version on 50 people with Parkinson's disease did not reveal any linguistic or content-related problems. CONCLUSION: The linguistically validated German version of the PUKSoPC presented in this paper is now freely available for measuring the levels of perceived control in people with Parkinson's disease to advance both research and clinical practice.

Individual characteristics associated with perceptions of control over mortality risk and determinants of health effort.

People who believe they have greater control over health and longevity are typically more likely to invest in their long-term health. Investigating individual differences in perceived control over risk and exploring different determinants of health effort may help to tailor health promotion programs to more effectively encourage healthy behaviors. From a sample of 1500 adults, we measured perceived control over 20 causes of death, overall perceived uncontrollable mortality risk (PUMR), state-level optimism, self-reported health effort, and the accuracy of estimations of avoidable deaths. We found individual differences in perceptions of control over specific causes of death based on age, gender, and income. PUMR was predicted by socioeconomic variables expected to influence exposure to risk and resource availability. Higher levels of PUMR, not perceptions of control over specific causes of death, predicted self-reported health effort. The strength of relationship between PUMR and lower health effort was not moderated by state-level optimism. Age and education both positively predicted greater accuracy in assessing the prevalence of avoidable deaths. We suggest that PUMR may capture people's "general sense" of mortality risk, influenced by both exposure to hazards and the availability of resources to avoid threats. Conversely, perceived control over specific risks may involve more deliberate, considered appraisals of risk. This general sense of risk is thought to play a more notable role in determining health behaviors than specific assessments of control over risk. Further study is needed to investigate the degree to which PUMR accurately reflects objective measures of individual risk.

Sense of control and likelihood of prescription drug misuse 10-years later among middle-aged and older adults.

Objectives: Sense of control (i.e. one's beliefs about their ability to influence life circumstances) has been linked to various psychological outcomes. However, it is unknown if sense of control is protective against prescription drug misuse (PDM). The present study sought to evaluate if sense of control is associated with reduced odds of PDM 9 to 10 years later among a sample of middle-aged and older adults.Methods: Data were evaluated from participants (M = 54 years, SD = 10.86; N = 2,108) of the second and third waves of the Midlife in the United States study. Logistic regression models were used to assess whether baseline sense of control (Wave 2) predicted odds of PDM 9 to 10 years later (Wave 3).Results: Findings revealed that greater sense of control at baseline was related to reduced odds of subsequent PDM (OR = 0.78; 95% CI: 0.64, 0.95), adjusting for baseline PDM, sociodemographic characteristics, health behaviors, psychological factors, number of prescription medications, and health. When assessing the subscales of sense of control separately, constraints (OR = 1.19; 95% CI: 1.00, 1.42), but not mastery (OR = 0.96; 95% CI: 0.80, 1.12), was predictive of odds of subsequent PDM. Further, being female was associated with greater odds of PDM (OR = 1.46; 95% CI: 1.02, 2.09), but did not moderate the association between sense of control and PDM.Conclusions: Sense of control may be a novel and viable target for interventions (e.g. using mobile phone apps) aimed at mitigating prescription drug misuse.

Valence and perceived control in personal and collective future thinking: the relation to psychological well-being.

Prior studies have shown that people imagine their personal future to be more positive than their country's collective future. The present research extends the nascent literature by examining the valence and perceived control of personal and national future events in a new experimental paradigm, the cultural generalizability of the findings, and the relation of future thinking to psychological well-being. US college students (Study 1) and US and Turkish community participants (Study 2) imagined what might happen to them and their country in three time points (i.e., next week, next year, and in 10-15 years). They then rated the emotional valence and perceived control of the events and completed a psychological well-being measure. Both US and Turkish participants imagined their personal future to be more positive than their country's future, whereas they attributed higher perceived control to their countries for national future events than to themselves for personal future events. The positivity of national (Study 1) and personal future events (Study 2) predicted better psychological well-being, whereas perceived control did not. These original findings enrich our theoretical understanding of future thinking.

The effect of episodic foresight on intertemporal decision-making: the role of future self-continuity and perceived control.

To investigate the mechanism of episodic foresight of different valences on intertemporal decision-making, this study examined the mediating role of future self-continuity in the influence of episodic foresight on intertemporal decision-making and the moderating role of perceived control in two experiments. The results found that (1) future self-continuity mediated the effect of episodic foresight on individuals' intertemporal decision-making; and (2) perceived control moderated the indirect effect of episodic foresight on intertemporal decision-making through future self-continuity. Under low perceived control, individuals with positive episodic foresight had stronger future self-continuity and preferred future options, while individuals with negative episodic foresight had lower future self-continuity. In contrast, under high perceived control, individuals with different episodic foresight potencies did not show significant differences in their future self-continuity levels, but all showed higher levels and tended to choose the delayed option when faced with an intertemporal choice. From the perspective of the self-cognition, this study provided new insights into the relationship between episodic foresight and intertemporal decision-making and the psychological mechanisms of intertemporal decision-making.

Perceived Neighborhood Safety and Depressive Symptoms: The Role of Perceived Neighborhood Cohesion and Perceived Control.

Few have examined mechanisms explaining the link between perceived neighborhood unsafety, neighborhood social processes, and depressive symptoms for Black adolescents. The goal of this study was to examine the role of perceived control as a mechanism linking perceptions of neighborhood unsafety and depressive symptoms, and neighborhood cohesion as a protective factor. Participants were 412 Black adolescents living in a major Mid-Atlantic urban center in the United States (49% female, Mage = 15.80, SD = 0.36). Participants reported perceptions of neighborhood unsafety at grade 10, neighborhood cohesion at grade 10, perceived control at grades 10 and 11 and depressive symptoms in grades 10 and 12. High neighborhood unsafety was associated with low perceived control and in turn high depressive symptoms only when neighborhood cohesion was high. The results highlight the role of neighborhood unsafety and perceived control in the development of depressive symptom and the possible downsides of neighborhood social factors.

Longitudinal Associations of Perceived Mastery and Constraints With Coping and Their Implications for Functional Health for Aging Adults.

The present study examined longitudinal associations of distinct dimensions of perceived control (i.e., perceived mastery and constraints) with approach and avoidance coping relating to functional health for aging adults, which had not been well studied previously. Using data from two waves of Midlife in the United States (N = 4,963, whose mean age was 55.4 [SD = 12.5]), a longitudinal path model was analyzed for direct and indirect effects among perceived mastery and constraints, approach and avoidance coping, and functional limitations. Bidirectional associations were observed between perceived mastery and approach coping and between perceived constraints and avoidance coping. Moreover, perceived constraints not only were directly associated with functional limitations but also mediated the longitudinal associations of the other factors of interest with functional limitations. These findings can inform future research on perceived control and coping in the context of promoting functional health.

Mechanisms of change in treatments for transdiagnostic emotion dysregulation: The roles of skills use, perceived control and mindfulness.

Emotion dysregulation (ED) is a key target for change among empirically supported treatments for emotional disorders, including dialectical behaviour therapy skills training (DBT-ST), yet how treatments improve ED is poorly understood. Using data from a randomised trial of DBT-ST versus supportive group therapy for transdiagnostic ED, we tested whether three mechanistic variables-behavioural skills use, mindfulness, and perceived control-explain variability in ED within people over time. We additionally explored the mediating roles of these variables between conditions. Adults with transdiagnostic ED (N = 44) participated in weekly groups for 4 months, with assessments at pre-, mid- and post-treatment and at 2-month follow-up. As hypothesised, multilevel models disaggregating within- and between-person effects indicated that skills use, mindfulness, and perceived control each had significant total and unique within-person associations with ED at concurrent time points, net the effect of time. Unexpectedly, these within-person relations were not significant for mechanistic variables predicting ED 2 months later. Further, unique between-person variability in skills use, mindfulness, and perceived control did not significantly mediate the relationship between condition and ED improvements. The present study is an important step in clarifying ED mechanisms of change, both within and between persons.

Valued Outcomes in the Cancer Experience (VOICE)™: Development and validation of a multidimensional measure of perceived control.

OBJECTIVE: Enhancing cancer patients' sense of control can positively impact psychological well-being. We developed and assessed the psychometric properties of Valued Outcomes in the Cancer Experience (VOICE)TM, a measure of patients' perceived control over key personal priorities within their cancer experience. METHODS: VOICE construction and testing were completed in three phases with separate participant samples: (1) item generation and initial item pool testing (N = 459), (2) scale refinement (N = 623), and (3) confirmatory validation (N = 515). RESULTS: A 21-item measure was developed that captures cancer patients' sense of control in seven key domains: (1) Purpose and Meaning, (2) Functional Capacity, (3) Longevity, (4) Quality Care, (5) Illness Knowledge, (6) Social Support, and (7) Financial Capability. VOICE demonstrated adequate internal consistency (full-scale α = 0.93; factor α = 0.67-0.89) and adequate to strong convergent and discriminatory validity. SIGNIFICANCE OF RESULTS: VOICE measures cancer patients' perceived control across a diverse range of personal priorities, creating a platform for elevating patient perspectives and identifying pathways to enhance patient well-being. VOICE is positioned to guide understanding of the patient experience and aid the development and evaluation of supportive care interventions to enhance well-being.

Coping with Coronavirus Pandemic: Risk Perception Predicts Life Optimism.

Given that the coronavirus pandemic has become a severe concern worldwide, how can optimism be maintained during an outbreak of a collective pandemic? We propose that perceived control and negative affect could be potential explanatory factors for optimism in the face of a pandemic. In Study 1 (N = 599), through a large-scale cross-sectional design, we showed the indirect effect of risk perception on optimism through perceived control and negative affect with structural equation modeling. In Study 2 (N = 191), we manipulated perceived risk of the pandemic and determined that experiencing a high-risk pandemic psychologically led to decreased optimism. Finally, through Study 3 (N = 186) and Study 4 (N = 217), we revealed that the effect of risk perception on optimism can be extended to overall subjective well-being and confirmed the indirect effects via perceived control and negative affect. These findings indicate that risk perception can make a difference in one's life optimism during a high-risk pandemic. Moreover, perceived control and negative affect are notable intermediary variables. Measures that strengthen publicity and transparency regarding recovery rates should be taken to help reduce public perceptions of risk and promote an optimistic life attitude.

Examining a domain-specific link between perceived control and conspiracy beliefs: a brief report in the context of COVID-19.

Although anecdotal evidence suggests that control-threatening situations are associated with an increase in conspiracy beliefs, existing research does not support this "compensatory control" hypothesis. In the current study, we test a more refined hypothesis: that the link between control threat and conspiracy beliefs is domain specific, such that perceived control in a particular domain should lead to conspiracy beliefs pertaining to that domain only. Moreover, given that conspiracy beliefs are stigmatized (i.e., not socially acceptable), we propose that they should be endorsed only when other compensatory systems are frustrated. We test these ideas in the context of the COVID-19 pandemic. Participants from North Macedonia and New Zealand, who differed in perceived government effectiveness, filled in a questionnaire measuring domain-specific and domain-general perceived control, as well as domain-specific and domain-general conspiracy beliefs. As expected, domain specificity of the control threat predicted domain-specific conspiracy beliefs in the Macedonian group only. The results have implication for compensatory control theory, suggesting that the compensatory process may not always be as fluid as believed. Supplementary Information: The online version contains supplementary material available at 10.1007/s12144-021-01977-0.

Participatory modeling from a stakeholder perspective: On the influence of collaboration and revisions on psychological ownership and perceived model quality.

Participatory enterprise modeling is about gathering domain experts and involving them directly in the creation of models, aided by modeling experts. It is meant to increase commitment to and quality of models. This paper presents an exploratory study focusing on the subjective view of the domain experts. We investigated the influence of direct collaboration versus individual modeling, and the influence of model revisions by modeling experts on psychological ownership and perceived model quality. We chose process modeling as a particular form of enterprise modeling. Our results give hint that domain experts working individually with a modeling expert perceive model quality as higher than those working collaboratively whereas psychological ownership did not show any difference. Revisions caused changes in the subjects' assessments only of model quality. Moreover, we will present qualitative results from interviews we led with the participants. They reveal interesting insight on how outcome and perception of the procedure and the method in both settings can be positively influenced. The interviews also emphasize the special role of the method experts who are sometimes even considered as co-owners of the model.