From health beliefs to self-regulation: Theoretical advances in the psychology of action control

Abstract

The paper reviews the theoretical concepts included in a range of social cognitive models which have identified psychological antecedents of individual motivation and behaviour. Areas of correspondence are noted and core constructs (derived primarily from the theory of planned behaviour and social cognitive theory) are identified. The role of intention formation, self-efficacy beliefs, attitudes, normative beliefs and self-representations are highlighted and it is argued that these constructs provide a useful framework for modelling the psychological prerequisites of health behaviour. Acknowledging that intentions do not translate into action automatically, recent advances in our understanding of the ways in which prior planning and rehearsal can enhance individual control of action and facilitate the routinisation of behaviour are considered. The importance of engaging in preparatory behaviours for the achievement of many health goals is discussed and the processes by which goals are prioritised, including their links to self-representations, are explored. The implications of social cognitive and self-regulatory theories for the cognitive assessment of individual readiness for action and for intervention design in health-related settings are highlighted.     

Self-regulation,health, and behavior: A perceptual-cognitive approach

Abstract

Self-regulation systems are designed to adapt to threats via coping procedures that make efficient use of resources based upon valid representations of the environment. We discuss two components of the common-sense model of health threats: illness representations (e.g., content and organization) and coping procedures (e.g., classes of procedure and their attributes - outcome expectancies, time-lines, dose-efficacy beliefs, etc.). Characteristics of each of these domains, and the connection between the two, are critical to understanding human adaptation to problems of physical health. Rather than posing a barrier to factors outside the person that control behavior, an emphasis on subjective construal involves a view of the person as an active problem-solver embedded in a bidirectional system of sensitivity and responsiveness vis á vis the social, physical, and institutional environments in which health threats occur and through which intervention efforts may be directed.     

Health promotion from the perspective of social cognitive theory

Abstract

This article examines health promotion and disease prevention from the perspective of social cognitive theory. The areas of overlap with some of the most widely applied psychosocial models of health are identified. The models of health promotion and disease prevention have undergone several generational changes. We have shifted from trying to scare people into health, to rewarding them into health, to equipping them with self-regulatory skills to manage their health habits, to shoring up their habit changes with dependable social supports. These transformations have evolved a multifaceted approach that addresses the reciprocal interplay between self-regulatory and environmental determinants of health behavior. Social cognitive theory addresses the socio structural determinants of health as well as the personal determinants. A comprehensive approach to health promotion requires changing the practices of social systems that have widespread detrimental effects on health rather than solely changing the habits of individuals. Further progress in this field requires building new structures for health promotion, new systems for risk reduction and greater emphasis on health policy initiatives. People's beliefs in their collective efficacy to accomplish social change, therefore, play a key role in the policy and public health approach to health promotion and disease prevention.     

Evaluating health care work settings: A holistic conceptual framework

Abstract

After offering a systems perspective that considers a diversity of job-related and personal factors, we discuss the determinants and impacts of health care work climates and how staff morale and performance can influence the treatment milieu and quality of patient care. We also describe the physical features, organizational structure and policies, and suprapersonal and task factors that help to shape health care work climates. We then review research on the connections between work climate and staff morale and performance, the interplay of work climate factors, and the role of personal factors in these relationships. Finally, we orovide some ideas about how to improve health care work settings and focus on some promising new research directions.     

Analyzing the latent factor structure of self-regulation in preschoolers: New directions regarding a differentiation of cool self-regulation

ABSTRACT

Self-regulation in preschool-aged children is a much-researched topic, but there are still disagreements regarding the dimensionality of the construct. Most studies distinguish between hot and cool self-regulation and consider self-regulation as two-factorial. Hot self-regulation tasks refer to the ability to adapt appropriately to emotional stimuli, while cool self-regulation tasks are emotionally neutral. Our study contributes to the understanding of self-regulation at preschool age and reveals new insights concerning a more differentiated view of cool self-regulation. With a total sample of 434 preschool-aged children, we conducted confirmatory and exploratory factor analyses that demonstrated a three-factorial solution. In accordance with the variables that determined the factor structure, we inferred one hot and two cool self-regulation dimensions. We identified a time component in task scoring as a potential reason for the differentiation in cool self-regulation. The novelty of our findings and study limitations are considered.     

A Big Five approach to self-regulation: personality traits and health trajectories in the Hawaii longitudinal study of personality and health

Self-regulatory processes influencing health outcomes may have their origins in childhood personality traits. The Big Five approach to personality was used here to investigate the associations between childhood traits, trait-related regulatory processes and changes in health across middle age. Participants (N = 1176) were members of the Hawaii longitudinal study of personality and health. Teacher assessments of the participants’ traits when they were in elementary school were related to trajectories of self-rated health measured on 6 occasions over 14 years in middle age. Five trajectories of self-rated health were identified by latent class growth analysis: Stable Excellent, Stable Very Good, Good, Decreasing and Poor. Childhood Conscientiousness was the only childhood trait to predict membership in the Decreasing class vs. the combined healthy classes (Stable Excellent, Stable Very Good and Good), even after controlling for adult Conscientiousness and the other adult Big Five traits. The Decreasing class had poorer objectively assessed clinical health measured on one occasion in middle age, was less well-educated, and had a history of more lifespan health-damaging behaviors compared to the combined healthy classes. These findings suggest that higher levels of childhood Conscientiousness (i.e. greater self-discipline and goal-directedness) may prevent subsequent health decline decades later through self-regulatory processes involving the acquisition of lifelong healthful behavior patterns and higher educational attainment.     

Effects of exercise self-regulation on subsequent eating self-regulation: Implications for depletion vs. improvement based on behavioral treatment foci

IntroductionAn improved understanding of individuals’ ability to self-regulate through barriers in the management of their weight-loss behaviors is important. Although self-regulation related to exercise might carry-over to increased eating-related self-regulation through the development of such skills, it also might be depleted because self-regulation is thought to be a limited resource. Additionally, mood might affect self-regulation change.ObjectiveThis field study aimed to determine if exercise-related self-regulation was associated with subsequent eating-related self-regulation, how treatment foci affected that relationship, and if mood change concurrently influenced self-regulation.MethodAn educational weight-loss treatment (n = 52) and a behaviorally based self-regulatory-focused treatment (n = 57) was administered to women with obesity via a community health-promotion setting. Baseline – Month 3 changes in their exercise self-regulation and overall negative mood, and Months 3–6 change in eating self-regulation, were assessed.ResultsImprovements were significantly greater in the self-regulation treatment group on exercise self-regulation, eating self-regulation, and mood. For the self-regulation group, there was a significant positive relationship between changes in exercise self-regulation and eating self-regulation, β = 0.27, p = 0.044. Conversely, the association of those variables was significant and inverse in the educational group, β = −0.29, p = 0.039. Reduction in negative mood was significantly related to increased exercise self-regulation, across groups, β = −0.32, p = 0.001.ConclusionWhen self-regulation was focused upon and rehearsed within an exercise context, its changes positively affected subsequent changes in eating self-regulation. However, when self-regulation was not targeted, self-regulation used for maintaining exercise depleted eating-focused self-regulation. Findings contributed to self-regulatory theory and had implications for the improvement of behavioral weight-loss treatments.     

Violence restrained: Effects of self-regulation and its depletion on aggression

Aggressive impulses arise from many factors, but they are usually held in check by social norms for self-control. Thus, the proximal cause of aggression is often failure of self-restraint. In five studies, depleted capacity for self-regulation (caused by prior, even irrelevant acts of self-regulation) increased aggressive responding, especially after an insulting provocation. When participants were insulted and their self-regulatory strength was depleted (i.e., after completing previous tasks that required self-regulation), participants were more likely to aggress. When the urge to aggress was relatively weaker (i.e., when participants were not insulted), self-regulatory depletion did not increase aggressive behavior. This effect was moderated by trait self-control: Participants low in trait self-control were particularly likely to express intentions of behaving aggressively in response to provocation, whereas participants high in trait self-control did not express intentions of responding aggressively. Laboratory, autobiographical memory, and hypothetical responses confirmed the pattern.     

Teleonics of health and healthcare: Focus on health promotion

Teleonics is an approach to the study of living systems. The latter can be regarded as synergistic collections of processes through which the systems interact with their internal and external environments. Teleonics can serve as a framework for positioning issues of health into the wider context of the fabric of life. There are essentially three webs of processes that are of relevance for a discussion of healthcare, viz, the normal web of the living fabric (Biomatrix), the “web of disease” (Pathomatrix) and the web of Healthcare. The latter interacts with the first two through the processes of Health Promotion, Disease Prevention and Disease Management. The end result of these interactions is an entirely new web of great complexity that incorporates the processes of all three webs intertwined with each other. This complexity presents a considerable challenge to all those involved in healthcare and can only be untangled with the aid of a process‐based methodology, such as teleonics.     

The allure of forbidden food: On the role of attention in self-regulation

The aim of the present studies was to examine the impact of food cues on restrained eaters’ attention for food. Previous research has shown that restrained eaters spontaneously activate hedonic thoughts in response to palatable food cues, and that such food cues also lead them to inhibit their dieting goal. We argue that as a consequence, restrained eaters’ selective attention will automatically be drawn towards hedonically relevant food items. Consistent with our expectations, the results of two studies revealed that restrained eaters, but not unrestrained eaters, displayed an attentional bias for hedonically rated food items when they had been pre-exposed to food cues. However, this attentional bias did not occur when restrained eaters were primed with the concept of dieting, thereby rendering the regulation of eating behavior more successful. These findings are discussed in the context of implicit processes in self-regulation.     

Agreeableness and the self-regulation of negative affect: Findings involving the neuroticism/somatic distress relationship

In the temperament literature, agreeableness has been theoretically linked to effortful control. Further, research in this area has suggested that effortful control may play a broad role in moderating temperament-based tendencies toward negative affect. The present three studies, involving a total of 300 undergraduate participants, sought to extend this perspective to the adult literature by examining potential interactions between agreeableness and neuroticism in predicting reported somatic symptoms. Although such symptoms have been linked to neuroticism, they are not characteristic of the interpersonal concerns linked to agreeableness. Nevertheless, all studies found that agreeableness and neuroticism interacted to predict somatic symptoms such that high levels of agreeableness decoupled the relationship between neuroticism and somatic distress. These findings indicate a broad role for agreeableness in the self-regulation of neuroticism-linked distress.     

Emergent self-regulation skills among very young ethnic minority children: A confirmatory factor model

Emerging self-regulation skills were assessed in 407 low-income African American and Latino (primarily Mexican-origin) preschoolers. A battery of self-regulation tasks was administered when children were 2½ years old and again approximately 1 year later. Confirmatory factor analyses supported four components of self-regulation: inhibitory control, complex response inhibition, set shifting, and working memory. Complex response inhibition was too rare a skill in this sample to be detected reliably from measures collected at 2½ years of age, but it emerged from measures collected at 3½ years. In addition, significant ethnic differences were found in that African American children scored better on measures of complex response inhibition and set shifting, whereas Latino children scored better on measures of inhibitory control and working memory. Implications of study findings for measuring self-regulation in low-income ethnic diverse populations of young children, as well as for developing interventions to enhance self-regulation development, are discussed.     

Parent-adolescent health conversations as action: Theoretical and methodological issues

Abstract

A qualitative research method based on action theory is proposed and illustrated for use in health psychology and health promotion research. Action refers to the goal-directed and intentional behaviors of individual and groups. Action theory has the advantage of using the perspectives provided by manifest behavior, internal processes, and social meaning in the analysis of action. In this article, the actions under consideration are the health-related conversations of parents and their adolescent children. The approach is premised on an understanding of health promotion as a family task constructed through actions such as conversations between family members. Health conversations in two parent-adolescent dyads are used to illustrate the method. The analysis includes the identification of goals, functional steps, and elements and their relation to the family health promotion project. Specific attention is paid to data gathering and analysis issues and their implications for health promotion research.     

Metacognitive processes in the self-regulation of performance in elite endurance runners

ObjectiveThis study sought to investigate the dynamics of attentional focus and cognitive control during endurance activity from a metacognitive perspective. The study also intended to examine the situational factors which may influence cognitive strategy use by elite endurance runners.DesignSemi-structured qualitative interviews were utilised.MethodTen elite-level endurance runners were interviewed to explore retrospectively their attentional focus and cognitive strategy use during endurance running.ResultsThe findings revealed that metacognitive strategies such as planning, monitoring, reviewing and evaluating, and metacognitive experiences were fundamental to cognitive control and cognitive strategy use in elite endurance runners. The findings also added to the array of active self-regulatory strategies previously reported in the literature.ConclusionsThese results suggest that metacognitive processes are central to effective cognitive control in elite endurance athletes during running. The findings allowed for the development of an integrative metacognitive framework, which incorporates dimensions of attentional focus. This model may better represent the processes which underpin cognitive control and determine cognitive strategy use in elite athletes during endurance running.     

Counteractive control over temptations: Promoting resistance through enhanced perception of conflict and goal value

The present research explored people’s everyday practice of counteractive control. Experience sampling was used to test our prediction that strong temptations would promote self-control. Participants were 237 Japanese citizens with ages ranging from 18 to 69. Results indicated that perceived temptation prompted stronger resistance and restraint of behaviors, compared to those cases where no conflict was perceived. In addition, multilevel path analysis revealed the underlying process such that (a) a strong desire toward temptation intensified perception of conflict; (b) perceived conflict bolstered the value of goals that were in disagreement with the temptation; and (c) highly valued goals promoted self-control (i.e., stronger resistance and hence less yielding to temptation).     

Socio-economic health inequalities: Their origins and implications

Abstract

Evidence attests to substantial variations in health contingent on socioeconomic position. It is argued that these effects cannot be dismissed as artefact nor can they be explained, in the main, by either social selection or an unequal distribution of accepted behavioural risk factors among different social groups. The most likely explanation would seem to be social causation. However, it is continuing social and material inequality that appears most implicated; accounts which locate the effects in childhood social and material causes are far less compelling. The persistence of socioeconomic health differentials into the materially better-off social strata and the possible determining role of relative as well as absolute living standards suggest that psychological, in addition to material, variables are likely to be involved. Isolating the key psychological variables and identifying the nature of their influences will not be easy tasks, although social relations, psychological stress, uplifts, and control have emerged as possible candidates. However, psychological mediators of this sort most probably constitute surface rather than basic causes. Socio-economic inequality, it is contended, remains the basic cause, and, as such, the proper target for intervention. Psychological interventions are unlikely to yield much in the way of dividends in this context and indeed could inadvertently contribute to victim blaming.     

A conceptual model for mental health and performance of North American athletes: A mixed methods study

ObjectiveThe demands of sport create psychological and physical challenges for athletes, making it essential to understand what factors contribute to mental health and performance optimization in sport. The purpose of this mixed-methods investigation was to develop a conceptual model for mental health and performance of North American athletes.MethodForty-three experienced athletes, coaches, and sport professionals identified, sorted, and rated 113 behaviors, thoughts, and feelings that contribute to optimal mental health and performance for athletes. Using Multidimensional Scaling, the research team created a two-dimensional point map of participant responses. Hierarchical Cluster Analysis was then used to reveal underlying clusters in the data.FindingsSeven clusters emerged from the data: Stress Management, Mental Skills, Self-Awareness, Managing Setbacks, Intentional Practice, Team Relationships, and Social Support. Though all clusters were rated as important to mental health and/or performance, the Managing Setbacks cluster displayed high importance ratings for both mental health and performance.ConclusionOur preliminary findings suggest a comprehensive approach to athlete thoughts, feelings, and behaviors contributes to optimal mental health and performance for North American athletes.     

Gender processes in school functioning and the mediating role of cognitive self-regulation

The catalysts for gender discrepancies across developmental outcomes are widely debated. This study examines cognitive self-regulation (CSR) as a mechanism for understanding gender differences in scholastic performance—both subjective school functioning and objective standardized achievement. Utilizing a national sample from the NICHD SECCYD (n = 1364), not only does CSR (i.e., attention and executive function) in 3rd grade mediate the relation between early mother–child interactions (at 54 months) and scholastic outcomes (in 5th grade), but it also predicts gender discrepancies favoring girls in grades, work persistence and socio-emotional development. Additional exploratory evidence suggests quality mother–child interactions may be more meaningful for girls' CSR; however, for boys, CSR is more predictive of school functioning. Both school functioning and standardized achievement were utilized in this study and highlight that gender differences in development and learning are nuanced and not readily discernible across all measures of scholastic performance. Implications for future research, intervention, and practice are discussed.     

Bringing out the agreeableness in everyone: Using a cognitive self-regulation model to reduce aggression

Research has shown that those individuals high in agreeableness recruit helpful thoughts in hostile contexts, presumably in the service of controlling aggressive behavior. The present experiment follows from such work, but importantly does so in a manner seeking to support causal conclusions. Participants were randomly assigned to an experimental training condition, in which hostile prime words were followed by helpful target words, or to a control condition that did not involve such pairings. Those assigned to the experimental condition subsequently exhibited lower levels of aggression in a laboratory task. Additional considerations and findings support the potential involvement of self-regulation processes. In general terms, the experiment reveals that a brief cognitive manipulation targeting processes thought to underlie aggression control was in fact causally effective in reducing subsequent levels of aggressive behavior.