Trends in Locus of Control Beliefs and Biosystemic Levels of
Functioning in Inpatients with Serious Mental Illness
Hayden C. Bottoms, B.S., Elizabeth A. Cook, B.A., & William D. Spaulding, Ph.D.
University of Nebraska – Lincoln
Introduction
The biosystemic paradigm conceptualizes psychopathology as a hierarchy
of neurophysiological, neurocognitive, social cognitive, and sociobehavioral
processes. The relationships between these processes are not well
understood. The serious mental illness (SMI) population typically has
pronounced deficits within these areas, and these processes appear to
affect overall treatment outcome. Therefore, understanding the
interrelationships between these processes may inform and subsequently
improve treatment.
This project examines trends in responses to locus of control (LOC)
measures (Inventory for Self-Efficacy and Externality (I-SEE/FKK) and
Internal, Personal, and Situational Attributions Questionnaire (IPSAQ)) and
scores on assessments of neurocognitive functioning and symptom
severity (neurophysiological domain). If LOC response patterns are
associated with functioning in these domains in a meaningful way, this may
suggest that these beliefs may be a beneficial target for psychiatric
rehabilitation.
It is hypothesized that: 1a) meaningful trends in LOC responding will be
revealed, with 1b) greater differentiation occurring between external LOC
items, and 1c) similar response trends between the I-SEE/FKK and the
IPSAQ. It is also hypothesized that: 2) individuals who attribute control of
life events mostly to external factors will exhibit poorer neurocognitive
functioning and more severe symptomatology. Further, it is hypothesized
that: 3) the I-SEE/FKK and IPSAQ will be strongly and significantly related
to each other.
Results
Results from the cluster analysis revealed a three-cluster solution (see Figure 1).
Results from the ANOVAs revealed that there were significant mean differences on the RBANS
Language Index, F(2,41) = 3.554, Mse = 121.611, p = .038, and BPRS Anergia Factor, F(2,27) = 3.828,
Mse = 3.870, p = .034, among the three clusters. Pairwise comparisons (with a minimum mean difference
= 8.229 for RBANS and a minimum mean difference = 1.835 for BPRS) revealed that Cluster 3 had
greater RBANS Language Index scores that Cluster 1, but not Cluster 2. Also, Cluster 2 had greater
BPRS Anergia Factor scores than Cluster 1 and Cluster 3. See Table 1 for univariate statistics.
Results from the multivariate analysis of the first ldf revealed a significant difference between the three
clusters (λ = .643, X2(4) = 11.267, p = .024), with an R2 –canonical = .24. Multivariate analysis of the
second ldf also revealed a significant difference between the three clusters (λ = .844, X2(1) = 4.321, p =
.038), with an R2 –canonical = .16. Together, these functions resulted in 55.2% correct re-classification
(16 out of 29; chance was 50%). Table 2 shows the standardized canonical coefficients and structure
weights for both functions, revealing that both of the variables contributed to the multivariate effect.
Results from the Pearson’s correlations revealed significant correlations between I-SEE/ FKK and
IPSAQ. The I-SEE/FKK Self-Efficacy scale was positively correlated with the IPSAQ Internal Positive
scale (r = .30, p = .04) and negatively correlated with the IPSAQ Personal Positive scale (r = -.48, p =
.001). These correlations were no longer statistically significant when demographic variables such as
race or 2nd Axis I diagnosis were controlled (ps > .05). When gender or Axis III diagnosis were controlled,
the correlation between I-SEE/FKK Self-Efficacy and IPSAQ Internal Positive was no longer statistically
significant (ps > .05).
Discussion
Method
Analyses were conducted using archival clinical data from 1991-2004
representing individuals whose primary diagnoses included Schizophrenia
Spectrum Disorders, Bipolar Disorder, and other severe mood or
personality disorders.
Index scores were used from the following assessments: I-SEE/FKK,
IPSAQ, and the Repeatable Battery for the Assessment of
Neuropsychological Status (RBANS). An exploratory factor analysis using
unweighted least squares and varimax rotation was performed on 16 items
of the Brief Psychiatric Rating Scale (BPRS). The resulting factors used in
the analyses were Thought Disturbance, Anergia, Anxiety/Depression, and
Lack of Rapport.
A hierarchical cluster analysis was performed using index scores from the
I-SEE/FKK and IPSAQ to determine whether groups of individuals could be
differentiated based on LOC beliefs. Index scores were converted to zscores prior to the analysis to prevent overrepresentation of any given
variable due to its absolute value. Ward’s method with squared Euclidean
distance was used.
Follow-up analyses were conducted to further clarify the observed
heterogeneity in LOC beliefs. One-way ANOVAs were performed to
determine if there were differences between clusters in neurocognitive
functioning (as indicated by RBANS) and symptom severity (as indicated by
BPRS). Pairwise comparisons using Fisher’s Least Significant Difference
were conducted to examine which pair(s) of clusters had mean differences
on RBANS and BPRS.
Second, a linear discriminant function (ldf) analysis was performed to
determine whether RBANS and BPRS could discriminate effectively
between the clusters.
Finally, the convergent validity between I-SEE/FKK and IPSAQ indexes
was evaluated with Pearson’s correlations.
Results partially support the hypotheses.
Consistent with hypothesis 1a, groups of individuals were separated based on meaningful trends in LOC
responding. However, contrary to hypothesis 1b, both internal and external LOC items showed similar
amounts of differentiation between clusters. Contrary to hypothesis 1c, I-SEE/FKK and IPSAQ items did
not typically show similar response trends. For example, Cluster 1 showed high scores on I-SEE/FKK
Chance, but low scores on IPSAQ Situational Positive and Negative items, indicating that it is possible to
believe that life events are chiefly controlled by chance but that chance has little influence on the type of
life event (positive or negative). Differential response trends between these two measures may be due to
slightly different constructs measured by the instruments or measurement error.
There did not appear to be a strong relationship between LOC responses and neurocognitive functioning
and symptom severity. Only one RBANS Index (RBANS Language) and one BPRS factor (Anergia) had
significant mean differences between clusters, and these variables only explained 24% and 16%
(respectively) of the between group variance between clusters. In addition, these variables correctly
reclassified only 55.2% of the members of each cluster, working only 5.2% better than what would be
expected by chance. Nevertheless, consistent with hypothesis 2, Cluster 1, which had the highest scores
on I-SEE/FKK Powerful Others and Chance, had the poorest scores on RBANS Language, suggesting
that functioning within at least one neurocognitive domain decreases given elevations in levels of external
LOC beliefs. However, contrary to hypothesis 2, Cluster 2, which had average scores on external LOC
items, had the highest score on the BPRS Anergia factor, suggesting that high levels of Anergia are not
associated with high levels of external LOC.
Contrary to hypothesis 3, I-SEE/FKK and IPSAQ share little convergent validity. Only two significant
relationships were observed. A positive linear relationship was observed between the I-SEE/FKK SelfEfficacy scale and the IPSAQ Internal Positive scale, suggesting that individuals who are more likely to
perceive themselves as controlling life events are also more likely to attribute positive situations to their
own behavior. A negative linear relationship was observed between the I-SEE/FKK Self-Efficacy scale
and the IPSAQ Personal Positive scale, suggesting that individuals who are more likely to perceive
themselves as controlling life events are less likely to attribute positive situation to the behavior of others.
No relationships were observed for negative events. The lack of convergent validity is likely because
these scales represent different constructs. The I-SEE/FKK measures locus of control, or the source to
which people attribute control of life events, whereas the IPSAQ measures attributional style, or how
people explain the outcome of life events. These distinctions between these constructs likely influenced
the observed lack of convergent validity.
Limitations to this study, such as small sample size, may have influenced our results.
Tables/Figures
Figure 1.
Table 1. Summary of Means (standard deviations) of RBANS Language and
BPRS Anergia between the 3 clusters
Variable
Cluster 1
Cluster 2
Cluster 3
RBANS Language
80.80 (14.40)
85.18 (11.33)
92 (8.16)
BPRS Anergia
4.03 (1.55)
6.36 (2.15)
4.42 (2.01)
Table 2. Standardized Canonical Coefficients and Structure weights from the
discriminant models
Function
Variable
Standardized
Coefficents
Structure Weights
1
RBANS Language
.567
.589
BPRS Anergia
.808
.824
RBANS Language
.824
.808
BPRS Anergia
-.589
-.567
2