Mindsets and Motivation
Claudia Mueller, PhD, MD
Division of Pediatric Surgery
Framework
 Based on work by psychologist Carol Dweck,
PhD
 Dweck et al have identified a set of “implicit
theories” or “mindsets” that individuals use to
analyze and interpret the world
 These theories are based on two different
assumptions that people make about the
malleability of personal attributes
Implicit theories
 “Entity” theory
 The belief that a personal attribute is fixed and
nonmalleable
 “Incremental” theory
 The belief that an attribute is a malleable quality that is
subject to change and development
 Beliefs can be applied in various domains: intelligence,
morality, athletics
Implicit theories 2
 Entity/incremental category determined by responses to
statements
 Implicit theories
 Intelligence
•
You can learn new things, but you can’t really change your
basic intelligence.
 Morality
•
A person’s moral character is something very basic about
them and it can’t be changed very much.
Mindset statements
 Your intelligence is something very basic about you that you can’t
change very much.
 You can learn new things, but you can’t really change how
intelligent you are.
 No matter how much intelligence you have, you can always change
it quite a bit.
 You can always substantially change how intelligent you are.
Implicit theories 3
 Entity vs. Incremental theories influence
 Judgments
•
Entity see failures as indicative of stable, low ability
 Goals
•
Performance (look good, avoid failure) vs. mastery
(learn material, may have to fail to do so)
 Response
•
to setbacks
Entity give up in face of challenge
 Theories create “mindsets” which influence behavior
 Independent of actual intelligence, morality, athletic
ability
Intelligence theory
 Entity view of intelligence as fixed stable trait
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Intelligence is reflected by individual outcomes
Performance goals: challenge is threatening
Failure is devastating (I’m dumb)
 Incremental view of intelligence as able to be developed
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Individual outcomes not representative of whole
Learning goals: challenge is informative
Failure is motivating (I need to work harder)
Theory development
 Likely related to
feedback received
throughout life

Parents, teachers, peers
 Some studies have
looked at feedback after
failure
 My work has focused on
feedback after success
Feedback studies
 Does feedback change how children respond to
challenge?
 Can different types of praise lead children to develop
different goals and theories (mindsets)?
 Conventional wisdom

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Praise in any form is good
Praise after success
•
•
builds self esteem
protects against disappointment after failure
Type of praise
 Praise for:
 Fixed
ability = “smartness”
 Malleable effort = “hard work”
 Would children respond differently based on the type
of praise given?
Conventional wisdom: no
 Hypothesis: yes

Dissertation
 Series of 6 studies with fifth-graders assessed for their work on
geometric puzzles (Mueller & Dweck)
 >500 participants

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public and private schools
Midwest, Northeast
 Dweck lab, Psychology Dept, Columbia University
Experimental Design
Puzzle 1
(Success)
Praise
manipulation
Measures
Puzzle Enjoyment
Task Persistence
Failure Attributions
Puzzle 2
(Failure)
Puzzle 3
(Test)
Puzzles
 Raven’s Progressive
Matrices
 John C. Raven,
Oxford Psychologists
Press
Praise
 Wow, you did very well on these problems. You got – right.
That’s a really high score.
 Ability

You must be smart at these problems.
 Effort

You must have worked hard at these problems.
Failure
 Children told they scored “a lot worse” on second set of puzzles
 Post-failure assessments
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How well they did
Enjoyment
Persistence
Attributions
• I didn’t work hard enough
• I’m not good enough at the problems
• I’m not smart enough
• I didn’t have enough time
Psychological impact of praise
 Children praised for effort
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Attributed failure to lack of trying
Enjoyed puzzles more
More likely to persist
 Children praised for ability
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Attributed failure to lack of ability
Enjoyed the puzzles less
Gave up sooner
 Content of praise matters
Puzzle Performance
Additional findings
 Ability praise
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Performance goals
Entity belief of intelligence
Sought information on performance not mastery
Misrepresented score to other kids
 Effort praise: learning, incremental theory
Conclusions
 Praise delivers message
 Praise for ability after success
•
•
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Poor performance = low ability
Avoid challenge
Praise for effort after success
•
•
Poor performance = work harder
Embrace challenge as opportunity for growth
 Feedback leads to “mindset” that determines behavior
My research paradigm
 Propose psychological framework of children’s illness that uses
their theories of health to predict adherence and outcomes
 Develop scale to identify these health theories
 Test scale in healthy children
 Study theories and behaviors in chronically ill adolescents
 Develop feedback messages to improve both adherence and
outcomes in pediatric populations
Response to disease
 Little is known about the psychological dimensions of
children’s disease
 Children respond very differently to stressful hospital
settings
 Some crumble and regress; others thrive and adapt
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“Mindset” of illness
Independent of illness severity
 “Mindset” can be created by theory which may
determine adherence and, ultimately, response to disease
Translation to clinical setting
 Illness is a challenge
 Hospitalized children behave similarly to children in
schools
 Do children perceive health as they do intelligence: fixed
vs. malleable?
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If fixed, less incentive to develop strategies for health
promotion
If malleable, more likely to be active in their health care
 Studies designed to examine how children think about
health and how this affects their behaviors
Scale development
 Potential statements tested with 500 healthy high school students
 Goal to identify cohesive set of items to categorize beliefs
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Entity theorists=health is fixed, unchangeable
Incremental theorists=health is malleable, subject to change
 Key items
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Your body has a certain amount of health, and you really can’t do much to
change it.
Your health is something about you that you can’t change very much.
You can try to make yourself feel better, but you can’t really change your
basic health.
Study 1: Test scale with healthy kids
 100 high school students
 Exclude any with chronic medical conditions
 Asked to respond to scenarios of kids with specific illnesses
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Broken leg
Asthma
Appendicitis
Results 1
 Definition of health

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Entity attribute to genes
Incremental attribute to behavior
 Assessment of health in others

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Entity exaggerate illness severity
Entity exaggerate illness duration
 Assessment of own health

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Incremental theorists believe they are healthier
Entity have higher BMI
 Minimal overlap with previous scale of health causation
(Locus of control)
Study 2
 250 high school students
 Asked to assess health of others (replicate first study)
 Also asked to self-report safety behaviors
 Hypothesis: Entity theorists might be less mindful of
safety
 Results confirmed Study 1
 No significant difference in safety precautions
Current study: Assessment of beliefs in patients
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Chronically ill adolescents: Type 1 Diabetes
Age 12-18 yrs
Implicit theories of health
Dependent measures
 Self-report of adherence attitudes
 Health outcomes
• Meter results
• Blood sugar levels
Current study 2
 Participants approached at regularly-scheduled clinic visit
 Consent from parents
 Assent from patients
 Participation rate 95%
 Questionnaire administered in waiting area
 Implicit theory of health scale
 Adherence attitudes
Results-adherence attitudes
 Entity theorists vs
incremental theorists

Less likely to believe that
adherence matters (p<.05)
• Taking the right amount
of medication on
schedule will help me
control my illness.
• If I do exactly what my
doctor tells me, I can
control my illness.
Results-actual health
 Meter results (previous 3 weeks)
 Entity vs. incremental
 Highest glucose (p<.05)
 Mean glucose (p<.05)
 Percent above target (p<.02)
 Hgb
A1c not significant
Overall results
 By measuring adolescents’ implicit theories of health, we
were able to predict
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Reactions to illness in others
Attitudes toward adherence
Actual health outcomes in diabetic patients
 Advantages of implicit theory scale (Mueller, Williams, Dweck)
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Simple
Easy to administer
Long history of use in various contexts
Future investigations
 Apply theory framework to other disease populations
 Post-transplant, Cystic fibrosis, IBD
 Post-op recovery cardiac surgery
 Design experimental manipulations in which theories are
changed (eg, fixed to malleable) to measure effect on
outcomes
 Deliver feedback messages targeted at theory change

Via web-based designs, technologies
Other ongoing research projects
 Implicit theories of body weight (Burnette)
 Plan to implement interventions (on-line reading
activities that present body weight as malleable)
 Measure motivation as well as weight loss over test
period
 Theories of trauma
 Teenagers hospitalized for trauma asked about cause
of injury
 Use attributions to develop prevention strategies
 Children’s perceptions of their surgical scars
Summary
 Perceptions can change behaviors
 In academic setting, children’s beliefs about intelligence
influence their performance
 In healthcare setting, children’s beliefs about health and
illness may affect their responses to disease
 My work is an attempt to create a psychological model
that explains children’s health behaviors
 Encouraging results using implicit theory framework to
predict adherence and outcomes in medical setting
Thank you
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Carol Dweck, PhD
Robert Wright, MA
Ryan Williams, MD
Bruce Buckingham, MD
Marily Oppezzo, MA
David Yeager, PhD
Jeni Burnette, PhD
Lindsey Eliopulos, MA
Mette Hoybye, PhD
References
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Berg et al. (1993). Medication compliance: A health care problem. Annals of Pharmacotherapy,
27, 2-21.
Burnette, J. (2009). Implicit theories of body weight: Fostering beliefs for healthy behavior. NIH
grant proposal.
Cimpian,A, Arce, HC, Markman, EM & Dweck, CS. (2007). Subtle linguistic cues affect
children’s motivation. Psychological Science, 18, 314-316.
Diener, CI & Dweck, CS. (1978). An analysis of learned helplessness: Continuous changes in
performance, strategy and achievement cognitions following failure. Journal of Personality and
Social Psychology, 36, 451-462.
Dweck, CS, Chiu, CY & Hong, YY. (1995). Implicit theories and their role in judgments and
reactions: A world from two perspectives. Psychological Inquiry, 6, 267-285.
Festa et al. (1992). Therapeutic adherence to oral medication regimens by adolescents with
cancer. J of Pediatrics, 120, 807-811.
Heyman, GD, Dweck, CS & Cain, K. (1992). Young children’s vulnerability to self-blame and
helplessness. Child Development, 63, 401-415.
Mueller, CM & Dweck, CS. (1998). Intelligence praise can undermine motivation and
performance. Journal of Personality and Social Psychology, 75, 33-52.
Shagena, MM, Sandler, HK & Perrin, EC. (1988). Concepts of illness and perception of control
in healthy children and in children with chronic illness. Developmental and Behavioral
Pediatrics, 9, 252-256.
Tebbi et al. (1986). Compliance of pediatric and adolescent cancer patients. Cancer, 58, 11791184.
Zora et al. (1989). Assessment of compliance in children using inhaled beta adrenergic agonists.
Annals of Allergy, 62, 406-409.