Increased internal/external locus of control (Health factor for workers with an MSD)

Interpretation of the “Increased internal/external locus of control” factor

An increased internal/external locus of control positively influences RTW or sickness absence duration.

Definition of the “Increased internal/external locus of control” factor

Short definition: Locus of control is a psychological concept stipulating that a person’s expectations of a given outcome are predictors of his or her behaviour in any given circumstance (Rotter, 1954). Individuals with an “internal locus of control” expect their behaviour to influence the outcome, whereas those with an “external locus of control” expect the outcome to be determined by external factors such as other people or forces beyond themselves (Rotter, 1954).

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There are three types of locus of control: internal (oneself), external (others) and external (chance, destiny) (Selander, Marnetoft et Asell, 2007). Generally speaking, individuals who show a high level of internal locus of control adjust/adapt better to illness (Burker, Evon, Galanko et Egan, 2005; Nyland, Johnson, Caborn et Brindle, 2002), whereas those who feel unable to control their own health (external locus of control) are less likely to adapt (Crisson et Keefe, 1988; Härkäpää, 1992). Some studies have shown that locus of control is a factor to be taken into account in individuals who are returning to work following a sick leave (Carosella, Lackner et Feurestein, 1994; Wiegmann et Berven, 1998). More specifically, having a high degree of internal locus of control positively influences RTW in workers with an MSD (Haldorsen, Indahl et Ursin, 1998; Selander et al., 2007). Interestingly, having a high degree of external “chance externality” locus of control, which means that the worker believe that health problems are due to chance and luck (not to their work, their efforts or involvement in their treatment) also positively influences RTW in these workers (Hagen, Svensen et Eriksen, 2005).

Burker, E. J., Evon, D. M., Galanko, J. et Egan, T. (2005). Health locus of control predicts survival after lung transplant. J Health Psychol, 10(5), 695-704. doi: 10.1177/1359105305055326

Carosella, A. M., Lackner, J. et Feurestein, M. (1994). Factors associated with early discharge from a multidisciplinary work rehabilitation program for chronic pain. Pain, 57 69-76.

Crisson, J. E. et Keefe, F. J. (1988). The relationship of locus of control to pain coping strategies and psychological distress in chronic pain patients. Pain, 35(2), 147-154. doi: 10.1016/0304-3959(88)90222-9

Hagen, E. M., Svensen, E. et Eriksen, H. R. (2005). Predictors and modifiers of treatment effect influencing sick leave in subacute low back pain patients. Spine (Phila Pa 1976), 30(24), 2717-2723. Tiré de

Haldorsen, E. M., Indahl, A. et Ursin, H. (1998). Patients with low back pain not returning to work. A 12-month follow-up study. Spine (Phila Pa 1976), 23(11), 1202-1207; discussion 1208. doi: 10.1097/00007632-199806010-00004

Härkäpää, K. (1992). Psychosocial factors as predictors for early retirement in patients with chronic low back pain. Journal of psychosomatic research, 36(6), 553-559.

Nyland, J., Johnson, D. L., Caborn, D. N. et Brindle, T. (2002). Internal health status belief and lower perceived functional deficit are related among anterior cruciate ligament-deficient patients. Arthroscopy: The Journal of Arthroscopic & Related Surgery, 18(5), 515-518.

Rotter, J. B. (1954). Social learning and clinical psychology.

Selander, J., Marnetoft, S. U. et Asell, M. (2007). Predictors for successful vocational rehabilitation for clients with back pain problems. Disabil Rehabil, 29(3), 215-220. doi: 10.1080/09638280600756208

Wiegmann, S. M. et Berven, N. L. (1998). Health locus-of-control beliefs and improvement in physical functioning in a work-hardening, return-to-work program. Rehabilitation Psychology, 43(2), 83.

Tools for measuring the “Increased internal/external locus of control” factor