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Locus of control matters because it shapes whether someone believes their own effort can change their situation, which in turn affects whether they act on health advice. Locus of control is a person's general belief about what causes events in their life: an internal locus attributes outcomes to one's own actions, while an external locus attributes them to luck, fate, or other powerful people. For example, imagine two patients told to increase their exercise. The one with an internal locus of control believes her own effort will improve her fitness, while the one with an external locus believes it is mostly down to genetics or chance. In practice, an internal locus of control is generally linked with better engagement in health behaviours, such as medication adherence.

Rotter proposed locus of control as part of social learning theory, describing it as a stable trait along an internal-external spectrum rather than a fixed either/or category. Someone with an internal locus of control believes rewards and outcomes follow from their own behaviour, so they tend to take more responsibility for changing it. Someone with an external locus of control believes outcomes are controlled by luck, fate, or powerful others, so effort feels less likely to matter. Say a smoker with an external locus of control believes lung cancer risk is just luck, so she sees little point in trying to quit. In practice, screening for locus of control can help clinicians tailor health advice, since patients with an external locus often respond better to support that builds a sense of personal control.

• Rotter developed the locus of control construct within a broader theoretical framework of his own. Which framework was this?
• A health psychologist uses a questionnaire separating belief in one's own influence from belief in doctors and in chance. What is this three-part instrument called?
• A trainee asks whether a strongly internal locus of control is invariably advantageous. Which situation illustrates a drawback of this orientation?
• How does locus of control differ from Bandura's concept of self-efficacy?

• Self-efficacy, a task-specific belief in your own competence, unlike locus of control's general belief about what causes outcomes.
• Health belief model, focuses on perceived susceptibility and barriers to a specific health action, rather than a general attributional style.
• Learned helplessness, a state of giving up after uncontrollable events, whereas locus of control is a stable trait present before any such event.
• Optimism/pessimism, about expected future outcomes, unlike locus of control, which is about who or what causes those outcomes.

• That tradition emphasises unconscious conflict instead.
• That framework belongs to a different theorist entirely.
• That tradition rejected internal expectancies as explanatory.
• That scale screens for anxiety and depressive symptoms.
• That instrument screens for general psychiatric morbidity.

• Name the learning, social or research principle being tested before reading the options.
• Identify the antecedent, behaviour, consequence or cognitive process in the vignette.
• Compare the direction of effect with the nearest competing principle.
• Apply the same rule to a new example to confirm that the answer transfers.