The influence of perceived control over causes and responses to health threats: A vignette study


Department of Psychology, University of Surrey, Guildford GU2 7XH, UK (e-mail:


Objectives: To test the hypothesis that a disease caused by controllable, compared with uncontrollable, factors is more likely to result in negative emotions and less likelihood of disclosure to significant others.

Design and methods: A between-participants design in which students (N=108) imagined they had just been diagnosed with either HIV or hypertension and where the cause for each was described as either controllable or uncontrollable. Anticipated emotional and behavioural responses by self and others were assessed by questionnaire.

Results: When the vignette represented a more controllable cause, participants thought they would have more negative feelings and that they would be less likely to disclose information about the disease to their family oran acquaintance than when the vignette represented a less controllable cause. The type of disease, but not the cause, influenced anticipated responses by others.

Conclusions: Although greater perceived control over future outcomes is often psychologically adaptive, these findings suggest that the perception that the onset of a disease was controllable may be maladaptive, resulting in more negative feelings and a greater reluctance to disclose the diagnosis to others. In the light of the increasing use of medical technologies aimed at primary prevention of disease, together with a cultural shift toward individual responsibility for health, there is a need for greater understanding of how the perceived controllability of the cause of a disease affects subsequent adjustment.