Journal of Behavioral Medicine

, Volume 29, Issue 6, pp 561–572 | Cite as

Physical Health, Self-Reliance, and Emotional Control as Moderators of the Relationship between Locus of Control and Mental Health among Men Treated for Prostate Cancer


This investigation examined the moderating effects of physical health and scripts for masculinity (i.e., self-reliance and emotional control) on the relationship between powerful other people locus of control and mental health for 230 men treated for prostate cancer. Regression analyses indicated that physical health and masculine gender scripts moderated the association between powerful other people locus of control and mental health. Specifically, men with poor physical health evinced negative mental health when they endorsed masculine gender scripts and believed powerful other people (i.e., family, friends, or peers) were influential in controlling their cancer. By comparison, men reporting poor physical health, strong beliefs that powerful other people controlled their cancer, and less adherence to masculine scripts experienced positive mental health. The authors discuss future research directions and potential mental health implications for men treated for prostate cancer.


health locus of control gender scripts masculinity mental health prostate cancer quality of life 


  1. Addis, M. E., and Mahalik, J. R. (2003). Men, masculinity, and the contexts of help-seeking. Am. Psychol. 58: 5–14.PubMedCrossRefGoogle Scholar
  2. American Cancer Society (2005a). Cancer statistics 2005 presentation. Retrieved September 21, 2005 from Scholar
  3. American Cancer Society (2005b). Detailed guide: Prostate can-cer. Retrieved September 21, 2005 from Scholar
  4. American Cancer Society (2006). Overview: Prostate Cancer: How many men get prostate cancer? Retrieved February 17, 2006 from Scholar
  5. American Cancer Society (2005c). Types of treatment. Retrieved September 21, 2005 from Scholar
  6. Andrykowski, M. A., and Brady, M. J. (1994). Health locus of control and psychological distress in cancer patients: Interactive effects of context. J. Behav. Med. 17: 439–548.PubMedCrossRefGoogle Scholar
  7. Burns, S. M., and Mahalik, J. R. (in press). Understanding how masculine gender scripts may contribute to men's adjustment following treatment for prostate cancer. Am. J. Men's Health.Google Scholar
  8. Burns, S. M., Maniss, S., Young, L. R. L., and Gaubatz, M. (2005). Attributions of control and seropositivity among Latinos: Examining the predictive utility of the locus of control construct. AIDS Care 17: 263–269.PubMedCrossRefGoogle Scholar
  9. Christensen, A. J., Turner, C. W., and Smith, T. W. (1991). Health locus of control and depression in end-stage renal disease. J. Consul. Clin. Psychol. 59: 419–424.CrossRefGoogle Scholar
  10. Courtenay, W. H. (2001). Counseling men in medical settings: The six-point HEALTH plan. In Brooks, G. R., and Good, G. E. (Eds.), The New Handbook of Psychotherapy and Counseling with Men. Jossey-Bass, San Francisco, pp. 59–91.Google Scholar
  11. Dunn, D. W., Austin, J. K., and Huster, G. A. (1999). Symptoms of depression in adolescents with epilepsy. J. Am. Acad. Child and Adolesc. Psychiatry 38: 1132–1138.CrossRefGoogle Scholar
  12. Eton, D. T., and Lepore, S. J. (2002). Prostate cancer and health-related quality of life: A review of the literature. Psycho-Oncology 11: 307–326.PubMedCrossRefGoogle Scholar
  13. Folkman, S. (1984). Personal control and stress and coping processes: A theoretical analysis. J. Pers. Soc. Psychol. 46: 839–852.PubMedCrossRefGoogle Scholar
  14. Frank, R. G., and Elliott, T. R. (1989). Spinal cord injury and health locus of control beliefs. Paraplegia 27: 250–256.PubMedGoogle Scholar
  15. Frazier, P. A., Tix, A. P., and Barron, K. E. (2004). Testing moderator and mediator effects in counseling psychology research. J. Counsel. Psychol. 51: 115–134.CrossRefGoogle Scholar
  16. Gray, R. E., Fitch, M., Davis, C., and Phillips, C. (1997). Interviews with men with prostate cancer about their self-help group experience. J. Palliative Care 13: 15–21.Google Scholar
  17. Gray, R. E., Fitch, M. I., Phillips, C., Labrecque, M., Fergus, K. D., and Klotz, L. (2002). Prostate cancer and erectile dysfunction: Men's experiences. Int. J. Men's Health 1: 15–29.Google Scholar
  18. Helgeson, V. S., and Lepore, S. J. (1997). Men's adjustment to prostate cancer: The role of agency and unmitigated agency. Sex Roles 37: 251–266.CrossRefGoogle Scholar
  19. Helgeson, V. S., and Lepore, S. J. (2004). Quality of life following prostate cancer: The role of agency and unmitigated agency. J. Appl. Soc. Psychol. 34: 2559–2585.CrossRefGoogle Scholar
  20. Kimmel, S. B., and Mahalik, J. R. (2005). Body image concerns of Gay Men: The roles of minority stress and conformity to masculine norms. J. Consult. Clin. Psycholo. 73: 1185–1190.CrossRefGoogle Scholar
  21. Kugler, J., Tenderich, G., Stahlhut, P., Posival, H., Korner, M. M., Korfer, R., and Kruskemper, G. M. (1994). Emotional adjustment and perceived locus of control in heart transplant patients. J. Psychosomatic Res. 38: 403–408.CrossRefGoogle Scholar
  22. Lintz, K., Moynihan, C., Steginga, S., Norman, A., Eeles, R., Huddart, R., Dearnaley, D., and Watson, M. (2003). Prostate cancer patients’ support and psychological care needs: Survey from a non-surgical oncology clinic. Psycho-Oncology 12: 769–783.PubMedCrossRefGoogle Scholar
  23. Llorente, M. D., Burke, M., Gregory, G. R., Bosworth, H. B., Grambow, S. C., Horner, R. D., Golden, A., and Olsen, E. J. (2005). Prostate cancer: A significant risk factor for late-life suicide. Am. J. Geriatric Suicide 13: 195–201.Google Scholar
  24. Mahalik, J. M., Good, G. E., and Englar-Carlson, M. (2003a). Masculinity scripts, presenting concerns, and help-seeking: Implications for practice and training. Prof. Psychol. 34: 123–131.Google Scholar
  25. Mahalik, J. R., Lagan, H. D., and Morrison, J. A. (in press). Health behaviors and masculinity in Kenyan and U.S. college students. Psychol. Men and Masculinity.Google Scholar
  26. Mahalik, J. R., Locke, B., Ludlow, L., Diemer, M., Scott, R. P. J., Gottfried, M., and Freitas, G. (2003b). Development of the conformity to masculine norms inventory. Psychol, Men and Masculinity 4: 3–25.CrossRefGoogle Scholar
  27. McCarthy, J., and Holliday, E. L. (2004). Help-seeking and counseling within a traditional male gender role: An examination from a multicultural perspective. J. Counsel. Dev. 82: 25–30.Google Scholar
  28. Morris, P. L. P., Robinson, R. G., Raphael, B., and Bishop, D. (1991). The relationship between the perception of social support and post-stroke depression in hospitalized patients. Psychiatry 54: 306–315.PubMedGoogle Scholar
  29. Murberg, T. A., Bru, E., Aarsland, T., and Svebak, S. (1998). Social support, social disability and their role as predictors of depression among patients with congestive heart failure. Scand. J. Soc. Med. 26: 87–95.PubMedGoogle Scholar
  30. Pirl, W. F., Siegel, G. I., Goode, M. J., and Smith, M. R. (2002). Depression in men receiving androgen deprivation therapy for prostate cancer: A pilot study. Psycho-Oncology 11: 518–523.PubMedCrossRefGoogle Scholar
  31. Powel, L. L., and Clark, J. A. (2005). The value of the marginalia as an adjunct to structured questionnaires: Experiences of men after prostate cancer surgery. Qual. Life Res. 14: 827–835.PubMedCrossRefGoogle Scholar
  32. Roberts, K. J., Lepore, S. J., and Helgeson, V. (2006). Social-cognitive correlates of adjustment to prostate cancer. Psycho-Oncology 15: 183–192.PubMedCrossRefGoogle Scholar
  33. Robertson, J. M. (2001). Counseling men in college settings. In Brooks, G. R., and Good, G. E. (Eds.), The New Handbook of Psychotherapy and Counseling with Men. Jossey-Bass, San Francisco, pp. 146–169.Google Scholar
  34. Roesch, S. C., Adams, L., Hines, A., Palmores, A., Vyas, P., Tran, C., Pekin, S., and Vaughn, A. A. (2005). Coping with prostate cancer: A meta-analytic review. J. Behav. Med. 28: 281–293.PubMedCrossRefGoogle Scholar
  35. Swinney, J. E. (2002). African Americans with cancer: The relationships among self-esteem, locus of control, and health perception. Res. Nurs. Health 25: 371–382.PubMedCrossRefGoogle Scholar
  36. Wallston, K. A., Stein, M. J., and Smith, C. A. (1994). Form C of the MHLC scales: A condition-specific measure of locus of control. J. Pers. Assess. 63: 534–553.PubMedCrossRefGoogle Scholar
  37. Wallston, K. A., Wallston, B. S., and DeVellis, R. (1978). Development of Multidimensional Health Locus of Control scales. Health Educ. Monogr. 6: 160–170.PubMedGoogle Scholar
  38. Ware, J. E., and Kosinski, M. (2001). SF-36 physical and mental summary scales: A manual for users of version 1. (2nd Ed.). Lincoln, RI: QualityMetric, Inc.Google Scholar
  39. Ware, J. E., Snow, K. K., Kosinski, M., and Gandek, B. (1993). SF-36 Health Survey: Manual and interpretation guide. Boston, MA: The Health Institute, New England Medical Center.Google Scholar
  40. Watson, M., Greer, S., Pruyn, J., and Van Den Borne, B. (1990). Locus of control and adjustment to cancer. Psychol. Rep. 66: 39–48.PubMedCrossRefGoogle Scholar
  41. Wei, J. T., Dunn, R. L., Litwin, M. S., Sandler, H. M., and Sanda, M. G. (2000). Development and validation of the expanded prostate cancer index composite (EPIC) for comprehensive assessment of health-related quality of life in men with prostate cancer. Urology 56: 899–905.PubMedCrossRefGoogle Scholar
  42. Willener, R., and Hantikainen, V. (2005). Individual quality of life following radical prostatectomy in men with prostate cancer. Urolog. Nurs. 25: 88–90, 95–100.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2006

Authors and Affiliations

  1. 1.Boston CollegeNewtonUSA

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