Spiritual Health Locus of Control Scales

Abstract

The Spiritual Health Locus of Control Scales (SHLOCS), revised by Cheryl L. Holt in 2001, is a psychological instrument designed to assess how individuals perceive the source of control over their health outcomes in relation to spiritual and religious factors. Drawing upon the established Locus of Control construct, the SHLOCS specifically measures the degree to which health status is attributed to active self-care guided by spiritual principles versus passive reliance on divine intervention alone. This scale is crucial for research in health psychology and behavioral medicine, particularly concerning the interaction between faith, personal responsibility, and well-being.

Keywords

Spiritual Health, Locus of Control, Health Psychology, Religious Coping, Active Spiritual Control, Passive Spiritual Control, Psychological Scale, Measurement.

Authors

Cheryl L. Holt

Purpose

The primary purpose of the Spiritual Health Locus of Control Scales is to provide researchers and practitioners with a nuanced tool for evaluating the spiritual dimensions of health beliefs. The scale aims to differentiate between two fundamental orientations: an Active Spiritual approach, where faith motivates self-care and collaboration with God/higher power (often termed collaborative control), and a Passive Spiritual approach, characterized by fatalistic reliance on divine will, often resulting in the neglect of personal health behaviors.

Understanding these distinct spiritual orientations is essential for tailoring health interventions, as an individual’s perceived locus of control significantly impacts their adherence to medical treatments and engagement in preventive behaviors. The SHLOCS helps illuminate how spiritual beliefs either empower or impede proactive health management.

Construct

The SHLOCS measures a specialized application of the Locus of Control (LOC) theory, focusing on the spiritual domain of health. While traditional LOC distinguishes between internal (personal effort) and external (chance or powerful others) control, the SHLOCS refines the external spiritual dimension into two measurable subcomponents:

• Active Spiritual Control: This subscale reflects the belief that health is maintained through a combination of personal effort, self-care, and cooperation with God or a higher power. Items reflecting this dimension often emphasize the role of faith in providing strength for self-management or the belief that God works through human agents (like doctors).

• Passive Spiritual Control: This subscale reflects a highly external, fatalistic orientation where health is seen as entirely dependent on God’s will, often leading to resignation or the rejection of personal responsibility or medical intervention. This dimension is conceptually closer to powerful-other external LOC but rooted specifically in spiritual fatalism.

Validity

Initial validation studies for the original and revised scales, including the work published by Holt (1998), established satisfactory construct validity. The scale demonstrated the ability to distinguish spiritual health LOC beliefs from general health LOC beliefs and other measures of religiousness, suggesting it measures a unique construct. Furthermore, the two subscales showed expected patterns of convergent and discriminant validity.

Specifically, the Active Spiritual Control subscale is often positively correlated with internal health locus of control and positive health behaviors, while the Passive Spiritual Control subscale tends to correlate positively with external LOC dimensions and is associated with poorer health outcomes or lower adherence to medical advice.

Reliability

The reliability of the Spiritual Health Locus of Control Scales, measured through internal consistency (Cronbach’s alpha), has generally been reported as acceptable to good. The overall scale and the primary subscales (Active Spiritual and Passive Spiritual) usually meet standard psychometric requirements for research purposes. High internal consistency ensures that items within each subscale reliably measure the same underlying dimension of spiritual health control.

Factor Analysis

The structure of the revised SHLOCS was confirmed through exploratory and confirmatory Factor Analysis. These analyses supported the hypothesized two-factor model, clearly separating the items loading onto the Active Spiritual factor from those loading onto the Passive Spiritual factor. This statistical separation is critical as it validates the theoretical distinction between collaborative spiritual beliefs that promote health engagement and fatalistic beliefs that may inhibit it.

Instrument

Test Type: Psychological Scale / Self-Report Questionnaire

Format: The scale utilizes a 5-point Likert Scale response format, ranging from “Strongly Agree” to “Strongly Disagree.”

Language Available: English (Original)

Population Group: General adult population; used predominantly in studies involving individuals who identify as religious or spiritual.

Age Group: Adults (typically 18 years and older)

Population Details: The scale is typically employed in samples reflecting diverse religious affiliations, though initial validation focused primarily on Christian populations in the United States.

Test Methodology: Respondents are asked to rate their level of agreement with 14 statements concerning the relationship between their faith, spiritual life, and physical health status.

Keywords

Health Beliefs, Psychological Measurement, Faith, Religion, Self-Efficacy, Collaborative Control, Health Outcomes, Psychometrics.

Authors

Author ORCID Identifier: Not publicly provided for this entry.

Affiliation Email addresses: Contact information must be sought through the author’s affiliated university at the time of publication.

Correspondence Address: Refer to the original publication for correspondence details.

Permissions & Fee and Test Year

Test Year: 2001 (Revised Scale)

Permissions and Fees: Use of the scale for academic research typically requires permission from the primary author, Cheryl L. Holt. Researchers should contact the author directly or consult the publisher of the original article regarding usage rights and fees.

Reference’s

Holt, C. L. (1998). A measure of spiritual health locus of control: Development and preliminary validation. Health Psychology Quarterly, 12(4), 597-611. The abstract for the foundational work can be found here: http://hpq.sagepub.com/content/12/4/597.abstract.

Items of the Spiritual Health Locus of Control Scales

IMPORTANT: The following scale items must be preserved in their original language and must not be changed in any way.

The Spiritual Health Locus of Control Scale (revised)

For these statements‚ I would like you to tell me if you strongly agree‚ agree‚ neither‚ disagree‚ or strongly disagree.

Please listen carefully to each statement because you may agree with some but disagree with others.

1. Through my faith in God‚ I can stay healthy.
2. If I lead a good spiritual life‚ I will stay healthy.
3. If I stay healthy‚ it’s because I am right with God.
4. Living the way the Lord says I’m supposed to live means I have to take care of myself.
5. Even though I trust God will take care of me‚ I still need to take care of myself.
6. God gives me the strength to take care of myself.
7. I rely on God to keep me in good health.
8. God works through doctors to heal us.
9. Prayer is the most important thing I do to stay healthy.
10. If I stay well‚ it is because of the grace of the good Lord.
11. It’s ok not to seek medical attention because
12. I feel that God will heal me.
13. There is no point in taking care of myself when it’s all up to God anyway.
14. God and I share responsibility for my health.

Subscales:

Active Spiritual: Items 4, 5, 6, 14, 1, 2, 3, 7, 8, 9, 10

Passive Spiritual: Items 12, 13