Mental Health Locus of Control Scale

Abstract

The Mental Health Locus of Control Scale (MHLOC) and the accompanying Mental Health Locus of Origin Scale (MHLO) are specialized psychological instruments designed to measure beliefs about the etiology and management of psychological disorders. These scales operationalize the concept of Locus of Control within the mental health domain.

The MHLOC specifically assesses the degree to which individuals believe they or external agents (such as therapists or fate) are responsible for the outcome and success of their treatment or recovery from mental health issues. Conversely, the MHLO measures beliefs regarding the origins of mental illness, contrasting internal, biological, or inherited causes with external, environmental, or psychological factors.

Keywords

Locus of Control, Mental health, Psychopathology, Etiology, Treatment responsibility, Psychotherapy, Assessment, MHLO, MHLOC

Authors

Salyers, O. L., Salyers, D. R., and Salyers, L. G. B.

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Purpose

The primary purpose of the MHLOC and MHLO scales is to provide researchers and clinicians with a robust tool to evaluate how individuals conceptualize their mental health challenges. Understanding a patient’s perceived locus of control is crucial, as these beliefs often influence treatment compliance, engagement, and overall prognosis in psychotherapy.

The scales help differentiate between individuals who adopt an internal perspective, believing their recovery hinges on personal effort and agency, versus those who hold an external perspective, relying heavily on professional expertise or viewing outcomes as determined by biological or environmental forces beyond their control.

Construct

The MHLOC and MHLO measure two distinct but related dimensions of the Locus of Control construct as applied to mental health:

• Mental Health Locus of Control (MHLOC): This subscale focuses on responsibility for *outcome*. It measures the extent to which an individual attributes success or failure in managing psychological problems to their own actions (Internal Control) versus the efforts of the therapist, medical professionals, or fate (External Control).
• Mental Health Locus of Origin (MHLO): This subscale focuses on the perceived *cause* or etiology of mental illness. It contrasts biological and inherited explanations with psychological, environmental, or learned explanations for mental health disorders. This allows for the measurement of fatalistic or medicalized views of psychological distress.

Validity

Validation studies associated with the development of the MHLOC and MHLO scales demonstrated appropriate construct validity. Both subscales were shown to correlate logically with established measures of general Locus of Control and related personality traits. For example, individuals scoring high on external MHLOC often exhibited higher levels of fatalism or reliance on authority figures.

Furthermore, the scales demonstrated discriminant validity by showing that while related, the Locus of Control (treatment responsibility) and Locus of Origin (etiology) dimensions are empirically separable, confirming that they measure distinct aspects of the individual’s psychological belief system regarding mental health.

Reliability

The scales have shown acceptable to good levels of internal consistency. Reliability analyses, typically measured using Cronbach’s alpha, indicate that the items within each subscale consistently measure the intended psychological construct. The MHLOC subscale, which focuses on treatment responsibility, generally exhibits strong internal consistency, suggesting high reliability for clinical and research application.

Factor Analysis

Exploratory and confirmatory factor analyses of the combined item pool typically reveal two primary orthogonal factors corresponding to the MHLOC and MHLO dimensions. The MHLOC factor further breaks down into internal and external control orientations related to treatment. The MHLO factor typically separates items related to biological/inherited causation from those related to environmental/psychological causation.

Instrument

Test Type: Self-report questionnaire, Psychological scale

Format: Likert-type response format (typically a 5-point scale ranging from Strongly Disagree to Strongly Agree)

Language Available: English (Original)

Population Group: Adults (clinical and non-clinical samples)

Age Group: 18 years and older

Population Details: Primarily developed and validated using university student samples and patients receiving psychiatric or psychological treatment.

Test Methodology: Used to assess attitudes and beliefs; scoring involves summing or averaging responses to create subscale scores for Internal Control (Treatment), External Control (Treatment), Biological Origin, and Environmental Origin.

Keywords

Etiology of mental illness, Responsibility, Internal Locus of Control, External Locus of Control, Psychological assessment, Factor structure, Internal consistency, Research tool

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Authors

Author ORCID Identifier: Not publicly available in the source material.

Affiliation Email addresses: Not publicly available in the source material.

Correspondence Address: Not publicly available in the source material.

Permissions & Fee and Test Year

Test Year: Circa 2005 (based on primary validation publication).

Permissions & Fee: The scale is typically available for non-commercial academic research use, often without charge, but users should contact the primary authors for formal permission and current usage guidelines.

Reference’s

The primary reference for the development and validation of these scales is:

Salyers, O. L., Salyers, D. R., & Salyers, L. G. B. (2005). The Mental Health Locus of Control and Origin Scales (MHLOC/MHLO): development and validation. The Journal of psychology, 139(6), 569-585. The original PubMed abstract can be found here: http://www.ncbi.nlm.nih.gov/pubmed/16366957

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Items of the Mental Health Locus of Control Scale

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

The Mental Health Locus of Control Scale

1. Psychotherapy is for people who can’t make it alone and need someone stronger than themselves to lean on.
2. To recover from a serious mental problem‚ you must be willing to temporarily surrender all responsibility to an experienced professional.
3. People with psychological problems should play a large part in planning their own treatment.
4. Someone receiving psychiatric help should not make any important decisions without seeking advice.
5. When a psychiatric patient is trying out new behaviors a professional should decide which behaviors s/he should try first.
6. The decision as to when to end psychotherapy should be taken by the patient rather than the therapist.
7. The lives of people with psychological problems are so complicated that it is almost impossible for them to figure out what they should do to make things better.
8. If psychotherapy is like building a house‚ a good therapist should not only give you the tools but should design the house for you.
9. Psychotherapists should tell their patients how to lead a healthy life instead of waiting to see if they find out for themselves.
10. Patients should try hard to accept their therapist’s opinion as to what is right and wrong.
11. When an individual goes to a therapist for help that individual should expect to take most of the responsibility for getting better.
12. In psychotherapy what the therapist thinks is less important than what the client thinks.
13. Most patients leaving a psychiatric hospital should be strictly supervised for some period of time.
14. The goals of psychotherapy should be set by the client rather than the therapist.
15. In group therapy the individuals who benefit the most are almost always those who pay the most attention to group leaders.
16. The mentally ill should not be encouraged to have others take care of their everyday needs
17. If a psychiatric patient feels sure he/she is well enough to stop taking medication‚ that is what he/she should do.
18. The aim of anyone who gets into psychotherapy is to seek the advice of an expert and to act on it.
19. As a general rule psychiatrists should feel o.k. about making decisions on behalf of their patients.
20. A good psychotherapist expects clients to decide for themselves what they should do.
21. Going to a professional to discuss your problems is better than talking to friends because the advice of a professional is more valuable.
22. When experiencing psychological problems the person least likely to come up with solutions is oneself.

The Mental Health Locus of Origin Scale

1. Eventually medical science will discover a cure for psychosis.
2. The cause of most psychological problems can be found in the brain.
3. If the children of schizophrenics were raised by normal parents they would probably grow up to be healthy.
4. Mental illness is usually caused by some disease of the nervous system.
5. Some people are born mentally unstable and are almost certain to spend some part of their lives in a mental hospital.
6. Most people suffering from mental illness were born with some kind of psychological deficit.
7. Some people are born depressed and stay that way.
8. Everybody’s system has a breaking point and those of mental patients are probably weaker.
9. The mental illness of some people is caused by the separation or divorce of their parents during childhood.
10. Being hot-blooded is the cause of mental illness in some people.
11. More money should be spent on discovering healthy methods of child rearing than determining the biological basis of mental illness.
12. Some people are born with the kind of nervous system that makes it easy for them to become emotionally disturbed.
13. Your choice of friends can have a lot to do with your becoming mentally ill.
14. Although they usually aren’t aware of it‚ many people become mentally ill to avoid the difficult problems of everyday life.
15. Some people are born with slightly greater capacity than others to commit suicide later in life.
16. Many normal people would become mentally ill if they had to live in very stressful situations.
17. Many health professionals probably underestimate the extent to which brain damage is responsible for mental illness.
18. When a group of people are forced to live under extremely stressful conditions the ones who crack under the strain are likely to be the ones who inherited a psychologically weak disposition.
19. The kind of nervous system you are born with has little to do with whether you become psychotic.
20. The cause of many psychological problems is bad nerves.