Psych summeries assignment

Need this back in 24 hours. Sooner if possible!! Please read and summerize in one page each article. So will be a total of 3 pages for eah article summerized!!! Please format in correct APA citation!!! Please use correct APA citation using page numbers found in article (example..Bandura, 1988, p.56)  and please only cite information found in each paper do dot go looking outside for information or citations!!!. This is a summery on the article only and what is written . Will be a total of 3 different summerizes so i should receive back 3 pages not including reference page which makes 4 pages. Thank you

APPLIED PSYCHOLOGY: AN INTERNATIONAL REVIEW, 2005

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(2), 245 –

254

© International Association for Applied Psychology, 2005. Published by Blackwell Publishing

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9600 Garsington Road, Oxford OX4 2DQ, UK and 350 Main Street, Malden, MA 02148, USA.

Blackwell Publishing, Ltd.Oxford, UKAPPSApplied Psychology: an International Review0269-994X© International Association for Applied Psychology, 2005April 2005542Original ArticlePRIMACY OF SELF-REGULATION

BANDURA

The Primacy of Self-Regulation in
Health Promotion

Albert Bandura*

Stanford University, USA

We are witnessing a divergent trend in the field of health. On the one hand,
we are pouring massive resources into medicalising the ravages of detri-
mental health habits. On the other hand, the conception of health is shifting
from a disease model to a health model. It emphasises health promotion
rather than mainly disease management. It is just as meaningful to speak of
levels of vitality and healthfulness as of degrees of impairment and debility.

Health promotion should begin with goals not means (Nordin, 1999). If
health is the goal, biomedical interventions are not the only means to it. A
broadened perspective expands the range of health promoting practices and
enlists the collective efforts of researchers and practioners who have much
to contribute from a variety of disciplines to the health of a nation.

The quality of health is heavily influenced by lifestyle habits. This enables
people to exercise some measure of control over the state of their health. To
stay healthy, people should exercise, reduce dietary fat, refrain from smoking,
keep blood pressure down, and develop effective ways of managing stres-
sors. By managing their health habits, people can live longer, healthier, and
retard the process of aging. Self-management is good medicine. If the huge
benefits of these few habits were put into a pill it would be declared a
scientific milestone in the field of medicine.

Current health practices focus heavily on the medical supply side. The
growing pressure on health systems is to reduce, ration, and delay health
services to contain health costs. The days for the supply-side health system
are limited. People are living longer. This creates more time for minor
dysfunctions to develop into disabling chronic diseases requiring health
services. In addition, growing public interest in health matters linked to
expensive health care technologies, and the medicalisation of problems of
living with aggressive public marketing of drug remedies for them, are add-
ing to the burdensome costs. Demand is overwhelming supply.

* Address for correspondence: Albert Bandura, Department of Psychology, Stanford Uni-
versity, Stanford, California 94305-2130, USA. Email: bandura@psych.stanford.edu

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The social cognitive approach, rooted in an agentic model of health pro-
motion, focuses on the demand side (Bandura, 2000, 2004a). It promotes
effective self-management of health habits that keep people healthy through
their life span. Psychosocial factors influence whether the extended life is
lived efficaciously or with debility, pain, and dependence (Fries & Crapo,
1981; Fuchs, 1974).

Aging populations will force societies to redirect their efforts from
supply-side practices to demand-side remedies. Otherwise, nations will be
swamped with staggering health costs that consume valuable resources
needed for national programs.

PRIMACY OF SELF-REGULATION

Individuals continuously preside over their own behavior. Hence, they are
a key locus in the development and successful maintenance of health pro-
motive habits. Whatever other factors may serve as guides and motivators,
they are unlikely to produce lasting behavioral changes unless individuals
develop the means to exercise control over their motivation and health-
related behavior.

Maes and Karoly (2005) report the growing shift from the medical man-
agement model centered on prescriptive regimens and compliance with
them, to a collaborative self-management model. They also identify a corres-
ponding change in the conception of health management in psychological
theorising. Trait approaches, that ascribe health behavior to personal char-
acteristics usually represented by clusters of behavior, are being supplanted
by process models that focus on psychosocial means and the mechanisms
through which they produce their effects.

Health habits are not changed by an act of will. Self-management requires
the exercise of motivational and self-regulatory skills. Self-regulation models
differ somewhat in particulars but they are rooted in three generic subfunc-
tions. These include self-monitoring of health-related behavior and the
social and cognitive conditions under which one engages in it; adoption of
goals to guide one’s efforts and strategies for realising them; and self-
reactive influences that include enlistment of self-motivating incentives and
social supports to sustain healthful practices.

Maes and Karoly conceptualise self-regulation in terms of a triadic pro-
cess by which individuals bring their influence to bear on their health habits.
In their goal-guidance model, goal adoption sets the stage for self-directed
change; implementation strategies convert goals into productive actions;
and maintenance strategies help to sustain achieved behavioral changes. The
authors review numerous health-related cognitions that can affect each of
the three generic self-regulatory processes. They describe the scales designed
to measure them, many of which are cast in trait terms, and evaluate the

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empirical evidence for their predictiveness. The article provides a thoughtful,
critical overview of the extant body of literature on the role of health-related
cognitions in the various self-regulation models.

THE MODEL OF THEORY BUILDING

The models of self-regulation are founded on the common metatheory that
cognitive factors are significant contributors to health behavior. The chal-
lenge in this field is to bring theoretical order to the vast array of posited
cognitive determinants reviewed by Maes and Karoly. The issues center on
theoretical incompatibilities, redundancies of factors given different names,
fractionation of the facets of higher-order constructs into seemingly differ-
ent determinants, evaluation of the unique contribution of factors when
tested in concert rather than singly, and the model of theory building that is
adopted.

Consider, for example, the incompatibility of the goal-setting practices
prescribed by Locke and Latham’s (1990) Goal Theory and by Ryan and
Deci’s (2000) Self-Determination Theory. The goal practices verified empir-
ically by Locke and Latham as providing optimal guides and motivators are
regarded by Deci and Ryan as underminers of motivation. Regression
analyses reveal redundancy of predictors bearing different names. For ex-
ample, after the contributions of perceived self-efficacy and self-evaluative
reactions to one’s health behavior are taken into account, neither intentions
nor perceived behavioral control add any incremental predictiveness
(Dzewaltowski, Noble, & Shaw, 1990). Factors that predict health behavior
when considered singly may not add any unique predictiveness when tested
in conjunction with other factors. Meyerowitz and Chaiken (1987) exam-
ined four possible mechanisms through which health communications could
alter health habits: By transmitting information on how habits affect health;
arousing fear of disease; increasing perceptions of one’s personal vulner-
ability or risk; or by raising people’s beliefs in their efficacy to alter their
habits. Self-efficacy beliefs emerged as the predictor of adoption of healthful
practices.

Were one to delve beneath the labels affixed to the cognitive factors and
address the redundancies among them, the seeming diversity would prob-
ably shrink to a small set of generic factors. They would most likely include
knowledge of health risks and benefits of different health practices; per-
ceived self-efficacy that one can exercise control over one’s health habits;
outcome expectations about the expected material, social, and self-evaluative
costs and benefits for different health habits; the health goals people set for
themselves and the concrete plans and strategies for realising them; and the
perceived sociostructural facilitators and impediments to the changes
they seek. Structural models of the paths of influence would specify the

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functional dependencies among these key determinants and their direct and
mediated effects on health behavior.

ENHANCING THE SCOPE AND SOCIAL UTILITY OF
SELF-REGULATORY MODELS

The value of a psychological theory is judged not only by its explanatory
and predictive power, but by its operative power to guide psychosocial
changes. Most of the self-regulation models focus mainly on predicting
health behavior, but they offer little operative guidance how to change and
maintain it. In social cognitive theory (Bandura, 2000), the sociocognitive
factors that form the prediction model are essentially the same as those that
inform the intervention model. The theory provides prescriptive guidance
on how to alter the sociocognitive factors governing self-regulation of habits
that promote health and those that impair it. The successful translation of
theory into practice is illustrated in two large-scale programs of research
that have developed new health-promotion models founded on the self-
regulatory mechanisms of social cognitive theory.

The self-management model devised by DeBusk and his colleagues
(Bandura, 2000; DeBusk et al., 1994) combines development of motivational
and self-regulatory skills with computer-assisted implementation. It pro-
motes healthful lifestyles by enabling programs that supplant sedentariness
with an active life, foster adoption of healthful nutritional practices, and aid
weight reduction and smoking cessation. For each health habit, people are
provided detailed guides on how to improve their health functioning. They
monitor their health habits, set themselves attainable short-term goals, and
report the changes they are making. The computer mails personalised
reports that include feedback of progress toward their subgoals. The feed-
back also provides guides on how to manage troublesome situations, and
has participants set new subgoals to realise. Self-efficacy ratings identify
areas in which self-regulatory skills must be developed if beneficial changes
are to be achieved and maintained. A single implementer, assisted with the
computerised implementation system, provides intensive, individualised guid-
ance in self-management to large numbers of people.

In tests of the preventive value of this self-management system (Bandura,
2000), employees in the workplace lowered elevated cholesterol by altering
eating habits high in saturated fats. A single nutritionist implemented the
entire program at minimal cost for large numbers of employees. This self-
management system promotes dietary changes with corresponding reduction
in cholesterol in different worksites and clinical settings (Clark, Ghandour,
Miller, Taylor, Bandura, & DeBusk, 1997).

In a large randomised control trial, Haskell and his associates (Haskell
et al., 1994) used the self-management system to promote lifestyle changes

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in patients suffering from coronary artery disease. This places them at high
risk of heart attacks. At the end of four years, those receiving medical care
by their physicians showed no change or they got slightly worse. In contrast,
those aided in self-management by nurse implementers achieved big reduc-
tions in multiple risk factors: They lowered their intake of saturated fat,
lost weight, lowered their bad cholesterol, and raised their good cholesterol,
exercised more, and increased their cardiovascular capacity. The program
also altered the physical progression of the disease. Those receiving the self-
management program had 47 per cent less build-up of plaque on their artery
walls. They also had fewer coronary events, hospitalisations, and deaths.

In another randomised control trial, the effectiveness of the self-
management system was compared in hospitals against the standard medical
post-coronary care in patients who have already suffered a heart attack
(DeBusk et al., 1994). At the end of the first year, the self-management sys-
tem was more effective in reducing risk factors and increasing cardiovascular
functioning than the standard medical care. In the clinical management of
heart failure (West et al., 1997), patients who had the benefit of the self-
management system exhibited, a year later, improvements in functional status,
diet, and pharmacologic adherence as well as reductions in physician visits,
emergency room visits, and hospitalisations for heart failure and other causes.

The self-management system is well received because it is individually
tailored to people’s needs. It provides continuing personalised guidance that
enables people to exercise control over their own change. It is a home-based
program that does not require any special facilities, equipment, or group
meetings plagued with high drop-out rates. It can serve large numbers of
people simultaneously under the guidance of a single implementer. It is not
constrained by time and place. It combines the high individualisation of the
clinical approach with the large-scale applicability of the public health
approach. It provides valuable health promotion services at low cost.

We need to enhance the scope, productivity, and social utility of our
health promotion models. In the applications described above, the com-
puter is used as a coordinating and mailing system to guide self-directed
change and to provide feedback of progress. By linking the interactive
aspects of the self-management model to the Internet, one can vastly expand
its availability to people wherever they may live, at whatever time they may
choose to use it.

The social utility of self-management systems can be enhanced by a step-
wise implementation model. In this approach, the level and type of inter-
active guidance is tailored to people’s self-efficacy beliefs, self-management
capabilities, and motivational preparedness to achieve desired changes. The
first level includes people with a high sense of efficacy and positive outcome
expectations for behavior change. They can succeed with minimal guidance
to accomplish the changes they seek.

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Individuals at the second level have self-doubts about their efficacy and
the likely benefits of their efforts. They make half-hearted attempts to
change and are quick to give up when they run into difficulties. They need
additional support and guidance by individualised interactive means to see
them through tough times. Much of the guidance can be provided by tele-
phone or via the Internet.

Individuals at the third level believe that their health habits are beyond
their personal control, they are convinced of the futility of effort, and are
highly skeptical of the value of behavioral changes. They need a great deal
of personal guidance in a structured mastery program. Progressive successes
build belief in their ability to exercise control and bolster their staying
power in the face of difficulties and setbacks.

Identifying cognitive predictive factors of health behavior without effective
guides on how to change them will not do much to improve human health.
We know from psychosocial applications in other domains of functioning that
powerful treatments that enable people to gain some measure of control
over their lives override the influence of negative predictors (Bandura, 1997).

We need to make creative use of the revolutionary advances in interactive
technologies. People at risk for health problems typically ignore preventive
or remedial health services. For example, young women at risk of eating
disorders resist seeking help. But they will use Internet-delivered guidance
because it is readily accessible, convenient, and provides a feeling of anonym-
ity. Studies by Taylor, Winzelberg, and Celio (2001) attest to the potential
of these types of self-management programs. Through interactive guidance,
adolescents and young women reduced dissatisfaction with their weight and
body shape, altered dysfunctional attitudes, and rid themselves of disordered
eating behavior.

The medical gatekeepers of health services are ill-equipped to promote
health by psychosocial means. They acknowledge a low sense of efficacy to
alter detrimental health habits (Hyman, Maibach, Flora, & Fortmann, 1992),
so they either ignore the problems or substitute pills for behavior change.
With further development of interactive Internet-based models, gatekeepers
will have the option of prescribing effective self-management programs that
can improve the health of those they serve.

The weight of disease is shifting from acute to chronic maladies. The
self-management of chronic diseases is another example of the use of self-
regulatory and self-efficacy theory to develop cost-effective models with
high social utility. Biomedical approaches are ill-suited for chronic
diseases because they are devised mainly for acute illness. The treatment
of chronic disease must focus on self-management of physical conditions
over time.

Lorig devised a generic self-management model in which patients are taught
pain control techniques, self-relaxation, and proximal goal-setting combined

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with self-incentives as motivators to increase level of activity (Holman &
Lorig, 1992). Participants are also taught problem-solving, self-diagnostic
skills, and how to take greater initiative for their health care in dealings with
health personnel. These skills are developed by modeling self-management
skills, providing guided mastery practices, and informative feedback.

In the self-management of arthritis, the program is implemented in
groups in community settings by leaders who lead active lives despite their
arthritis. In follow-up assessments with arthritic patients, the program
retards the biological progression of disease, raises perceived self-efficacy,
reduces pain, decreases the use of medical services, and improves health
behavior, health status, and quality of life (Lorig, 1990; Lorig & Holman,
2003; Sobel, Lorig, & Hobbs, 2002). Both the baseline self-efficacy beliefs
and the efficacy beliefs instilled by the self-management program predict the
health outcomes.

Achievement of widespread health benefits requires merging the unique
contributions of three models, each drawing on a different knowledge base.
The first is a theoretical model that provides the guiding principles. The
second is a translational and implementational model that converts theoret-
ical principles into effective health practices. The third is a social diffusion
model to promote widespread adoption of successful practices by functional
adaptation to different life circumstances. Global applications of social cog-
nitive theory illustrate the fusion of these three models (Bandura, 2004b).

The generic self-management model devised by Lorig lends itself readily
to widespread applications. It can be adapted with supplementary com-
ponents to different chronic diseases (Lorig et al., 1999). It promotes diverse
improvements in health in ethnic participants such as Spanish-speaking
ones suffering from arthritis (Lorig, Gonzalez, & Ritter, 1999) and those at
risk for diabetes (Lorig, Ritter, & Gonzalez, in press; Lorig, Ritter, &
Jacquez, in press). Major HMOs have adopted this model and integrated
it into mainstream health care systems (Lorig & Holman, 2003; Lorig,
Hurwicz, Sobel, & Hobbs, in press).

It is being widely disseminated internationally as well. England has
adopted it as part of its National Health Service. The National Health
Board of Denmark is in the process of integrating it into their health system,
and it is being widely applied in Australia, where it is central to their chronic
disease management policy. In a randomised control trial in China involving
diverse chronic conditions (Dongbo, McGowan, Yi-e, Lizhen, Huiqin, Jianguo,
Shitai, Yongming, & Zhihua, 2003), the generic self-management program
achieved the same type of health benefits as elsewhere. It raised self-regulatory
efficacy, fostered health-promoting behavior, improved health status, and
reduced hospitalisations. The generalisability of a self-regulatory model to
health promotion is further verified by Clark and her colleagues in a ran-
domised control trial in school-based applications in China for children

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with asthma (Clark, Gong, Kaciroti, Yu, Wu, Zeng, & Wu, in press). It
improved asthma management in the home, reduced hospitalisation and
school absenteeism, and improved academic performance. Efforts are being
made to disseminate this program to schools.

Our field does not profit from its theorectical advances because, for the
most part, it lacks creative translational and social diffusion models. These
are the vital, but weakest, links in the field of health promotion. Much
attention is devoted to the development and predictive validity of self-
regulation theories but surprisingly little to their social utility. Theories
are predictive and operative tools. In the final analysis, the evaluation of a
science of self-regulation for health promotion will rest heavily on its social
utility.

REFERENCES

Bandura, A. (1997).

Self-efficacy: The exercise of control

. New York: Freeman.
Bandura, A. (2000). Health promotion from the perspective of social cognitive

theory. In P. Norman, C. Abraham, & M. Conner (Eds.),

Understanding and
changing health behaviour: From health beliefs to self-regulation

(pp. 299 –339).
Amsterdam: Harwood Academic.

Bandura, A. (2004a). Health promotion by social cognitive means.

Health Education
& Behavior

,

31

, 143 –164.
Bandura, A. (2004b). Social cognitive theory for personal and social change by

enabling media. In A. Singhal, M.J. Cody, E.M. Rogers, & M. Sabido (Eds.),

Entertainment-education and social change: History, research, and practice

( pp. 75 –96). Mahwah, NJ: Lawrence Erlbaum.
Clark, M., Ghandour, G., Miller, N.H., Taylor, C.B., Bandura, A., & DeBusk, R.F.

(1997). Development and evaluation of a computer-based system of dietary
management of hyperlipidemia.

Journal of the American Dietetic Association

,

97

,
146 –150.

Clark, N., Gong, M., Kaciroti, N., Yu, J., Wu, G., Zeng, Z., & Wu, Z. (in press).
A trial of asthma self-management in Beijing schools.

Chronic Illness

.
DeBusk, R.F., Miller, N.H., Superko, H.R., Dennis, C.A., Thomas, R.J., Lew, H.T.,

Berger, III, W.E., Heller, R.S., Rompf, J., Gee, D., Kraemer, H.C., Bandura, A.,
Ghandour, G., Clark, M., Shah, R.V., Fisher, L., & Taylor, C.B. (1994). A case-
management system for coronary risk factor modification.

Annals of Internal
Medicine

,

1

20

, 721–729.
Dongbo, F., McGowan, P., Yi-e, S., Lizhen, Z., Huiqin, Y., Jianguo, M., Shitai, Z.,

Yongming, D., & Zhihua, W. (2003). Implementation and quantitative evaluation
of chronic disease self-management programme in Shanghai, China: Randomized
controlled trial.

Bulletin of the World Health Organization

,

81

, 174 –182.
Dzewaltowski, D.A., Noble, J.M., & Shaw, J.M. (1990). Physical activity participa-

tion: Social cognitive theory versus the theories of reasoned action and planned
behavior.

Journal of Sport and Exercise Psychology

,

12

, 388 – 405.
Fries, J.F., & Crapo, L.M. (1981).

Vitality and aging: Implications of the tectangular
curve

. San Francisco, CA: Freeman.

PRIMACY OF SELF-REGULATION

25

3

© International Association for Applied Psychology, 2005.

Fuchs, V. (1974).

Who shall live? Health economics and social choice

. New York:
Basic Books.

Haskell, W.L., Alderman, E.L., Fair, J.M., Maron, D.J., Mackey, S.F., Superko,
H.R., Williams, P.T., Johnstone, I.M., Champagne, M.A., Krauss, R.M., &
Farquhar, J.W. (1994). Effects of intensive multiple risk factor reduction on
coronary atherosclerosis and clinical cardiac events in men and women with
coronary artery disease.

Circulation

,

89

, 975 –990.
Holman, H., & Lorig, K. (1992). Perceived self-efficacy in self-management of

chronic disease. In R. Schwarzer (Ed.),

Self-efficacy: Thought control of action

(pp. 305 –323). Washington, DC: Hemisphere.
Hyman, D.J., Maibach, E.W., Flora, J.A., & Fortmann, S.P. (1992). Cholesterol

treatment practices of primary care physicians.

Public Health Reports

,

107

, 441–
448.

Locke, E.A., & Latham, G.P. (1990).

A theory of goal setting and task performance

.
Englewood Cliffs, NJ: Prentice-Hall.

Lorig, K.R. (1990). Self-efficacy: Its contributions to the four year beneficial out-
come of the Arthritis Self-Management Course. Paper presented at the meeting
of the Society for Behavioral Medicine, Chicago, April.

Lorig, K.R., González, V., & Ritter, P.L. (1999). Community-based Spanish language
arthritis education program: A randomized trial.

Medical Care

,

37

, 957–963.
Lorig, K.R., & Holman, H.R. (2003). Self-management education: History,

definition, outcomes, and mechanisms.

Annals of Behavioral Medicine

,

26

, 1–7.
Lorig, K.R., Hurwicz, M., Sobel, D., & Hobbs, M. (in press). A national dissemina-

tion of an evidence based self-management program: A translation study.

Patient
Education and Counseling

.
Lorig, K.R., Ritter, P.L., & González, V. (in press). Hispanic chronic disease self-

management: A randomized community-based outcome trial.

Nursing Research

.
Lorig, K.R., Ritter, P.L., & Jacquez, A. (in press). Outcomes of border health Spanish/

English chronic disease self-management programs.

Diabetes Educator

.
Lorig, K., Sobel, D.S., Stewart, A.L., Brown, B.W., Bandura, A., Ritter, P.,

Gonzalez, V.M., Laurent, D.D., & Holman, H.R. (1999). Evidence suggesting
that a chronic disease self-management program can improve health status while
reducing hospitalization: A randomized trial.

Medical Care

,

37

, 5 –14.
Maes, S., & Karoly, P. (2005). Self-regulation assessment and intervention in

physical health and illness: A review.

Applied Psychology: An International Review

,

54

(2), 245 – 277.
Maibach, E., Flora, J., & Nass, C. (1991). Changes in self-efficacy and health beha-

vior in response to a minimal contact community health campaign.

Health Com-
munication

,

3

, 1–15.
Meyerowitz, B.E., & Chaiken, S. (1987). The effect of message framing on breast

self-examination attitudes, intentions, and behavior.

Journal of Personality and
Social Psychology

,

52

, 500 –510.
Nordin, Ingemar (1999). The limits of medical practice.

Theoretical Medicine and
Bioethics

,

20

, 105 –123.
Ryan, R.M., & Deci, E.L. (2000). Self-determination theory and the facilitation of

instrinsic motivation, social development, and well-being.

American Psychologist

,

55

, 68 –78.

254

BANDURA

© International Association for Applied Psychology, 2005.

Sobel, D.S., Lorig, K.R., & Hobbs, M. (2002). Chronic disease self-management
program: From development to dissemination.

The Permanente Journal

,

6

, 15–22.
Taylor, C.B., Winzelberg, A., & Celio, A. (2001). Use of interactive media to prevent

eating disorders. In R. Striegel-Moor & L. Smolak (Eds.),

Eating disorders: New
direction for research and practice

(pp. 255 –270). Washington, DC: American
Psychological Association.

West, J.A., Miller, N.H., Parker, K.M., Senneca, D., Ghandour, G., Clark, M.,
Greenwald, G., Heller, R., Fowler, M., & DeBusk, R. (1997). A comprehensive
management system for heart failure improves clinical outcomes and reduces
medical resource utilization.

Americal Journal of Cardiology

,

79

, 58 – 63.

Journal of Personality and Social Psychology
1983, Vol. 45, No. 2,

464

-469

Copyright 1983 by the
American Psychological Association, Inc.

Self-Efficacy Determinants of Anticipated Fears and Calamities

Albert Bandura
Stanford University

This comment analyzes the issues raised by Kirsch regarding the role of self-
percepts of coping efficacy in avoidance behavior. Evidence is reviewed that shows
that people who perceive themselves as inefficacious in wielding control over
potentially aversive events view them anxiously, conjure up possible injurious
consequences, and display phobic avoidance of them. Self-efficacy theory pos-
tulates an interactive, though asymmetric, relation between perceived self-efficacy
and fear arousal, with self-judged efficacy exerting the greater impact. This enables
people to perform activities at lower strengths of self-judged efficacy despite fear
arousal and to take self-protective action without having to wait for fear arousal
to prompt them to action.

In a recent article, Kirsch (1982) reported
that college students who say they fear snakes
raise their confidence that they could hold
one if offered such hypothetical incentives as
money ranging up to $ 1 million, saving some-
one’s life, or even sparing one’s own life. In
contrast, a majority of these same students
steadfastly maintain they could not toss a
wad of paper into a wastepaper basket at an
easy distance (54%) or at a distance of 50 feet
(15.2 m; 76%) even if a million dollars, their
own life, or the lives of others depended on
it. When asked for their reasons for their hy-
pothetical reluctance in these hypothetical
situations, the reluctant snake handlers said
they were deterred by expected fear and aver-
sive consequences, whereas the reluctant pa-
per throwers said they were immobilized by
want of ability.

Kirsch concluded from these data that peo-
ple refrain from performing tasks they find
threatening “due to expected negative con-
sequences, including the expectation that
they will experience fear” (p. 133). This type
of interpretation simply begs the question
because the causes of expected negative con-
sequences and fear arousal themselves need
explaining. This is one of a number of issues
that the self-efficacy formulation addresses.
People who doubt they can cope effectively
with potentially aversive situations approach

Requests for reprints should be sent to Albert Ban-
dura, Department of Psychology, Building 420 Jordan
Hall, Stanford University, Stanford, California 94305.

them anxiously and conjure up possible in-
jurious consequences. The self-efficacy de-
terminants of outcome expectancies and ap-
prehensions are discussed briefly next.

Disjoined Outcome Expectancies

In transactions with the environment, out-
comes do not occur as events disjoined from
actions. Rather, how one behaves largely de-
termines the outcomes one experiences.
Hence, performances that differ in adequate-
ness beget different effects. Indeed, even small
performance variations can produce mark-
edly different consequences, as when a swerve
on a mountain road sends a car careening
down a ravine. Similarly, the type of out-
comes people expect depend largely on their
judgments of how well they will be able to
perform in given situations. Thus, drivers
who distrust their skill in navigating twisting
mountain roads will conjure up outcomes of
wreckage and bodily injury, whereas those
who are fully confident of their driving ca-
pabilities will anticipate sweeping vistas rather
than tangled wreckage. For activities in which
outcomes are either inherent to the actions
or are linked through socially structured con-
tingencies, expected consequences are heavily
rooted in judgments of performance efficacy.
In acknowledging only the end point of the
multilinked judgment, Kirsch disjoins out-,
come expectations from the very perfor-
mance efficacy expectations on which they
are conditional. People think contingently
rather than believe that how skillfully they

464

SELF-EFFICACY AND FEARFUL ANTICIPATION 465

perform has no effect on the types of out-
comes they will experience.

Self-Efficacy Determinants of
Anticipatory Fear

Kirsch invokes anticipatory fear as a reg-
ulator of avoidance behavior. However, he
fails to explain the source of the fearful an-
ticipations, nor does he address the large
body of evidence disputing the view that fear
controls avoidant action.

The notion that fear regulates avoidance
behavior has been extensively tested and
found seriously wanting (Bolles, 1975; Herrn-
stein, 1969; Schwartz, 1978). Avoidance be-
havior is frequently performed in the absence
of fear arousal and can persist long after fear
of threats has been eliminated (Black, 1965;
Notterman, Schoenfeld, & Bersh, 1952; Res-
corla & Solomon, 1967). Assessments con-
ducted during the course of treatment of pho-
bic disorders reveal no consistent relations
between changes in fear arousal and phobic
behavior. Elimination of phobic behavior can
be preceded by increases, reductions, or no
change in fear arousal (Barlow, Leitenberg,
Agras, & Wincze, 1969; Leitenberg, Agras,
Butz, & Wincze, 1971). Neither the pattern
nor the magnitude of change in fear arousal
accompanying treatment correlates signifi-
cantly with changes in avoidance behavior
(O’Brien & Borkovec, 1977; Orenstein &
Carr, 1975; Schroeder & Rich, 1976). Al-
though there is little evidence that fear con-
trols avoidance behavior, the cause of antic-
ipatory fear is an issue of interest in its own
right.

Self-efficacy theory posits that it is mainly
perceived inefficacy in coping with poten-
tially aversive events that makes them fear-
some. If people believe they can exercise con-
trol over the occurrence of events that can be
injurious, they do not fear them. That per-
ceived control does indeed reduce anticipa-
tory and performance fear of aversive stimuli
has been abundantly documented by diverse
lines of research (Averill, 1973; Lazarus,
1980; Miller, 1979, 1981). People led to be-
lieve that they can exercise some control over
painful stimuli display less autonomic arousal
and impairment in performance than do
those who believe they lack personal control,

even though both groups are subjected to the
same painful stimulation. Evidence that the
same aversive stimuli produce differential
fear arousal depending on misbeliefs about
controlling efficacy bears testimony for the
power of self-belief rather than for a condi-
tioned-anxiety view. Wortman and her as-
sociates (Wortman, Panciera, Shusterman,
& Hibscher, 1976) have similarly shown that
repeated failures create stress reactions when
ascribed to personal inefficacy, but the same
painful experiences leave people unperturbed
if ascribed to situational factors.

The relation between self-percepts of cop-
ing efficacy and fear has now been tested di-
rectly in several lines of research with severe
phobics (Bandura & Adams, 1977; Bandura,
Adams, & Beyer, 1977; Bandura, Adams,
Hardy, & Howells, 1980). In these experi-
ments the intensity of fear is analyzed as a
function of the strength of perceived self-ef-
ficacy in coping with different threats. The
findings consistently show that phobics ex-
perience high anticipatory and performance
fear on tasks on which they perceive them-
selves to be inefficacious, but as the strength
of their self-percepts of efficacy increases,
their fear declines. Kirsch replicated this now
well-established relation for reported fear
with regard to hypothetical performances.

The generality of the perceived inefficacy-
fear relation is further confirmed in research
using physiological indexes of fear (Bandura,
Reese, & Adams, 1982). Phobics display no
visceral arousal while performing coping
tasks they regard with utmost self-efficacious-
ness. However, on tasks about which they
doubt their coping efficacy, their heart rate
accelerates and their blood pressure rises dur-
ing anticipation and performance of the ac-
tivities. After self-percepts of coping efficacy
are strengthened to maximal levels, these
same activities are executed without any vis-
ceral agitation.

Research in which anticipatory and per-
formance fear toward the same threat are
measured after self-perceived efficacy is sys-
tematically raised to differential levels further
shows that perceived coping inefficacy is con-
ducive to fear arousal (Bandura et al., 1982).
Regardless of whether self-percepts of effi-
cacy are increased enactively or vicari-
ously—or whether the analysis involves dif-

466 ALBERT BANDURA

ferential levels of perceived self-efficacy across
groups or within the same subjects—the less
efficacious subjects judge themselves to be,
the more fear they experience when they later
perform the threatening task.

Telch (Note 1) tested the comparative pre-
dictiveness of perceived coping efficacy and
different indexes of anxiety with treated ago-
raphobics. Perceived self-efficacy proved to
be a good predictor of different facets of psy-
chological change—it predicted anticipatory
fear, performance attainments in the behav-
ioral posttreatment assessment, and self-ini-
tiated behavioral venturesomeness in the nat-
ural milieu. In contrast, the anxiety indexes
lacked consistent predictive value. Antici-
patory fear was related to behavior in the
posttest but not in the natural milieu. Au-
tonomic arousal in the posttest yielded only
one correlate and that in a direction sug-
gesting that self-percepts override arousal in
the regulation of action. The more physio-
logically perturbed the persons have been the
more they ventured outdoors. Leland (Note
2) examined by multiple regression many
potential determinants of precompetition
anxiety in young athletes. Perceived self-ef-
ficacy emerged as the major predictor, ac-
counting for 40% of the variance in precon-
test anxiety, whereas a measure of anxiety
proneness accounted for only 6% of the vari-
ance. Beck and Lund (1981) studied the per-
suasiveness of health communications in
which the seriousness of periodontal disease
and susceptibility to it were varied. Perceived
self-efficacy in implementing health practices
predicts who will adopt them, whereas level
of fear arousal does not.

Asymmetric Interactive Relation

Self-efficacy theory postulates an interac-
tive, though asymmetric, relation between
perceived self-efficacy and fear arousal, with
self-judged efficacy exercising the greater im-
pact. People who judge themselves to be inef-
ficacious in managing potential threats ap-
proach such situations anxiously, and the ex-
perience of disruptive arousal, in turn, lowers
their sense of efficacy that they will be able
to perform skillfully.

In the self-appraisal of efficacy, past ac-
complishments and social comparative eval-
uation carry the greater weight because these

sources of efficacy information are consid-
erably more trustworthy indicants of capa-
bleness than are the indefinite stirrings of the
viscera. People are therefore much more
likely to act on their self-percepts of efficacy
inferred from multiple sources than primar-
ily on visceral cues. Given a sufficient level
of perceived self-efficacy to venture threat-
ening tasks, phobics perform them with vary-
ing amounts of fear arousal depending on the
strength of their self-percepts. By considering
the level, strength, and generality of self-per-
cepts of efficacy, one can predict not only
which threatening tasks subjects will perform
but also how much anticipatory and perfor-
mance fear they will experience in the process
(Bandura et al., 1980; Bandura et al., 1982).

Substantial benefits accrue from the fact
that actions are not directly controlled by fear
independently of self-percepts of efficacy.
People have fearful anticipations about many
of the things they do in their life pursuits that
fall at the lower limits of their self-judged ef-
ficacy. If fear arousal routinely triggered im-
mobility or avoidance action, human func-
tioning would be severely constricted. It is
because people can perform activities at
weaker strengths of perceived efficacy despite
trepidations that they are able to overcome
inappropriate fears and function effectively
even in the face of considerable stress arising
from realistic threats.

Truncated Inquiry

Kirsch presents questionnaire ratings and
quotations to show that students are deterred
from any commerce with snakes by the fear
and the anticipated negative consequences
that could occur were they to attempt the
interactive behavior. In considering threat-
ening prospective actions, the amount of fear
and injurious effects people envisage de-
pends, as we have seen, on how much control
they judge they will be able to wield over the
threats. Negative outcome expectancies re-
flect the causal dependencies postulated by
self-efficacy theory.

Preliminary study in which snake phobics
verbalize aloud their thoughts while attempt-
ing to cope with a snake reveals that their
fearful anticipations and cognized injuries
are indeed rooted in self-percepts of coping
inefficacy. They believe that their inept cop-

SELF-EFFICACY AND FEARFUL ANTICIPATION 467

ing efforts will cause the snake to strike (“I
may squeeze him too hard and provoke him.”
“Oh my god, if I drop its head it is going to
be annoyed and suddenly bite.”)- They
promptly abort actions they have undertaken
when they find they do not know how to con-
trol the writhing beast in their hands (“I don’t
know how do it, sort of like holding a baby;
I don’t know how because he keeps squirm-
ing like a worm.”). Sometimes they are re-
luctant to try actions because they view the
threat as unpredictable and, hence, would be
imable to use their self-protective skills (“It
can take you by surprise with those slithering
unpredictable movements.”). The most pro-
found self-inefficacy involves perceived vul-
nerability to total loss of personal control
rather than self-doubts about particular cop-
ing performances (“As I get closer to the cage
I feel the tension spread to my hands and
shoulders. If I picked him up, I’d lose control
of my hands and arms and drop him.”). The
loss of personal control, they believe, would
then leave them defenseless. Gaining coping
efficacy not only eliminates fear but even al-
ters how the attributes of the phobic object
are perceived (“Now that I know how to han-
dle it, it doesn’t look all that horrible.”).

The prevalence of self-inemcacy thinking
in phobic disorders is further revealed by
Rappoport and Williams (Note 3). They re-
corded, via a portable electronic device, on-
going thoughts of agoraphobics as they coped
with threats in natural milieus. Self-apprais-
als of coping capabilities, and reappraisals as
situational circumstances changed, figured
prominently in the persons’ thinking as they
took on, or shied away from, the situations
confronting them. In these coping encounters
they gave relatively little thought to negative
outcomes. If self-percepts foster actions judged
to be relatively safe, there is little need to
dwell on catastrophic outcomes. In two stud-
ies conducted by Lee (in press, Note 4)—one
involving snake handling and the other as-
sertiveness—perceived self-efficaciousness
predicted performance much better than did
expected outcomes. Regression analyses re-
veal that when the effect of perceived self-
efficacy is partialed out, expected outcomes
do not add much to the prediction of
behavior.

In brief, phobics envisage the outcomes
arising from transactions with threats as very

much dependent on their perceived coping
efficacy. Operating behind fears and cognized
negative outcomes are self-judged inefficacies
to exercise control over potentially threat-
ening situations. Failure to explore why sub-
jects fear that mishaps will befall them should
they venture into coping activities presents
a truncated analysis of the personal deter-
minants of avoidance behavior.

Perceived Self-Efficacy; Generative
Capability Rather Than Fixed Property
Perceived self-efficacy is concerned with

people’s judgments of how well they can or-
ganize and execute, constituent cognitive, so-
cial, and behavioral skills in dealing with pro-
spective situations. Operative self-efficacy is
neither a static nor a fixed behavioral prop-
erty that one does or does not have in one’s
repertoire any more than one would view lin-
guistic efficacy in terms of a collection of sen-
tences in a verbal repertoire. There is a
marked difference between possessing con-
stituent skills and being able to use them well
under diverse circumstances. For this reason,
people with similar constituent skills, or the
same individuals on different occasions, may
perform poorly, adequately, or extraordinar-
ily (Langer, 1979; Weinberg, Gould, & Jack-
son, 1979; Collins, Note 5). Variable perfor-
mance attainments with comparable or
identical subskills are partly mediated by self-
percepts of efficacy (Bandura, 1982). In short,
perceived self-efficacy is concerned not with
what one has, but with judgments of what
one can do with what one has. If, by dwelling
on their presumed coping deficiencies, people
scare themselves to the point at which they
believe they will be even less able than or-
dinarily to perform adequately, they will reg-
ister lowered perceived self-efficacy.

Because operative self-efficacy is concep-
tualized as a generative capability, self-per-
cepts of efficacy are measured in terms of
variable use of constituent skills under cir-
cumstances that differ in complexity, diffi-
culty, or threat. Thus, for example, in gauging
driving self-efficacy the issue is not whether
drivers know they can steer, accelerate, and
slow down a car but whether they judge they
can use these skills effectively to navigate
through busy arterial roads, congested city
traffic, onrushing freeway traffic, and twisting
mountain roads.

468 ALBERT BANDURA

In reasoning that phobics know they pos-
sess in their “behavioral repertoire” the “se-
ries of motor responses” needed to perform
effectively, Kirsch embraces the type of me-
chanical-entity view of operative efficacy that
self-efficacy theory rejects. To return to the
reptilian example, snake phobics judge not
whether their behavioral repertoire contains
grasping motor responses but whether they
can muster whatever skills they possess to
cope with a mobile reptile in increasingly
closer contacts.

According to Kirsch, coping with a shifty
reptile involves no skill, but tossing a wad of
paper into a wastepaper basket does. Her-
petologists who know how to handle poison-
ous snakes and therapists who minister to
self-doubting phobics testify to the fact that
it takes some skill to control a snake. Indeed,
recent research discloses that perceived cop-
ing efficacy can be promptly raised with sub-
sequent reductions in fear and phobic be-
havior by explicitly modeling effective strat-
egies for controlling phobic objects, which
observers later put to good use (Bandura et
al., 1982).

Social persuasion serves as one, though far
from the best, means of raising people’s be-
liefs concerning their operative capabilities
(Bandura, 1977; Biran & Wilson, 1981). It
is not entirely surprising that the prospect of
vast sums of money could persuade students
that they might be able to boost their coping
facility through extraordinary effort, espe-
cially because they would not be called on
to perform the tasks anyway. When big stakes
are involved, it is not uncommon for people
to psych themselves up with inflated judg-
ments of their self-efficacy. The pretend in-
centives even persuaded many of the paper
throwers that they too could marshall suffi-
cient dexterity to hit a wastepaper basket at
a distance. Not only is perceived self-efficacy
subject to persuasory boosts but most inef-
ficacious people would be quite willing to risk
or even endure some injury for a hefty bank-
roll. There are countless things people would
judge they could do, however ineptly, for a
large sum of money or to spare human life.

When snake phobics selected through be-
havioral tests rather than verbal reports are
offered real money to cope with real snakes,
they do not change their behavior (Rimm
& Mahoney, 1969). However, snake phobics

need not despair that fortunes would be
needed to raise their self-percepts of efficacy
to the point at which they could master their
reptilian nemesis. A mastery modeling treat-
ment (Bandura, 1982), that conveys depend-
able coping strategies can, in short order, in-
state robust self-percepts of coping efficacy
that wipe out anticipatory fear, phobic think-
ing, and phobic behavior without requiring
any offers of currency or physical salvation.

Reference Notes

1. Telch, M. J. A comparison of behavioral and phar-
macological approaches to the treatment of agora-
phobia. Unpublished doctoral dissertation, Stanford
University, 1982.

2. Leland, E. I. Relationship of self-efficacy and other
factors to precompetitive anxiety in basketball players.
Unpublished doctoral dissertation, Stanford Univer-
sity, 1983.

3. Rappoport, A., & Williams, L. An investigation into
the nature and modification of phobic thinking. Paper
presented at the meeting of the Phobia Society of
America, San Francisco, October 1981.

4. Lee, C. Efficacy expectations and outcome expecta-
tions as predictors of performance in a snake-handling
task. Unpublished manuscript, University of Ade-
laide, Australia, 1983.

5. Collins, J. Self-efficacy and ability in achievement
behavior. Paper presented at the meeting of the
American Educational Research Association, New
York, March 1982.

References

Averill, J. R. Personal control over aversive stimuli and
its relationship to stress. Psychological Bulletin, 1973,
80, 286-303.

Bandura, A. Self-efficacy: Toward a unifying theory of
behavioral change. Psychological Review, 1977, 84,
191-215.

Bandura, A. Self-efficacy mechanism in human agency.
American Psychologist, 1982, 37. 122-147.

Bandura, A., & Adams, N. E. Analysis of self-efficacy
theory of behavioral change. Cognitive Therapy and
Research, 1977, 1, 287-308.

Bandura, A., Adams, N. E., & Beyer, J. Cognitive pro-
cesses mediating behavioral change. Journal of Per-
sonality and Social Psychology, 1977, 35, 125-139.

Bandura, A., Adams, N. E., Hardy, A. B., & Howells,
G. N. Tests of the generality of self-efficacy theory.
Cognitive Therapy and Research, 1980, 4, 39-66.

Bandura, A., Reese, L., & Adams, N. E. Microanalysis
of action and fear arousal as a function of differential
levels of perceived self-efficacy. Journal of Personality
and Social Psychology, 1982, 43, 5-21.

Barlow, D. H., Leitenberg, H., Agras, W. S., & Wincze,
J. P. The transfer gap in systematic desensitization:
An analogue study. Behaviour Research and Therapy,
1969, 7, 191-196.

Beck, K. H., & Lund, A. K. The effects of health threat
seriousness and personal efficacy upon intentions and

SELF-EFFICACY AND FEARFUL ANTICIPATION 469

behavior. Journal of Applied Social Psychology, 1981,
;/, 401-415.

Biran, M., & Wilson, G. T. Cognitive versus behavioral
methods in the treatment in phobic disorders: A self-
efficacy analysis. Journal of Consulting and Clinical
Psychology, 1981, 49, 886-899.

Black, A. H. Cardiac conditioning in curarized dogs: The
relationship between heart rate and skeletal behavior.
In W. F. Prokasy (Ed.), Classical conditioning: A sym-
posium. New York: Appleton-Century-Crofts, 1965.

Bolles, R. C. Learning theory. New York: Holt, Rinehart
& Winston, 1975.

Herrnstein, R. J. Method and theory in the study of
avoidance. Psychological Review, 1969, 76, 49-69.

Kirsch, I. Efficacy expectations or response predictions:
The meaning of efficacy ratings as a function of task
characteristics. Journal of Personality and Social Psy-
chology, 1982,42, 132-136.

Langer, E. J. The illusion of incompetence. In L. C. Perl-
muter & R. A. Monty (Eds.), Choice and perceived
control. Hillsdale, N.J.: Erlbaum, 1979.

Lazarus, R. S. The stress and coping paradigm. In C.
Eisdorfer, D. Cohen, A. Kleinman, & P. Maxim (Eds.),
Theoretical bases for psychopathology. New York:
Spectrum, 1980.

Lee, C. Accuracy of efficacy and outcome expectations
in predicting performance in a simulated assertiveness
task. Cognitive Therapy and Research, in press.

Leitenberg, H., Agras, W. S., Butz, R., & Wincze, J.
Relationship between heart rate and behavioral change
during the treatment of phobias. Journal of Abnormal
Psychology, 1971, 78, 59-68.

Miller, S. M. Controllability and human stress: Method,
evidence and theory. Behaviour Research and Therapy,
1979, 17, 287-304.

Miller, S. M. Predictability and human stress: Towards
a clarification of evidence and theory. In L. Berkowtiz

(Ed.), Advances in experimental social psychology (Vol.
14). New York: Academic Press, 1981.

Notterman, J. M., Schoenfeld, W. N., & Bersh, P. J. A
comparison of three extinction procedures following
heart rate conditioning. Journal of Abnormal and So-
cial Psychology, 1952, 47, 674-677.

O’Brien, G. T., & Borkovec, T, D. The role of relaxation
in systematic desensitization: Revisiting an unresolved
issue. Journal of Behavior Therapy and Experimental
Psychiatry, 1977, 8, 359-364.

Orenstein, H,, & Carr, J. Implosion therapy by tape-re-
cording. Behaviour Research and Therapy, 1975,13,
177-182.

Rescorla, R. A., & Solomon, R. L. Two-process learning
theory: Relationships between Pavlovian conditioning
and instrumental learning. Psychological Review, 1967,
74, 151-182.

Rimm, D. C., & Mahoney, M. J. The application of
reinforcement and participant modeling procedures
in the treatment of snake-phobic behavior. Behaviour
Research and Therapy, 1969, 7, 369-376.

Schroeder, H. E., & Rich, A. R. The process of fear
reduction through systematic desensitization. Journal
of Consulting and Clinical Psychology, 1916,44, 191-
199.

Schwartz, B. Psychology of learning and behavior. New
York: Norton, 1978.

Weinberg, R. S., Gould, D., & Jackson, A. Expectations
and performance: An empirical test of Bandura’s self-
efficacy theory. Journal of Sport Psychology, 1979, /,
320-331.

Wortman, C. B., Panciera, L,, Shusterman, L., &
Hibscher, J. Attributions of causality and reactions to
uncontrollable outcomes. Journal of Experimental
Social Psychology, 1976, 12, 301-316.

February 25, 1982 •

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