The role of self-regulation in health and illness

Self-regulation is an increasingly important topic within Psychology, Health & Medicine. Generally, self-regulation emphasizes the active role that individuals can play to enhance health, and prevent or ameliorate the effects of illness. For this special section, we selected four empirical studies that address the impact of self-regulation on health and disease from two perspectives. One approaches self-regulation as an individual characteristic, a personal resource that enables the individual to act in goal-directed behaviors that, in turn, influence health. The other perspective approaches self-regulation as behaviors or skills that can be taught and practiced to improve health and well-being by people who are confronted with an existing illness.

The longitudinal study by deBlois and Kubzansky (2016, this section) illustrates the first perspective. It analyzes data obtained from a cohort of over 1700 children from the United States, ranging from 6 to14 years of age in order to determine if parents’ assessments of their children’s self-regulatory behaviors predict trying cigarettes or becoming a regular smoker 5 years later. The ability to regulate behaviors such as ‘waiting one’s turn’ was associated with reduced likelihood of trying cigarettes. This ability, together with the ability to regulate emotions (e.g. getting over being upset), attention (e.g. being able to concentrate), and social interactions (getting along with peers) further decreased the risk of becoming a regular smoker. Interestingly, these findings were most pronounced among girls and among those with non-smoking caregivers.

Similarly, Hampson et al. (2016, this section) focus on childhood trait-related regulatory processes, using the Big Five approach to personality (Goldberg, 2001), to examine predictors of self-rated and objective measures of health trajectories into middle age. In their analyses of data from more than 2400 elementary school children in the Hawaii longitudinal study of personality and health, they identified high childhood conscientiousness as an important individual asset that was associated with stable good health over a period of 40 years. Conscientiousness in this study encompasses similar self-regulatory behaviors as assessed by deBlois and Kubzansky (2016, this section), such as being self-disciplined and goal directed, manifested in planful and organized actions, which require the ability to control impulses and delay gratification. Thus, both studies point to the importance of individual or personality characteristics as influencing self-regulatory processes that are related to enhanced health in later life. To cite Hampson et al., ‘Self-regulatory processes influencing health outcomes may have their origins in childhood personality traits’ (Hampson et al., 2016, this section).

Turning to the second perspective, we now focus on the question of whether self-regulatory behaviors can be enhanced in an effort to improve physical health and psychological well-being in the context of an existing illness. This question underlies the two intervention studies in this section, in which self-regulation strategies are taught to patients with serious chronic diseases. We know from survivorship research, that many patients confronted with a serious condition, take an active approach and initiate self-regulation strategies in addition to conventional medical treatment. For example, a cross-sectional survey (Shneerson et al., 2016) of 445 cancer survivors in the West Midlands in the United Kingdom, found that the large majority (91%) had engaged in several self-regulatory behaviors after cancer treatment. Among these, exercise (84%) and diet (56%) were the most popular practices. The exercise category included a wide range of movement-based physical activities, including jogging, walking, and yoga.

The study by Ungar and colleagues (Ungar, Sieverding, Weidner, Ulrich, & Wiskemann, 2016, this section) recruited 72 physically inactive cancer patients to evaluate the effectiveness of a physical activity intervention that emphasized mobilizing self-regulatory skills and encouraged contact with a physically active cancer patient role model. Patients were randomized to the intervention or to stress management, which served as an active control group. Both groups increased their physical activity and reported reduced stress. However, long-term adherence to physical activity was most pronounced by those in the physical activity intervention who also had contact with their role models.

The intervention study by Shahabi, Naliboff, and Shapiro (2016, this section) evaluated the effects of two common movement-based self-regulation strategies, walking and yoga, on symptom relief and emotions in patients with irritable bowel syndrome. While both interventions resulted in short-term benefits on symptoms and psychological well-being, long-term adherence to the targeted behaviors and sustained symptom relief was greater for patients in the walking group compared to those in the yoga group. The fact that long-term adherence to the walking regimen was superior to yoga adherence, illustrates the importance of designing easily implementable self-regulation enhancement interventions for chronically ill patients. Taken together, both intervention studies included in this section clearly demonstrate that self-regulatory behaviors can be taught, and, most importantly, can be changed, with salutary effects in persons with chronic illnesses. Thus, future research on self-regulation skill enhancement for patients holds much promise for the treatment of chronic illness, either as an alternative, or an adjunct to conventional medical therapy.

To conclude, this section highlights the relevance of self-regulation for psychology, health, and medicine. The ability to engage in self-regulation across a number of domains (behavioral, emotional, attentional, and social) appears to be a psychological characteristic of the individual that is evident in children, and asserts an influence on the adoption and maintenance of health behaviors and health trajectories across the life span. The challenge for health professionals will be to find ways to enhance self-regulatory skills to facilitate acquisition of lifelong health habits in young people and adults, to maintain health, to prevent illness, to slow disease progression, and to enhance quality of life.

Gerdi Weidner
Department of Biology, San Francisco State University, Tiburon, CA, USA
Monika Sieverding
Institute of Psychology, University of Heidelberg, Heidelberg, Germany
Margaret A. Chesney
Osher Center for Integrative Medicine, Department of Medicine, School of Medicine, University of California, San Francisco, CA, USA
[email protected]
© 2015 Taylor & Francis
http://dx.doi.org/10.1080/13507486.2015.1100940