Feist−Feist: Theories of
Personality, Seventh
EditionV. Learning Theories 16. Bandura: Social
Cognitive Theory(^510) © The McGraw−Hill
Companies, 2009
his theory for encouraging people to engage in healthy behaviors that can increase
overall well-being, health, and longevity (Bandura, 1998b).
Recently, William Sacco and colleagues (2007) studied Bandura’s construct of
self-efficacy as it relates to Type 2 diabetes. Diabetes is a chronic disease that re-
quires very careful management including a special diet and exercise regime. Dia-
betes presents people with a variety of physical challenges, but it also is associated
with significant mental health challenges. Indeed, the prevalence of depression among
those with diabetes is double that of the general population (Anderson, Freedland,
Clouse, & Lustman, 2001). One of the hallmark traits of depression is a lack of mo-
tivation and, given the strict diet and exercise plan diabetes patients must adhere to,
this is particularly problematic for those trying to manage diabetes. The less patients
adhere to their disease management plan the greater their diabetes symptoms be-
come, which creates a downward spiral with negative implications for physical and
mental health.
Sacco and his colleagues (2007) therefore sought to explore the role of self-
efficacy as a variable that could increase adherence to the disease management plan
and decrease negative physical and mental health symptoms. Their prediction was that
the greater level of self-efficacy patients felt, the more likely people would be to ad-
here to their disease management plan and therefore the better the patients would feel.
In order to test their prediction, Sacco and colleagues recruited a sample of
adults who had been diagnosed with Type 2 diabetes. Participants completed self-
report measures of how much they adhered to their diet, exercise, glucose testing,
and medication plan, a measure of depression, and a measure of self-efficacy specif-
ically tailored to assess how much self-efficacy they felt with regard to managing
their diabetes. Additionally, participants completed a measure of the frequency and
severity of their diabetes symptoms, and their body mass index (BMI) was computed
based on data from their medical records.
The results of this study clearly demonstrated just how important self-efficacy
is to the management of chronic disease. Higher levels of self-efficacy were related
to lower levels of depression, increased adherence to doctors’ orders, lower BMI, and
fewer and decreased severity of diabetes symptoms. Given these compelling results
for the importance of self-efficacy, the researchers further examined its role in the
management of diabetes. In other analyses, Sacco and his colleagues found that BMI
was positively related to depression and that adherence to doctors’ orders was nega-
tively related to depression.
But might self-efficacy play a role in these relationships? To answer this ques-
tion, the researchers conducted more complex analyses and what they found only
further highlighted how important it is to feel as though you have a sense of control
over your health when it comes to managing a disease like diabetes. Self-efficacy
was directly responsible for both the relationship between BMI and depression and
the relationship between adherence and depression. Specifically, having a high BMI
led people to feel less self-efficacy, which in turn led to increased depression. Con-
versely, being able to adhere to the disease management plan served to increase
self-efficacy, and it was this increase in a sense of control over the disease that was
responsible for decreased depression.
There are many aspects of social cognitive theory that have influenced research
in psychology, but these studies on coping with terrorism and diabetes management
504 Part V Learning Theories