A study examining the mental well-being of college students reveals insights about their health locus of control and its relationship with anxiety and depression. Conducted among 3,951 college students across China, the research shows how different perceptions of personal control influence mental health outcomes, especially under pressures intensified by the COVID-19 pandemic.
Published on March 4, 2025, the study employed multi-stage cluster random sampling and logistic regression models to assess health locus of control (HLC) variables. These include internality, powerful others externality, and chance externality, which represent different beliefs about what controls health outcomes: one’s own actions, others’ influence, or fate.
The findings indicate significant associations: students with higher levels of internality, or belief in personal control, exhibited lower rates of both anxiety and depression, with odds ratios of 0.94 (95% CI, 0.91–0.97) for depression and 0.96 (95% CI, 0.95–0.98) for anxiety. Those who trusted others to manage their health were also less likely to experience these negative mental health effects (0.93 for depression), whereas students who relied on chance faced higher risks of anxiety (OR = 1.13) and depression (OR = 1.24).
The research also highlights the mediational role of health risk behaviors — including smoking, drinking, and physical inactivity — which were found to mediate these relationships. Specifically, health risk behaviors accounted for 7.55% of the association between internality and anxiety, 2.37% for powerful others externality and anxiety, and 2.18% for chance externality and anxiety. For depression, the mediated proportions were even more significant, with powerful others externality accounting for 10.48% and chance externality contributing 2.14%.
College life imposes many stressors, from academic pressure to social competition, leading to mental distress. Amid the COVID-19 pandemic, these factors have only worsened. According to the study, the association of HLC dimensions with mental health is particularly relevant during this tumultuous period, indicating the potential for positive change through enhanced self-efficacy and behavior modification.
The research utilized the Multidimensional Health Locus of Control Questionnaire and followed participants from October to December 2020, limiting its scope to one cultural perspective — Chinese students. Yet, the data could prove instrumental for mental health practitioners seeking to understand how beliefs about personal control impact student well-being.
The study’s results advocate for increased focus on health locus of control as pivotal for improving anxiety and depression outcomes among college students. Simply put, when students believe they can control their health, they are likelier to maintain positive mental states. Effective interventions could, for example, integrate training on resilience and healthy coping strategies targeted toward students struggling with low levels of internality or high levels of chance externality.
Overall, this research presents community health advocates and policy makers with actionable insights. Addressing the mental health needs of students involves not only recognizing external stressors but also fostering positive health-related beliefs and behaviors. Future interventions should continue to explore this pathway, focusing on shaping healthier outlooks on personal control and reducing risk behaviors among vulnerable students.