BRIEF REPORTS Personal and Interpersonal Perceived Control and the Quality of Life of Persons With Severe Mental Illness Ilanit Hasson-Ohayon, PhD,* Sophie Walsh, PhD,* David Roe, PhD,† Shlomo Kravetz, PhD,* and Mark Weiser, MD‡§ Abstract: Studies have been carried out to explore the impact of sense of control on the outcome of persons with severe mental illness (SMI). However, few studies have compared the differential effects of perceived personal control (control of the self) and perceived interpersonal control (the control of significant others). In the present study, we investigated the relations between perceived personal and perceived interpersonal control and different domains of quality of life (QOL) of persons with SMI. Measures of perceived personal and interpersonal control and QOL were administered to 145 participants with a diagnosis of SMI (schizophrenia, affective disorders, anxiety disorders, personality disorders). The results showed personal control to be positively related to various domains of QOL ( = .28 –.31, p  0.001– 0.01) while interpersonal control was negatively related to the physical domain of QOL (= –.20, p  0.05). Theoretical, empirical, and clinical implications of the distinction between personal and interpersonal control for persons with SMI are discussed. Key Words: Severe mental illness, perceived control, quality of life. (J Nerv Ment Dis 2006;194: 538 –542) M ost of the theoretical and empirical attempts to explore the impact of the sense of control on coping with stress and on the outcome of such coping (Bandura, 1997; Skinner, 1995) have focused on perceptions of personal control. Only a few studies have examined the consequences of perceived interpersonal control, and even fewer comparisons have been made between the differential effects of perceived personal and perceived interpersonal control. General feelings of autonomy, mastery, control, and efficacy are considered to be both desirable themselves and resources for maintaining and achieving QOL in the face of illness in general (Affleck et al., 1987; Culos-Reed and Brawley, 2000) and of severe mental illness (SMI) in particular (Hansson et al., 1999; Kravetz et al., 2000; Warner et al., 1989; Zissi et al., 1998). A central premise of this study was that the consequences and treatment of SMI challenges an individual’s sense of control. There- fore, issues of control and autonomy may be even more relevant for persons with SMI. The theory by Rothbaum et al. (1982) of perceived control distinguishes between primary and secondary per- ceived control. Primary control, which connotes the tradi- tional view of perceived personal control, refers to the feeling that one is able to bring the environment into line with one’s wishes. However, according to Rothbaum et al. (1982), persons are motivated to strive for some sense of control and, when primary control is not available, may replace it with one of four kinds of secondary control. These are predictive control, lowering expectations to avoid disappointment; illusory control, attributing uncon- trollable events to chance; vicarious control, identifying with others who have power or control; and interpretative control, seeking an understanding and meaning for the uncontrollable events to accept them. In other theory and research, what Rothbaum et al. (1982) originally referred to as vicarious control (i.e., control through others who have power and control) has been interpreted as interpersonal control (Smith et al., 2000). Perceived interpersonal control can be the conse- quence of the instrumental use of relationships. It can also serve as a major human goal and motive (Baumeister et al., 1999; see Ryan and Sulky, 1996, for a discussion of this issue.). Consequently, this kind of control may be more central to coping with stress than the other three forms of secondary control. Achieving control by means of relation- ships with significant others can also have the negative connotations of dependency or manipulation. Accordingly, Smith et al. (2000) qualify their findings of positive rela- tions between interpersonal agency and perceived primary control and psychosocial well-being with a question as among them to the “threshold point beyond which contin- ued support leads to dependence, enmeshment, and de- creased feelings of agency” (p. 466). Rothbaum et al. (1982) contend that the different forms of secondary control (interpersonal control among them) have often been falsely labeled as passivity, withdrawal, and sub- *Department of Psychology, Bar-Ilan University, Ramat-Gan, Israel; †De- partment of Psychiatric Rehabilitation and Behavioral Health Care, University of Medicine and Dentistry of New Jersey, Scotch Plains, New Jersey; ‡Department of Psychiatry, Sheba Medical Center, Tel- Hashomer, Ramat-Gan, Israel; and §Sackler School of Medicine, Tel Aviv University, Ramat Aviv, Israel. Send reprint requests to Ilanit Hasson-Ohayon, PhD, Department of Psychol- ogy, Bar-Ilan University, Ramat-Gan 52900, Israel. Copyright © 2006 by Lippincott Williams & Wilkins ISSN: 0022-3018/06/19407-0538 DOI: 10.1097/01.nmd.0000225116.21403.34 The Journal of Nervous and Mental Disease • Volume 194, Number 7, July 2006 538