Notes on Psychological Determinants of Health and Well-Being

Psychological Theory

Psychological theory is defined as “a set of propositional statements based on prior evidence summarizing current knowledge on associations between variables (e.g., psychological determinants) and outcomes (e.g., health behavior)” (Hagger, M. S. 2025). This framing situates theory as a structured description of how psychological determinants relate to health-related outcomes, guiding both research and intervention. Relatedly, a psychological mechanism is described as a “mental process implied or represented by effects among determinants (e.g., autonomy) and outcomes (e.g., health behavior)” (Hagger, 2025). The theory–mechanism distinction underpins how determinants are translated into observable behaviors through mediating processes.

Psychological Determinants of Health and Well-Being

Psychological determinants are the mental processes implicated in the initiation and maintenance of health behavior (Hagger, 2025). In exploring what shapes health behavior, the slides enumerate a range of determinants that include dispositions, personality, social structure, demographics, health beliefs and cognitions, motivational constructs, affective perceptions, and nonconscious processes. A broad inventory appears in the diagrammatic page showing how dispositional constructs (including personality and individual differences/traits), social structure (social environment, demographic factors like age and sex, socioeconomic factors such as race, income, education), health beliefs and cognitions (outcome expectancies, social/normative influence, control/capacity perceptions, risk perceptions, and intention), affective perceptions and anticipated emotion, emotion regulation, implicit cognition and nonconscious processes, habit, and self-regulatory capacities all feed into health intention and ultimately behavior.

Psychological Mechanisms and Well-Being

Psychological mechanisms are the mediating processes that connect determinants to outcomes. A model by Newman, Tay, and Diener (2014) examines leisure and subjective well-being, proposing psychological mechanisms as mediating factors. Across well-being research, two influential theoretical traditions are highlighted:

• Marie Jahoda (1958) identified core psychological mechanisms contributing to well-being, including: acceptance of oneself, perception of reality, autonomy, environmental mastery, growth and development, and becoming (or actualization).

• Carol Ryff and colleagues (1989–1998) proposed a six-factor model of psychological well-being: self-acceptance, autonomy, environmental mastery, personal growth, positive relations with others, and purpose in life (meaning).

Ryff’s Scales of Psychological Well-Being (Empirical Items)

Examples from Ryff’s scales illustrate each dimension:

• Autonomy: “I have confidence in my opinions, even if they are contrary to the general consensus.”

• Environmental Mastery: “In general, I feel I am in charge of the situation in which I live.”

• Personal Growth: “I think it is important to have new experiences that challenge how you think about yourself and the world.”

• Positive Relations with Others: “People would describe me as a giving person, willing to share my time with others.”

• Purpose in Life: “Some people wander aimlessly through life, but I am not one of them.”

• Self-Acceptance: “I like most aspects of my personality.”
  These items are part of Ryff, C. D., & Singer, B. H. (2006) work on the six-factor model of well-being.

Psychological Determinants of Health Behavior

Psychological determinants are defined as “mental processes implicated in the initiation and maintenance of health behavior” (Hagger, 2025). This framing emphasizes the cognitive, affective, and motivational factors that drive whether people start and continue health-related actions.

What Are Some Psychological Determinants?

In Week 2, student responses highlight a broad set of determinants: mistrust of the healthcare system, belief systems, stressors, emotional support, social structure (hierarchy), coping, stigma, mindset, life burdens/stress, health behaviors, trauma, resilience, neurodivergence, and attitudes. These determinants span individual differences, social contexts, experiences, and belief systems, all contributing to health-related decision making and behavior.

A Structural View of Determinants and Outcomes

A schematic view (Hagger, 2025) places dispositional constructs (personality and individual differences/traits) and social structure (social environment, demographic and socioeconomic factors) alongside health beliefs and cognitions, outcome expectancies, social/normative influence, control perceptions, risk perceptions, and disposition to act. The model traces a path from these determinants through Health Intention to Motivation, and then to Behavior, with affective perceptions, emotion, anticipation, emotion regulation, implicit cognition and nonconscious processes, habit, and self-regulatory capacity feeding into these processes.

INTENTION

Intention is central to health behavior models. It is defined as the “intention” to perform a health-related action and is treated as the driver of deliberate action. In the literature cited (Hagger, 2025), intention is the focal point around which the Theory of Planned Behavior, Theory of Reasoned Action, Protection Motivation Theory, Social Cognitive Theory, and Health Action Process Approach revolve. Important empirical notes include that intentions rarely explain all variance in behavior, giving rise to the intention–behavior gap. A meta-analysis of meta-analyses indicates that intentions explain about $28\%$ of the variance in future behavior on average. Moderators and mediators further shape this relationship (Conner & Norman, 2022; Sheeran, 2002).

Intention and Behavioral Intentions

Behavioral intentions are defined as the self-instructions that people use to guide behavior, signaling motivation and commitment to act. They reflect both direction (whether to perform X) and intensity (how much effort, time, and energy one is prepared to expend) and lie at the heart of health-behavior models (Conner & Norman, 2022; Sheeran, 2002).

Intention at the Crux of Health Promotion

Intention is influenced by multiple theories and constructs: Theory of Planned Behavior/Reason Action (Fishbein & Ajzen, 2010); Protection Motivation Theory (Rogers, 1983); Social Cognitive Theory (Bandura, 1997); Health Action Process Approach (Schwarzer, 2008; Schwarzer et al., 2011). The key empirical point is the intention-behavior gap: intentions do not always translate into action. As noted, intentions explain about $28\%$ of the variance in future behavior, with several moderators and mediators affecting the link (Conner & Norman, 2022; Sheeran, 2002).

Moderators in the Intention–Behavior Relationship

A moderator is defined as a variable that alters the strength or direction of the relationship between an independent variable (IV) and a dependent variable (DV). In this context, intention is the IV and behavior is the DV, and researchers observe variation in the intention–behavior link across different conditions, making moderators essential to understanding when intentions are more or less predictive of behavior (Arnold, 1982).

MODERATORS IN THE INTENTION-BEHAVIOR RELATIONSHIP

Goal Dimension

Goal dimension includes goal difficulty, goal desire, goal priority, and goal conflict. Increased goal difficulty is associated with greater predictive power of intention for behavior, i.e., harder goals can strengthen the intention–behavior link (Sheeran et al., 2003). Goal priority and goal conflict moderate the intention–behavior relationship across a range of health behaviors (Unsworth et al., 2014; Conner et al., 2016).

Basis of Intention I: Stronger Intentions Based on Affective Attitude and Moral Norms

Affective attitude strengthens intention when people base their intentions on affective evaluations. Moral norms indirectly impact behavior by strengthening intention, and intentions aligned with moral norms predict behavior more strongly than those aligned with attitudes alone. This is demonstrated through measures such as “I personally think that is wrong/right” and “I would feel guilty about not adhering to __.” Key sources: Keer et al. (2014); Godin, Conner, & Sheeran (2005); Conner & Norman (2022).

Basis of Intention II: Stronger Intention–Behavior Relationships

Anticipated regret (Beliefs about future regret following inaction) directly predicts intention and moderates the intention–behavior link (Abraham & Sheeran, 2003). Self-identity moderates the effect of past behavior on intentions and behaviors (Carfora et al., 2017; Christensen et al., 2004). Self-identity comprises roles fulfilled by the person and can induce habitual actions that support the self-concept verification.

Structure of Intention

The structure of intention concerns: (i) Degree of reasoned action – how well behavior-relevant cognitions predict intentions (Sheeran & Connor, 2019); (ii) Motivational coherence – the extent to which predictors of intentions (attitudes, norms, perceived behavioral control) point in the same direction (Sheeran & Conner, 2017); (iii) Realism of intention – whether the intention is grounded in realistic considerations of whether the behavior can be performed (Avisha et al., 2019).

Past Behavior: Strengthen or Weaken?

Past behavior/habit can influence the intention–behavior link in an inverted U-shaped pattern. At low levels of past behavior, increasing experience strengthens the power of intention to predict behavior; at high levels, additional past behavior weakens this power as behavior becomes more automatic or habitual. This pattern is explained in part by experience effects (Fazio & Zanna, 1978; Ouellette & Wood, 1998) and summarized in Conner & Norman (2022).

Personality

Personality dimensions (Openness, Conscientiousness, Extraversion, Agreeableness, Neuroticism) influence intention–behavior links. Empirical evidence shows no broad significant effects except for conscientiousness, which tends to predict more stable and reliable behavior change (Conner & Norman, 2022; Rhodes et al., 2022). The Five-Factor Model (Big Five) of personality is described by McCrae & Costa (1987) and McCrae & John (1992).

Sociodemographic Factors

Age, gender, and socioeconomic status (SES) are examined as moderators. Evidence on age and gender is inconclusive, while SES shows mixed findings; some studies suggest a weaker intention–behavior relationship for lower SES groups (Conner et al., 2013; Schüz et al., 2020, 2021). These ideas are summarized in Conner & Norman (2022).

Temporal Stability of Intentions

Temporal stability refers to how similar intentions remain over time and is a key feature of a strong intention. It also serves as a mechanism to explain how other moderators influence the intention–behavior relationship (Conner & Norman, 2022).

The Intention–Behavior Gap

The gap questions whether intentions causally drive behavior, noting that conscious intention may not fully explain behavior. Wegner & Wheatley (1999) argue that the real causal mechanisms may be unconscious processes of the mind, challenging the view that conscious intention alone causes action. Conner & Norman (2022) emphasize role of intention strength in understanding the gap.

MOTIVATION

Motivation is the disposition to act and is defined as the energization or activation toward an end. A person can be motivated (energized) or unmotivated (lacking impetus to act). This framing is from Ryan & Deci (2000).

Motivation: Intrinsic vs Extrinsic

Motivation can be intrinsic (doing something because it is inherently enjoyable or interesting) or extrinsic (doing something to obtain separable outcomes). These definitions come from Ryan & Deci (2000).

Intrinsic Motivation

Intrinsic motivation is the drive to pursue an activity for its own sake, arising from a meaningful relationship between the activity and personal goals (Csikszentmihalyi 2014; Deci 1975; Deci & Ryan 1985; Kruglanski 1975; Kruglanski et al. 2018; Vallerand 2007). A newer perspective notes that intrinsic motivation can be shaped by how activities relate to goals and ongoing experiences of mastery.

Causes and Phenomena Related to Intrinsic Motivation

Intrinsic motivation increases when (i) the activity-goal link is unique, (ii) repeated activity-goal pairings occur, (iii) there is a fit between the activity and the goal, and (iv) the proximity of the activity to the goal is close (Fishbach & Woolley, 2022).

Increasing Intrinsic Motivation and Persistence

Intrinsic motivation and persistence rise when (i) the activity provides immediate benefits, (ii) immediate benefits are added to an activity that lacks them, and (iii) attention is focused on immediate benefits. These factors enhance choice and ongoing engagement (Fishbach & Woolley, 2022).

Positive Psychology: Flow

Flow is a central construct in positive psychology, referring to a psychological state of deep engagement during high-quality, challenging activities. The 8 characteristics of flow are: complete concentration on the task; clarity of goals and immediate feedback; transformation of time; the activity is intrinsically rewarding; effortless engagement; balance between challenge and skills; merging of actions and awareness; and a sense of control over the task. Csikszentmihalyi’s work on flow is foundational to this concept (Csikszentmihalyi 1982). Acknowledgments in the slides cite the broader discourse on flow.

BELIEFS AND COGNITIONS

Key beliefs and cognitions include self-efficacy, outcome expectancy, hope theory, and optimism. These constructs influence goal-setting and subsequent behavior change by shaping perceived capabilities and anticipated outcomes.

Self-Efficacy and Outcome Expectancy

Self-efficacy is the belief in one’s own ability to perform a given action toward a desired outcome. It is associated with persistence, optimism, better social integration, a strong sense of competency, better decision-making, and increased goal setting (Bandura, 1997, 2001; Luszczynska & Schwarzer, 2005).

Outcome expectancy refers to beliefs about the consequences of engaging in a behavior. These include physical outcomes (e.g., short-term reductions in coughing from quitting smoking; longer-term reductions in respiratory risk), social outcomes (e.g., changes in social responses from friends or family), and self-evaluative outcomes (e.g., feelings of pride or shame) (Luszczynska & Schwarzer, 2005).

Hope and Hope Theory

Hope is defined as a positive motivational state based on an interactively derived sense of successful agency (goal-directed energy) and pathways (planning to meet goals). It is described as a goal-directed cognitive-motivational process (Snyder et al., 1991).

Optimism and Hope Theory

Hope theory integrates goals (direction and endpoints), agency (motivation to pursue routes toward goals), and pathways (routes to achieve goals and perceived ability to produce them) (Snyder et al., 2006).

Positive Psychology 101

Positive psychology is defined as the scientific study of what goes right in life, from birth to death, and at all stops in between, including ordinary strengths and virtues and the processes contributing to flourishing or optimal functioning. Foundational voices include Seligman, Peterson, Gable & Haidt, among others (Seligman 2018; Peterson 2006; Gable & Haidt 2005).

PERMA: A Theory of Well-Being

PERMA stands for Positive Emotions, Engagement, Relationships, Meaning, and Accomplishment. It is a framework for understanding well-being, with engagement (flow), meaning (purpose), positive relationships, positive emotions, and achievement as the five pillars. Seligman (2018) formalizes PERMA as a building block of well-being.

Positive Emotions and the Broaden-and-Build Theory

Positive emotions signal and promote optimal functioning and can broaden cognition and behavioral tendencies, enabling the building of enduring personal resources such as social support, resilience, skills, and knowledge. Fredrickson’s broaden-and-build theory posits that positive emotions broaden thought-action repertoires and build resources over time, contributing to health, survival, and fulfillment (Fredrickson, 2011; 2013).

The Broaden-and-Build Emotions: Specific Emotions

Specific positive emotions such as joy, interest, contentment, pride, and love broaden cognition and motivate exploratory, social, and creative behaviors. Joy leads to playful, creative behavior; interest promotes exploration and information intake; contentment fosters savoring and integration of life circumstances; pride encourages sharing achievements and pursuing future goals; love broadens through recurring cycles of play, exploration, and shared experiences with loved ones. Over time, these broadening effects yield more opportunities for growth and resource-building (Fredrickson, 2011).

Relationships, Social Support, and Health

Positive social relationships predict better health, faster healing, and longer life, and are among the strongest predictors of happiness and emotional well-being. Ellen Berscheid and Elaine Hatfield highlighted that adult relationships contribute critically to happiness and productivity across domains (Reis et al., 2013). Successful, satisfying relationships are associated with better health outcomes (Cohen et al., 1998; Kiecolt-Glaser et al., 2005; Holt-Lunstad, Smith, & Layton, 2010; House, Umberson, & Landis, 1988; King & Reis, 2012).

Social Support: Types

Social support is multifaceted and includes Appraisal support (constructive feedback and affirmation; social comparison), Emotional support (empathy, trust, caring, nurturance), Informational support (advice, suggestions, solutions), and Instrumental support (tangible aid and services). Classic sources include House (1981) and House, Umberson, & Landis (1988).

MEANING IN LIFE

Meaning in life is defined in several ways: coherence in life (Battista & Almond, 1973; Reker & Wong, 1988), goal-directedness or purpose (Ryff & Singer, 1998), and a sense of ontological significance from the experiencing individual (Crumbaugh & Maholick, 1964). The Meaning in Life Questionnaire assesses the presence of and search for meaning (Steger et al., 2006).

Perspectives on Meaning and Happiness

Perspectives on meaning suggest no universal meaning applicable to everyone; meaning is individually constructed through pursuing important goals or developing a coherent life narrative (Battista & Almond, 1973; Frankl, 1965; Klinger, 1977; McAdams, 1993; Baumeister, 1991). Happiness tends to increase with satisfying needs and wants and is often linked to being a taker rather than a giver, while meaningfulness increases with altruism and integration across past, present, and future (Peterson, 2006; Steger et al., 2006).

Reminders (Administrative)

Reminders include: read textbook sections 1.2, 6.1, Ep.1, Ep.2; lectures on Health Promotion Models; guest speaker; assignment deadlines (Quiz 3 due 9/28; Quiz 2 due 9/21). These items contextualize the coursework and assessment timeline.