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Control Theory, Hierarchy of superordinate and subordinate goals …
Control Theory
Negative Feed back loop
Negate (or reduce) deviations from comparison value
Carver and Scheier (1982)
Input function
Sense the present state
How much road CAN we see in front of us
ACTUAL temperature in the room
Sensor in Purple Book
Comparator
Comparison of Input function
vs. Reference value
Reference value
The ideal - of which deviations are measured
How much road SHOULD we see in front of us
IDEAL temperature in a room
Referent standard in Purple Book
Output function
Performed behavior to reduce discrepancy
Effector in Purple Book
Impact on environment
Change in present condition
New perception continues loops
Disturbances - From outside
An open window
Cross wind on the car
NOT A CLOSED LOOP
Can create, worsen or improve discrepancy
Hit a slice, but cross wind keeps you in fairway
Purpose is not to create behavior
Purpose is to create and maintain the perception of a specific condition :red_flag: :red_flag:
Where does the standard come from?
Attention and Self-Regulation
When posed with a new situation our behavior is determined both by previous experience AND focus of attention
When we are provoked to look at a behavioral standard based on our role or setting we direct our attention at the SELF
Compare present state against the standard
Based on feedback loop, leads to reduction of perceptible discrepancies - Self improvement
If comparator functioning reveals discrepancy between perceived state and reference value
Automatic result will be a behavioral output aimed at countering deviation
Evidence to support self-focus leads to increased conformity with behavioral standards
Most studies look at principle and program levels of self-regulation
"Self focus promotes self-regulation"
This is not always a conscious event, but it can be
Consciousness of process not required for self-regulation
Self-directed attention leads to increased tendency to compare present state to relevant reference values
Two applications of Control Theory
Cognitive models of Behavior Change
Begins with reference value
Requires self-reflection on reference value and one's present state
Attempt to match present state to reference value
Unlike learning models, control theory does not account for self-reinforcement or self-punishment for goal attainment
Maladaptive behavior stems from inability to identify reference values from the levels of system concepts down through program control.
Unable to reduce discrepancy
Social environment does not allow for complete disengagement which leads to repeated, painful failures to adapt
Health Psychology
Affective element in Purple Book
Good health as a reference value
Actively checking a present state and comparing to reference value and assess for discrepancy
Take action to reduce discrepancy
i.e. Take blood pressure medication
Can have ineffective self-regulation, or misregulation
If one develops a faulty behavioral specification at a lower level that is irrelevant to the higher order goal, then discrepancy may not be addressed or even worsened
i.e. Regulating blood pressure management based on a symptom when hypertension typically has no symptoms.
Hierarchy of superordinate
and subordinate goals
Multiple tasks being performed at once
Most important tasks or goals are higher on the hierarchy
Output from above determines the reference value for level below
Top most hierarchy is an image or goal of/for ourselves we strive to attain.
Powers (1973) calls this a "System Concept"
i.e. Being a good person, Increase sales contracts
We attempt to behave in such a manner as to find congruence with this image
System Concept:
Highest level of self-regulation
Principle Control
Guiding principles, a starting point for self-regulating to attain the upper goal
Applicable to many kinds of behavior
A quality of behavior
Program control
General course of action
Course of action dependent on situation (if-then)
The program represents the output necessary to self-regulate at the Principle level
Relationship control
Sequence control
Transition
Configuration
Sensation
Intensity
Goal of student who has borrowed notes from a classmate:
Be a responsible person
Follow through on commitments
Specific to situation
Drive over and return notes
IF out of gas THEN stop for gas
IF accident on 95 THEN take 215
ALL decisions are to match behavior to goal
Returning the notes is a necessary output, in this situation, to follow through on his commitments
We all know that driving requires several actions done in specific sequences which, in turn, require even more actions as we get into lower and lower levels of control
Driving
Make a right turn
Turning of the steering wheel
Fingers around the wheel
Gripping
Muscle tension
The further down we go the more actions there are and the more quickly reference values change
i.e. many muscle tension changes required for the simpler action of turning the steering wheel
Carver and Scheier posit that most people function at the level of program control
No reference to higher order goals
This is because of all the implicit decisions that should be made.
When posed with a new situation we use our mental models from previous experiences to establish a standard from which we then self-regulate at the program level
Functionally superordinate
Perhaps, such as in an assembly line, a lower level action takes priority in self-regulation with no acknowledgement of higher order goals
Where does the reference value for this
level come from? - Prior experiences?
What would lead someone to self-regulate at the level of principles or system concepts when most self-regulate at the program control?
Link to research topic
Metacognition in healthcare delivery
Be the best primary doctor possible
Provide high quality care
Make correct diagnoses
Build different diagnoses
Perform cardiovascular exam
Assess heart sounds
Use stethoscope
Listen
1 more item...
I would agree with Carver and Scheier that the majority of time our level of self-regulation defaults at this stage, if not even lower
It may even be safe to say that in most instances that self-regulation begins at this stage as very often this is implicit. We only THINK about making the correct diagnoses if we are unsure, but most patients present with typical signs and symptoms and a differential diagnoses is clear
From here and below is automatic
The purpose of my possible research topic would be determining how often, as medical providers, we our self-regulating at this level
I suspect not often
Would self-reflection and self-regulation at this level improve outcomes and reduce medical errors?
What would it take to get providers to self -reflect at this level more frequently? What motivates this?
How would I design a study to evaluate this?
What would be the value of these results?
Could we assess health outcomes with self-reflection
Could we assess the cost of care changes related to self-reflection?
Reduction in unnecessary procedures and testing
Reduction in legal fees
Reduction in re-hospitalization costs
Effects of self-regulation and self-reflection on provider engagement and burn-out
