Mindsets and Motivation

Claudia Mueller, PhD, MDDivision of Pediatric Surgery

Framework Based on work by psychologist Carol

Dweck, PhD

Dweck et al have identified a set of “implicit theories” or “mindsets” that individuals use to analyze and interpret the world

These theories are based on two different assumptions that people make about the malleability of personal attributes

Implicit theories “Entity” theory

The belief that a personal attribute is fixed and nonmalleable

“Incremental” theory The belief that an attribute is a malleable

quality that is subject to change and development

Beliefs can be applied in various domains: intelligence, morality, athletics

Implicit theories 2 Entity/incremental category determined by

responses to statements

Implicit theories Intelligence

• You can learn new things, but you can’t really change your basic intelligence.

Morality• A person’s moral character is something very

basic about them and it can’t be changed very much.

Mindset statements Your intelligence is something very basic about you

that you can’t change very much.

You can learn new things, but you can’t really change how intelligent you are.

No matter how much intelligence you have, you can always change it quite a bit.

You can always substantially change how intelligent you are.

Implicit theories 3 Entity vs. Incremental theories influence

Judgments• Entity see failures as indicative of stable, low

ability Goals

• Performance (look good, avoid failure) vs. mastery(learn material, may have to fail to do so)

Response to setbacks• Entity give up in face of challenge

Theories create “mindsets” which influence behavior

Independent of actual intelligence, morality, athletic ability

Intelligence theory Entity view of intelligence as fixed stable trait

Intelligence is reflected by individual outcomes Performance goals: challenge is threatening Failure is devastating (I’m dumb)

Incremental view of intelligence as able to be developed Individual outcomes not representative of whole Learning goals: challenge is informative Failure is motivating (I need to work harder)

Theory development

Likely related to feedback received throughout life Parents, teachers,

peers Some studies have

looked at feedback after failure

My work has focused on feedback after success

Feedback studies Does feedback change how children respond

to challenge?

Can different types of praise lead children to develop different goals and theories (mindsets)?

Conventional wisdom Praise in any form is good Praise after success

• builds self esteem• protects against disappointment after failure

Type of praise Praise for:

Fixed ability = “smartness” Malleable effort = “hard work”

Would children respond differently based on the type of praise given? Conventional wisdom: no Hypothesis: yes

Dissertation Series of 6 studies with fifth-graders assessed for

their work on geometric puzzles (Mueller & Dweck)

>500 participants public and private schools Midwest, Northeast

Dweck lab, Psychology Dept, Columbia University

Experimental Design

Puzzle 1(Success)

Praisemanipulation

Puzzle 2(Failure)

MeasuresPuzzle EnjoymentTask Persistence

Failure Attributions

Puzzle 3 (Test)

Puzzles

Raven’s Progressive Matrices

John C. Raven, Oxford Psychologists Press

Praise Wow, you did very well on these problems. You got –

right. That’s a really high score.

Ability You must be smart at these problems.

Effort You must have worked hard at these problems.

Failure Children told they scored “a lot worse” on second set

of puzzles

Post-failure assessments How well they did Enjoyment Persistence Attributions

• I didn’t work hard enough• I’m not good enough at the problems• I’m not smart enough• I didn’t have enough time

Psychological impact of praise Children praised for effort

Attributed failure to lack of trying Enjoyed puzzles more More likely to persist

Children praised for ability Attributed failure to lack of ability Enjoyed the puzzles less Gave up sooner

Content of praise matters

Puzzle Performance

Additional findings Ability praise

Performance goals Entity belief of intelligence Sought information on performance not mastery Misrepresented score to other kids

Effort praise: learning, incremental theory

Conclusions Praise delivers message

Praise for ability after success• Poor performance = low ability• Avoid challenge

Praise for effort after success• Poor performance = work harder• Embrace challenge as opportunity for growth

Feedback leads to “mindset” that determines behavior

My research paradigm Propose psychological framework of children’s illness

that uses their theories of health to predict adherence and outcomes

Develop scale to identify these health theories

Test scale in healthy children

Study theories and behaviors in chronically ill adolescents

Develop feedback messages to improve both adherence and outcomes in pediatric populations

Response to disease Little is known about the psychological

dimensions of children’s disease Children respond very differently to stressful

hospital settings Some crumble and regress; others thrive and

adapt “Mindset” of illness Independent of illness severity

“Mindset” can be created by theory which may determine adherence and, ultimately, response to disease

Translation to clinical setting Illness is a challenge Hospitalized children behave similarly to

children in schools Do children perceive health as they do

intelligence: fixed vs. malleable? If fixed, less incentive to develop strategies for

health promotion If malleable, more likely to be active in their health

care

Studies designed to examine how children think about health and how this affects their behaviors

Scale development

Potential statements tested with 500 healthy high school students

Goal to identify cohesive set of items to categorize beliefs Entity theorists=health is fixed, unchangeable Incremental theorists=health is malleable, subject to change

Key items Your body has a certain amount of health, and you really

can’t do much to change it. Your health is something about you that you can’t change

very much. You can try to make yourself feel better, but you can’t really

change your basic health.

Study 1: Test scale with healthy kids 100 high school students Exclude any with chronic medical conditions Asked to respond to scenarios of kids with specific

illnesses

Broken leg Asthma Appendicitis

Results 1 Definition of health

Entity attribute to genes Incremental attribute to behavior

Assessment of health in others Entity exaggerate illness severity Entity exaggerate illness duration

Assessment of own health Incremental theorists believe they are healthier Entity have higher BMI

Minimal overlap with previous scale of health causation (Locus of control)

Study 2 250 high school students Asked to assess health of others (replicate

first study) Also asked to self-report safety behaviors

Hypothesis: Entity theorists might be less mindful of safety

Results confirmed Study 1 No significant difference in safety precautions

Current study: Assessment of beliefs in patients

Chronically ill adolescents: Type 1 Diabetes Age 12-18 yrs Implicit theories of health Dependent measures

Self-report of adherence attitudes Health outcomes

• Meter results• Blood sugar levels

Current study 2 Participants approached at regularly-

scheduled clinic visit Consent from parents Assent from patients

Participation rate 95% Questionnaire administered in waiting area

Implicit theory of health scale Adherence attitudes

Results-adherence attitudes Entity theorists vs

incremental theorists Less likely to believe

that adherence matters (p<.05)

• Taking the right amount of medication on schedule will help me control my illness.

• If I do exactly what my doctor tells me, I can control my illness.

Results-actual health Meter results (previous 3 weeks)

Entity vs. incremental Highest glucose (p<.05) Mean glucose (p<.05) Percent above target (p<.02)

Hgb A1c not significant

Overall results By measuring adolescents’ implicit theories of

health, we were able to predict Reactions to illness in others Attitudes toward adherence Actual health outcomes in diabetic patients

Advantages of implicit theory scale (Mueller, Williams, Dweck) Simple Easy to administer Long history of use in various contexts

Future investigations Apply theory framework to other disease

populations Post-transplant, Cystic fibrosis, IBD Post-op recovery cardiac surgery

Design experimental manipulations in which theories are changed (eg, fixed to malleable) to measure effect on outcomes

Deliver feedback messages targeted at theory change Via web-based designs, technologies

Other ongoing research projects Implicit theories of body weight (Burnette)

Plan to implement interventions (on-line reading activities that present body weight as malleable)

Measure motivation as well as weight loss over test period

Theories of trauma Teenagers hospitalized for trauma asked

about cause of injury Use attributions to develop prevention

strategies

Children’s perceptions of their surgical scars

Summary Perceptions can change behaviors

In academic setting, children’s beliefs about intelligence influence their performance

In healthcare setting, children’s beliefs about health and illness may affect their responses to disease

My work is an attempt to create a psychological model that explains children’s health behaviors

Encouraging results using implicit theory framework to predict adherence and outcomes in medical setting

Thank you Carol Dweck, PhD Robert Wright, MA Ryan Williams, MD Bruce Buckingham, MD Marily Oppezzo, MA David Yeager, PhD Jeni Burnette, PhD Lindsey Eliopulos, MA Mette Hoybye, PhD

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