50 (50)    MH REPORT (601.93)

.| .| Multidimensional Health Locus of Control: Form C| | Date Given: <.Date_Given.>| Clinician: <.Staff_Ordered_By.>| Location: <.Location.>| | Veteran: <.Patient_Name_Last_First.>| SSN: 
see that the right things happen.|     <*Answer_5390*>| 11. Whatever improvement occurs with my condition is largely a matter of good fortune.|     <*Answer_5391*>| 12. The main thing which affects 
my condition is what I myself do.|     <*Answer_5392*>| 13. I deserve the credit when my condition improves and the blame when it gets worse.|     <*Answer_5393*>| 14. Following doctor's orders to 
the letter is the best way to keep my condition from getting any worse.|     <*Answer_5394*>| 15. If my condition worsens, it's a matter of fate.|     <*Answer_5395*>| 16. If I am lucky, my condition 
will get better.|     <*Answer_5396*>| 17. If my condition takes a turn for the worse, it is because I have not been taking proper care of myself.|     <*Answer_5397*>| 18. The type of help I receive 
from other people determines how soon my condition improves.|     <*Answer_5398*>| | | Information contained in this note is based on a self-report assessment and is not sufficient to use alone for 
diagnostic purposes.  Assessment results should be verified for accuracy and used in conjunction with other diagnostic activities and procedures.|     $~
<.Patient_SSN.>| DOB: <.Patient_Date_Of_Birth.> (<.Patient_Age.>)| Gender: <.Patient_Gender.>| | MHLC-C| |    Internal: <-Internal->|      Range: 6-36. High score indicates belief that one's behavior 
controls one's health. |    |    Chance: <-Chance->|      Range: 6-36. High score indicates belief that health is controlled by chance, luck or fate.  |    |    Doctors: <-Doctors->|      Range: 
3-18. High score indicates belief that health is controlled by health professionals.|    |    Other People: <-Other People->|      Range: 3-18. High score indicates belief that significant others 
determine one's health.| | Questions and Answers| | 1. If my condition worsens, it is my own behavior which determines how soon I will feel better again.|     <*Answer_5381*>| 2. As to my condition, 
what will be will be.|     <*Answer_5382*>| 3. If I see my doctor regularly, I am less likely to have problems with my condition.|     <*Answer_5383*>| 4. Most things that affect my condition happen 
to me by chance.|     <*Answer_5384*>| 5. Whenever my condition worsens, I should consult a medically trained professional.|     <*Answer_5385*>| 6. I am directly responsible for my condition getting 
better or worse.|     <*Answer_5386*>| 7. Other people play a big role in whether my condition improves, stays the same, or gets worse.|     <*Answer_5387*>| 8. Whatever goes wrong with my condition 
is my own fault.|     <*Answer_5388*>| 9. Luck plays a big part in determining how my condition improves.|     <*Answer_5389*>| 10. In order for my condition to improve, it is up to other people to