Published: 17/03/2005, Volume II5, No. 5947 Page 34

Locus of control may sound a rather obscure psychological/scientific concept, but it is one of the most important features of personality. Your locus of control is what you believe controls your fate. Do you consider what has happened to you in life to be the product of your environment, or do you see yourself as personally responsible for your destiny?

'Internals' accept personal responsibility for what happens to them, while 'externals' believe luck or powerful others determine their fate.

San Diego State University psychologist Jean Twenge recently completed a large survey of studies of young people in the 1960s, and she found that today they are much more likely to believe their fate is beyond their control.

People are now much less likely to believe that anyone can be a success, and instead they are convinced there is little they can do to change themselves, or the world around them. This dramatically impacts on the nature of politics, our mental and physical health, crime rates, drug abuse, teenage pregnancy and obesity.

The attribution of one's fate to external forces encourages a victim mentality that always blames anyone but the self for anything bad in your life, and in undermining personal responsibility produces crime, inactivity and self-loathing.

Why bother to discipline your children if you can now blame their bad behaviour on attention deficit hyperactivity disorder? Why diet if you can sue fast food chains for making you fat? Why accept you are lazy when you can blame chronic fatigue syndrome?

An issue at the core of working in the NHS is whether the kind of organisational culture which has evolved is not one likely to render managers more 'external' and less 'internal', just as it appears to do to patients.

A more dynamic management culture is one which encourages internality in the workforce, but this means allowing people to have the experience of making a difference to their environment.

Dr Raj Persaud is consultant psychiatrist at South London and Maudsley trust and Gresham professor for public understanding of psychiatry.