Factors Related to Stress, Anxiety, and Depression in Northern Iran: Application of Health Locus of Control

Background: The health locus of control framework predicts health-promoting behaviors based on beliefs about whether health is influenced by internal or external factors. Objectives: This study aimed to explore factors associated with stress, anxiety, and depression, using the health locus of control theory in patients over 18 attending comprehensive health centers in Babol, Northern Iran, in 2022. Methods: In this cross-sectional study, participants were selected from eight comprehensive health care centers in Northern Iran using simple random sampling method. Data were collected via a self-report questionnaire covering demographics, the Depression, Anxiety, and Stress Scale, and the Multidimensional Health Locus of Control. Multivariate logistic regression model was applied to explore the association between dimensions of health locus of control with Depression, Anxiety, and Stress. Results: Of 373 participants, 63.5% were female, with a mean age of 37.12 years (SD = 10.18). A greater number of children was significantly associated with higher odds of depression, whereas a history of chronic disease and COVID-19-related hospitalization were linked to reduced odds of depression. Anxiety was associated with gender, education, occupation, income, and the number of children. Stress levels were higher among middle-aged individuals and divorcees. None of the dimensions of the health locus of control showed a significant association with stress, anxiety, or depression. Conclusions: Given the limited predictive power of the health control-based model, incorporating other health education and promotion models—alongside considering individual and social characteristics—may enhance effectiveness.