Compliance with the gluten-free diet: the role of locus of control in celiac disease.
OBJECTIVE
To verify whether subjects with celiac disease (CD) have a different locus of control (LoC) compared with healthy subjects, and to evaluate the relationship between LoC and compliance with a prescribed gluten-free diet (GFD) and quality of life (QoL).


METHODS
We studied 156 subjects on a GFD (mean age, 10 years) and 353 healthy controls (mean age, 12 years). All subjects completed tests on the Nowicki-Strickland Locus of Control Scale; the subjects with CD also completed a questionnaire to measure compliance with dietary treatment and the disease's impact on QoL.


RESULTS
There was no difference in LoC values between patients with CD and controls. Subjects with CD with good dietary compliance had a more internal LoC compared with those who were not compliant (P = .01). Patients who reported a satisfactory QoL had a more internal LoC compared with those who reported negative affects on QoL due to CD (P = .01).


CONCLUSIONS
Our study confirms the usefulness of the LoC concept for identifying those patients who might be at risk for dietary transgression. Given the enhanced, psychological, and social well being that can result from adherence to a GFD, educational and psychological support can help internalize the LoC in those patients at risk for dietary transgression.
Bellini
Anna
A
Department of Reproductive, Developmental and Public Health Sciences, University of Trieste and Institute of Child Health, IRCCS "Burlo Garofolo," Trieste, Italy.
Zanchi
Chiara
C
Martelossi
Stefano
S
Di Leo
Grazia
G
Not
Tarcisio
T
Ventura
Alessandro
A
D000293:Adolescent; D000367:Age Factors; D016022:Case-Control Studies; D002446:Celiac Disease / Q000178:diet therapy*; D002648:Child; D055050:Diet, Gluten-Free; D005260:Female; D006801:Humans; D007389:Internal-External Control; D007558:Italy; D008297:Male; D010349:Patient Compliance / Q000523:psychology*; D011788:Quality of Life