Running head: LEARNED HELPLESSNESS CONCEPT ANALYSIS

Concept Analysis: Learned Helplessness

Kalyn Skinner
Auburn University/Auburn University Montgomery

Running head: LEARNED HELPLESSNESS CONCEPT ANALYSIS

Abstract
This concept analysis was completed in an effort to explore the theoretical and empirical
meaning behind the concept of learned helplessness. Learned Helplessness is defined as a
psychological state that occurs when one sees a situation as uncontrollable and gives up
all efforts to escape (Seligman, 1975). This phenomenon is seen in all disciplines and
stages of life. With this analysis, the concept of learned helplessness and its relationship
to chronic illness and poverty will be explored. Walker and Avants (2011) modified
version of Wilsons classic concept analysis was used in defining the antecedents,
attributes, consequences, and empirical referents of the phenomenon of learned
helplessness. The antecedents identified are low self-esteem, low self-confidence, a lack
of motivation, and hopelessness. The defining attributes are a perceived feeling of no
control that leads to cognitive, motivational, and emotional deficits. The consequences of
learned helplessness are depression, lack of motivation for self-care, suicide, and no
motivation to escape the helpless situation. The empirical referents provided are the
Attributional Style Questionnaire (ASQ) and Learned Helplessness Survey (LHS). Case
illustrations are provided as an example of learned helplessness in real life scenarios. The
implications of learned helplessness for nurses caring for chronically ill individuals are
also discussed. It is essential for all healthcare providers to recognize antecedents to
learned helplessness early to prevent these individuals from developing the helpless
characteristics. Care for these individuals should focus on maximizing their ability for
self-care and education on preventable aspects of the disease. Presenting this information
should help healthcare providers identify these patients and intervene early.

Running head: LEARNED HELPLESSNESS CONCEPT ANALYSIS

Learned Helplessness Concept Analysis

Learned helplessness is something seen every day by healthcare providers.
Completing an analysis of this concept will help to better understand the concept and
provide better patient care. Helplessness is a psychological state that frequently results
when an event is uncontrollable (Seligman, 1975). The concept can be related to all
disciplines and walks of life. Helplessness in chronic illness often results after multiple
relapses and failed attempts to improve health status. Helplessness in poverty stricken
individuals often results after receiving chronic welfare assistance from the government.
The individual losses hope of change, and therefore makes no further attempts at
escaping their fate. Learned helplessness is an interesting topic and exploring its
components should be very beneficial to improving patient care.
Selection of the Concept
The chosen topic of learned helplessness was selected based on personal interest
and experience with the given concept. The idea or concept of learned helplessness is
something that as healthcare professionals we witness on a daily basis. Patients who are
chronically and terminally ill are often patients that have a feeling of hopelessness and
may become helpless. Exploring this topic will help define the theory behind this
phenomenon.
Definition
In 1965, Martin Seligman and his colleagues began experiments on dogs to
determine the relationship between fear and avoidance learning. With this experiment,
they discovered that if the dogs were restrained when receiving an initial shock then even
after being freed they made no attempts at escape. They believed that the animals learned

Running head: LEARNED HELPLESSNESS CONCEPT ANALYSIS

that shock termination was independent of any attempt to escape the shock and the
learned helplessness hypothesis was developed (Seligman, 1975).
Helplessness is the psychological state that frequently results when events are
uncontrollable (Seligman, 1975, p.9). A person or animal is helpless when an outcome
occurs independently of all his voluntary responses. Helplessness is a phenomenon often
experienced by depressed individuals.
Learned Helplessness is experienced by individuals and occurs initially when an
individual perceives a situation as an unfavorable stress or challenge. The individual will
identify potential actions to manipulate the situation to make it less challenging or
stressful. After multiple failed attempts to influence the situation then an expectation of
response-outcome independence is learned (Smallheer, 2011). This idea is the underlying
assumption of the learned helplessness theory.
Analysis of the Concept
A modified version of Wilsons classic concept analysis created by Walker and
Avant (2011) was used to complete the following analysis. A concept analysis should
result in a precise operational definition of a term and defining that term will increase its
validity. Learned Helplessness is an ambiguous term and can be used in healthcare as a
stereotype or classification. This analysis should help define the meaning behind the term
and help nurses classify this group correctly.
Aim of the Analysis
The aim of this paper is to analyze the concept of learned helplessness and define
its relationship to chronically ill patients as well as to poverty stricken individuals.
Completing an analysis will assist in identifying these individuals and understanding the

Running head: LEARNED HELPLESSNESS CONCEPT ANALYSIS

concept behind their actions. Once they are identified treatment can be decided. By better
understanding this phenomenon, patient outcomes and satisfaction will improve.
Identification of Antecedents
An antecedent is an event or characteristic that is present before the
uncontrollable negative event occurs (Walker & Avant, 2011). Low self-esteem and little
to no self-confidence is often present when individuals develop learned helplessness.
Poor coping mechanisms may also be present. An event that will contribute to learned
helplessness is one that the individual feels they have no control over. With the
chronically ill characteristics of low self-esteem, lack of motivation and helplessness may
not be present when first diagnosed, but after multiple relapse and failures learned
helplessness may develop (Seligman, 1975). Hopelessness is often seen in individuals
prior to developing learned helplessness. A feeling of hopelessness stems from events that
the individual feels there is a lack of control over (Dunn, 2005). According to Abramson,
Metalysky, and Alloy, hopelessness is more likely if the person has a negative cognitive
style and sees life events in a negative light (1989). To better care for all individuals it is
important to recognize the antecedents and provide care to the individual before
helplessness becomes an issue.
Critical Defining Attributes
A situation in which a subject believes they cannot solve a solvable problem can
precede a feeling of helplessness. The subject attempts to change the situation with no
success leaving them to feel like a failure and that they have lost control of the current
situation (Abramson, Seligman, & Teasdale, 1978). Realizing that outcomes are

Running head: LEARNED HELPLESSNESS CONCEPT ANALYSIS

uncontrollable leads to reduced motivation, depression, and difficulty recognizing the

relationship between action and outcomes (Sullivan, et al., 2012).
Three defining deficits that characterize learned helplessness are motivational,
cognitive, and emotional/affective. Motivational deficits in learned helplessness are
characterized by apathy, lack of energy, and decreased incentive to initiate action against
the cause of helplessness (Slimmer, Lopez, LeSage, & Ellor, 1987). Multiple studies
have shown the decrease in individuals attempt to respond to a situation after repeated
failures. (Mclaughlin, Lefaivre, & Cumming, 2010; Seligman; 1975, Smallheer, 2011).
Cognitive deficits are revealed by reduced decision-making, failure to perceive success
when it does occur, and decreased ability to learn new responses (Majer & Seligman,
1976; Slimmer, et al, 1987; Smallheer, 2011). Emotional deficits are characterized by a
feeling of hopelessness, loneliness, social withdrawal, fear, and frustration (Abramson et
al, 1978; Majer & Seligman, 1976; Slimmer, et al, 1987)
Chronic illness.
Learned helplessness is often seen in individuals that are attempting to cope with
a chronic illness. These individuals are often confronted with repeated exposure to
negative, uncontrollable disease-related events. When an individual makes multiple
attempts to overcome the disease, but is repeatedly faced with failure and relapse they are
more likely to give up hope and fall into a helpless state.
When a negative event occurs and an individual links negative causes to that
event than in theory they will expect such negative events to occur in the future and
become helpless (Abramson et al, 1978). This attributional style is described as
depressogenic and is often seen in chronically ill individuals. Depressogenic style is

Running head: LEARNED HELPLESSNESS CONCEPT ANALYSIS

described as internal, stable, and global. This means that the individual sees the event as
caused by personal factors, which are constant, and are present in all situations (Vargas,
2010). Many researchers have completed studies on chronically ill individuals in an
attempt to explain why learned helplessness is common among chronically ill individuals
(Chaney, Mullins, Uretsky, Pace, Warden, & Hartman, 1999; McLaughlin, et al, 2010;
Smallheer, 2011; Vargas, 2010). The studies conclude that the repeat exposure to negative
events will bring the individual to believe that no matter what effort they placed they
cannot escape the disease, leading them to be hopeless and helpless.
Poverty stricken individuals.
Poverty stricken individuals is another group that often experiences learned
helplessness. Individuals that fall below the poverty line in the United States are offered
aid by the government through programs such as child support, energy or utility
assistance, food stamps, and medical assistance (U.S. Department of Health and Human
Services, 2013). These programs are designed as emergency funds for individuals that
have currently lost a job or lack skills to obtain a job that will support a growing family.
However, many individuals become chronic welfare recipients and because of this never
make any attempt to bring themselves above the poverty line. Ruby Payne, an American
educator, found after studying the modern American class system that generational
poverty is often caused by learned helplessness that is passed down from parents to
children. She found that learned helplessness is seen when the individuals feel that there
is no escape from poverty so in order for them to make the best of their situation one
must live in the moment and experience what they can when they can (2005). This can
often explain why these individuals do not save money or invest it, but rather spend it on

Running head: LEARNED HELPLESSNESS CONCEPT ANALYSIS

items such as alcohol and cigarettes. Not all individuals that are in poverty are helpless
individuals, but the feeling of having no control over ones success in life can lead to
frustration with ones situation and helplessness may occur.
Empirical Referents
The means by which you can recognize or measure the defining characteristics
or attributes (Walker & Avant, 2011, p.168) defines an empirical referent. Peterson et al.
(1982) developed an Attributional Style Questionnaire (ASQ) to measure individuals
disposition to make particular attributions to certain events. The tool measured the
Attributional styles described by Abramson et al in the reformulation of the learned
helplessness theory (1978). The tool described 12 different real life scenarios. Half of the
scenarios were bad and half were good. Also, half of the events described were
interpersonal while the other half was based off achievement. Participants are asked to
rate the event on a scale of 1 to 7 and determine the cause of the event and who or what
was responsible. This scale helps determine whether one will relate an event to an
internal or external cause and whether it will be unstable or stable. The tool has had
continued use in psychology and is a valid resource when determining ones Attributional
style in relation to learned helplessness.
The Learned Helplessness Scale (LHS) is another tool used to assess the degree of
an individuals helplessness. The scale contains twenty items that assesses an individuals
degree of learned helplessness. For each item the respondent is asked to read paragraphs
and assess how closely the content relates to them. Each item is then scored using a 4point scale ranging from strong disagreement to strong agreement. Each question has a

Running head: LEARNED HELPLESSNESS CONCEPT ANALYSIS

score associated with it and the highest score is an 80. The higher the score the more
likely one will develop learned helplessness (Shae, 2008).
Consequences
There are several consequences that are related to learned helplessness. When one
becomes helpless they are more likely to become depressed and hopeless (Seligman,
1975). A lack of hope in an individual with chronic or terminal conditions can lead to
suicide or attempted suicide. (Cochinov, Wilson, Enns, & Lander, 1996; Dunn, 2005;) In
chronically ill individuals helplessness associated with hopelessness and depression will
decrease their motivation for self-care activities and health promotion leading to rapid
decline in health status (Dunn, 2005). Different consequences are seen with other
disciplines of learned helplessness.
Consequences seen in helpless poverty stricken individuals, is a lack of
motivation for change and lack of determination to better their lives. Poverty can cause
an individual to see the effort they place and the outcomes as independent variables and
therefore see efforts as futile (Seligman, 1975). The individuals that are chronically on
welfare are unlikely to make effort to remove themselves from persistent poverty, even
when opportunities do arise. A connection is made between their lack of meaning in life,
with their sense of lifes purposelessness, and their pointless place in society (Dixon &
Frolova, 2011).
Case Illustration
A case illustration is used in a concept analysis to show the relationship of the
concept to real life scenarios. A model case will have all the defining attributes associated
with learned helplessness. In A borderline case, the individual has most of the defining

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attributes but not all of them. A related case will provide a scenario for a case that is
related to the concept (Walker & Avant, 2011). Case Illustrations will help readers
understand the concept and to place the concept into real scenarios that they too may
have experienced.
Case model.
Mrs. B. is a 45-year-old white female that was diagnosed with the systemic
disease multiple sclerosis at the age of 30. When Mrs. B. was first diagnosed she had
been married for 3 years and did not have any children, but she and her husband were
hopeful that the disease would not keep her from reproducing. At first, Mrs. B. and her
husband were very compliant with treatment and hopeful that she could overcome this
progressive disease. She went on daily walks and completed the prescribed exercises just
as the doctor had ordered. Despite her efforts, by the age of 33 Mrs. B was in a
wheelchair and had minimal function of her legs. All hopes of having children were gone
and Mr. and Mrs. B were devastated. At the age of 40 Mrs. Bs condition had worsened
and her husband gave up hope and placed her in a nursing home. He visited only on
special occasions and never called to check on his wife. When first admitted to the
nursing facility, Mrs. B. was still able to move her arms, and could feed herself and assist
with self-care activities. Mrs. B. began to blame herself for the loss of her husband, her
disease, and her diminished quality of life. Because of this her effort to care for herself
slowly declined over the years, and now at the age of 45 Mrs. B is a bed bound individual
with contractures and bedsores. She has a flat affect and has no interest in
communicating with others. Mrs. B. shows characteristics of all three defining attributes:
motivational, cognitive, and emotional. Mrs. B. at first had the motivation to overcome

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the disease but over time and after repeated failures gave up and let herself become a
helpless individual. Cognitively Mrs. B has decided that there is no hope for her
overcoming the disease, therefore she stopped making decisions for herself and let her
husband place her in a nursing home. Emotionally Mrs. B. gave up on herself and started
to blame herself for the disease, which led to depression and a disinterest in activities.
Mrs. B. case is an illustration of learned helplessness from an uncontrollable chronic
disease.
Borderline case.
An 18-year-old girl who was raised by her parents at the local housing community
and lived off of federal aid, had an opportunity to go to college at no cost utilizing federal
aid. Her parents had never worked and had been living off Welfare and government
assistant their entire life. The girl approached her parents with the opportunity and they
told her she was crazy for trying to go to college that she needed to have babies and make
money that way. Because of her parents disapproval of her attempt to escape poverty and
government assistance, the girl declined the offer and applied for welfare and her first
baby was born that fall. This girl learned helplessness is attributed to a global cause. Her
parents have become chronic welfare users and feel that they have no hope of bettering
themselves. They passed this philosophy down to their daughter and therefore have
passed the learned helplessness down to future generations continuing the cycle of
welfare dependent poverty. The attributions seen best in this case are motivational and
cognitive. This girl has a lack of motivation because of inability to escape her poverty
stricken lifestyle. She was presented with an escape but chose to not take this route.
Cognitively she has told herself that she cannot overcome her lifestyle because her

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parents did not support her, leaving her to continue the generational cycle of poverty
within her family.
Related case.
Hopelessness is a related concept to helplessness and the following case uses
hopelessness as the chosen scenario. Mr. S. is a 49- year- old male who has a family
history of heart disease. His father and grandfather both died of heart attacks before their
60th birthday. Mr. S. has a family history and is also morbidly obese, smokes, and lives a
sedentary life style. His physician has educated him multiple times on the preventable
risk factors for heart disease, but Mr. S. refuses to change his lifestyle. He states, Whats
the point, I am going to die anyways, no matter what I do. Mr. S. also attributes his fate
to a global factor. His hopelessness has stemmed from his cognitive belief that his life is
doomed no matter what he does therefore he has given up hope. Hopelessness in
individuals also is antecedent to developing learned helplessness. Therefore, the
healthcare providers should recognize this sign and provide education to prevent him
from becoming helpless.
Application to Nursing
Learned helplessness is a concept that is seen often in healthcare. As primary care
nurse practitioners many opportunities will arise to help prevent helplessness in
individuals. When an individual is diagnosed with a chronic condition it is often life
altering, not only for the individual but for their families also. It is our job to provide
education on ways to continue self-care activities, preventable symptoms of the disease,
and support for the entire family throughout the stages of disease. Nurses are often seen
as the caring patient advocate therefore that places nurse practitioners in the ideal

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position to intervene when attributes of learned helplessness are present and prevent the
individual from developing learned helplessness.
Conclusion
This paper was written to define the concept of learned helplessness using a
concept analysis method. Learned helplessness is defined throughout this paper and the
accompanying antecedents, attributes, empirical referents, and consequences are defined.
The uses of this concept and its relationship to chronic illness and poverty stricken
individuals were discussed. This concept analysis in its completion should provide
healthcare providers with information on how to diagnose learned helplessness in
individuals and the underlying causes behind this phenomenon. Early recognition can
prevent negative consequences and help optimize health in chronically ill individuals.

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