Running head: CONCEPT ANALYSIS OF LEARNED HELPLESSNESS

7340 Concept Analysis of Learned Helplessness

Lauren Smith
Auburn University/Auburn University Montgomery

CONCEPT ANALYSIS OF LEARNED HELPLESSNESS

Abstract
This concept analysis will review the defining attributes of learned helplessness and apply it to nursing
practice. Learned helplessness is when prior difficult tasks have an impact on subsequent tasks, even if
they are less difficult. The aim of this analysis is to explore the concept of learned helplessness and to
apply this concept to the nurse practitioners decision to become a prescribing or non-prescribing
practitioner. A total of three databases, seven peer-reviewed articles, and a textbook were all used to
provide information on the concept of learned helplessness. The antecedents, attributes or characteristics,
and the consequences of learned helplessness are provided in this literary analysis from psychology,
healthcare, and education disciplines. Empirical referents are also provided for the measurement of
learned helplessness. Case illustrations are provided in this analysis to support the concept and its
attributes. The analysis ends with the application to nursing practice, specifically nurse practitioners
prescriptive role.

CONCEPT ANALYSIS OF LEARNED HELPLESSNESS

Concept Analysis of Learned Helplessness

Learned helplessness is a concept that can affect all individuals at all stages in their lives.
Learned helplessness is developed when an individual encounters an unsuccessful task that they perceive
to be out of their control, due to their lack of ability, lack of their effort, or previous low achievements on
similar tasks. This concept is widely studied in the psychology discipline as well as the education
discipline. This analysis will review the antecedents, the attributes, empirical referents, and consequences
of learned helplessness across these two disciplines. In this paper the information provided will be used
to apply to the healthcare discipline, specifically nurse practitioners and their prescriptive authority. Case
illustrations are provided to support the concept of learned helplessness and link it to the role of the nurse
practitioner. Nurse practitioners have an active role in whether they will develop learned helplessness or
stay motivated to achieve prescriptive authority and this paper will present some applications to their
practice. Learned helplessness can be detrimental to an individual causing failure of tasks due to previous
experiences. This analysis paper will explore the concept, its attributes, and its consequences and apply
them to the nursing practice.
Rationale for Selection of the Concept
The topic decision for this paper began by doing an article search with learned helplessness and
nursing as keywords for the research. An article was found that looked at learned helplessness,
hardiness, and risk-taking in nurse practitioners to see if those attributes contributed to their willingness to
prescribe. The studys purpose was to identify factors related to nurse practitioner prescriptive behavior
in order to enhance graduate nursing education, particularly with clinical pharmacology (Chappell,
Marquis, Ward, & Kiehne, 2011). This was extremely interesting to the author of this analysis because
she is a graduate nursing student who plans to be a prescribing nurse practitioner. It is believed that this
topic and the aim of the analysis will provide information that will help give understanding of learned
helplessness and the full scope of prescribing medications as a practicing nurse practitioner.

CONCEPT ANALYSIS OF LEARNED HELPLESSNESS

Concept Definition
Learned helplessness is a universal concept that transfers through many disciplines such as
education, psychology, and health care. Learned helplessness has a basic definition, but can mean
something different to each discipline. Merriam-Webster (Learned Helplessness, 2013) defines learned
helplessness as a mental state in which a subject forced to bear aversive stimuli becomes unwilling to
avoid subsequent applications even if they are escapable, presumably through having learned that control
is out of ones hand. In laymans terms: learned helplessness is when someone or something has had
something done to them or for them for so long that they forget they can change it or do something
different. For example in health care, nurses have followed physicians prescriptions for so long, they
become accustomed to not having the ability to prescribe and forget or refuse to use the power when they
achieve it through advanced practice. In education, learned helplessness can be defined by a students
passivity resulting in cognitive and emotional changes, motivational losses, and behavior reductions
(Yates, 2009). It also is defined by having three components: contingency (uncontrollability of the
situation), cognition (attributions regarding surroundings), and behavior (determination to proceed or give
up on task) (Firmin, Hwang, Copella, & Clark, 2004). Learned helplessness refers to the process where
experiencing major aversive life events that are uncontrollable leads the individual to respond to
subsequent events as if they are also uncontrollable, even if there are in fact not (Pryce et al., 2012).
Analysis of the Concept
A concept analysis defines a concept and describes its function in relation to theory. When
writing a concept analysis, the author is examining the basic elements of a concept in order to separate the
concept from similar concepts. Walker and Avant (2011) describe a concept analysis as having steps
which include: selection of concept, determination of analysis aim, identification of concept uses,
determination of the concept attributes, identification of case models, identification of antecedents of the
concept, determination of concept consequences, and determining empirical referents of the concept.
This analysis will follow those steps to define and describe the concept of learned helplessness. A total of

CONCEPT ANALYSIS OF LEARNED HELPLESSNESS

three databases were used to collect data and articles to support the concept of learned helplessness across
two disciplines.
Aim of the Analysis
The aim of this analysis is to explore the concept of learned helplessness and to apply this
concept to the nurse practitioners decision to become prescribing or non-prescribing practitioners.
Chappell, Marquis, Ward, and Kiehne (2011) explore the relationship between learned helplessness and
nurse practitioners decisions to engage, or not to engage, in prescriptive practice. They look into the
history of nursing and the evolution of the nursing profession to see its impact on nurse practitioners
decision as well (Chappell et al., 2011). This analysis will research what leads up to learned helplessness,
what the characteristics are, and what the effects of learned helplessness are among individuals. The
analysis will also provide graduate nursing students the ability to learn about the concept of learned
helplessness in an effort to use prescriptive rights as a practicing nurse practitioner.
Identification of Antecedents
Learned helplessness suggests that individuals are aware of contingencies and non-contingencies
in their settings and their experience with non-contingency in one situation may cause inappropriate
expectations in subsequent situations. When this overgeneralization occurs, an individual is said to have
learned to be helpless (Hanusa & Schulz, 1977). Many things contribute to an individuals learned
helplessness; these contributing factors are called antecedents. Antecedent, as defined by MerriamWebster, is going before another in time or order (Antecedent, 2013). Ones lack of ability to control
an outcome in an important situation contributes to performance on later tasks. An antecedent to learned
helplessness is the perceived lack of ability or lack of effort to complete a task (Hanuna & Schulz, 1977).
Learned helplessness is comprised of three dimensions: emotional (increased arousal, anxiety, and fear
relative to events); motivational (reduced level of incentive to terminate the event); and cognitive
(reduced expectancy that the event can be terminated by own behavior) (Pryce et al., 2012). Therefore, if
a person experiences any of the three dimensions of emotional, motivational, or cognitive, those feelings
can all lead to the development of learned helplessness in future situations with similar tasks.

CONCEPT ANALYSIS OF LEARNED HELPLESSNESS

Individuals experiencing learned helplessness are more likely to give up easily or fail more often
even at easier tasks. Situations where failure is uncontrollable are more likely to result in learned
helplessness. If the individual relates the failure to internal causes they were more inclined to give up
than those who attributed their failures to external causes. The type of situation can also be an antecedent
for learned helplessness, as it may affect the way individuals respond to difficult tasks. Low motivation
due to beliefs that the person is not in control is also an antecedent. If a student has perceived failure, that
is enough to lead the student to develop learned helplessness (Firmin, et al., 2004). The feelings of being
discouraged, turned off, or wanting to give up trying are all antecedents to learned helplessness. Negative
attitudes toward learning; discouraged, disengaged, inappropriate behaviors; and a history of lower
achievement all contribute to the development of learned helplessness among students. Students who see
success as determined by a factor such as luck, which is out of their control, generally believe they will
never be successful because of their perceived lack of ability and therefore learn helplessness (Yates,
2009). Helplessness is a result of internally controlled success and exposure to externally controlled
rewards and punishment (Zuroff, 1980).
Identification of Critical Defining Attributes
Many things can contribute to the development of learned helplessness, just as many things can
be attributions of learned helplessness. Attributes are defined as an inherent characteristic by MerriamWebster (Attributes, 2013). In the studies reviewed in Zuroffs (1980) article it was shown that
changing rooms, experimenters, and different tasks under different titles helped to decrease helplessness;
therefore, changing situations of the event may decrease learned helplessness. However, other studies
reviewed in Hanusa and Shulzs (1977) article show that characteristics of individuals with learned
helplessness feel they cannot control the outcome even when the experimenter, room, and tasks have been
changed. These study findings contradict, but they tell us that learned helplessness really depends on the
individuals characteristics. Individuals with learned helplessness usually have the characteristic of
anxiety and hostility (Zuroff, 1980). Hanusa and Schulzs (1977) article also presented these five
attributions: ability, luck, mood, effort, and task difficulty.

CONCEPT ANALYSIS OF LEARNED HELPLESSNESS

Characteristics of learned helplessness can vary with gender. In educational studies it has been
found that learned helplessness effects individuals differently, such as attention-deficit hyperactivity
disorder diagnosed boys become more frustrated and report feeling increased boredom and anxiety
(Firmin et al., 2004). In the study looking at learned helplessness among students in mathematics, it was
found that more girls than boys believed the subject matter was beyond them (Yates, 2009). In testing
students, if they had hard questions before the easy questions they would tend to give up on the easy
questions due to frustration (Firmin et al., 2004). Students that have developed learned helplessness show
the characteristics of decreased efforts, engagement in a variety of work avoidance strategies, or simply
give up no matter their gender.
Empirical Referents
The word empirical is defined by Merriam-Webster as capable of being verified or disproved by
observation or experiment (Empirical, 2013). This section will review empirical referents used to
study learned helplessness. Learned helplessness translates across species and has been experimented
with rats and mice as well as humans. Pryce et al. (2012) study uses mice in an inescapable and
escapable electro-shock exposure and escape test using brothers. There was a central gate and electroshock escape that allowed transfer to the safe compartment. They used a tone pre-shock, which exhibited
increased reactivity in the inescapable group of mice. The empirical referent in this study was the shock
chamber that either allowed escape or in-escape. The validity of the study is supported by showing the
development of a high level of escape failure under the escapable shock conditions. The studys
reliability is efficient due to the consistency of the findings among the three experiments. The study
supported that emotional attributions of learned helplessness do effect subsequent situations. The
problem with this studys generalizability is that it is used on mice which may bring forth some problems
with implying the results on humans (Pryce et al., 2012).
Another empirical referent used to study learned helplessness is in the experiment by Hanusa and
Schulz (1977) where four groups were given non-contingent reinforcement on a computer-administrated
concept formulation task. Three of the groups received information indicating that their ability, lack of

CONCEPT ANALYSIS OF LEARNED HELPLESSNESS

effort, or the difficulty of the task was responsible for their failure. The fourth group was given no
attributions. This empirical referent provides individuals responses to non-contingency experiences as
important attributions and supports learned helplessness. Problems with this study are that the individuals
may not have believed the experimenter when informed that the testing task is soluble. The validity of
this study is shown through the non-contingency training leading to failure, as was expected by selecting
this tool. The reliability of this study is supported by the review of similar studies with the same results
supporting the attributions and learned helplessness. This was also an early study on learned
helplessness; now there are many new technologies that can change the empirical referent of the study
(Hanusa & Schulz, 1977).
The most common empirical referent used in studying learned helplessness in students is the use
of tests. The effect of learned helplessness on test taking was studied by giving tests to two groups; one
group received a test with hard questions first and the second group received a test with easy questions
first. The result was that the participants missed easy questions after taking the hard questions first.
These results can be applied to other tests where learned helplessness can negatively affect test scores.
The validity of this study is supported by the negative outcome of the tests. The reliability of this study is
supported by the use of the groups and multiple tests to provide the consistent results. This empirical
referent supports that prior experiences of frustration or lack of control can have a negative impact on
subsequent experiences even if those experiences do allow control. This study can be generalized to other
testing and shows support for the theory of learned helplessness among students (Firmin et al., 2004).
The last empirical referent used for this paper is studying learned helplessness in students is
through the Student Behavior Checklist. Yates (2009) reviews this tool in mathematics students
experiencing learned helplessness. The items in the Student Behavior Checklist relate to the way in
which students responded to mathematics tasks; therefore, it is likely that these behaviors influenced
students actual achievement. This creates a circle in which helplessness and lack of achievement were
intertwined. The validity of this article is supported by the findings of students with learned helplessness
behaviors in the classroom by the use of this checklist. The reliability of this study is supported by the

CONCEPT ANALYSIS OF LEARNED HELPLESSNESS

consistent findings of learned helplessness behaviors and lower mathematic achievement. This article
also supports the attributions to learned helplessness and shows the impact that it has on students
achievements by the use of this tool (Yates, 2009). These are just a few of the tools used to study learned
helplessness. The empirical referents described above were used on different types of participants and
were used to test different types of hypotheses; however, each one supported the theory of learned
helplessness and provided information on the attributions to the development of learning to be helpless.
Consequences
Consequence, as defined by Merriam-Webster, is something produced by a cause or necessarily
following from a set of conditions (Consequence, 2013). Learned helplessness is a serious problem
for individuals whether they are students or nurse practitioners. The attributions that lead to the
development of learned helplessness all pose consequences to the individual. Yates (2009) describes the
consequences of learned helplessness among students as the student ultimately becomes unsuccessful.
The student shows passive learned behaviors such as they stop showing effort, avoid work, give up on
tasks, show lower achievement, and become a failure. This study only looked at mathematics, but this
can be generalized to other subjects and situations in life, which has a big impact on an individual.
Firmin et al. (2004) also studied students learned helplessness through testing. They found that after the
student had developed learned helplessness the outcomes were that students gave up on tasks more
readily and blamed their failure on external factors. The consequences of this readily accepted failure due
to the learned helplessness can be detrimental for students at any level of education.
Zuroff (1980) told of the consequences of learned helplessness as individuals had become
anxious, hostile, and depressed as a result of this concept. The individual had debilitated performance
and passivity on subsequent tasks, abandoned efforts, and had little goal directed behavior. Zuroff (1980)
also found that after individuals experienced any outcome, whether it is positive or negative, the
individual accepted it as failure and had high expectancies for receiving negative outcomes. The
outcomes of learned helplessness are all the same or at least similar and consists of decreased motivation,
failure, giving up on tasks, lower achievements, and expectancy of negative outcomes. All of these lead

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the individual to either unsuccessful completion of a task or lower outcomes on that task. These
limitations that individuals develop can handicap their success in their education, career, home lives, and
every task that they must undertake.
Case Illustrations
Case illustrations help us to understand what the defining attributes to the concept are. A model
case is a pure example of the concept with all of the defining attributes of the concept. The use of other
cases allows us to clearly understand what is included in the concept and what is not. Other cases permit
us to compare and contrast concepts in order to establish what is strictly in one concept opposed to
another concept (Walker & Avant, 2011). This concept analysis will use a model case, a borderline case,
and a related case to show what elements are in the concept of learned helplessness and which elements
are not.
Model case.
Model cases demonstrate all of the antecedents, attributes, and consequences of the concept
(Walker & Avant, 2011). A model case example for learned helplessness in a nurse practitioner is best
described with prescriptive authority. Nurse practitioners have gained or are attempting to gain
prescriptive authority in their practicing state. Many practitioners are embracing this new role, yet this
case tells of one that has learned helplessness in prescribing medications. The nurse practitioner had
struggled in school with pharmacology and had received low scores in those classes giving her the feeling
of low achievement associated with medications. She believed that the subject matter was beyond her
and experienced increased anxiety and the feeling of no control when confronted with pharmacological
tasks. She graduated from her program, passed her boards, and landed a job at a primary care clinic. She
did not have a good relationship with the doctor that she was working under, because he made her feel
that she lacked ability in her practice. She began with hard, time-consuming prescriptive cases which
lead her to overthinking and frustration with subsequent prescriptive cases. The nurse practitioner started
to decrease her efforts in writing prescriptions for patients due to her lack of motivation and feelings of
little ability to efficiently prescribe medication. She soon stopped writing prescriptions for her patients

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which led to fewer patients coming in to see her and dismissal from her job. She felt that this all was a
result from her lack of ability to understand pharmacology from school, her low achievement on tests, and
previous failures on prescriptive tasks. These prior situations and feelings impaired her ability to
implement the prescriptive roles of her job; therefore, leading to the development of learned helplessness.
The antecedents are her perceived lack of ability and previous low achievements; the attributes are the
frustration and decrease in prescriptive writing; and the consequences are the stopping of prescribing
medications and the dismissal from her job. The attributes are measured by the empirical referent of the
having a difficult task followed by an easier task to measure the degree of learned helplessness on the
second task due to the outcome of the first task. This is a model case because it has all of the attributes of
the concept and can be measured by the use of testing with hard cases before easier cases, with failure of
later cases due to experiences in earlier cases.
Borderline case.
Borderline cases contain most of the attributes of the concept, but leave some of them out or
differ sustainably in one of them (Walker & Avant, 2011). This borderline case will tell of a nurse
practitioner who encountered problems with prescriptive authority also. He also suffered from low
achievement in pharmacology classes in school, but rather he related his to impossible assignments and
test questions rather than his own lack of ability. He too graduated, passed his boards, and landed a job in
a primary care clinic. He encountered problems with prescribing medications to patients due to his
previous low achievements in pharmacology classes and basic lack of understanding. Instead of giving
up on the task of writing prescriptions he still was motivated to achieve this task. He had times where he
felt out of control, increased anxiety, and a lack of ability to prescribe, but he continued to work on this
despite his previous failures in prescription writing. The difference in this borderline case and the above
model case is that the nurse practitioner in the borderline case attributed his unsuccessful history in
prescription writing to external causes rather than internal causes, which helped him to keep the
motivation to become successful eventually. He had some of the attributions of learned helplessness, but
he kept the motivation to work towards his goal which kept him from developing helplessness in

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prescriptive authority. In this case the antecedents are previous low achievement and previous failures;
the attributes are the feelings of not being in control, being anxious, and experiencing lack of ability; and
the consequences are difficulty in writing prescriptions and feeling in control of the prescriptive role. The
attributes were measured using previous prescriptive achievements versus subsequent prescriptive tasks.
This is a borderline case because the attributes, acceptance of failure and low motivation, of the concept
are missing and this nurse practitioner is motivated to conquer future prescriptive tasks.
Related case.
Related cases are similar to the concept, but do not contain all of the defining attributes. They are
similar and related to the main concept, yet differ when examined closely. This close examination helps
to identify what counts as identifying attributes to the concept (Walker and Avant, 2011). This related
case will describe a nurse practitioners hopelessness rather than learned helplessness. Hopelessness is
defined by Merriam-Webster (2013) as having no expectation of good or success; not susceptible to
remedy or cure; or incapable of redemption or improvement (Hopelessness, 2013). The nurse
practitioner in this story achieved high grades in her pharmacology courses, graduated, passed her boards,
and began work in a primary care clinic. She lacked self-confidence in herself with prescriptive authority
and soon developed the feeling that she would never be able to achieve or improve this role. She
encountered difficult cases which led to frustration in writing prescriptions and the expectation of no
success when dealing with prescribing medications. Her overseeing doctor frequently tried to help her to
find better prescriptions for the case or told her of ways to make improvements to her prescriptive
strategies. Rather than embracing the help and suggestions she just assumed hopelessness and decided
that she was incapable of improvements. This case has a similar outcome as the model case; however,
they had different concepts that lead them to the consequences of not using their prescriptive authority.
The model case showed how she had previous failures that lead to the development of her learned
helplessness, yet the nurse practitioner in the related case did not experience previous failure rather she
just assumed failure because of hopelessness. The antecedents are previous high achievement and low
self-confidence; the attribute is that she gave up on her prescriptive role; and the consequences are that

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she lost her prescriptive authority due to her hopelessness. This can be measured by looking at her
previous cases and their impact on subsequent cases, which she showed positive prescriptive writing in
the past, despite her outlook. This is a related case because it is similar to learned helplessness, but rather
it is of another concept.
Summary of the Analysis
This analysis had the aim of exposing the concept of learned helplessness in order to educate
advanced practice nurses on ways to avoid developing it in their prescriptive authority. Psychology and
education disciplines provided definitions, antecedents, attributes, empirical referents, and consequences
to learned helplessness that are reviewed in this analysis. Learned helplessness is developed when
someone or something encounters a difficult task that they perceive their failure due to lack of ability,
lack of effort, lack of motivation, lack of control, or previous low achievements in similar tasks. These
perceptions led the individuals to exhibit characteristics such as anxious, hostile, holding a negative
outlook, easy to abandon tasks, and acceptance of failure. The outcomes of this development and these
characteristics are that individuals except their unsuccessfulness in tasks and become unwilling to strive
for a better outcome in the task, which hampers their success in their education, career, and all aspects of
their life. This information about the concept of learned helplessness was analyzed and applied to nurse
practitioners and their prescriptive authority. This analysis provides information on learned helplessness,
gives examples of cases, and applies the information to the nursing discipline.
Application to Practice
Learned helplessness can affect anyone, at any stage in their life, and in any career. In this
analysis learned helplessness has been studied to help avoid the future development of learned
helplessness as a nurse practitioner, specifically with prescriptive authority. Nurse practitioners battle the
history of nursing along with societys view of nursing, which tells of how nurses are to be at the side of
physicians and only are to follow the orders handed down to them (Chappell et al., 2011). This history of
the role of nurses plays an important role in the mindset and feelings of ability of an advanced practice

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nurse. Nurse practitioners must overcome the predisposed roles that history and society expect of them to
be able to completely fulfill their roles and to do so in the most successful way.
Nurse practitioners must actively educate the public about their roles and their ability to write
prescriptions effectively. They also need to establish good working relationships with their overseeing
doctors and administrators to assist in prescription writing. It can also be suggested that a support group
of some kind that would provide provision and education to help with previous unsuccessful tasks would
enable future successful tasks for the nurse practitioner. Nurse practitioners must also become active in
the political aspect of prescriptive authority. Only twelve states have prescriptive authority independent
of direct physician involvement. The requirements of physician involvement provide barriers to
prescriptive writing, which can lead to the feelings of a lack of ability or the feelings of not being in
control of ones own practice (Kaplan & Brown, 2004). If nurse practitioners make their voices heard in
the political arena these barriers might decrease and allow more control and motivation to gain
prescriptive authority. Nurse practitioners must be active in their roles, take advantage of support so that
they may avoid helpless feelings, and educate the politicians and the public of their ability to efficiently
write prescriptions in order to avoid the development of learned helplessness among nurse practitioners in
their prescriptive roles.

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