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This paper challenges the individual deficit paradigm by critically analyzing how fundamental psychological needs compete with health goals. Using self-determination theory, this paper identified 10 mechanisms that legitimately interfere with health behaviors. Four mechanisms protect autonomy through temporal discounting, learned helplessness, health avoidance coping, and cognitive dissonance reduction. Three preserve competence via personalized standards, expertise domain protection, and perfectionism. Three maintain relatedness through social bond maintenance, caregiving role prioritization, and identity protection. These mechanisms serve adaptive functions that create complex trade-offs between health and other vital human needs. This reframing shifts focus from overcoming individual deficits to designing interventions that accommodate competing psychological demands. This study has significant implications for clinical practice, public health policy, and research approaches.<\/jats:p>","DOI":"10.1177\/13591053261468423","type":"journal-article","created":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T08:31:38Z","timestamp":1784536298000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["A critical analysis of psychological mechanisms that compete with health goals"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6001-1586","authenticated-orcid":false,"given":"Shan","family":"Li","sequence":"first","affiliation":[{"name":"Lehigh University, Bethlehem, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,20]]},"reference":[{"key":"e_1_3_2_2_1","doi-asserted-by":"crossref","unstructured":"Bailey RR (2019) Goal setting and action planning for health behavior change. 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