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Motives for cannabis use as a moderator variable of distress among young adults.

This study examined the moderating effect of social and coping motives on distress among young cannabis-using adults. A random sample of 2031 young Swiss adults was interviewed by means of a computer-assisted telephone interview. Cannabis users showed more distress, less positive health behaviour and higher hedonism compared to non-users. Taking motive for use as a moderator variable into consideration, it became evident that only cannabis users with coping motives showed lower mental health, more symptoms of psychopathology, more psychosocial distress and more life events than non-users. Young adults with social motives for use on the other hand did not differ from non-users in terms of distress. These differences between cannabis users with social and those with coping motives remained stable over two years. In both subgroups, participants with regular cannabis use at baseline did not increase distress nor did participants with higher distress at baseline increase the frequency of their cannabis use. Our results suggest that secondary prevention for cannabis users should target especially young adults with coping motives for use.

Adaptation, Psychological↗

Protection from neuronal damage evoked by a motivational excitation is a driving force of intentional actions.

Motivation may be understood as an organism's subjective attitude to its current physiological state, which somehow modulates generation of actions until the organism attains an optimal state. How does this subjective attitude arise and how does it modulate generation of actions? Diverse lines of evidence suggest that elemental motivational states (hunger, thirst, fear, drug-dependence, etc.) arise as the result of metabolic disturbances and are related to transient injury, while rewards (food, water, avoidance, drugs, etc.) are associated with the recovery of specific neurons. Just as motivation and the very life of an organism depend on homeostasis, i.e., maintenance of optimum performance, so a neuron's behavior depends on neuronal (i.e., ion) homeostasis. During motivational excitation, the conventional properties of a neuron, such as maintenance of membrane potential and spike generation, are disturbed. Instrumental actions may originate as a consequence of the compensational recovery of neuronal excitability after the excitotoxic damage induced by a motivation. When the extent of neuronal actions is proportional to a metabolic disturbance, the neuron theoretically may choose a beneficial behavior even, if at each instant, it acts by chance. Homeostasis supposedly may be directed to anticipating compensation of the factors that lead to a disturbance of the homeostasis and, as a result, participates in the plasticity of motivational behavior. Following this line of thought, I suggest that voluntary actions arise from the interaction between endogenous compensational mechanisms and excitotoxic damage of specific neurons, and thus anticipate the exogenous compensation evoked by a reward.

Animals↗

Adjustment to chronic pain in back pain patients classified according to the motivational stages of chronic pain management.

UNLABELLED: According to Prochaska's transtheoretical model, the Freiburg Questionnaire stages of chronic pain management (FQ-STAPM) were used to classify chronic back patients into 4 distinct motivational stages. The FQ-STAMP was completed by 163 chronic back pain patients. Pain chronicity was measured by the Mainz Pain Staging System; pain intensity was measured by the numeric rating scale. Healthcare system expenses were considered as number of consulted physicians, number of stays in hospital, and number of rehabilitation programs. As psychometric tests, the lower pain disability index (PDI), the Hospital Anxiety and Depression Scale (HADS), and a quality of life score (SF36) were used. Patients were in the following motivational stages: precontemplation in 30%, preparation in 19%, action in 30%, maintenance in 21%. The intensity of pain in the precontemplation stage patients was significantly higher compared to patients in the maintenance stage. A lower pain chronicity was related to a significantly higher motivation. Moreover, there was a significant increase in healthcare system expenses by the lesser motivated patients. Patients in the maintenance stage used significantly less opioids than patients in the precontemplation stage. The higher motivated patients had a significantly lower PDI, a significantly lower HADS, and a significantly higher quality of life compared to less motivated patients. PERSPECTIVE: The study indicates that the FQ-STAPM might be a useful tool to classify chronic back pain patients and to work out a strategy together with the patient relevant to the outcome of pain management among chronic back pain patients.

Adaptation, Psychological↗

Cardiovascular risk factors and motivation for a healthy life-style in a German community--results of the GP-based Oestringen study.

This paper explores the motivation of patients towards a healthy life-style in a small community with a special general practice and community-based health education program in order to identify reasons for different motivations and barriers and to improve preventive measures and outcome. The last of six standardised health surveys carried out over 9 years in the five general practices was therefore combined with a questionnaire to explore the attitudes of a sample of patients from these practices (N = 1044) and all attendees of 11 health education courses (N = 153). In addition to the cardiovascular risk factors, data were collected on sociodemographic factors and motivations for health promotion. The results show that, over time, the risk factors of hypertension (P < 0.001) and smoking (P < 0.005) had decreased. Health-promoting activities were not associated with cardiovascular risk factors; the motivations "duty" and "staying young" correlated with gender (P < 0.05). Patients with good health and white collar professions were more active. About 20% specified specific barriers to health-related activities. As expected, the participants of an educational program were more highly motivated by "fun", "fitness" and "meaningfulness". This group was mainly female. Future preventive measures should take into account that motivation for health promotion depends more on psychosocial factors than on risk factors; frequent obstacles should be noticed in the community.

Attitude to Health↗

[Loss of motivation and frontal dysfunction. Role of the white matter change].

Since the recognition of white matter changes on computed tomography, researches were done to investigate a possible relation with ageing and cognition. This study examined whether computed tomography evidence of cerebrovascular disease in the form of white matter changes was associated with decreased implicit performance of frontal tests and with a loss of motivation in a group of 10 elderly volunteers with a mild cognitive impairment and in a group of 29 demented patients; 39 old patients (28 females: 82.4 +/- 7.1; 10 males: 75.5 +/- 11.3) cared in a psycho-geriatric day care hospital were enrolled for this essay. Motivation was evaluated with a specific scale: EAD. Patients were tested during the same period with MMSE for cognition, Cornell's scale for depression, Marin's scale for apathy. There were also assessed with a battery of frontal tests: BREF test. A brain scan was used to determinate the presence of leukoaraïosis. Table 1 give a description of the population according to the pathology. Cognitive disorder, but also apathy and loss motivation, frontal evaluation significantly differ in the two studied groups. The presence of a leukoaraïosis is associated with older people, a weaker cognitive status, a more important apathy or loss of motivation, and weaker results with frontal evaluation (table 2). Similar results were obtained considering only the frontal lesions (table 3). Age related changes of the white matter observed on computed tomography were associated with a decreased cognitive status. Leukoaraïosis is associated with loss of motivation and related with a poor results on frontal assessment. Loss of motivation is associated with certain frontal dysfunctions and with brain abnormal scan anomalies.

Aged↗

Motivation and glycemic control in diabetes mellitus.

Although adherence to treatment regimes is clinically important in diabetes mellitus, the best way to improve it is unclear. As a precursor to evaluating the place of a brief intervention (motivational interviewing) in the treatment of diabetes, this study investigated the relation between motivation and glycemic control in 361 diabetic out-patients. Outcome measures were the Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES) and HbA1C level--a measure of glycemic control. The majority of patients (86.7%) could be allocated to a single motivational stage, indicating that this concept is applicable in the study of diabetes. There were significant associations between HbA1C level and motivational stage, but not in the direction predicted. That is, patients at an earlier motivational stage had lower HbA1C levels than those at later stages. The results suggest that feedback of HbA1C level may partly determine the patient's motivation to control their diabetes, although the effect is quite weak.

Adolescent↗

Loratadine versus cetirizine: assessment of somnolence and motivation during the workday.

OBJECTIVE: This parallel-group, double-blind study compared the somnolence and motivation profiles of 2 second-generation antihistamines, loratadine and cetirizine, in patients with allergic rhinitis. BACKGROUND: Second-generation antihistamines were developed to provide symptomatic relief from allergic disorders without the unwanted side effects of first-generation antihistamines, including somnolence. Recent research has indicated that not all second-generation antihistamines are comparable with respect to somnolence and other cognitive processes. METHODS: Patients aged > or = 12 years and actively exhibiting symptoms of allergic rhinitis were randomized to 2 treatment groups to receive 10 mg loratadine or 10 mg cetirizine daily at 8:00 AM for 1 week. After patients took the medication, their somnolence and degree of motivation to perform activities were recorded in an electronic diary using a visual analog scale 4 times during the workday (8:00 AM, 10:00 AM, noon, and 3:00 PM). RESULTS: Sixty patients (31 men, 29 women) were randomized to treatment. Somnolence scores were similar for both groups at baseline and at the time of dosing (8:00 AM). However, there was a statistically significant difference in somnolence scores between the loratadine and cetirizine groups at 10:00 AM (P = 0.008), noon (P = 0.001), and 3:00 PM (P < 0.001), with the cetirizine group showing a greater degree of somnolence. The scores on motivation to perform activities were similar for both groups at the baseline and 8:00-AM measurements. In parallel with the somnolence scores, there were statistically significant differences in motivation scores between the loratadine and cetirizine groups at 10:00 AM (P = 0.014), noon (P = 0.001), and 3:00 PM (P < 0.001), indicating that patients taking loratadine were relatively more motivated during the workday. CONCLUSION: The results of this study demonstrate that in patients aged > or = 12 years who had allergic rhinitis, cetirizine use promoted somnolence and decreased motivation to perform activities during the workday compared with loratadine.

Adult↗

Impaired metabolic capacity in the perirhinal and posterior parietal cortex lead to dissociation between attentional, motivational and spatial components of exploration in the Naples High-Excitability rat.

This study aimed at investigating the neural substrates of spatial and non-spatial Behavioural components of exploration to novelty by a neurogenetic approach. Thus, functional imaging and Behavioural analysis were carried out in the Naples High-Excitability (NHE) rats, a model of hyperactivity and attention-deficit. Quantitative cytochrome oxidase (C.O.) histochemistry was used to measure the basal metabolic capacity of different forebrain structures. In parallel experiments, exploration in an 8-arm radial maze (Olton-maze) with extra-maze cues was used to measure attentional, motivational and spatial components of Behaviour after feeding rats' ad-libitum or at a reduced diet. Functional imaging analysis: brains from naive rats were stained for quantitative C.O. histochemistry along with standards. NHE rats showed lower C.O. activity in perirhinal and posterior-parietal cortex (all layers) and cortical amygdala, and greater activity in entorhinal cortex (superficial layers). The outer granular cell layer of the dentate gyrus had greater activity in NHE. Behavioural analysis: at low and high motivational level, maze exploration was reinforced during shaping throughout and then only a single arm. The Behaviour was monitored by a CCD camera and videotaped. (i) There was no line difference in working memory during non reinforced maze exploration, independent of the motivational level; (ii) during shaping with all baited arms, there was no line difference in working memory, but NHE rats showed a very low or lower food consumption at low and high motivational level, respectively; (iii) rats showed a higher working memory in finding the single baited arm at high motivational level; (iv) NHE rats paid little attention towards reinforcement upon visiting the baited arm only at low motivational level. Thus, Behavioural and functional neuroimaging analysis suggests the neural substrates of spatial and non-spatial components of exploration to be underlined by different network operations in the neocortical and limbic cortices in the NHE rat lines. Therefore, they appear as an useful tool to the understanding of Attention-Deficit Hyperactivity Disorder (ADHD) in children.

Animals↗

Motivational views of reinforcement: implications for understanding the behavioral functions of nucleus accumbens dopamine.

Although the Skinnerian 'Empirical Law of Effect' does not directly consider the fundamental properties of stimuli that enable them to act as reinforcers, such considerations are critical for determining if nucleus accumbens dopamine systems mediate reinforcement processes. Researchers who have attempted to identify the critical characteristics of reinforcing stimuli or activities have generally arrived at an emphasis upon motivational factors. A thorough review of the behavioral literature indicates that, across several different investigators offering a multitude of theoretical approaches, motivation is seen by many as being fundamental to the process of reinforcement. The reinforcer has been described as a goal, a commodity, an incentive, or a stimulus that is being approached, self-administered, attained or preserved. Reinforcers also have been described as activities that are preferred, deprived or in some way being regulated. It is evident that this 'motivational' or 'regulatory' view of reinforcement has had enormous influence over the hypothesis that DA directly mediates 'reward' or 'reinforcement' processes. Indeed, proponents of the DA/reward hypothesis regularly cite motivational theorists and employ their language. Nevertheless, considerable evidence indicates that low/moderate doses of DA antagonists, and depletions of DA in nucleus accumbens, can suppress instrumental responding for food while, at the same time, these conditions leave fundamental aspects of reinforcement (i.e. primary or unconditioned reinforcement; primary motivation or primary incentive properties of natural reinforcers) intact. Several complex features of the literature on dopaminergic involvement in reinforcement are examined below, and it is argued that the assertions that DA mediates 'reward' or 'reinforcement' are inaccurate and grossly oversimplified. Thus, it appears as though it is no longer tenable to assert that drugs of abuse are simply turning on the brain's natural 'reward system'. In relation to the hypothesis that DA systems are involved in 'wanting', but not 'liking', it is suggested in the present review that 'wanting' has both directional aspects (e.g. appetite to consume food) and activational aspects (e.g. activation for initiating and sustaining instrumental actions; tendency to work for food). The present paper reviews findings in support of the hypothesis that low doses of DA antagonists and accumbens DA depletions do not impair appetite to consume food, but do impair activational aspects of motivation. This suggestion is consistent with the studies showing that low doses of DA antagonists and accumbens DA depletions alter the relative allocation of instrumental responses, making the animals less likely to engage in instrumental responses that have a high degree of work-related response costs. In addition, this observation is consistent with studies demonstrating that accumbens DA depletions make rats highly sensitive to ratio requirements on operant schedules. Although accumbens DA is not seen as directly mediating appetite to consume food, principles of behavioral economics indicate that accumbens DA could be involved in the elasticity of demand for food in terms of the tendency to pay work-related response costs. Future research must focus upon how specific aspects of task requirements (i.e. ratio requirements, intermittence of reinforcement, temporal features of response requirements, dependence upon conditioned stimuli) interact with the effects of accumbens DA depletions, and which particular factors determine sensitivity to the effects of DA antagonism or depletion.

Animals↗

Triadic model of the neurobiology of motivated behavior in adolescence.

BACKGROUND: Risk-taking behavior is a major cause of morbidity and mortality in adolescence. In the context of decision theory and motivated (goal-directed) behavior, risk-taking reflects a pattern of decision-making that favors the selection of courses of action with uncertain and possibly harmful consequences. We present a triadic, neuroscience systems-based model of adolescent decision-making. METHOD: We review the functional role and neurodevelopmental findings of three key structures in the control of motivated behavior, i.e. amygdala, nucleus accumbens, and medial/ventral prefrontal cortex. We adopt a cognitive neuroscience approach to motivated behavior that uses a temporal fragmentation of a generic motivated action. Predictions about the relative contributions of the triadic nodes to the three stages of a motivated action during adolescence are proposed. RESULTS: The propensity during adolescence for reward/novelty seeking in the face of uncertainty or potential harm might be explained by a strong reward system (nucleus accumbens), a weak harm-avoidant system (amygdala), and/or an inefficient supervisory system (medial/ventral prefrontal cortex). Perturbations in these systems may contribute to the expression of psychopathology, illustrated here with depression and anxiety. CONCLUSIONS: A triadic model, integrated in a temporally organized map of motivated behavior, can provide a helpful framework that suggests specific hypotheses of neural bases of typical and atypical adolescent behavior.

Adolescent↗

Nursing Motives for Helping Scale (N-MHS): reliability and validity.

This paper presents the Nursing Motives for Helping Scale (N-MHS), an instrument designed for the evaluation of three of the four motives for helping derived from Batson's helping pathway theory. Dimensionality was analyzed by means of principal component analysis (n = 113), followed by confirmatory factor analysis. A 3-factor structure (corresponding to Batson's differentiation among altruistic motivation, reward-seeking motivation, and punishment-avoidance motivation, respectively), with 9 items distributed in three latent variables, revealed an acceptable fit to the data. Alpha values (.60 - .74) showed that internal consistency was acceptable for a newly developed subscale with a small number of items. Convergence validity was evaluated with correlations between N-MHS subscales scores and scores on the Professional Expectations Scale (Garrosa, Moreno-Jiménez, Rodríguez-Carvajal, and Morante, 2005). The three resulting subscales are a promising instrument for the evaluation of three nursing motives for helping that can contribute to reduce the potential risks and to improve the potential benefits both for the nurse and the patient.

Adult↗

Focus on motivation in the work rehabilitation planning process: a qualitative study from the employer's perspective.

Since the working environment act was passed in 1991, employers in Sweden are to plan and control the working environment conditions in workplaces. They are responsible for organized rehabilitation at the workplace including the development of rehabilitation plans and a plan for interventions in order for a sick-listed client to be able to return to work. The aim of this study was to describe employers' experiences of how motivation can be improved in a work rehabilitation process. Qualitative interviews were performed with 10 employers who had employees that had taken part in a period of vocational rehabilitation at a rehabilitation center in the north of Sweden, over a 2-year period. The result showed that increased focus on motivation for change is needed in work rehabilitation. The clients' motivation for change could be improved by a focus on motivational conversations at the workplace aiming at motivation for change in their working and living conditions. The employers' power of initiative, competence, economic resources, and motivation are needed for creative solutions at the workplace.

Adult↗

Learning root debridement with curettes and power-driven instruments in vitro: the role of operator motivation and self-assessment.

The influence of systematic dummy-head training with Periopolishe (PP, group A) and Gracey instruments (GRA, group B) on the effectiveness of root debridement was evaluated by Rühling et al., 2002 (9). Their results indicate that independent of the instrument used, untrained operators were only able to debride root surfaces at low levels of effectiveness. It was possible to increase effectiveness to a high level through systematic training in both groups. The aim of the present study was to assess the role of operator motivation and self-assessment on scaling effectiveness. Before baseline, operators were asked to answer a questionnaire rating the expectation of the instrument performance. Four groups of inexperienced operators (n = 11 each) received 10 weeks dummy-head training. In groups A (GRA) and B (PP), training was combined with a motivational programme. Groups C (GRA) and D (PP) received the same training, but no additional motivational programme. In a dummy-head, 10 test teeth were debrided and operators were asked to estimate their effectiveness of debridement at each test day. Effectiveness was calculated as percentage of debrided root area on 10 test teeth at different time points with an image analysis programme (NIH Image) and ANOVA. Two groups were compared using the Mann-Whitney U-test (unpaired) and the Wilcoxon signed ranks test (paired). Motivated groups (A and B) reached about 25% higher debridement results (p < 0.001) and were able to estimate their effectiveness more precisely compared to groups C and D. In the low motivation groups (C and D), overestimation of more than 20% was evident (p < 0.001). The questionnaires revealed underestimation of the GRA instruments and overestimation of PP instruments. Operator motivation and self-assessment greatly influence learning of effective root debridement.

Analysis of Variance↗

Cholecystokinin modulation of mesolimbic dopamine function: regulation of motivated behaviour.

This article reviews evidence and presents a hypothesis regarding the effects of stress on motivated behaviour, and in particular the observation that stress can have both motivationally inhibitory and motivationally facilitatory effects. This issue will be addressed with regard to psychostimulant self-administration, and the role that the neurobiological mechanisms underlying motivated behaviour are thought to be involved in the evolution of addictions. Evidence from animal studies shows that stress and stress-related hormones such as corticosterone can facilitate mesolimbic dopamine function and the behavioural effects of psychostimulants, particularly at lower levels of stress. Conversely, higher levels of stress can inhibit motivated behaviour, and evidence is presented that this may occur in part through the effects of the neuropeptide cholecystokinin (CCK), acting through CCK-B receptors in the nucleus accumbens. Individual differences in endogenous CCK and dopamine systems are hypothesized to be important modulators of individual differences in motivated behaviour.

Animals↗

Goal setting, achievement orientation, and intrinsic motivation: a mediational analysis.

This study investigated the interactive effects of achievement orientation and evaluative focus of assigned, task-specific goals on intrinsic motivation for an enjoyable pinball game. Regression analyses revealed that the effect of performance or mastery-focused goals on intrinsic motivation varied as a function of achievement orientation. Specifically, the provision of task-specific standards with a performance focus enhanced intrinsic motivation for achievement-oriented individuals, whereas the assignment of such goals proved deleterious to the intrinsic motivation of those low in achievement orientation. Individuals low in achievement orientation displayed the highest levels of intrinsic motivation when provided with mastery-focused goals. A similar pattern of effects was obtained on competence valuation and task involvement, both of which were additionally validated as mediators of the direct effects on intrinsic motivation.

Achievement↗

Understanding and assessing the motivations of volunteers: a functional approach.

The authors applied functionalist theory to the question of the motivations underlying volunteerism, hypothesized 6 functions potentially served by volunteerism, and designed an instrument to assess these functions (Volunteer Functions Inventory; VFI). Exploratory and confirmatory factor analyses on diverse samples yielded factor solutions consistent with functionalist theorizing; each VFI motivation, loaded on a single factor, possessed substantial internal consistency and temporal stability and correlated only modestly with other VFI motivations (Studies 1, 2, and 3). Evidence for predictive validity is provided by a laboratory study in which VFI motivations predicted the persuasive appeal of messages better when message and motivation were matched than mismatched (Study 4), and by field studies in which the extent to which volunteers' experiences matched their motivations predicted satisfaction (Study 5) and future intentions (Study 6). Theoretical and practical implications are discussed.

Adult↗

Reactions to a black professional: motivated inhibition and activation of conflicting stereotypes.

The motivation to form a particular impression of an individual can prompt the inhibition of applicable stereotypes that contradict one's desired impression and the activation and application of stereotypes that support it. Participants, especially those high in prejudice, inhibited the Black stereotype when motivated to esteem a Black individual (because he had praised them). Participants motivated to esteem a Black doctor also activated the doctor stereotype. In contrast, participants motivated to disparage a Black doctor (because he had criticized them) inhibited the doctor stereotype. Participants motivated to disparage a Black individual also applied the Black stereotype to him, rating him as relatively incompetent. All these effects were driven by the self-protective motives of recipients of feedback from Black evaluators; detached observers showed no such effects.

Adult↗

Social motives and cognitive power-sex associations: predictors of aggressive sexual behavior.

The present study investigated whether implicit social motives and cognitive power-sex associations would predict self-reports of aggressive sexual behavior. Participants wrote stories in response to Thematic Apperception Test pictures, which were scored for power and affiliation-intimacy motives. They also completed a lexical-decision priming task that provided an index of the strength of the cognitive association between the concepts of "power" and "sexuality." For men, high levels of power motivation and strong power-sex associations predicted more frequent aggression. There was also an interaction: Power motivation was unrelated to aggression for men with the weakest power-sex associations. For women, high levels of affiliation-intimacy motivation were associated with more frequent aggression. Strong power-sex associations were also predictive for women but only when affiliation-intimacy motivation was high.

Adult↗