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Can the practitioner correctly predict outcome in motivational interviewing?

We have examined whether practitioner ratings (immediately post-intervention) or other recorded characteristics of a single-session 1-hour motivational intervention were predictive of 3-month cannabis use outcome. In the context of a cluster randomized trial involving 200 non help-seeking illegal drug users (age range 16-20), 105 were randomized to the intervention, of whom 97 (92%) were interviewed for followup at 3 months, 96 of whom were current cannabis users at study entry. Six intervention characteristics and seven practitioner ratings as well as patterns of self-motivational statements were investigated in relation to substantial change in use, (which was defined as cessation or reduction by more than 50%). Both practitioner ratings post-session, and also the subject's own elicited self-motivational statements, were found to be predictive of outcome 3 months later. The strongest predictor of substantial change, however, was simply whether change had been discussed during the session. On the basis of the above findings, it does indeed appear possible for outcome to be predicted by the motivational interviewing practitioner immediately following delivery of the intervention, on the basis of simple observations and ratings. This area warrants more specific study.

Adolescent↗

Behavioral evidence for competing motivational drives of nociception and hunger.

Homeostasis, an organisms' tendency to maintain a healthy balance of the physiological state of the body, is necessary for survival. Hunger induces a motivational state to consume food. Recently, pain has been referred to as a homeostatic emotion similar to hunger or thirst in that animals are motivated to respond in a certain way that may increase their chance of survival. Therefore, the purpose of the present experiment was to examine behavior in rodents during two competing homeostatic/motivational drives (i.e., hunger and formalin pain). During the first phase of the formalin test, animals displayed typical responsiveness to the inflammatory condition and completed fewer chains for food reinforcement as compared to the baseline session. However, during the second phase of the formalin test, animals showed decreased nociceptive behavior compared to formalin-injected animals that were not trained in the operant conditioning paradigm. During this phase, the trained animals exhibited maximal responsiveness for food reinforcement. These results demonstrate that the engagement of behaviors reflecting motivational drives to restore homeostasis depends on the intensity or degree of imbalance of the competing drives. More specifically, animals are motivated to attend to one state of imbalance at a time.

Animals↗

Age-related decline in caloric intake and motivation for food in rhesus monkeys.

Human studies have documented age-related declines in caloric intake that are pronounced at advanced ages. We examined caloric intake from a longitudinal study of aging in 60 male and 60 female rhesus monkeys (Macaca mulatta) collected for up to 10 years. Monkeys were provided a standardized, nutritionally fortified diet during two daily meals, and intake was measured quarterly. About half of the monkeys were on a regimen of caloric restriction (CR) representing about a 30% reduction in caloric intake compared to controls (CON) of comparable age and body weight. CR was applied to determine if this nutritional intervention retards the rate of aging in monkeys similar to observations in other mammalian studies. Following reproductive maturity at 6 years of age, there was a consistent age-related decline in caloric intake in these monkeys. Although males had higher intake than females, and CON had higher intake compared to CR, the sex and diet differences converged at older ages (>20 years); thus, older CR monkeys were no longer consuming 30% less than the CON. When adjusted for body weight, an age-related decline in caloric intake was still evident; however, females had higher intake compared to males while CR monkeys still consumed less food, and again differences converged at older ages. Motivation for food was assessed in 65 of the monkeys following at least 8 years in their respective diet groups. Using an apparatus attached to the home cage, following an overnight fast, monkeys were trained to reach out of their cage to retrieve a biscuit of their diet by pushing open a clear plastic door on the apparatus. The door was then locked, and thus the biscuit was irretrievable. The time spent trying to retrieve the biscuit was recorded as a measure of motivation for food. We observed an age-related decline in this measure, but found no consistent differences in retrieval time between CR and CON groups of comparable age and time on diet. The results demonstrate an age-related decline in food intake and motivation for food in rhesus monkeys paralleling findings in humans; however, we found no evidence that monkeys on a long-term CR regimen were more motivated for food compared to CON. Examining the relationship of selected blood proteins to food intake following 7-11 years on the study, we found a negative correlation between globulin and intake among males and females after accounting for differences in age. In addition, a positive correlation was observed between leptin and intake in males.

Age Factors↗

Social and motivational functioning is not critically dependent on feedback of autonomic responses: neuropsychological evidence from patients with pure autonomic failure.

Social, emotional and motivational behaviours are associated with production of automatic bodily responses. Re-representation in the brain through feedback of autonomic and skeletomuscular arousal is proposed to underlie "feeling states". These influence emotional judgments and bias motivational decision-making and guide social interactions. Consistent with this hypothesis, dissocial behaviour and deficits on emotional and motivation tasks are associated with blunted bodily responses in patients with orbitofrontal brain lesions or developmental psychopathy. To determine the critical dependence of social and emotional behaviours on bodily responses mediated by the autonomic nervous system, we examined patients with pure autonomic failure (PAF), a peripheral denervation of autonomic neurons with onset in middle age. Compared to healthy subjects, PAF patients were unimpaired on tests of motivational decision-making (Iowa Gambling Task), recognition of emotional facial expressions, Theory of Mind Tasks and tests of social cognition. Only on a test of emotional attribution, which is perhaps more sensitive to subjective feeling states, did PAF patients score worse than the comparison group, though there was no evidence that this deficit was specific to a discrete emotion and requires further validation. These findings suggest that emotional and social functioning is not critically tied to on-going experience of autonomic arousal state, Acquisition of autonomic failure late in life may protect against maladaptive social behaviour through established behavioural responses that may be associated with central "as if" representations.

Aged↗

Characteristics of patients with COPD in three motivational stages related to smoking cessation.

OBJECTIVE: To characterize patients with chronic obstructive pulmonary disease (COPD) in different motivational stages related to smoking cessation. METHODS: 633 smoking COPD patients from 67 general practices participated in a cross-sectional study. The patients were compared with respect to health indicators, demographics, self-efficacy, nicotine dependence, attitudes, and action plans. RESULTS: In line with previous Dutch results, smokers in precontemplation associated significantly fewer advantages with smoking cessation than smokers contemplating quitting and preparing to quit. Preparers had significantly higher self-efficacy expectations about quitting than the other smokers. Patients preparing to quit suffered from more COPD complaints than precontemplators. Smokers contemplating quitting and preparing to quit developed more plans to turn intentions to quit into action. CONCLUSION: More than 50% of the smokers with COPD are amenable to smoking cessation support. Preparers and contemplators did not differ as much as previous studies found. It would be advantageous to tailor COPD counseling to two distinct groups (unmotivated smokers and smokers motivated to quit), to discuss the advantages of quitting with unmotivated smokers, and to increase self-efficacy, and action planning for smokers motivated to quit. PRACTICE IMPLICATIONS: COPD patients are amenable to counseling to quit smoking. Addressing COPD complaints may contribute to greater motivation.

Adaptation, Psychological↗

Motivation concepts in behavioral neuroscience.

Concepts of motivation are vital to progress in behavioral neuroscience. Motivational concepts help us to understand what limbic brain systems are chiefly evolved to do, i.e., to mediate psychological processes that guide real behavior. This article evaluates some major motivation concepts that have historic importance or have influenced the interpretation of behavioral neuroscience research. These concepts include homeostasis, setpoints and settling points, intervening variables, hydraulic drives, drive reduction, appetitive and consummatory behavior, opponent processes, hedonic reactions, incentive motivation, drive centers, dedicated drive neurons (and drive neuropeptides and receptors), neural hierarchies, and new concepts from affective neuroscience such as allostasis, cognitive incentives, and reward 'liking' versus 'wanting'.

Animals↗

Pharmacological manipulations of dopamine and opioids have differential effects on sexually motivated song in male European starlings.

Vocal communication is common among social vertebrates, though little is known about the neural mechanisms regulating the motivation to communicate. This study examined a possible role for dopamine and opioids in sexually motivated song in male European starlings. The dopamine reuptake inhibitor GBR-12909 increased singing behavior, whereas the D1 dopamine receptor antagonist SCH-23390 decreased song, suggesting a role for dopamine in the motivation to sing. In contrast, the opioid agonist fentanyl decreased song, and the antagonist naloxone has previously been shown to increase song, findings consistent with a role for opioids in reward associated with song production. These results suggest that dopamine and opioids play opposing roles in the regulation of the motivation to communicate.

Analgesics, Opioid↗

It is possible to help smokers in early motivational stages to quit. The Inter99 study.

BACKGROUND: In a population-based sample of smokers in early motivational stages, we found a high acceptance of smoking cessation groups. METHODS: Inter99 is a randomized population-based intervention study, in Copenhagen, Denmark. Smokers in all motivational stages were included. All participants underwent a lifestyle consultation and 2,168 smokers in the high intensity intervention group were offered assistance to quit in smoking cessation groups. RESULTS: Thirty-five percent were validated to be continuously abstinent at the end of the smoking cessation groups. Eighty-four percent of the smokers achieving sustained abstinence in our study had no serious plans to quit soon before the lifestyle consultation. Motivation to quit before the lifestyle consultation could not predict abstinence. Being a man, and having a job and at least 1 year of vocational training were predictors of abstinence in a multivariate model, whereas high nicotine dependence and living with a smoking spouse were predictors of failure. CONCLUSION: High cessation rates were obtained in a population of heavy smokers with moderate nicotine dependence. It was possible to obtain sustained abstinence in smokers in early motivational stages. These smokers would probably not have been reached by traditional smoking campaigns.

Adult↗

Attitudes, social influences and self-efficacy expectations across different motivational stages among immigrant smokers: replication of the Ø pattern.

BACKGROUND: Information about the factors that determine motivation to quit in immigrant populations is needed to enable the development of tailored smoking cessation programs for them. Dutch studies in the general population suggest that attitudes are important for motivating persons to change and self-efficacy for helping motivated persons to change. We analyzed whether this pattern also exists among Surinamese immigrants. METHODS: Structured face-to-face interviews were held among 1,100 Surinamese people in Amsterdam (The Netherlands), including measures of attitudes towards smoking (cessation), social influences and self-efficacy expectations (between 2001 and 2003). RESULTS: The majority of the smokers were not motivated to quit and in the pre-contemplation phase (73%). Pre-contemplators perceived significantly weaker advantages of quitting than contemplators and preparators. Self-efficacy expectations of Surinamese pre-contemplators were lower than those of smokers preparing to quit within a month. CONCLUSION: Similar attitudinal and self-efficacy patterns as those in the general population were found in an immigrant population. However, the items constituting the factors are culturally sensitive. Furthermore, many Surinamese smokers were unmotivated to quit smoking.

Attitude to Health↗

Emotion, motivation, and anxiety: brain mechanisms and psychophysiology.

The organization of response systems in emotion is founded on two basic motive systems, appetitive and defensive. The subcortical and deep cortical structures that determine primary motivated behavior are similar across mammalian species. Animal research has illuminated these neural systems and defined their reflex outputs. Although motivated behavior is more complex and varied in humans, the simpler underlying response patterns persist in affective expression. These basic phenomena are elucidated here in the context of affective perception. Thus, the research examines human beings watching uniquely human stimuli--primarily picture media (but also words and sounds) that prompt emotional arousal--showing how the underlying motivational structure is apparent in the organization of visceral and behavioral responses, in the priming of simple reflexes, and in the reentrant processing of these symbolic representations in the sensory cortex. Implications of the work for understanding pathological emotional states are discussed, emphasizing research on psychopathy and the anxiety disorders.

Animals↗

The effect of environmental pH on the proton motive force of Helicobacter pylori.

BACKGROUND & AIMS: Responses of the proton motive force (the driving force for protons) in Helicobacter pylori to varying medium pH may explain gastric colonization. The aim of this study was to determine the effect of external pH (pHout) on the proton motive force, the sum of the pH gradient, and the potential difference across the bacterial membrane. METHODS: Intracellular pH (pHin) was measured by bis-carboxyethyl-carboxy fluorescein fluorescence and transmembrane potential difference (PD) by fluorescent quenching of 3,3'-dipropyl thiadicarbocyanine iodide at differing pHout and was correlated with survival. RESULTS: PD was -131 +/- 0.36 mV (n = 3), and pHin was about 8.4 at loading pHout 7.0. PD increased as pHout was increased from 4.0 to 8.0, giving a constant proton motive force of about -220 mV. Outside these limits, PD collapsed irreversibly to zero. Addition of 5 mmol/L urea to weak buffer at pH 3.0 or 3.5 prevented irreversible collapse of PD by elevation of pHout caused by NH3 production. Urea addition to weak buffer at pH 7.0 collapsed the PD as urease activity increased the pHout to about 8.4. Survival was also limited to this range of pHout. CONCLUSIONS: H. pylori survives over the range of pHout where it maintains a proton motive force. The effect of urease activity on pHout, while allowing gastric survival in acidic media, may limit survival in nonacidic media.

Ammonium Chloride↗

The phenomenon of "one-trial tolerance" to the anxiolytic effect of chlordiazepoxide in the elevated plus-maze is abolished by the introduction of a motivational conflict situation.

A single exposure to the elevated plus-maze test of anxiety reduces or abolishes the anxiolytic efficacy of benzodiazepines. The present study was designed to examine whether this phenomenon of "one-trial tolerance" resulted from a motivational deficit on trial 2. We hypothesized that whereas there is a motivational conflict on trial 1 in relation to the open arms (exploration drive X natural fear of open spaces), there is no "reason" for an animal to explore it on trial 2. A motivational conflict was introduced on trial 2 by rendering the enclosed arms of the apparatus aversive on trial 1. Thus, every time rats entered the enclosed arms, an aversive situation (light and hot air blow) was produced until they left the arm. On trial 2, rats did not receive this aversive stimulation. Chlordiazepoxide significantly enhanced the percent open arm time as well as the percent open arm entries on trial 2 in rats that had been submitted to the aversive stimulation in the enclosed arms on trial 1, but was not effective in rats which had been exposed to the apparatus in the absence of the aversive stimulation on trial 1. In addition, there was no difference in the percent open arm time and entries on trial 2 between saline-treated rats submitted to the aversive or non-aversive condition on trial 1. The aversive condition on trial 1 did not modify the number of total arm entries on trial 2, either. The results suggest that the anxiolytic effect of chlordiazepoxide in the elevated plus-maze depends on the presence of a motivational conflict situation.

Animals↗

Copulation-contingent aversive conditioning and sexual incentive motivation in male rats: evidence for a two-stage process of sexual behavior.

Male rats were tested for sexual incentive motivation and for copulatory behavior during acquisition of a copulation-malaise association. One group received an injection of 20 ml/kg of 0.15 M LiCl 1 min after ejaculation with a capelin oil-scented female and the other group received saline. LiCl was administered independently of copulation to this group. The subjects in the conditioned group showed reduced sexual motivation after two conditioning sessions, and copulation was almost extinguished after five sessions. At a postconditioning test with an unscented female, there was no group difference with regard to sexual motivation but the conditioned group still showed suppression of copulatory behavior. These data show that sexual incentive motivation and copulatory behavior can vary independently and that the associations copulation-malaise and scented female-malaise had been established during conditioning.

Animals↗

Motivational conflict among water need, palatability, and cold discomfort in rats.

Rats were placed in situations pitting three motivations against each other. Two motivations, ambient temperature and need of water, were physiological drives. The third, water sweetness provided by sodium saccharin, was not considered as immediately physiological because saccharin does not provide physiological benefits for the animals; nevertheless they continued to seek the sweet taste after repeated exposure to it. Therefore, our aim was to explore whether these motivations are of the same nature for rats and, if they are, whether they are also quantitatively comparable. From the behavioral evidence we wanted to obtain information on the common currency that permits the rats to solve conflicts. Our results confirm the existence of a common currency in rats' motivations. The similarity of rats' behavior to that of humans observed in conflict situations, where maximizing the bidimensional sum of pleasure was the key to optimal behavior, allows us to suggest a role for affectivity in decision making of mammals.

Animals↗

Haloperidol challenge during copulation prevents subsequent increase in male sexual motivation.

Male rats manifest an increase in sexual motivation following sexual experience. The current experiment was devised to investigate the role of dopamine in this process by assessing whether sexual behavior occurring in the presence of the dopamine receptor antagonist, haloperidol, would continue to alter the subjects' subsequent sexual motivation. Four groups of male Long-Evans rats (total N=34) traversed an operant runway once per day for one of two goalbox targets: a nonestrous or estrous female. Following establishment of baseline run times (10 trials), all males received one ejaculation with a receptive female in a separate testing environment. Subjects were pretreated with vehicle or one of three doses of haloperidol (0.05, 0.075, 0.10 mg/kg) 45 min prior to being paired with the receptive female. All subjects successfully achieved ejaculation under these conditions. Subjects were then re-tested within the runway for their motivation to approach the two types of female targets (10 trials). Vehicle-treated subjects expressed the expected increase in sexual motivation following sexual experience, while haloperidol treatment dose-dependently attenuated this effect. Subjects that received the highest haloperidol dose subsequently manifested increased run times and intra-runway "retreat" behaviors, suggesting that female cues may have become associated with an aversive sexual experience. These results are consistent with the view that dopamine systems play a role in the rewarding or reinforcing consequences of male sexual behavior.

Animals↗

The selective serotonin reuptake inhibitor fluoxetine reduces sexual motivation in male rats.

A male rat put in an open-field arena in which it is free to spend time in the vicinity of--but not in contact with--an estrous female, or in the vicinity of a male, usually spends more time with the female than with the male or elsewhere. Tentatively, the percentage of time spent in the vicinity of the female in this paradigm may be regarded as a measure of sexual motivation. In humans, treatment with selective serotonin reuptake inhibitors (SSRIs) may cause reduced libido. To investigate to what extent serotonin reuptake inhibition influences sexual motivation also in rats, we have tested the effect of subchronic treatment with fluoxetine on the behavior in the sexual motivation test described above; in addition, the effect of fluoxetine on male copulatory behavior was studied. Fluoxetine significantly reduced sexual motivation at subchronic but not at acute administration; moreover, fluoxetine-treated rats displayed an increased ejaculation latency. It is concluded that humans and rats respond similarly to the SSRI fluoxetine with respect to various aspects of sexual behavior.

Animals↗

A cross-media content analysis of motivational themes in direct-to-consumer prescription drug advertising.

BACKGROUND: Direct-to-consumer (DTC) advertising of prescription drugs is a widely discussed issue in health care. However, little is known about the characteristics of the motivational themes used in this type of advertising. OBJECTIVES: The aim of this study was to investigate the concurrent presentation of motivational themes in DTC print and television advertisements. METHODS: The content analyses focused on advertisements of 2 targeted drug classes (cyclooxygenase-2 enzyme inhibitors and 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors) in magazines and on television. Targeted print advertisements (for celecoxib, rofecoxib, atorvastatin, pravastatin, and simvastatin) from September to December 2001 and targeted television advertisements (for celecoxib, rofecoxib, and simvastatin) from November 2001 were investigated. The motivational themes were assessed using a theoretical framework based on self-regulatory focus theory and cultural orientation. Self-regulatory focus was examined in terms of goal orientation (promotion vs prevention) and emotional aspects, (e.g., cheerfulness, dejection, quiescence, agitation). The cultural orientation was examined in terms of individualism versus collectivism. The visual-verbal match was categorized as direct if the audio and visual information was semantically redundant, as partial if it was partially related, and as no match at all if it was different or conflicting. RESULTS: Twelve print advertisements in 10 magazines and 4 television advertisements on 4 television networks were examined; the interrater reliability scores from 3 independent, trained judges ranged from 0.93 to 0.99. The score was low (0.57) in the visual-verbal match measurement for television advertisements. Products in the same category appeared to be promoted using different self-regulatory foci. For example, celecoxib and atorvastatin advertisements tended to be promotion oriented, whereas pravastatin advertisements tended to be prevention oriented. Motivational themes were found throughout the print advertisements (e.g., pictures, headlines, main text). Only a few advertisements illustrated factual information about a product in a pictorial format. The cultural orientation of the advertisements was similar across brands, with individualistic appeals being common. On television, visual-verbal matches (either direct or partial matches) were generally found, except in the section where risk information was presented. CONCLUSION: In this content analysis, prescription drugs in the same class appeared to be promoted using different self-regulatory foci, but individualistic appeals were found more often than collectivistic appeals across brands.

Advertising↗

Motivational control of sexual behavior in Aplysia fasciata: sequencing and modulation by sexual deprivation and by addition of partners.

Variables similar to those affecting feeding behavior also modulate sexual behavior in Aplysia fasciata, indicating that mating is under motivational control. Motivated behaviors are often patterned into appetitive and consummatory components. Courtship, the appetitive phase of male sexual behavior, was temporally related to subsequent mating. Although many bouts of courtship failed to lead to mating, most incidents of mating were preceded by courtship. Motivation is also characterized by satiation after the goal of the behavior is achieved. We found an increase in likelihood to mate following a period of sexual isolation. Motivated behaviors are also modulated by environmental stimuli that induce arousal. Time spent mating was found to be a function of the number of potential mates accessible for mating. Number of A. fascinata participating in a mating group was also found to be a function of number of potential mates available.

Animals↗