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PubMed2005

Development of the Motivational Interviewing Supervision and Training Scale.

The movement to use empirically supported treatments has increased the need for researchers and supervisors to evaluate therapists' adherence to and the quality with which they implement those interventions. Few empirically supported approaches exist for providing these types of evaluations. This is also true for motivational interviewing, an empirically supported intervention important in the addictions field. This study describes the development and psychometric evaluation of the Motivational Interviewing Supervision and Training Scale (MISTS), a measure intended for use in training and supervising therapists implementing motivational interviewing. Satisfactory interrater reliability was found (generalizability coefficient p(2) = .79), and evidence was found supporting the convergent and discriminant validity of the MISTS. Recommendations for refinement of the measure and future research are discussed.

Clinical Competence↗
PubMed2006

Compelled to consume: the Implicit Association Test and automatic alcohol motivation.

The Implicit Association Test (IAT; A. G. Greenwald, D. E. McGhee, & J. L. K. Schwartz, 1998) has recently been used to assess the role of alcohol-affect associations in drinking behavior. The current study examined the validity of an alcohol IAT with 88 hazardous-drinking college students who completed measures of drinking behavior, an explicit measure of alcohol motivation, and an IAT that assessed alcohol-motivation associations. Regression analyses indicated that IAT scores correlated with binge drinking and cue reactivity, replicating T. P. Palfai and B. D. Ostafin's (2003) results. Results also indicated convergent validity (the IAT was related to an explicit measure of alcohol motivation) and incremental validity (IAT scores were correlated with alcohol behavior after controlling for the explicit measure). Implications for understanding the self-regulation of drinking are discussed.

Adolescent↗
PubMed2003

Separating emotion and motivational direction in fear and anger: effects on frontal asymmetry.

State effects on frontal alpha electroencephalograph asymmetry (ASY) are thought to reflect approach and withdrawal motivational tendencies. Although this motivational direction model has inspired a large body of research, efforts to disentangle influences of emotion (EMO) and motivational direction (MOT) on ASY are rare. The authors independently manipulated EMO (fear and anger) and MOT (approach and withdrawal) in a between-subjects design. Irrespective of MOT, anger led to greater changes toward relative left frontal activation (LFA) than did fear. Conversely, higher ratings of negative valence were associated with greater changes toward LFA in withdrawal but with greater changes toward relative right frontal activation in approach. Results are discussed within a model based on behavioral inhibition system-behavioral activation system theory.

Adolescent↗
PubMed2005

Perceived facial expressions of emotion as motivational incentives: evidence from a differential implicit learning paradigm.

Participants (N = 216) were administered a differential implicit learning task during which they were trained and tested on 3 maximally distinct 2nd-order visuomotor sequences, with sequence color serving as discriminative stimulus. During training, 1 sequence each was followed by an emotional face, a neutral face, and no face, using backward masking. Emotion (joy, surprise, anger), face gender, and exposure duration (12 ms, 209 ms) were varied between participants; implicit motives were assessed with a picture-story exercise. For power-motivated individuals, low-dominance facial expressions enhanced and high-dominance expressions impaired learning. For affiliation-motivated individuals, learning was impaired in the context of hostile faces. These findings did not depend on explicit learning of fixed sequences or on awareness of sequence-face contingencies.

Adult↗
PubMed1975

Self-perception of intrinsic and extrinsic motivation.

Self-perception theory predicts that intrinsic and extrinsic motivation do not combine additively but rather interact. To test this predicted interaction, intrinsic and extrinsic motivation were both manipulated as independent variables. The results revealed a significant interaction for task satisfaction and a trend for the interaction on a behavioral measure. These results are discussed in terms of a general approach to the self-perception of motivation.

Attention↗
PubMed1997

Attachment, self-concept, and academic motivation in high-school students.

The contributions of parent and teacher attachment and self-concept to academic motivation were examined in a sample of 150 high-school students in the 11th and 12th grades. Findings indicated that parent attachment and attachment to a teacher were individually and collectively related to academic motivation, and that academic self-concept was a significant predictor of academic motivation.

Achievement↗
PubMed1997

Patients in phase I trials of anti-cancer agents in Japan: motivation, comprehension and expectations.

We attempted to characterize the motivation, comprehension and expectations of patients who had given informed consent to participate in phase I trials of anti-cancer agents at the National Cancer Center of Japan. Thirty-three patients were given a simple multiple-choice questionnaire and asked to return it at a later date. The completed survey was returned by 32 patients. The patients were surveyed before they had received any investigational phase I agents. Nineteen per cent of patients were motivated to participate in the phase I trials by the possibility of therapeutic benefit, 9% because participation seemed a better choice than no treatment and only 6% for altruistic reasons. Most patients comprehended the major features of a phase I trial, namely its investigational nature, the unknown effects of the agent investigated and the unclear benefit to the patients themselves. Fifty-nine per cent of the patients anticipated that they might suffer severe or life-threatening side-effects if they participated in the phase I trial, and 43% were able to indicate accurately the purpose of the phase I trial as a dose determination study. Although only a minority of the patients indicated that their motivation to participate was possible treatment benefit to themselves, when answering questions regarding expectations, more than half indicated that there might be personal benefits of varying degrees by participation.

Antineoplastic Agents↗
PubMed2006

Employee motivation in laboratory animal science: creating the conditions for a happy and productive staff.

High rates of employee turnover are the source of a considerable loss of time and resources, but managers are not always aware of the reasons that motivate employees to stay in their positions. The author compares prominent theories of employee motivation and then puts them to the test by surveying 82 cagewashers, animal caretakers, animal technicians, and supervisors working in a laboratory animal facility to determine the job characteristics that motivate them.

Data Collection↗
PubMed2005

Human behaviour: Egalitarian motive and altruistic punishment.

Altruistic punishment is a behaviour in which individuals punish others at a cost to themselves in order to provide a public good. Fehr and Gächter present experimental evidence in humans indicating that negative emotions towards non-cooperators motivate punishment, which, in turn, provokes a high degree of cooperation. Using Fehr and Gächter's original data, we provide an alternative analysis of their experiment that suggests that egalitarian motives are more important than motives for punishing non-cooperative behaviour. This finding is consistent with evidence that humans may have an evolutionary incentive to punish the highest earners in order to promote equality, rather than cooperation.

Altruism↗
PubMed2005

Differential regulation of the consummatory, motivational and anticipatory aspects of feeding behavior by dopaminergic and opioidergic drugs.

Various aspects of feeding behavior (eg consumption, motivation and anticipation) are regulated by homeostatic and hedonic systems, and are modulated by dopaminergic and opioid brain systems. Here, we have studied the modulation of these aspects of feeding behavior by opioid and dopaminergic neurotransmission while taking into account food palatability and homeostatic state. Foods that varied in palatability were presented to either food sated or food restricted rats following injections of different doses of naloxone, an opioid receptor antagonist, or flupenthixol, a dopaminergic receptor antagonist, in behavioral paradigms that measured different aspects of feeding. Naloxone decreased food intake in a dose-dependent manner in sated rats given access to palatable food, without modifying food intake in food restricted rats. Flupenthixol did not have any effect on food intake. With regard to motivation, which was tested in a straight alley, naloxone increased the latency to reach the food only in sated rats presented with palatable food. Flupenthixol did not modify the latency of any group. Conditioned locomotor activity to repeated food presentation, a measure of anticipation, is expressed only in food restricted rats. Naloxone did not modify anticipatory activity, whereas flupenthixol decreased it only in food restricted rats presented with palatable food. These results reinforce the idea that the opioid system regulates feeding through the modulation of the perceived palatability of food. The dopaminergic system seems to be more important for the regulation of anticipatory activity related to motivationally relevant stimuli.

Animals↗
PubMed2005

Mice with chronically elevated dopamine exhibit enhanced motivation, but not learning, for a food reward.

Dopamine has been critically implicated in learning and motivation, although its precise role remains to be determined. In order to investigate the involvement of dopamine in learning and motivation for a food reward, we used dopamine transporter knockdown mice (DAT KD) that have chronically elevated levels of extracellular dopamine. The present study demonstrates that chronically elevated dopamine enhances tendency to work for a food reward without apparent effects on Pavlovian and operant learning for this reward. The increase in dopamine is associated with elevated levels of dynorphin and Fos B expression in the dorsal caudate-putamen and the core but not the shell subregion of the nucleus accumbens. These data suggest that motivation to work, but not learning, for a food reward appears to be under the critical influence of tonic dopaminergic activity in discrete brain areas relevant for a reward-directed behavior.

Animals↗
PubMed2000

Motivating general practitioners to change their prescribing: the incentive of working together.

OBJECTIVE: To determine the extent to which GPs were motivated to change their prescribing upon joining a Primary Care Commissioning Group (PCCG) and how effective certain interventions planned by the PCCG might be as a means to change prescribing. To define the characteristics of GPs less motivated to change their prescribing. DESIGN: A cross-sectional survey of participating general practitioners linked with current prescribing information derived from PACT data. SETTING: General practice covering a geographical locality within inner-city south London. SUBJECTS: All 72 general practitioners who had joined a GP Commissioning Group. MAIN OUTCOME MEASURES: questionnaire responses. RESULTS: 93% of GPs entering the GP Commissioning Group expected their prescribing to change but none expected substantial change. There was no difference between fundholders, singlehanders nor training practices in their expectation of change. GPs in practices with the lowest quality prescribing, as measured by a quality index, were least likely to expect change (Spearman's r = 0.25, P = 0.04). Those in practices with higher prescribing costs were not more likely to expect their prescribing to change, whereas expensive prescribers who were unaware of their practices' prescribing costs were associated with a reduced expectation of prescribing change (P = 0.05). Educational interventions were thought to be the most effective means by which prescribing could be changed, whereas formularies and financial factors were perceived as weaker influences. CONCLUSION: Acceptance of a cash-limited prescribing budget by GPs is accompanied by the expectation of personal prescribing change. The motivation to change prescribing may be related to a strongly developed collectivist perspective amongst GPs who are prepared to consider the prescribing implications for their fellow GPs. It is ironic that those with the least expectation of change should have the lowest quality prescribing, or be unaware of their high cost prescribing. Engendering greater commitment to the professional group may be one way of changing their prescribing.

Adult↗
PubMed2003

Understanding and motivating health care employees: integrating Maslow's hierarchy of needs, training and technology.

AIM: This paper applies Maslow's Hierarchy of Needs Model to the challenges of understanding and motivating employees in a rapidly changing health care industry. BACKGROUND: The perspective that Maslow's Model brings is an essential element that should be considered as the health care arena is faced with reorganization, re-engineering, mergers, acquisitions, increases in learning demands, and the escalating role of technology in training. EVALUATION: This paper offers a new perspective related to how Maslow's Model, as used in business/organizational settings, can be directly related to current workforce concerns: the need for security and freedom from stress, social belongingness, self-esteem, self-actualization, altered work/social environments, and new opportunities for learning and self-definition. KEY ISSUES: Changes in health care will continue at an accelerated pace and with these changes will come the need for more and more training. The use of technology in training has heightened access, faster distribution, innovation and increased collaboration. However, with this technology come attendant challenges including keeping up with the technology, the increased pace of training, depersonalization, and fear of the unknown. The Maslow model provides a means for understanding these challenges in terms of universal individual needs. CONCLUSION: How does one motivate employees in the face of increased demands, particularly when they are being asked to meet these demands with fewer resources? The answer is, in large part, to make the employee feel secure, needed, and appreciated. This is not at all easy, but if leaders take into consideration the needs of the individual, the new technology that provides challenges and opportunities for meeting those needs, and provides the training to meet both sets of needs, enhanced employee motivation and commitment is possible.

Attitude of Health Personnel↗
PubMed2003

Parents with mental illness: lacking motivation to parent.

Parents with mental illness sometimes struggle to manage the demands of a family and the disabling symptoms of their illness. Limited interaction and poor relationships can negatively impact on children. Lack of motivation may inhibit these parents' ability to interact with, and provide adequate care for their children. This is especially problematic following a hospital admission. Lack of motivation, in psychiatric illnesses, can be a symptom, due to medication, or perhaps associated with frontal lobe disorder. Assessment, rehabilitation and support that focuses on parents' problems with motivation and planning and enhances their parenting would be beneficial in helping parents with mental illness provide the best possible care for their children.

Adult↗
PubMed1999

Changes in the work and motivation of staff delivering home care services in Finland.

This article describes how the policy to emphasize noninstitutional care is reflected in home care service strategies and work characteristics as well as the work motivation of home care staff in Finland. The data were gathered through a questionnaire answered by 312 employees in home care services and 22 social welfare and primary health care administrators. The methods of analysis used were cross-tabulations, one-way analysis of variance, and regression analysis. According to the results, institutional care had been reduced too fast and home care services had not been developed sufficiently. Most of the staff reported that their work had changed considerably. Although their work had become more interesting and more independent, over one third of the employees felt that the pressure of work had become unbearable and their responsibility was too heavy. The views of the home care staff differed from those of the administrators regarding the change strategies that had been carried out. The majority of the staff were moderately or highly motivated. Thirty-four percent of the variance of work motivation was explained mainly by work characteristics. More attention should be paid to the development of home care services before institutional care is reduced. Training the staff and informing them about the planned reform should not be neglected.

Analysis of Variance↗
PubMed2005

[Motivational interviewing for patients with comorbid schizophrenia and substance abuse disorders: a review].

Patients with schizophrenia and substance abuse disorders [dually diagnosed patients (DD)] show an unfavourable course of the illness and little interest in participating on specific integrated treatment programmes. Motivational interviewing (MI) has been shown to be effective among other substance abuse disorders and it aims to enhance intrinsic motivation to change problem behaviour. MI has been adapted for DD. The present paper reviews the empirical evidence for the efficacy of MI in DD. A search in the databases MEDLINE, EMBASE, PsycINFO was conducted and the methodological quality of the identified trials was assessed according to the Cochrane Collaboration and to the JADAD Scale. We identified 4 randomised studies with a total of 346 participants, in which MI interventions of 1 to 3 sessions were compared with various control conditions over a follow-up period of up to 6 months. With regard to the main outcome measures "subsequent participation at integrated treatment programme" (1 x positive, 2 x negative) and "substance use" (1 x positive, 1 x negative,) the studies gained contradictory results. In all 4 studies, there were relevant general methodological limitations (randomisation, blindness of raters, description of the reasons for drop-outs) and specific methodological shortcomings (sample size and sample homogenity, numbers of MI sessions, assessment of motivational status). Hence, at present the evidence for supporting MI in DD is not clear. This may be due to the methodological problems mentioned above or it may be that there is, in fact, no effect. Therefore, there is an urgent need for further research of MI in DD.

Diagnosis, Dual (Psychiatry)↗
PubMed1992

[Personality, motivation and affect as modulating factors in suicidal behavior of depressed women].

From a psychological point of view, we would expect that motivational rather than biological dysfunctions mediate initiation of violent and non-violent suicidal actions. To prove this assumption we classified depressed women in four groups according to their suicidal behaviour and matched them to age: suicide ideators, violent suicide attempters, non-violent suicide attempters, non-suicidal depressed controls. We then tested group differences in respect of aggression, impulsivity, introversion, affective lability, anxiety, depression and electrodermal activity (EDA). To take a closer look at motivational dysfunctions, we implemented the Action Control Scale (corresponding to Kuhls theory of action and state orientation), since we regard chronic state orientation as a risk factor for suicidal behaviour. Results show few differences in violent attempters compared with controls. In contrast to non-violent attempters, they show a greater tendency to achievement and action oriented behaviour being less introverted. Non-violent attempters, however, show most significant differences to their controls: Corresponding to a high state orientation, they are more depressed, anxious, less stable in respect of affectiveness, and more introverted, with low scores in aggression and contentedness in life. In contrast to some other studies, nonreactivity in the electrodermal system dominates in all groups. Results demonstrate that motivational dysfunctions like state orientation allow better prediction and understanding of violent or non-violent suicidal behaviour in depressed women than does electrodermal reactivity.

Adult↗
PubMed2003

Low-income consumers' attitudes and behaviour towards access, availability and motivation to eat fruit and vegetables.

OBJECTIVE: To determine low-income consumers' attitudes and behaviour towards fruit and vegetables, in particular issues of access to, affordability of and motivation to eat fruit and vegetables. DESIGN AND SETTING: Questionnaire survey mailed to homes owned by a large UK housing association. PARTICIPANTS: Participants were 680 low-income men and women, aged 17-100 years. RESULTS: Age, employment, gender, smoking and marital status all affected attitudes towards access, affordability and motivation to eat fruit and vegetables. Few (7%) participants experienced difficulty in visiting a supermarket at least once a week, despite nearly half having no access to a car for shopping. Fruit and vegetables were affordable to this low-income group in the amounts they habitually bought; purchasing additional fruits and vegetables was seen as prohibitively expensive. Less than 5% felt they had a problem with eating healthily and yet only 18% claimed to eat the recommended 5 or more portions of fruit and vegetables every day. CONCLUSIONS: Supported by research, current UK Government policy is driven by the belief that low-income groups have difficulties in access to and affordability of fruit and vegetables. Findings from this particular group suggest that, of the three potential barriers, access and affordability were only a small part of the 'problem' surrounding low fruit and vegetable consumption. Thus, other possible determinants of greater consequence need to be identified. We suggest focusing attention on motivation to eat fruit and vegetables, since no dietary improvement can be achieved if people do not recognise there is a problem.

Adolescent↗