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Solitary drinking, social isolation, and escape drinking motives as predictors of high quantity drinking, among Anglo, African American and Mexican American males.

This paper addresses the phenomenon of 'solitary drinking', considering whether Anglo, African American and Mexican American male regular drinkers differ in the propensity to drink in solitary contexts and whether such differences may help to explain observed ethnic variation in patterns of heavy drinking. Further, the paper considers whether apparent relationships between solitary drinking and drinking patterns are explained by individual personality characteristics such as social isolation and/or by endorsement of 'escape drinking' motives. Data were analysed from a random community sample of 481 adult male regular drinkers in San Antonio, Texas, USA. Contingency table and logistic regression analyses indicated that initially observed ethnic differences in high quantity and high maximum drinking were largely eliminated by controls for education, escape motives and solitary drinking. Ethnic variation in the role of solitary drinking was suggested as well, with solitary drinking more strongly related to high quantity consumption, in particular, among African Americans than among Mexican Americans. The nature of the observed interactions suggests that fundamental differences between Anglos and African Americans in the roles of solitary drinking and escape drinking motives may underlie seemingly similar frequent, lower quantity drinking patterns in these groups that appear more frequently than among Mexican American males.

Adult↗

Motivational considerations in physical activity involvement.

The purpose of this article is to examine movement science research on personal and social-environmental motivational influences in physical activity contexts. Motivation is defined as a process in which internal and external factors direct and energize thoughts, feelings, and actions. Motivation is described as a consequence of meaning, which is derived from a combination of personal and social factors, including personal goals or incentives, expectations of personal efficacy, movement-related perceptual and affective experiences, and social and physical features of the environment. Recent literature from sport and exercise psychology is presented on these variables, their determinants, and their consequences for choice, effort, persistence, and performance behavior in exercise and sport contexts.

Adolescent↗

Cognitive rehabilitation for schizophrenia and the putative role of motivation and expectancies.

Cognitive rehabilitation (CR) approaches seek to enhance cognitive processes or to circumvent cognitive impairments in schizophrenia in an effort to improve functional outcome. In this review we examine the research findings on the 8 evidence-based approaches to cognitive remediation listed in the 2005 Training Grid Outlining Best Practices for Recovery and Improved Outcomes for People With Serious Mental Illness, developed by the American Psychological Association Committee for the Advancement of Professional Practice. Though the approaches vary widely in theoretical orientation and methods of intervention, the results are, for the most part, encouraging. Improvements in attention, memory, and executive functioning have been reported. However, many persons with schizophrenia are more impaired in real-world functioning than one would expect given the magnitude of their cognitive deficits. We may need to look beyond cognition to other targets such as motivation to identify the reasons that many persons with schizophrenia demonstrate such marked levels of disability. Although a number of current CR approaches address motivation to varying degrees, treating motivation as a primary target may be needed to maximize CR outcomes.

Adaptation, Psychological↗

Timing and motivation in pediatric career choices.

A total of 257 third-year residents in pediatrics, internal medicine, and family practice were asked about their career goals for the year following their residency and in five years, and information was obtained from them about their motives for career choices. The authors specifically examined the following: humanitarian interests; intellectual motivation; service motives; and practical, personal, and financial considerations. The characteristics of the residency training program which may have influenced their career choices were also examined. A majority of the 214 pediatric residents said they had not considered going into pediatrics on entry to medical school. Of these residents, 109 planned academic pursuits for the following year, while only 81 of the 109 anticipated an academic career within five years. Intellectual stimulation, geographic location, and an "opportunity to clarify goals" were the three most frequently mentioned factors in choosing positions for the following year.

Career Choice↗

Patterns of vocational interests and work motivation among mentally retarded adults attending vocational rehabilitation centres.

The present study describes a survey of the vocational interests and work motivation of trainees attending vocational rehabilitation centers for the mentally retarded in Israel. A random sample of 152 subjects was chosen from a total of 1,509 trainees. Two sets of questionnaires were applied: (1) the Illustrated Vocational Inventory (IVI) (Whelan and Reiter, 1980); and (2) a specially designed questionnaire on work motivation based on Herzberg's model (Herzberg et al., 1959). The most significant finding of the study was that several consistent patterns of vocational knowledge, vocational interests and motivational factors emerge with regard to mentally retarded clients attending vocational rehabilitation centers; and this lends strong support to the view that such people can be placed in employment on the open labour market.

Adolescent↗

A motivational counseling approach to improving heart failure self-care: mechanisms of effectiveness.

BACKGROUND: Self-care is an integral component of successful heart failure (HF) management. Engaging patients in self-care can be challenging. METHODS: Fifteen patients with HF enrolled during hospitalization received a motivational intervention designed to improve HF self-care. A mixed method, pretest posttest design was used to evaluate the proportion of patients in whom the intervention was beneficial and the mechanism of effectiveness. Participants received, on average, 3.0 +/- 1.5 home visits (median 3, mode 3, range 1-6) over a three-month period from an advanced practice nurse trained in motivational interviewing and family counseling. Quantitative and qualitative data were used to judge individual patients in whom the intervention produced a clinically significant improvement in HF self-care. Audiotaped intervention sessions were analyzed using qualitative methods to assess the mechanism of intervention effectiveness. RESULTS: Congruence between quantitative and qualitative judgments of improved self-care revealed that 71.4% of participants improved in self-care after receiving the intervention. Analysis of transcribed intervention sessions revealed themes of 1) communication (reflective listening, empathy); 2) making it fit (acknowledging cultural beliefs, overcoming barriers and constraints, negotiating an action plan); and, 3) bridging the transition from hospital to home (providing information, building skills, activating support resources). CONCLUSION: An intervention that incorporates the core elements of motivational interviewing may be effective in improving HF self-care, but further research is needed.

Communication↗

The intrinsically motivated nurse. Help and hindrance from evaluation feedback sessions.

Self-determination theory describes the working conditions necessary for the experience of self-motivation. Performance evaluation sessions represent extraordinary opportunities to enhance motivation, yet often are approached with anxiety. An innate desire for feedback meets with a learned response of fear, by both the evaluator and evaluatee. Psychological fusion theory explains the source of this conflict and what nurse executives can do to use these sessions for motivational impact while ameliorating the attendant stress.

Employee Performance Appraisal↗

Wellness motivation theory: an exploration of theoretical relevance.

Data were collected from 14 older, rural African American men and women to explore how individual motivation affects the initiation and maintenance of health-related behavior. The research consisted of an inductive exploration designed to examine the validity and cultural relevance of an existing theoretical framework for wellness motivation in health behavior change. Through the technique of constant comparative analysis, the basic social process of empowering potential was substantiated as a process of individual growth and goal-directed behavior that facilitated the initiation and maintenance of positive health patterns. The process of empowering potential consisted of three stages: appraising readiness, changing, and integrating change. Two categories provided a cultural context for the process: health value orientation and network affiliation. The data validated and expanded a developing theoretical framework for wellness motivation in health behavior change.

Adaptation, Psychological↗

Relationship of the type A coronary-prone behavior pattern to achievement, power, and affiliation motives.

The present investigation examined the relationship of Pattern A as assessed by the Jenkins Activity Survey (JAS) and interview to measures of job involvement and a series of motivation constructs included because of their descriptive resemblance to Pattern A. The Type A scores were unrelated to achievement, power, and affiliation motives. Individuals high on resultant achievement motivation (high on nAch and low on test anxiety) scored as extreme Type A's on the JAS. Job involvement was also related to JAS Type A measures but was unrelated to the interview Type A. Evidently Pattern A, because of its multidimensional nature, is not strongly related to individual constructs. As our knowledge increases about the Pattern A characteristics that contribute to coronary-proneness, we can more adequately develop measures of those characteristics and individually relate them to current psychological constructs.

Achievement↗

Motivation and expectancy factors in symptom perception: a laboratory study of the placebo effect.

Placebos are widely recognized as having a potentially powerful effect on health and health behavior, yet our understanding of the placebo phenomenon is limited. Many factors are considered to be associated with placebo responding. This study was designed to examine, in a laboratory context, the effects of two of these factors, motivation and expectation, on one kind of placebo response, that which involves the perception of symptoms. The results point to the importance of motivation in influencing the perception of symptom change, and provide limited support for the importance of expectation. The findings underscore the necessity for examining placebo effects from a multicomponent perspective, and appear to mandate the inclusion of both expectancy and motivation factors in future process and outcome studies.

Adult↗

Motivating the obese child to move: the role of structured exercise in pediatric weight management.

BACKGROUND: The prevalence of childhood obesity is rapidly increasing. Successful prevention and treatment of childhood obesity depends on increasing the physical activity patterns of obese youth. However, motivating the obese child to participate in physical activity is difficult. METHODS: We designed a four-phase physical activity intervention, consisting of a structured progressive exercise program of moderate intensity, along with motivational methods to increase physical activity and improve body movement awareness. RESULTS: Seventy-three overweight children participated in the weight management program. They had a significant weight loss and reduction in body fat, which was maintained at 1-year follow-up. Subjects also maintained lean body mass and showed improved physical activity patterns. CONCLUSIONS: Progressive exercise, used in conjunction with nutrition and behavior modification, provides successful motivational strategies. These strategies encourage increased physical activity patterns, the adoption of regular structured exercise training, and the loss of excess body fat.

Adolescent↗

Mood, cue and gender influences on motivation, craving and liking for alcohol in recreational drinkers.

The effects of exposure to an alcohol-related cue (drinking low-alcohol beer) and a musical depression/elation mood induction procedure, on craving, motivation and liking for alcohol, were studied in male and female recreational drinkers. Alcohol craving was assessed using the multidimensional desires for alcohol questionnaire (DAQ), motivation for alcohol was assessed by performance on a progressive ratio (PR) task reinforced with small volumes (25 ml) of low-alcohol beer, and liking for the reinforcers earned in the PR task was assessed using a visual analogue scale. Consumption of a half-pint of low-alcohol beer increased alcohol craving in male subjects but had no effect or decreased craving in female subjects. Subsequent induction of a depressed mood increased craving scores, relative to elated or neutral mood groups, but these effects were confined to abstinent (non-cued) subjects, both male and female. Performance on the PR task correlated significantly with one of the four factors of the DAQ, negative reinforcement, and was increased by induction of a depressed mood in abstinent female and cued male subjects. Reinforcer liking was unchanged following mood induction in male subjects, but decreased in both groups of female subjects. To summarize, the cue of drinking low-alcohol beer increased alcohol craving in men but not in women, and induction of a depressed mood increased alcohol craving and motivation, but also decreased alcohol liking. These effects were present to different extents in different cue/gender subgroups, and were partially independent.

Adult↗

Low-dose diazepam primes motivation for alcohol and alcohol-related semantic networks in problem drinkers.

Considerable research with animals indicates that the GABA-benzodiazepine (BZ) system plays a key role in alcohol reinforcement. However, only limited research appears to have assessed this issue directly in humans. The present study investigated whether low-dose diazepam would cross-prime motivation for alcohol in problem drinkers. Twelve male problem drinkers (Alcohol Dependence Scale; ADS score > or =9) received oral diazepam (5 mg) and placebo, in a counterbalanced manner on separate sessions. There were three measures of primed motivation for alcohol: self-reported desire for alcohol, consumption of placebo beer in an ostensible taste test procedure, and automatically executed vocal reading responses to Alcohol versus Neutral words on a computer-based task. Diazepam significantly increased beer consumption, and produced a marginally significant increase in reported desire for alcohol. On the reading task, diazepam significantly decreased response latency to Alcohol words relative to Neutral words. Latency to Alcohol words correlated significantly with beer consumption under the drug. Moreover, response latency to Alcohol words under the drug also predicted ADS scores. Thus, severity of dependence was directly linked with vulnerability to a BZ priming effect on motivation for alcohol. These findings provide direct evidence that the GABA-BZ system plays an important role in alcohol reinforcement in problem drinkers.

Administration, Oral↗

Motivational effects on motor timing in attention-deficit/hyperactivity disorder.

OBJECTIVE: This study was designed to clarify whether poor performance of children with attention-deficit/hyperactivity disorder (ADHD) on motor timing tasks reflects a true deficit in the temporal organization of motor output or is due to a lack of intrinsic motivation. METHOD: Eighteen children with ADHD (age 8-12) were compared with 18 age- and gender-matched normal controls with respect to timing precision, timing variability, and the frequency of extreme under- and overestimations during a 1-second interval production task. Monetary reward, response cost, and no reward were implemented to manipulate motivation. RESULTS: Children with ADHD produced significantly more inaccurate and more variable time intervals and exhibited a larger number of extreme over- and underestimations than control children. Although all children performed significantly better when monetary incentives were applied, group differences were not eliminated. CONCLUSIONS: In this study, no evidence was found for a motivational deficit as an explanation for impaired performance on a time production task in ADHD. Rather, results provide clear support for a generic motor timing deficit, probably due to a dysfunctional frontostriatocerebellar network involved in temporal aspects of motor preparation.

Adolescent↗

Naltrexone combined with either cognitive behavioral or motivational enhancement therapy for alcohol dependence.

Although naltrexone has been shown to be effective in the treatment of alcohol dependence, less is known about its efficacy when combined with different behavioral therapies. Previous work has suggested that naltrexone works best when combined with weekly cognitive behavioral therapy (CBT). This study examined the efficacy of naltrexone when combined with CBT or a motivational enhancement therapy involving less patient contact. Outpatient alcoholics (N = 160) were randomly assigned to either naltrexone (50 mg/d) or placebo and either CBT (12 sessions) or motivational enhancement therapy (4 sessions), in a 4-cell design, and treated over a 12-week period. Subjects were evaluated periodically for alcohol consumption, craving, and biologic markers of drinking (carbohydrate-deficient transferrin and gamma-glutamyltransferase). There was high retention and adherence to therapy and medication in the trial with no significant difference across the treatment groups. Naltrexone, independent of therapy assignment, increased the time to first relapse. However, the CBT-naltrexone group did better than the other groups on a variety of outcome measures. Fewer CBT-naltrexone-treated subjects relapsed, and those that did had both fewer, and more time between, subsequent relapses. This randomized controlled trial is consistent with previous reports about the utility of combining naltrexone with CBT. Despite being more efficient to administer, the combination of motivational enhancement therapy and naltrexone is less effective than CBT and naltrexone. Because CBT and naltrexone share common mechanisms of action, such as craving reduction and relapse prevention, these therapies are likely to be well suited to use in combination.

Adult↗

Posttrial HIV vaccine adoption: concerns, motivators, and intentions among persons at risk for HIV.

BACKGROUND: Suboptimal uptake of existing vaccines, potential obstacles specific to HIV/AIDS stigma and mistrust, and marked health disparities suggest that it is vital to investigate consumer concerns, motivations, and adoption intentions regarding posttrial HIV vaccines before a vaccine is publicly available. METHOD: Nine focus groups were conducted with participants (n = 99; median age, 33 years; 48% female; 22% African American, 44% Latino, and 28% white) recruited from 7 high-risk venues in Los Angeles using purposive venue-based sampling. A semistructured interview guide elicited concerns, motivators, and adoption intentions regarding hypothetical U.S. Food and Drug Administration-approved HIV vaccines. Data were analyzed using narrative thematic analysis and Ethnograph qualitative software. RESULTS: Concerns included vaccine efficacy, vaccine-induced infection, vaccine-induced HIV seropositivity, side effects, cost/access, trustworthiness, and relationship issues. Motivators included protection against HIV infection and the ability to safely engage in unprotected sex. Participants expressed reluctance to adopt partial efficacy vaccines and likelihood of increased sexual risk behaviors in response to vaccine availability. CONCLUSION: Tailored interventions to facilitate uptake of future U.S. Food and Drug Administration-approved HIV vaccines and to prevent risk behavior increases may be vital to the effectiveness of vaccines in controlling the AIDS pandemic.

AIDS Vaccines↗

Motivations for participating in an HIV vaccine efficacy trial.

Understanding why people join HIV vaccine efficacy trials is critical for trial recruitment and education efforts. We assessed participants' motivations for joining the VaxGen VAX004 study, a randomized, double-blind, placebo-controlled, phase 3 multicenter trial. Of 5417 participants, 94% were men who have sex with men (MSM) and 6% were women at risk for heterosexual transmission of HIV. Most participants gave altruistic reasons for trial participation: 99% reported having joined to help find an HIV vaccine, and 98% reported having joined to help their community. Some gave more personal reasons: 56% joined to reduce risk behavior and 46% joined to get protection from HIV. Additional reasons related to receiving services or compensation included to obtain information about HIV (75%), to receive free HIV testing (34%), and for financial reimbursement (14%). Multivariate logistic regression analysis showed that female participants were significantly more motivated than male participants to join the trial for protection and to receive services or compensation (all P<0.05). Participants with 13 or more sex partners in the 6 months before enrollment were more likely than those with fewer sex partners to report having joined the trial for protection but less likely to have joined to reduce risk behavior (both P<0.05). Because many participants reported personal protection from HIV as their reason for joining, vaccine trial risk-reduction counseling should continue to emphasize the placebo-controlled trial design and unknown efficacy of the test product, particularly for women and persons with large numbers of sex partners. Because a significant minority of participants reported joining to receive HIV information, HIV testing, and financial reimbursement, a need is indicated for provision of HIV prevention services outside research trials and for monitoring to ensure that participants are not motivated to join trials for financial gain.

AIDS Vaccines↗

Motivation for living-donor liver transplantation from the donor's perspective: an in-depth qualitative research study.

BACKGROUND: There has been a lack of systematic in-depth research on the motives of living liver donors before transplantation that could contribute to an advanced understanding of their situation and to a more precise psychosocial evaluation, to protect the autonomy for decision, and to prevent psychosocial complications. METHODS: Twenty-eight living liver donors were assessed preoperatively through a semistructured clinical interview. The taped and transcribed interviews were analyzed using a combination of grounded theory and empirically grounded type construction. RESULTS: Various factors contribute to the donor's motivation for donation: the relationship to the recipient, the personal attitude of the donor, his or her personal history, family dynamics, the donor's personal profit, and the exceptional situation of the recipient's life-threatening disease combined with the life-rescuing possibility of living-donor liver transplantation (LDLT). In reference to this, five "ideal types" of living donors emerged from the authors' data. CONCLUSIONS: A complete absence of coercion on the decision to donate seems unrealistic because of the dynamics initiated by the life-threatening condition of the recipient. It is important that donors feel they are gaining something by donation to be sufficiently motivated and that their profit is of an emotional or moral nature (i.e., the donation being set in an emotionally meaningful context). A mature relationship with the recipient usually provides such a context. The role of the clinician as a part of LDLT dynamics has a decisive influence.

Adult↗