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PubMed2004

Impact of a motivational intervention on mechanisms of change in low-income pregnant smokers.

Numerous smoking cessation interventions targeting pregnant women have been developed and tested. An overall increase in smoking cessation is indicated, yet quit rates are modest and variable. Although efficacious with other substance abuse populations, motivational interviewing (MI) interventions with pregnant smokers have resulted in marginal outcomes. Examining treatment mechanisms affected by MI interventions may assist in understanding negative results and in developing more innovative and effective interventions. This study assessed the impact of an MI intervention on transtheoretical (TTM)-based mechanisms of change in low-income pregnant smokers (N = 54). Repeated measures analyses indicated that relative to usual care (UC), pregnant smokers who received MI reported a greater increase in confidence to abstain from smoking, a decrease in temptation to smoke, and a decrease in level of depression. However, the MI intervention was not associated with forward progression in the stages of change. More intensive motivational and cognitive-behavioral interventions demonstrated effective in nonpregnant, smoking populations, with more frequent sessions separate from prenatal visits, are recommended to further increase smoking cessation rates among low-income pregnant smokers.

Adolescent↗
PubMed2005

Performance of heavy marijuana-smoking adolescents on a laboratory measure of motivation.

Marijuana smoking produces effects that may persist for hours or days beyond the period of acute intoxication. Despite evidence that adolescence represents a period of heightened exposure to marijuana, little research exists regarding possible impairment in adolescents who smoke marijuana regularly, and none exists regarding basic behavioral processes. In the present study, adolescents who smoked marijuana on a regular basis (near daily) were compared to a control group of adolescents on a two-option experimental task designed to measure motivation. The contingencies were arranged such that one option (work), which required systematically increasing response output, initially produced greater rates of monetary reinforcement than an alternative option (non-work) that required no response output to earn money. Switching to the non-work option was interpreted as a measure of reduced motivation. Significant differences were found between the groups: the marijuana-smoking participants switched earlier to the non-work option, and derived a greater percentage of their earnings from the non-work option. These differences existed when controlling for differences in cognitive aptitude, gender, and the presence of conduct disorder. A significant correlation between cannabinoid levels and percent of earnings derived from the non-work option suggests that these effects could be associated with the presence of cannabinoids in the marijuana-smoking group.

Adaptation, Psychological↗
PubMed2004

Brief motivational intervention for adolescent smokers in medical settings.

This study evaluated the efficacy of using a brief motivational intervention to reduce smoking among adolescent patients treated in a hospital outpatient clinic or Emergency Department. Patients aged 14-19 years (N=85) were randomly assigned to receive either one session of motivational interviewing (MI) or standardized brief advice (BA) to quit smoking. The assessment and intervention were conducted in the medical setting proximal to the patient's medical treatment. Patients were proactively screened and recruited, and were not seeking treatment for smoking. Follow-up assessments were conducted at 1, 3, and 6 months post-intervention. Self-report data indicated that 7-day abstinence rates at 6-month follow-up were significantly higher in the MI group than in the BA group, but this difference was not confirmed biochemically. Self-reported smoking rate (average cigarettes per day) was significantly lower at 1, 3, and 6 months follow-up than it was at baseline. Cotinine levels indicated reduced smoking for both groups at 6 months, but not at 1 month. At 3-month follow-up, only those in MI showed cotinine levels that were significantly reduced compared to baseline. Findings offer some support for MI for smoking reduction among non-treatment-seeking adolescents, but overall changes in smoking were small.

Adolescent↗
PubMed2004

Self-reported motivations to change and self-efficacy levels for a group of recidivist drink drivers.

The present study reports on a group of 132 recidivist offenders' stages of change and self-efficacy levels for changing and controlling both their drinking and drink driving behaviours. The majority of the sample reported being motivated to change their drink driving, but not their drinking behaviours. The sample also indicated high self-efficacy levels for the two behaviours, although a notable finding was that participants reported higher levels of control over their drinking rather than drink driving behaviours. Examination of the self-reported frequency of drink driving revealed that both motivations and self-efficacy levels were predictors of past offences and future intentions to drink and drive. The findings have direct implications for the management of repeat offenders, such as the inclusion of rehabilitation and alcohol treatment programs in sentencing outcomes for individuals who appear resistant to change.

Alcohol Drinking↗
PubMed2005

Dispositional motivations and genetic risk feedback.

This study examined interest in genetic testing for lung cancer susceptibility among college students, a group whose smoking rates have increased significantly in the last decade. Sixteen smokers who participated in focus group discussions indicated a generally high level of interest in testing. They also indicated that knowledge of genetic susceptibility would make them feel anxious and motivate them to quit smoking. The study also examined, in a separate sample of undergraduate smokers (n=186), whether these outcomes depend on personality differences in threat sensitivity-responsiveness of the behavioral inhibition system (BIS)--and reward sensitivity--responsiveness of the behavioral activation system (BAS). Smokers completed measures of personality and risk perceptions at baseline and rated risk perceptions, affect, and likelihood of changing smoking behavior in response to 2 hypothetical risk feedback scenarios (high vs. low risk). Smokers higher in reward sensitivity (reward responsiveness) evidenced greater interest in taking genetic tests. If a test indicated elevated risk smokers higher in reward responsiveness would perceive themselves at increased risk and attempt to quit smoking. Threat sensitive smokers would react with greater negative affect. Overall, results indicate that genetic biomarker feedback is a motivator for college student smokers to quit and would be more effective among smokers high in reward sensitivity.

Adolescent↗
PubMed2006

Motivation to quit using cigarettes: a review.

This review asks why persons decide to quit using cigarettes. We summarize three literatures from five decades, including over 30 data sets grouped by different methodologies: (a) retrospective reports of ex-smokers (n = 15), (b) cross-sectional surveys of current smokers (n = 14), and (c) prospective studies of smokers in cessation studies (n = 6). Taken together, the data strongly suggest that health concern is the primary motive for quit attempts. These data fit with theoretical reasoning that persons wish to control danger and negative affect. The data also suggest that health professionals should continue emphasizing the negative health consequences of smoking to motivate cessation attempts.

Adolescent↗
PubMed2005

Nicotine dependence, motivation to quit, and diagnosis in emergency department patients who smoke.

OBJECTIVES: To assess the effect of diagnosis on motivation to quit in adult smokers in an emergency department (ED). METHODS: A survey of patients visiting two EDs from September to November, 2003. Patients screening positive for smoking completed a Fagerstrom Test for Nicotine Dependence and Ladder of Contemplation. ICD9 codes and disposition status were recorded. Smoking-related diagnoses were drawn from standard sources. Data were analyzed with parametric and non-parametric statistics. RESULTS: Five hundred and eighty-five were interviewed, median age 40 (interquartile range 29-50); 323 (55%) were female. Ninety percent of all patients were non-White; 69% were uninsured or had Medicaid. Of 152 patients with smoking-related diagnoses, the median Fagerstrom score was 4.7 vs. 4.1 for patients with a non-smoking-related diagnosis (p=0.02, 95% CI for the difference 0.2, 0.9). Patients with smoking-related and non-smoking-related diagnoses had similar levels of motivation to quit (Ladder score, respectively, 5.5 vs. 5.1, p=0.03, 95% CI for difference 0.03, 0.8). CONCLUSIONS: Adult ED smokers exhibit mild-moderate levels of nicotine addiction and interest in quitting. ED-based tobacco control should target all smokers.

Adult↗
PubMed2005

Reasons for dropout from drug abuse treatment: symptoms, personality, and motivation.

Previous research has identified risk factors for early attrition from substance abuse treatment, but has not assessed reasons for dropout from the client's perspective. Interview and self-report assessment data were collected from 24 clients who prematurely terminated outpatient treatment to evaluate their subjective reasons for dropping out and the association of these reasons with demographic and clinical variables. Items from scales indicating problems with client motivation or conflicts with program staff were the most commonly endorsed. The severity of participant's symptoms and logistical problems interfering with appointments were less commonly reported as reasons for dropping out. Demographic, substance abuse, and motivational stage indicators were infrequently associated with subjective reasons for dropout. In contrast, indicators of maladaptive personality functioning were strongly associated with many reasons for dropping out, especially concerns about privacy and boundary issues within the program. Results from this preliminary evaluation will guide the development of an instrument and intervention focused on dropout risk factors and treatment reengagement.

Adult↗
PubMed2005

Recent drinking consequences, motivation to change, and changes in alcohol consumption over a three month period.

Little is known about what type of drinking related consequences may enhance motivation to change or may hinder behavior change over time. In order to examine this research question, 120 adult participants abusing alcohol were administered the Drinker Inventory of Consequences-Recent (DrInC-R), the Brief Readiness to Change Questionnaire (BRTC), and the Steady Pattern Chart (SP). Subscale scores from the DrInC-R and the BRTC; and alcohol consumption as assessed by the SP at baseline and three month follow-up were retained for data analyses. Greater intrapersonal DrInC-R consequences scores significantly predicted greater contemplation stage scores (R2=.37, p<.001), and lower precontemplation stage scores (R2=.32, p<.001), and DrInC-R impulse control and interpersonal consequences scores significantly predicted alcohol consumption at three month follow-up after controlling for baseline consumption (R2=.50, p<.001). Increased awareness of intrapersonal drinking related consequences may motivate change, whereas numbers of impulse control and interpersonal consequences may predict changes in drinking behavior over the short-term.

Adolescent↗
PubMed2006

Evaluating a method of assessing competence in Motivational Interviewing: a study using simulated patients in the United Kingdom.

In this evaluation of a method of assessing competence in Motivational Interviewing (MI), participants were asked to interview an actor simulating a substance abuser who was ambivalent about an important issue. The interviews were videotaped and subsequently rated for competence in MI using the Motivational Interviewing Treatment Integrity code (MITI). Ratings of 43 interviews made independently by trained judges found high levels of inter-rater agreement. Ratings of 11 pairs of interviews carried out by the same interviewer with different simulated patients, a mean of 26days apart, resembled each other closely. Participants who had been trained in MI were significantly more competent than others. There was a significant association between researchers' and patients' ratings of the extent to which the interviewer demonstrated the spirit of MI. These findings imply that the assessment method produces reasonably reliable and valid ratings of competence in MI and can be used for both clinical and research purposes.

Adult↗
PubMed2005

Early social and physical deprivation leads to reduced social motivation in adulthood in Wistar rats.

Behavioural abnormalities in adulthood may have their origin in a disturbed interaction with the environment during postnatal development. We tested the consequences for adult social motivation of early deprivation (ED) of rat pups from mothers and littermates relative to nonhandled (NH) pups. Early deprivation was performed at room or warm ambient temperatures, cold-ED and warm-ED, respectively, and during either the dark or light phase of the daily cycle. In adulthood, rats that were unrelated and unfamiliar but of the same treatment group were introduced in pairs to an open field for a 30-min test. Social behaviour in home base and exploration modes was assessed using algorithmic analysis of the XY locations of the two rats. Findings revealed that Cold-ED induced a preference for a separate home base, which limited significantly the episodes of social interactions, in comparison to NH. Warm-ED had no comparable effect on the rats' social behaviour. These findings indicate that ED under ambient conditions that constitute severe thermal stress for rat pups leads to development of reduced social motivation in adulthood.

Analysis of Variance↗
PubMed2004

Relative levels of motivation and asymmetries of viewing and detour task in guppies (Poecilia reticulata).

Cerebral lateralisation once thought to be confined to humans has been reported for a range of vertebrate species now. We report here biases in visual perceptual processing in a teleost fish. Female guppy fish used the right eye preferentially to view a familiar stimulus. This bias reversed on being presented with a strange female guppy, the left eye being used more to view it. This pattern of viewing is probably associated with the right eye system, which is used to view a stimulus with an intention to approach it. The increase in the left eye use, to view a stranger may be associated with the role of the left eye in comparing the features of a strange conspecific. In the second experiment, lateralisation of viewing visual stimuli that could evoke different levels of motivation to biologically relevant stimuli was tested. It is known that female guppies prefer to approach orange coloured males. Lateralisation of detour response as well as eye use after detour to view a dull or an orange male stimulus was recorded in deprived female fish. There was a bias to detour to the left side; which was more significant for the orange than the dull male. Once the female guppies detoured the cage they preferentially used the left eye to view the male conspecific; this being significant for the deeply orange male. Thus, colouration of males evoking different levels motivation can be used to measure lateralisation in guppies.

Animals↗
PubMed2005

The effect of REM sleep deprivation on motivation for food reward.

Prolonged sleep deprivation in rats produces a characteristic syndrome consisting of an increase in food intake yet a decrease in weight. Moreover, the increase in food intake generally precedes the weight loss, suggesting that sleep deprivation may affect appetitive behaviors. Using the multiple platform method to produce rapid eye movement (REM) sleep deprivation, we investigated the effect of REM sleep deprivation (REMSD) on motivation for food reward utilizing food-reinforced operant tasks. In acquisition or maintenance of an operant task, REM sleep-deprived rats, with or without simultaneous food restriction, decreased responding for sucrose pellet reward in comparison to controls, despite the fact that all REM sleep-deprived rats lost weight. Furthermore, the overall response deficit of the REM sleep-deprived rats was due to a within-session decline in responding. REM sleep-deprived rats showed evidence of understanding the contingency of the task comparable to controls throughout deprivation period, suggesting that the decrements in responding were not primarily related to deficits in learning or memory. Rather, REM sleep deprivation appears to alter systems involved in motivational processes, reward, and/or attention.

Animals↗
PubMed2005

Rat ultrasonic vocalization in aversively motivated situations and the role of individual differences in anxiety-related behavior.

Our previous work has shown that male Wistar rats, although identical in breeder, age and housing conditions, can differ systematically in their anxiety-related behavior as measured in the elevated plus-maze. Since such individual dispositions can affect the responsiveness in other aversively motivated situations, we asked in a 1st experiment whether such rats might also differ in a test of conditioned fear. Based on their levels of spontaneous open arm avoidance in the elevated plus-maze, 20 adult male Wistar rats were divided into those with "high open arm" (HOA) versus "low open arm" (LOA) time. These rats were then tested in a standard fear conditioning paradigm. During the conditioning procedure, they received 6 tone (3 kHz, 20 s) and shock (0.5 mA, 0.5 s) pairings, each followed by a 60 s inter-stimulus interval. Conditioned responses to the tone were tested 24 h thereafter. During both days, freezing behavior and ultrasonic vocalization were measured. Differences in ultrasonic vocalization between HOA and LOA rats were detected during the conditioning day, where vocalization was more likely in LOA rats. Furthermore, LOA rats emitted calls with higher frequency components than HOA rats. On the subsequent day of testing, the number of animals vocalizing, and the rate of vocalization was decreased, and call differences between groups were no longer detectable. In freezing, differences between HOA and LOA rats were observed on the conditioning day, where LOA rats showed more freezing behavior during the tone/shock intervals. Also, on the test day, they showed more freezing behavior during the tone intervals compared to HOA rats. These results indicate that acute and conditioned responses of rats in a conventional fear conditioning paradigm can depend on individual dispositions of anxiety-related behavior as measured with the elevated plus-maze. In a 2nd experiment, we asked whether exposure to an elevated plus-maze would lead to ultrasonic vocalization, which we tested in rats which had been handled or non-handled prior to testing. Most importantly, we found that none of the animals displayed any vocalization in the plus-maze, neither during a 1st nor a repeated test 1 day later. These data are discussed with respect to the presumed role of ultrasonic vocalization in aversively motivated situations, and the mechanisms, which may account for the behavioral differences between HOA and LOA rats in such tests.

Analysis of Variance↗
PubMed2006

Affective-motivational influences on feedback-related ERPs in a gambling task.

Theories have proposed that both the stimulus-preceding negativity (SPN) and the medial frontal negativity (MFN) reflect affective/motivational processing. We examined the effect of the motivational impact of feedback stimuli on these ERPs using a simple gambling task, focusing on the influence of prior losses and gains on ERPs and choice behavior. Choices were riskier following large losses than following small losses or large gains. The MFN, however, was larger following larger gains. The SPN preceding the outcome was also larger after a greater gain. Thus, we confirmed that both the MFN and the SPN respond to the motivational properties of the feedback. A dissociation between risk-taking behavior and these ERPs suggests that there could be two monitoring systems: one that leads to riskier responses following losses and a second that leads to heightened expectancy.

Adult↗
PubMed2005

Motivating forces of human actions. Neuroimaging reward and social interaction.

In neuroeconomics, reward and social interaction are central concepts to understand what motivates human behaviour. Both concepts are investigated in humans using neuroimaging methods. In this paper, we provide an overview about these results and discuss their relevance for economic behaviour. For reward it has been shown that a system exists in humans that is involved in predicting rewards and thus guides behaviour, involving a circuit including the striatum, the orbitofrontal cortex and the amygdala. Recent studies on social interaction revealed a mentalizing system representing the mental states of others. A central part of this system is the medial prefrontal cortex, in particular the anterior paracingulate cortex. The reward as well as the mentalizing system is engaged in economic decision-making. We will discuss implications of this study for neuromarketing as well as general implications of these results that may help to provide deeper insights into the motivating forces of human behaviour.

Decision Making↗
PubMed2005

[Radiation oncology training in France: demography, analysis of motivations of the young specialists, evaluation of the training].

During the 5 past national courses organised by the French society of radiation oncology (SFRO), three different types of survey were performed to analyse demography, motivations and quality of training of the young specialists. During the 5 past years, 50 radiation oncologists were training for the whole country (about 15 per year were graduated). A recent increase the number of young specialists is observed with a total number of 50 in 2000 to 75 in 2005. Nevertheless, the number of young specialists is dramatically insufficient and exposes for the future to an important demographic crisis. Analysis of motivations of choice for radiation oncology confirms the influence of a practical stage of oncology during the second cycle of the medical studies for 60% of the young specialists. Analysis of practical and theoretical training was performed according to the point of view and living experiences of the students. On the other hand, informations from teachers were less complete. Some needs are emphased as: 1) the quality of the follow during the training (importance of the recent implementation of a logbook); 2) importance of theoretical and practical training at the radiotherapy department; 3) help and incentive for research and scientific publication.

Demography↗
PubMed2004

The transtheoretical model and motivational interviewing in the treatment of eating and weight disorders.

The transtheoretical stages of change model suffers from conceptual and empirical limitations, including problems of stage definition, measurement, and discreteness. Sequential transition across stages has not been established. The model lacks strong predictive utility, and there is little evidence that therapeutic interventions must be matched to stage to facilitate change. Initial tests applying the model to weight and eating disorders have been negative. Although the model is frequently associated with motivational interviewing (MI), no theory links the two. MI should be evaluated independently as a treatment for weight and eating disorders, to be used either alone or prior to treatments not explicitly addressing motivation. The conceptual compatibility and procedural overlap between cognitive behavioral therapy (CBT) and MI are analyzed.

Cognitive Behavioral Therapy↗