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PubMed2003

'Grasp life again'. A qualitative study of the motive power in myocardial infarction patients.

Myocardial infarction is the most common cause of death in Sweden today and is responsible for approximately 30% of all deaths. The aim of this study was to obtain increased knowledge and understanding of what motive power is and how it affects the individual's rehabilitation and return to a functioning daily life. Thirteen patients, six females and seven males, who had experienced a myocardial infarction, aged between 39 and 72 years and with a minimum interval from myocardial infarction diagnosis of at least 12 months, were interviewed. Grounded theory was the method used for data collection and analysis, since the method is focusing on social processes and interaction. The analysis process identified motive power as a core category: zest for life. The participants expressed a desire and a longing to continue living. The participants' experiences of their disease as well as being discharged from hospital forced them to reorientation. Autonomy, the individual's own active decision-making, plays a significant role in this zest for life. Care for was identified as the support base for zest for life. As health-care professionals we must, at a very early stage on the ward, form an idea of what kind of patient we have in front of us.

Activities of Daily Living↗
PubMedDate not supplied

Keeping mammography referral appointments: motivation, health beliefs, and access barriers experienced by older minority women.

Older women of color tend to have much lower rates of regular mammography screening for breast cancer than younger Caucasian women; yet, they have higher rates of mortality. This study was designed to increase mammography rates among inner-city women aged 50 years or older. Another goal was to investigate differences in mammography utilization related to race/ethnicity and language after barriers associated with cost and the difficulty of making an appointment are removed. A peer delivered intervention, which consisted of interview, mammography referral, and the scheduling of a next-day appointment, was conducted among a convenience sample of 151 culturally and racially diverse older women through a primary care referral project operating within an urban emergency department (ED). A brief motivational interview and mammography referral at the time of an ED visit, including scheduling of a next-day no cost appointment, was followed by a cross-sectional telephone survey of utilization and motivating and hindering factors. Follow-up was achieved with 96 women (66%). Fifty-eight women (60%) had a post-intervention mammogram; of those, 69% were first time users. More than 90% planned a repeat mammogram the following year. Of the 27 who did not receive a mammogram, 21 (77%) requested a "second try" appointment. These findings demonstrate that an interactive intervention among older women of color has the potential to dramatically increase mammography rates.

Black or African American↗
PubMed2006

Abnormal function of the brain system supporting motivated attention in medicated patients with schizophrenia: an fMRI study.

BACKGROUND: Patients with schizophrenia have an impaired ability to generate activity that is appropriate to current circumstances and goals. METHOD: We report a study using functional magnetic resonance imaging (fMRI) to examine cerebral activity during a three-tone auditory oddball target detection task in a sample of 28 patients with schizophrenia and 28 healthy controls. RESULTS: The patients exhibited significantly less activation in response to target stimuli relative to baseline in an extensive set of sites in association neocortex, paralimbic cortex, limbic structures and subcortical nuclei, yet demonstrated a normal level of activation in the sensorimotor cortex. Comparison of activity elicited by rare target stimuli with that elicited by equally rare novel stimuli makes it possible to distinguish cerebral activity associated with attention to behaviourally salient stimuli from activity associated with attending to other attention-capturing stimuli. This comparison revealed that the patients with schizophrenia also exhibited a deficit in activation of basal forebrain areas that mediate motivation during the processing of behaviourally salient stimuli, including the amygdala, ventral striatum, orbital frontal cortex and rostral anterior cingulate cortex. CONCLUSION: Patients with schizophrenia have a deficit in function of the brain system concerned with mediating motivation, in addition to a more general deficit in the cerebral response to attention-captivating stimuli.

Acoustic Stimulation↗
PubMed2002

Motivational versus volitional mediation of passivity in institutionalized older people.

The relationship between perceived loss of control and passivity in social activities in a non-handicapped institutionalized elderly population was assessed. Perceived loss of control was assessed from three different types of expectancies: low action-outcome expectancies, high situation-outcome expectancies, and low efficacy expectancies. Passivity scores were reported by the staff. The effect of these three types of expectancies on passivity was analyzed in terms of motivation and volition, which were treated as mediating variables. Overall analysis of the structural equations, as well as partial hierarchical regression analyses, showed that efficacy expectancies were good predictors of passivity, but this was not the case for the action-outcome and situation-outcome expectancies. These results lend more support to a volitional rather than to a motivational interpretation of the effect of control on passivity. The implications of these results for intervention and for a differentiated conception of expectancies are discussed.

Aged↗
PubMed2006

Motivational processes and autonomic responsivity in Asperger's disorder: evidence from the Iowa Gambling Task.

Asperger's disorder (ASP), like other autism spectrum disorders, is associated with altered responsiveness to social stimuli. This study investigated learning and responsiveness to nonsocial, but motivational, stimuli in ASP. We examined choice behavior and galvanic skin conductance responses (SCRs) during the Iowa Gambling Task (IGT; Bechara et al., 1994) in 15 adolescents and young adults with ASP and 14 comparison subjects. We examined aspects of learning, attention to wins and losses, and response style with a formal cognitive model, the Expectancy-Valence Learning model (Busemeyer & Stout, 2002). The ASP group did not differ from the comparison group in proportions of selections from advantageous decks. However, ASP participants showed a distinct pattern of selection characterized by frequent shifts between the four IGT decks, whereas comparison participants developed clear deck preferences. SCR results showed some evidence of reduced responsiveness in the ASP group during the IGT. Results from the cognitive model indicated that, in contrast to the comparison group, the ASP group's selections were less consistent with the motivational significance they assigned to decks. Findings are discussed in the context of the neurobiological substrates associated with IGT performance.

Adolescent↗
PubMed2001

Ward atmosphere, client satisfaction, and client motivation in a psychiatric work rehabilitation unit.

This study investigated the ward atmosphere of a psychiatric work rehabilitation unit and its relationships to clients' satisfaction with the unit and client motivation, operationalised as proneness to set personal goals for their rehabilitation. The Community-oriented Programs Environment Scale was used and 52 clients participated. Their report of the ward atmosphere was in accordance with recommended levels on 5 sub-scales out of 10. A regression analysis revealed that optimal levels of order-and-organization and support were of importance for satisfaction with the unit. An optimal level of support was associated with a high rating of personal goals. This study added two therapeutically interesting factors-satisfaction and motivation-to the flora of factors that have been related to perceptions of the ward atmosphere.

Adult↗
PubMed2002

Exploring college student gambling motivation.

The present research combined qualitative and quantitative approaches in examining gambling motives among college student gamblers. A comprehensive set of 16 gambling motives was identified by categorizing 762 open-ended reasons for gambling, provided by 184 college student gamblers. Results revealed that most college students gamble to win money, for fun, for social reasons, for excitement, or just to have something to do. Overall, the results suggest the need for an eclectic biopsychosocial approach with regard to etiology of college student gambling.

Adult↗
PubMed1999

Relations of age to cognitive and motivational elements of impulse control in boys with and without externalizing behavior problems.

In a cross-sectional study of 83 unmedicated boys, 6 to 16 years of age (M = 10.6, SD = 2.1), attending public (N = 48) and therapeutic schools for behaviorally disturbed children (N = 35), we examined relations of externalizing psychopathology to age-dependent change in performance on cognitive and motivational dimensions of impulse control assessed by laboratory tasks. When we controlled for internalizing symptoms and IQ or school achievement, all children showed improving competence with increasing age on both dimensions over the age range of the sample. Children with externalizing problems performed more poorly on both dimensions at all ages than children without such problems. Comparing age-dependent competence for the two groups, a model of convergent maturation in cognitive aspects of impulse control, and a model depicting a stable deficit in motivational aspects of impulse control in those children with externalizing behavior problems, relative to those without such problems, emerged. Studies of individual growth in impulse control, together with correlates of growth, are needed to validate these observations.

Adolescent↗
PubMed2003

Analysis of cyclic adenosine-3',5'-monophosphate levels in structures of the "informational" and "motivational" systems of the rat brain during acquisition of a conditioned active avoidance reaction.

Cyclic adenosine-3'5'-monophosphate (cAMP) levels in structures of the "informational" and "motivational" systems of the brain were measured during acquisition of a conditioned two-sided active avoidance reflex in rats. cAMP levels were measured in three groups of animals--intact animals, trained animals, and an active control group (given uncombined presentations of the conditioned (light) and unconditioned (electric shock) stimuli)--immediately after reproduction of the acquired reflex. Significant accumulation of cAMP levels in brain structures was seen in animals of the active control group in the hypothalamus and in trained animals in the left and right hippocampus and the right frontal cortex. Positive correlations were found between cAMP levels in symmetrical parts of the frontal cortex, amygdala, and hypothalamus in animals of all study groups. In addition, active control rats and trained rats showed interhemisphere and intrahemisphere correlations between cAMP levels in brain macrostructure, whose patterns were specific for each group. The pattern of correlations observed here is assessed from the point of view of the role of the "informational" and "motivational" structures in the organization of adaptive behavior.

Amygdala↗
PubMed2003

A pilot study comparing motivational interviewing and an educational intervention in patients with schizophrenia and alcohol use disorders.

Thirty subjects with comorbid schizophrenia and alcohol use disorders were randomly assigned to receive either a Motivational Interviewing (MI) or Educational Treatment (ET) intervention with treatment goals of abstinence and/or decreased alcohol use. Subjects were followed up at 4, 8 and 24-weeks upon completion of the interventions. Outcome measures included number of drinking days, abstinence rates, average blood alcohol concentration and standard ethanol content per drinking day. Subjects randomized to the MI intervention had a significant reduction in drinking days and an increase in abstinence rates when compared to subjects receiving ET. Motivational Interviewing may be a useful treatment intervention for individuals with schizophrenia and alcoholism.

Adult↗
PubMedDate not supplied

The development of the scientific ideas of I. P. Pavlov on the goal reflex in studies of the mechanisms of biological motivation.

Data obtained in experimental studies developing I. P. Pavlov's concept of the "goal reflex" are presented. It is shown that purposive behavior in the systems organization of behavioral acts is constructed by the dominant motivation. This article discusses mechanisms determining the energy of biological motivations and their controlling component--the results of action acceptor. The role of reinforcement in the mechanisms forming molecular engrams of behavior on structures of the results of action acceptor is assessed.

Animals↗
PubMed2004

New age eunuchs: motivation and rationale for voluntary castration.

We used a survey posted on the Internet to explore the motivation of men who are interested in being castrated. Out of 134 respondents, 23 (17%) reported already having been castrated. The 104 (78%) individuals who said they had not been castrated were asked why they wanted to be castrated and why they had not actualized that desire. They were given multiple-choice answers to select from. The major reason (selected by 40% of respondents) for desiring castration was to achieve a "eunuch calm" and freedom from sexual urges; however, a large proportion (approximately 30%) of respondents found fantasies about being castrated sexually exciting and a similar percentage desired castration for the "cosmetic" appearance it achieved (which we interpret to mean scrotal removal along with an orchiectomy). This high interest in castration as either a sexual stimulus (a fetish) or a cosmetic enhancement was unexpected and contrasted with the more classically stated motivation for voluntary castration in the psychiatric literature, i.e., libido control and transsexualism. Internet discussion groups that serve these men may encourage them to act out their castration fantasies. Alternately, Internet discussions may give them a displacement outlet for their fantasies and decrease the risk of castration by nonmedically qualified "street-cutters" or by self-mutilation. Forty percent of our respondents claimed that they would have an orchiectomy, if it were cheap, safe, and simple. A quarter wanted to try chemical castration first, but 40% were embarrassed to talk to their doctors about their interest in castration. Information now available on the Internet provides these men with increasingly easy access to street-cutters and directions on how to perform surgical castrations, putting them at risk of permanent injury and disability. Physicians need to be aware of these risks.

Adult↗
PubMed2002

Motivational interviewing among psychiatric in-patients with substance use disorders.

OBJECTIVE: There were three aims of the present study: 1) to document patterns of substance misuse among psychiatric in-patients with comorbid alcohol and other drug (AOD) use; 2) to examine associations among psychiatric and substance use diagnoses and readiness to change; and 3) to evaluate the effectiveness of an opportunistic motivational interview on engagement in a Specialist Substance Misuse Service (SSMS). METHOD: One hundred and sixty subjects were randomly assigned to receive either a motivational interview or no intervention. RESULTS: Overall, 66.3% of subjects met intervention threshold for cannabis, 60.6% for alcohol and 22.5% for amphetamines. There was a bimodal distribution of stage of change for cannabis use which was associated with age, with precontemplation being associated with older age and less frequent use. Attendance at the SSMS was low and unrelated to intervention status. CONCLUSION: A different approach to treatment is recommended, including early intervention among cannabis users.

Adolescent↗
PubMed1998

Young children use motive information to make trait inferences.

The present study investigates children's capacity to understand traits in a psychologically meaningful way. Participants included 18 individuals in each of 4 age groups: kindergarten (ages 5-6), 2nd grade (ages 7-8), 5th grade (ages 10-11), and adult. They heard a series of 6 short stories in which a main character performs an action based on a particular motive (positive, negative, or incidental) that results in either a positive or a negative emotional consequence for another character. Participants evaluated each main character and predicted the character's behavior and mental states in different social contexts. Participants in all age groups, even the 5- to 6-year-olds, made trait inferences that were influenced by motive information. These results provide evidence that young children are capable of more sophisticated reasoning about traits than has been suggested previously.

Age Factors↗
PubMed1992

Pseudomemory in hypnotized and task-motivated subjects.

Highly hypnotizable hypnotized (H; n = 16) and task-motivated (TM; n = 13) subjects received pseudomemory suggestions (see Orne, 1979). TM subjects reported being more awake and motivated than did H subjects and were more likely to pass the target noise suggestion. However, 69% of subjects in both conditions who passed the noise suggestion reported pseudomemories. Pseudomemory rate (for H subjects, 69% and for TM subjects, 46%) was not reduced by informing subjects that they could distinguish reality and fantasy in a state of deep concentration. At final inquiry, after deep concentration, pseudomemories remained stable (for H subjects, 75% and for TM subjects, 54%). As predicted, H subjects reported more unsuggested noises and more pseudomemories of novel noises than did TM subjects. Subjects who reported pseudomemories were more confident in the accuracy of their memories than were subjects who reported that the suggested noises were imagined.

Adult↗
PubMed1991

Evaluation of intrinsic and extrinsic motivation interventions with a self-help smoking cessation program.

Personalized feedback and a financial incentive, developed from an intrinsic/extrinsic motivation framework, were evaluated as adjuncts to self-help materials for smoking cessation. Ss (N = 1,217) were randomized to 4 treatment groups and were followed up at 3 and 12 months. Consistent with hypotheses derived from the motivation framework, the financial incentive increased the use of self-help materials, did not increase cessation rates among program users, and was associated with higher relapse rates among those who did manage to quit. The personalized feedback increased both smoking cessation and use of the materials 3 months after distribution of the materials. Continuous abstinence (abstinence at 3 and 12 months) in the group that received the personalized feedback alone was twice the rate of the other groups.

Adult↗
PubMed2001

Motivational interviewing with cocaine-dependent patients: a pilot study.

A brief motivational interviewing (MI) intervention was evaluated within the context of an outpatient, cocaine-detoxification program. MI was hypothesized to assist patients in completing the detoxification program and to improve outcomes during subsequent treatment. Participants (N = 105) were randomly assigned to MI or to detox-only conditions. Results indicated that although participants completed the detoxification program at equal rates, completers who received MI increased use of behavioral coping strategies and had fewer cocaine-positive urine samples on beginning the primary treatment. MI patients with lower initial motivation were more likely to complete detoxification.

Adult↗
PubMed1975

Individual differences in game motivation as moderators of preprogrammed strategy effects in prisoner's dilemma.

The impact of three programmed strategies (tit-for-tat, 100% cooperation, and 100% defection) on cooperation level in the Prisoner's Dilemma game is examined as a function of the subject's motivational orientation (cooperative, competitive, or individualistic). Motivational orientation was assessed on the basis of each subject's choices across four classes of decomposed games. Following this assessment, subject's played 30 trials of Prisoner's dilemma in matrix form against one of the above-mentioned strategies. Results were wholly consistent with predictions, showing that (a) cooperatively oriented subjects cooperate with a tit-for-tat and a 100% cooperative strategy, but defect against a 100% defecting strategy, (b) competitive subjects defect against all three strategies; and (c) individualistic subjects defect against both 100% cooperative and 100% defective strategies, but they cooperate with a tit-for-tat strategy. It appears reasonable to conclude that the outcomes of a Prisoner's Dilemma have affectively different meaning (i.e., values) for subjects of differing orientations, and that subjects of all three orientations adopt strategies that effectively maximize their particular type of reward in the game.

Adolescent↗