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Introduction: Students' peer relatedness is vital to their academic achievement and engagement. However, little is known about the mechanisms that can explain such a link in health professions education, especially in interprofessional education (IPE), where interprofessional socialization is promoted. To address the research gap in understanding the social dynamics embedded within IPE and their impact on crucial motivational outcomes, this study examines how peer relatedness (belonging) mediates the link between motivation (both intrinsic and extrinsic) and engagement in IPE. Methods: Data from 841 students enrolled in IPE from Medicine, Nursing, Social Work, Chinese Medicine, Pharmacy, Speech and Hearing Sciences, Clinical Psychology, and Food and Nutritional Science from a university in Hong Kong were used in this study. Intrinsic and extrinsic motivation were collected at baseline, while peer relatedness need satisfaction and engagement and disaffection in IPE were assessed after four weeks. We used a fully latent structural equation model to examine whether peer relatedness mediated the link between motivation and engagement in IPE. Results: Our results indicate that intrinsic motivation at baseline significantly increases engagement and reduces disaffection four weeks later, while extrinsic motivation shows the opposite effect. Crucially, the adaptive role of motivation to engagement was significantly mediated by relatedness from IPE teams. Specifically, the effect of students' motivation on their engagement/disaffection in IPE can be partially explained by their relatedness within IPE teams. Conclusion: This study underscores the importance of peer relatedness in IPE, highlighting its role in harnessing student motivation to foster student engagement. The findings contribute to a deeper understanding of the psychosocial mechanisms in IPE and highlight the value of collaborative learning environments in fulfilling students' need for relatedness, thereby fostering adaptive IPE learning outcomes. The implications and limitations of the study are also discussed. [ABSTRACT FROM AUTHOR]

While physician empathy is a vital ingredient in both physician wellness and quality of patient care, consensus on its origins, and how to cultivate it, is still lacking. The present study examines this issue in a new and innovative way, through the lens of self-determination theory. Using survey methodology, we collected data from N = 177 (44%) students at a Canadian medical school. We then used a person-centered approach (cluster analysis) to identify medical student profiles of self-determination (based on trait autonomy and perceived competence in learning) and how the learning environment impacted empathy for those in each profile. When the learning environment was more autonomy-supportive, students experienced higher satisfaction and lower frustration of their basic psychological needs in medical school, as well as greater empathy towards patients. The translation into increased empathy, however, was only evident among the students with higher self-determination at baseline. Results from this study suggest that autonomy-supportive learning environments will generally support medical students' psychological needs for optimal motivation and well-being, but whether or not they lead to empathy towards patients will depend on individual differences in self-determination. Findings and their implications are discussed in terms of developing theory-driven approaches to cultivating empathy in medical education. [ABSTRACT FROM AUTHOR]

Research on the impostor phenomenon (IP) is rapidly growing in medical education due to its relationship with distress and burnout. How IP is theoretically conceptualized and analyzed has been inconsistent, however, which limits our understanding of results and how to act on them. We hypothesized that a person-centered analysis, in combination with a robust theoretical framework, would provide a more specific 'profile' of medical student IP and help to optimize supports for their well-being. We used exploratory factor analysis to assess the factor structure of the Clance Impostor Phenomenon Scale (CIPS) in medical students, followed by cluster analysis to identify distinct 'impostor' profiles, based on the identified factors. We then used self-determination theory's (SDT) framework of motivation to explore how students in each profile differed in their general causality orientation, autonomous motivation towards going to medical school, and psychological need satisfaction in the medical program – factors that SDT identifies as predictors of engagement, performance, and well-being. Factor analysis yielded three main IP factors – feeling like a fake, attributing success to luck, and discounting achievement – in line with Clance's original definition of IP. The cluster analysis then identified four distinct IP profiles based on individual differences in these factors, each varying in aspects of their self-determination. This study sheds light on the ways that medical students may experience IP, further reinforcing the notion that not all 'impostors' are created equal. Findings support the three-factor structure of the CIPS among medical students, and that most students will fall into one of four IP profiles. These profiles and their implications are discussed. [ABSTRACT FROM AUTHOR]

The purposes of this study were to (i) describe the lived experiences of participating in a Singaporean vocational rehabilitation (VR) program among individuals with stroke and spinal cord injury and (ii) identify salient features of the program that facilitated their return-to-work process. This was a qualitative phenomenological study. Participants were invited to complete an interview about their return-to-work process after acquiring a disability vis-à-vis their participation in a local VR program. The qualitative data were analyzed inductively. Twenty-four middle-aged participants with a stroke or spinal cord injury completed the interviews. The participants' experiences with the local VR program were largely positive. Several key features of the VR program were identified. These were: (i) providing a multi-disciplinary and individualized program; (ii) building positive collaborations between service providers and participants; and (iii) supporting personal growth among participants. The Singaporean VR program demonstrated internationally recommended best practices. These best practices were beneficial for the participants' return-to-work process, as reflected by their positive feedback about the program. Our study emphasizes the need for comprehensive and evidence-based VR programs to meet the complex needs of individuals with disabilities who want to return to work. Multi- or inter-disciplinary care services are needed in vocational rehabilitation (VR) programs to support the complex return-to-work process of clients. VR programs should have the capacity to provide client-centered care as their clients may experience diverse, yet unique challenges during their return-to-work process VR service providers play a crucial role in engaging and motivating their clients throughout the program to achieve their return-to-work goals VR service providers should address concurrent or future concerns that could impact on their clients' ability to return to or remain at work. [ABSTRACT FROM AUTHOR]

Introduction: Academic motivation (AM), motivation in relation to formal studies that as a construct of the self-determination theory (SDT), is frequently assessed by the Academic Motivation Scale (AMS). However, the scoring of AMS in itself is not fully consistent with the SDT theory as only scores of the subscales can be calculated resulting in seven different score means instead of positioning the individual on the self-determination continuum. There have been few attempts at a person-centered approach to AMS scoring, especially among medical students. Our study aimed to find distinct academic motivation profiles and demonstrate their concurrent criterion validity with mental health variables (psychological distress, life satisfaction) among medical students. Methods: The AMS-28 college version, the General Health Questionnaire (GHQ-12), and the Single-Item Measure of Life Satisfaction were administered among medical freshmen. Academic motivation profiles were generated by two methods: 1) two-step cluster analysis, and 2) quantile analysis. Results: The sample consisted of 189 participants (mean age = 19.38 ± 2.03 years, 72% females). The cluster analyses revealed three fairly distinct profiles of self-determination: 'High' (n = 59; mean im = 5.48 ± 0.60; mean em = 6.07 ± 0.41; mean am = 1.57 ± 0.95), 'Moderate' (n = 111; mean im = 4.5 ± 1.06; mean em = 4.41 ± 0.87; mean am = 1.25 ± 0.36), and 'Low' (n = 19; mean im = 4.22 ± 1.02; mean em = 4.03 ± 1.16; mean am = 3.07 ± 1.30). The creation of deciles allowed the identification of those who were most intrinsically (n = 14, 7.4%), extrinsically (n = 10, 5.3%), and least motivated (amotivated) (n = 18, 9.5%). 'Low' self-determination/amotivation was associated with increased psychological distress and decreased life satisfaction. Conclusion: Our results provide means to position medical students on the SDT continuum based on 'Low', 'Moderate', or 'High' levels of self-determination toward their studies. These AM profiles predict the mental health of medical freshmen, which supports the validity of the outcomes and highlight the risks of amotivation for psychological morbidity. The limitations and implications are discussed. [ABSTRACT FROM AUTHOR]

Theory: Impostor phenomenon (IP) refers to people's feelings of intellectual fraudulence and fear of being "discovered," despite contradicting evidence of success. Due to its association with burnout and distress, it is progressively being studied in medicine. While various explanations for IP have been discussed in the literature, the role of motivation has largely been neglected. Hypotheses: Using self-determination theory (SDT) as a lens, it was hypothesized that different general causality orientations (impersonal, control, autonomy), domain-specific types of motivation (autonomous vs. controlled) toward going to medical school, and levels of satisfaction of basic psychological needs (autonomy, competence, relatedness) in the medical program, would each predict severity of IP symptoms. Method: A total of 1,450 medical students from three Canadian institutions were invited to complete a survey containing the Clance Impostor Phenomenon Scale and scales derived from SDT's mini theories: basic psychological needs theory, causality orientations theory, and organismic integration theory. We explored the prevalence of IP among the students and used regression to capture variable relationships, accounting for gender effects. Results: Data from 277 (19.1%) students were assessed, 73% of whom reported moderate or worse IP symptoms. Having an impersonal general causality orientation, more controlled motivation toward going to medical school, and lower need satisfaction in the medical program, each related to increased IP severity. Together, these motivational factors accounted for 30.3%, 13.6%, and 21.8% of the variance in students' IP severity, respectively. Conclusions: Findings from this study suggest that students who are more self-determined (both in general and in medical school), and whose basic psychological needs are more supported in their medical program, will experience less frequent and severe IP symptoms. Preliminary explanations and implications of these findings are discussed within the medical education context. [ABSTRACT FROM AUTHOR]

Objective: The purpose of the current study was to examine the relationship between the level of perceived support for the basic psychological needs of autonomy, competence, and relatedness and satisfaction with health and quality of life among undergraduate college students with disabilities. Method: 286 postsecondary students with disabilities were surveyed in the spring of 2019. Cross-sectional data was analyzed to assess the relationship between students' perceived support for their basic psychological needs and their satisfaction with health and quality of life. Results: Results of the analyses revealed that perceived support for the basic psychological needs of autonomy, competence, and relatedness statistically significantly predicted satisfaction with health and quality of life. Conclusions: The results of this study provide key insights into the nature of the relationship between support for malleable psychosocial factors within the college context and student satisfaction with their health and quality of life in the college context. [ABSTRACT FROM AUTHOR]

Converging global evidence highlights the dire consequences of climate change for human mental health and wellbeing. This paper summarises literature across relevant disciplines to provide a comprehensive narrative review of the multiple pathways through which climate change interacts with mental health and wellbeing. Climate change acts as a risk amplifier by disrupting the conditions known to support good mental health, including socioeconomic, cultural and environmental conditions, and living and working conditions. The disruptive influence of rising global temperatures and extreme weather events, such as experiencing a heatwave or water insecurity, compounds existing stressors experienced by individuals and communities. This has deleterious effects on people's mental health and is particularly acute for those groups already disadvantaged within and across countries. Awareness and experiences of escalating climate threats and climate inaction can generate understandable psychological distress; though strong emotional responses can also motivate climate action. We highlight opportunities to support individuals and communities to cope with and act on climate change. Consideration of the multiple and interconnected pathways of climate impacts and their influence on mental health determinants must inform evidence-based interventions. Appropriate action that centres climate justice can reduce the current and future mental health burden, while simultaneously improving the conditions that nurture wellbeing and equality. The presented evidence adds further weight to the need for decisive climate action by decision makers across all scales. [ABSTRACT FROM AUTHOR]

Motivation may predict return to work (RTW), yet the measurement of motivation needs more scientific evidence. We adopt a dimensional approach, based on the self-determination theory (SDT), distinguishing between amotivation, controlled and autonomous motivation. We seek to explore the presence of these dimensions in sick-disabled patients, and are interested in associations with quality of life, depression, patient's predictions of RTW, and health care provider estimations of patient's motivation. A cross-sectional study in 336 patients was conducted. Motivation was assessed using the Motivation at Work Scale (MAWS) and examined in relation to patient outcomes, patient's prediction of RTW, and health care provider estimations of patients' motivation. A cluster analysis was performed, and differential associations between motivational profiles were explored. Cluster analysis revealed four profiles. Highly controlled profiles were most prevalent, reported poorer mental quality of life, and expected a longer time before RTW, regardless of the level of autonomous motivation. Interestingly, the health care provider's estimation was not related to controlled motivation. Our results show that SDT may help to differentiate people with a work disability regarding their motivation to RTW. Most notably, the devastating consequences of controlled motivation are discussed, and clinical implications are provided. Assessing the different dimensions of motivation in the context of RTW will be a significant advance as the self-report measures appear to be viable tools. Controlled motivation, which indicates that people are motivated to RTW but only because they "have to", has negative consequences yet a high prevalence and should therefore be addressed by the practitioner. Practitioners should keep in mind that employees are motivated by several motives at the same time, with some being more beneficial than others. Controlled motivation can be converted into autonomous (i.e., good quality) motivation by supporting autonomy of the patient, by supporting their relationships with colleagues, managers, and health care providers and by supporting their feeling of competence in the RTW process. [ABSTRACT FROM AUTHOR]

Theory: Medical programs have turned to mindfulness-based initiatives to help reduce student distress and promote healthy coping within the learning environment. However, little attention has been paid to how fulfillment of medical students' basic psychological needs (autonomy, competence, and relatedness) impacts their capacity to be mindful and cope with stress. Self-Determination Theory (SDT) posits that mindfulness facilitates adaptive coping and wellness, in large part because of need fulfillment. Hypotheses: Using SDT as a lens, it is hypothesized that medical students' resilience and, to a greater extent, need fulfillment in medical school, will mediate the relationship between their mindfulness and coping reactions to stress. Method: One-hundred-ninety-seven medical students from the University of Saskatchewan were recruited to participate in this study: 71 first year, 58 second year, and 36 third and fourth year, each. Students completed an anonymous survey, measuring need fulfillment in medical school, mindfulness, resilience, and frequent use of various adaptive and maladaptive coping strategies. We assessed the extent that need fulfillment and resilience mediated the relationship between mindfulness and coping styles. Results: Need satisfaction and resilience fully mediated the relationship between mindfulness and adaptive coping. Conversely, need frustration and resilience partially mediated the relationship between mindfulness and maladaptive coping. Need fulfillment was a stronger mediator than resilience in both coping models. Conclusions: Findings suggest that increased supports for medical students' resilience and basic psychological needs may promote their mindfulness, and in turn, their ability to respond more adaptively and less maladaptively to stressors they face in medical school. [ABSTRACT FROM AUTHOR]

Self-determination theory proposes that the satisfaction of basic psychological needs (competence, autonomy, and relatedness) is essential to psychological well-being. This study aims to explore the acute impact of a mild traumatic brain injury on the perception of need satisfaction as well as to better understand which variables among post-concussion symptoms and mood are associated with the satisfaction of these psychological needs. A total of 179 adults with mild traumatic brain injury were included. The Basic Psychological Needs Satisfaction Scale (BPNS) was completed retrospectively to assess need satisfaction pre-injury and after the injury to assess need satisfaction post-injury. The Rivermead Post Concussion Symptoms Questionnaire as well as the Hospital Anxiety and Depression Scale were also completed post injury. A significant difference between the perception of need satisfaction pre- and post- was found on the total BPNS score, with lower scores on the post-injury evaluation (less satisfaction). Moreover, higher levels of depression and anxiety were associated with less satisfaction. These results suggest that sustaining a mild traumatic brain injury may have a negative impact on the satisfaction of competence, autonomy, and relatedness needs. To conclude, it is recommended that these concepts be included in psychological intervention programs following mild traumatic brain injury. A significant decrease in psychological need satisfaction is highlighted following mild traumatic brain injury. It is recommended that the needs of autonomy, competence, and relatedness in intervention programs following mild traumatic brain injury needs to be addressed. The more mild traumatic brain injury patients are anxious and depressed the more likely it is that they will present a diminished satisfaction of needs, expressed by a lower level of perception of their autonomy, competence, and relatedness. Thus, integrative intervention for anxiety as well as depression following mild traumatic brain injury is also recommended. [ABSTRACT FROM AUTHOR]

Medical student distress is an increasing concern in medical education. Addressing this issue requires a comprehensive understanding of what factors influence learners' stress in medical school. Grounded in Self-Determination Theory (SDT), this study explores the relative association between medical students' mindfulness, resilience, basic psychological needs, and perceived stress. Materials and methods: Of all year 1–4 medical students at our institution, 197 (49%) completed an online survey, measuring satisfaction and frustration of their basic psychological needs (autonomy, competence, relatedness), mindfulness, resilience, and perceived stress. Variables were assessed in relation to perceived stress, controlling for students' gender and year. Higher mindfulness, resilience, and need satisfaction were associated with lower perceived stress. Conversely, need frustration was associated with higher perceived stress. When students' need frustration was included in the model, the association between mindfulness, resilience, and perceived stress weakened. Third years reported more autonomy frustration than all other years. Compared to males, females in second and fourth year reported higher stress, lower mindfulness and resilience, and less competence fulfilment. Findings of this study suggest that, while mindfulness and resilience are important qualities for medical student well-being, their stress-protective benefits may diminish when students' basic psychological needs are frustrated in medical school. Addressing potentially need-thwarting aspects of the learning environment is therefore recommended, to help reduce student stress and promote their well-being. Preliminary suggestions on how this might be achieved are discussed, from an SDT perspective. [ABSTRACT FROM AUTHOR]

Purpose: With the growing attention in pediatric rehabilitation services for supporting self-management, the need increases for more shared understanding of the concept. The aim of this study was to explore parent activation, associated factors of- and underlying perceptions on parental self-management of parents of children with chronic conditions. Materials and methods: Using a mixed-methods strategy, first variations in self-management behaviors, motivation and perceived autonomy support were assessed with a cross-sectional survey among parents of children with chronic conditions (N = 239). Statistical analysis involved descriptive statistics and univariate analysis of variance. The survey was followed by 18 in-depth interviews with parents. Thematic analysis was used to recognize relevant topics in the qualitative data. Results: In the survey most parents reported being active self-managers. Nevertheless, only one third persisted in self-management when under stress. Autonomous motivation was strongly associated with parental self-management. In the interviews, parents mentioned attuning with professionals and finding balance as important aspects of self-management. To facilitate self-management, professionals were expected to have expert knowledge, be engaged and empathic. Conclusion: From the perspective of parents, self-management should be viewed as a collaborative effort in which they are supported by professionals, rather than having to manage it "by themselves". To facilitate self-management, parents expect professionals to have expert knowledge and additionally show interpersonal competences as openness, engagement and empathy. Motivating parents may facilitate their level of self-management regarding the care for their child with a chronic disorder. Good communication and collaboration with professionals appear to be key aspects of parental self-management. Parents expect pediatric rehabilitation teams to tune their services to the needs, desires and expectations of parents to support them in "self-managing" the care for their child. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to investigate associations between motivation for return to work and actual return to work, or increased employability among people on long-term sick leave. Materials and methods: Data by responses to questionnaires was collected from 227 people on long-term sick leave (mean = 7.9 years) due to pain syndrome or mild to moderate mental health conditions who had participated in a vocational rehabilitation intervention. The participants' motivation for return to work was measured at baseline. At 12-month follow-up, change in the type of reimbursement between baseline and at present was assessed and used to categorise outcomes as: "decreased work and employability", "unchanged", "increased employability", and "increased work". Associations between baseline motivation and return to work outcome were analysed using logistic and multinomial regression models. Results: Motivation for return to work at baseline was associated with return to work or increased employability at 12-month follow-up in the logistic regression model adjusting for potential confounders (OR 2.44, 95% CI 1.25–4.78). Conclusions: The results suggest that motivation for return to work at baseline was associated with actual chances of return to work or increased employability in people on long-term sick leave due to pain syndrome or mild to moderate mental health conditions. High motivation for return to work seems to increase the chances of actual return to work or increased employability in people on sick leave due to pain syndrome or mild to moderate mental health conditions. The potential impact of motivation for return to work is suggested to be highlighted in vocational rehabilitation. Rehabilitation professionals are recommended to recognise and take into consideration the patient's stated motivation for return to work. Rehabilitation professionals should be aware of that the patient's motivation for return to work might have an impact on the outcome of vocational rehabilitation. [ABSTRACT FROM AUTHOR]

Objective: Motivation is suggested as an important factor in pediatric motor rehabilitation. Therefore, we reviewed the existing evidence of (motivational) motor rehabilitation paradigms, and how motivation influences rehabilitation outcome using self-determination theory as conceptual framework. Methods: PubMed and Web-of-Science databases were systematically searched until June 2015. Data were independently extracted and critiqued for quality by three authors. Studies reporting motivational aspects were included. Most studies examined new technology (e.g., virtual reality [VR]). Results: Out of 479 records, three RCT, six case-control, and six non-comparative studies were included with mixed quality. Motivation was rarely reported. Training individualization to the child’s capabilities with more variety seemed promising to increase motivation. Motivation increased when the exercises seemed helpful for daily activities. Conclusions: Motivation in pediatric rehabilitation should be comprehensively assessed within a theoretical framework as there are indications that motivated children have better rehabilitation outcomes, depending on the aspect of motivation. [ABSTRACT FROM AUTHOR]

Purpose:The aim of the current study was to examine whether patient perceptions of autonomy support from the treatment team in a vocational rehabilitation program will be associated with change (increase) in need satisfaction, autonomous motivation, perceived competence, well-being, physical activity, and return to work (RTW), and whether the self-determination theory (SDT) Model of Health Behavior will provide adequate fit to the data. Method:A total of 90 participants were enrolled in a longitudinal study and completed measures at four time points over 15 months. Results:Participants reported increases in all variables, and in general these changes were maintained at six weeks post-rehabilitation and at 15 months post-baseline. As well, the SDT Model of Health Behavior provided adequate fit to the data. Conclusions:These results underscore the importance of health care practitioners’ providing support for their patients’ autonomy, competence, and relatedness to improve well-being, physical activity, and RTW in the context of vocational rehabilitation.Implications for RehabilitationVocational rehabilitation that emphasizes physical activity is associated with increases in patients’ well-being, physical activity, and return to work (RTW).It is important for health care practitioners to provide support for their patients’ autonomy, competence, and relatedness in the context of vocational rehabilitation, as doing so is associated with increases in patients’ autonomous motivation, perceived competence, and psychosocial outcomes. [ABSTRACT FROM AUTHOR]

Purpose: The aim of the current study was to examine whether patient perceptions of autonomy support from the treatment team in a vocational rehabilitation program will be associated with change (increase) in need satisfaction, autonomous motivation, perceived competence, well-being, physical activity, and return to work (RTW), and whether the self-determination theory (SDT) Model of Health Behavior will provide adequate fit to the data. Method: A total of 90 participants were enrolled in a longitudinal study and completed measures at four time points over 15 months. Results: Participants reported increases in all variables, and in general these changes were maintained at six weeks post-rehabilitation and at 15 months post-baseline. As well, the SDT Model of Health Behavior provided adequate fit to the data. Conclusions: These results underscore the importance of health care practitioners' providing support for their patients' autonomy, competence, and relatedness to improve well-being, physical activity, and RTW in the context of vocational rehabilitation. [ABSTRACT FROM AUTHOR]

Background: Considerable numbers of young people are not meeting physical activity guidelines. Wearable fitness devices can provide opportunities for physical activity promotion.Purpose: The aim of the study was to explore whether wearable healthy lifestyle technologies impacted on adolescents’ (13- to 14-year-olds) motivation for physical activity.Methods: The study was a mixed method sequential design. Participants were 84 adolescents (44 girls, 40 boys) from 6 physical education classes. Pupils were issued with a Fitbit to wear for 8 weeks and completed pre-/posttest questionnaires that assessed motivational regulation and psychological need satisfaction. Adolescents also engaged in focus group interviews after wearing the Fitbit for 8 weeks. Quantitative data were analyzed using a repeated measures multivariate analysis of variance (MANOVA) to explore differences between gender and time. Qualitative data analysis was conducted deductively using self-determination theory.Results: The quantitative findings identified significant reductions in need satisfaction and autonomous motivation and significant increases in amotivation after 8 weeks. Qualitative evidence suggested short-term increases in motivation through feelings of competition, guilt, and internal pressure.Discussion: Findings suggest that healthy lifestyle technology may have negative motivational consequences.Translation to Health Education Practice: Certified Health Education Specialists should support young people to personalize health targets in order to critically engage with normalized health targets. [ABSTRACT FROM PUBLISHER]

In medical education, students are increasingly regarded as active seekers of feedback rather than passive recipients. Previous research showed that in the intentions of students to seek feedback, a learning and performance goal can be distinguished. In this study, we investigated the intentions (defined as level and orientation of motivation) of different performing students (low, average, and high performing students) to seek feedback in the clinical workplace using Self-Determination Theory. We conducted a quantitative study with students in their clinical clerkships and grouped them based on their performance. The level of motivation was measured by the number of Mini-CEXs each student collected. The orientation of motivation was measured by conducting the Academic Self-Regulation Questionnaire. We found that high performing students were more motivated and demonstrated higher self-determination compared to low performing students. [ABSTRACT FROM AUTHOR]

Background:Research examining relationships between social support and smoking cessation has paid little attention to non-treatment seeking smokers and not considered the role of autonomy support for fostering quitting motivation. This study examined if autonomy support received from family and friends was associated with quitting motivation and making a quit attempt among diverse smokers with varying levels of quitting motivation. Demographic characteristics associated with autonomy support were explored. Methods:Participants (N = 312) responded to advertisements seeking smokers ‘not quite ready to quit,’ and were primarily Black, low-income and unemployed. Most (255) of them were enrolled in a clinical trial of smoking cessation induction strategies (treatment sample). An additional 57 not meeting the trial eligibility criteria of low quitting motivation were enrolled for baseline assessments only. Participants completed baseline measures of autonomy support received from friends and autonomous quitting motivation. In the treatment sample, quit attempts were assessed at six-month follow-up. Results:Females reported higher levels than males of autonomy support from friends (p = 0.003). Participants with a high school diploma/GED reported higher levels of support from family (p < 0.001) and friends (p = 0.014) than those with less education or a college/graduate degree. Both family (p = 0.007) and friends (p = 0.004) autonomy support scores were significantly, albeit weakly, associated with autonomous quitting motivation. Autonomy support was not associated with making a quit attempt. Conclusions:Support from family and friends may promote autonomous reasons to quit among diverse smokers. Research is needed to assess the role of social support in the pre-quitting phases among racial and socio-economically diverse populations. Clinical trial registration:ClinicalTrials.gov NCT01188018. [ABSTRACT FROM PUBLISHER]

Drawing on Self-Determination Theory, this study explored the motivational profiles toward Physical Activity (PA) among adults with type 2 diabetes and the relationships between motivational profile, perceived competence and PA. Participants were 350 men and women (Mean age 62.77 years) who were interviewed on their motivations toward PA, perceived level of competence to practice, and PA practice. Cluster analyses reveal the existence of three distinct profiles: "High Combined" (ie, high scores on motivations ranging from intrinsic to external regulation, moderate level on amotivation), "Self-Determined" (ie, high scores on intrinsic, integrated, and identified regulations; low scores on other regulations), and "Moderate" (ie, moderate scores on all regulations). Participants with "High Combined" and "Self-Determined" profiles reported higher perceived competence and longer leisure-time PA practice in comparison to those with a "Moderate" profile. This study highlights the necessity of adopting a person-centered approach to better understand motivation toward PA among type 2 diabetics. [ABSTRACT FROM AUTHOR]

The article details a study of the relationship between the stages of and the motivations for change among problem gamblers who have intentions to quit or reduce gambling as measured by Self-Determination Theory and the Transtheretical Model of Change. Results include the correlation between the severity of problem gambling with introjected and autonomous motivations, and the association of external motivation of quitting with little likelihood of being in the preparation stage.

In the United States, chronic pain is often poorly treated at an exceedingly high cost. The use of the biomedical model to manage pain is frequently ineffective, and evidence suggests that the biopsychosocial (BPS) model is a better choice. A problem with the BPS model is that it has not been operationalized in terms of patient behavior. This commentary addresses that issue by suggesting that people with chronic pain and illness participate daily in four self-management health behaviors: socialize, work, exercise, and meditation, and discusses evidence that supports these recommendations. These self-management behaviors may decrease pain and thus reduce the need for pain medications and other medical interventions. Additional topics include patient adherence and health coaching. [ABSTRACT FROM AUTHOR]

A four-week experimental study (N = 113) examined the effects of reflecting on intrinsic values. In the experimental group, participants learned about the distinction between intrinsic (e.g. having close relationships) and extrinsic (e.g. being popular) values, wrote about two personal intrinsic values, and then reflected on these values weekly for four weeks. In the control group, participants completed parallel exercises related to the daily details of their lives. Results revealed that participants in the intrinsic values group experienced greater well-being immediately following the written reflection than participants in the control group. Four weeks later, the more engaged participants felt in the reflection exercises, the more they prioritized intrinsic over extrinsic values and the greater their well-being. These effects occurred only for participants in the intrinsic values condition. The implications for changing value priorities and improving well-being are discussed. [ABSTRACT FROM PUBLISHER]

It was hypothesized that occupational health and safety (OHS) inspectors who prefer to use autonomy supportive tactics to resolve workplace conflicts (e.g. providing rationale, choices) would be more effective in resolving industry non-compliance with OHS regulations, compared to inspectors who prefer to use coercive tactics (e.g. deadlines, pressure). Preferences for resolving work conflicts were collected from 39 Canadian OHS inspectors and were linked to administrative records documenting 17,960 industry inspection episodes and 29,451 compliance orders issued by those inspectors from 2003-2006. Multilevel Poisson and negative binomial regression models examined associations between inspector autonomy-supportiveness and compliance outcomes, adjusting for covariates at the inspector level (e.g. job experience, number of inspection episodes) and at the worksite level (e.g. workplace safety record). Relative to coercive inspectors, autonomy-supportive inspectors issued fewer severe compliance orders and achieved compliance after fewer worksite visits. Use of autonomy-supportive approaches may reduce exposure to preventable injuries at non-compliant worksites. [ABSTRACT FROM AUTHOR]

This study used self-determination theory (Deci, E.L., & Ryan, R.M. (2000). The 'what' and 'why' of goal pursuits: Human needs and the self-determination of behavior. Psychological Inquiry, 11, 227-268.) to examine predictors of body image concerns and unhealthy weight control behaviours in a sample of 350 Greek adolescent girls. A process model was tested which proposed that perceptions of parental autonomy support and two life goals (health and image) would predict adolescents' degree of satisfaction of their basic psychological needs. In turn, psychological need satisfaction was hypothesised to negatively predict body image concerns (i.e. drive for thinness and body dissatisfaction) and, indirectly, unhealthy weight control behaviours. The predictions of the model were largely supported indicating that parental autonomy support and adaptive life goals can indirectly impact upon the extent to which female adolescents engage in unhealthy weight control behaviours via facilitating the latter's psychological need satisfaction. [ABSTRACT FROM AUTHOR]

The present study examines the ways in which breast cancer survivors' perceptions of emotional and instrumental social support from an intimate partner and need satisfaction in their partner role influence depression during and after breast cancer treatment. Our sample was comprised of 163 women who were an average of 57 years old, mostly White/Caucasian, and diagnosed primarily with early-stage breast cancer. Longitudinal data were analysed using both multilevel and structural equation modelling. Results reveal that (a) greater perceived partner emotional support is associated with lowered levels of depression at each wave, (b) partner-role need satisfaction mediates the relationship between perceived partner emotional support and depression at each wave, (c) perceived partner emotional support predicts subsequent changes in depression by way of need satisfaction and (d) depression prospectively predicts lowered perceptions of partner emotional and instrumental support. The findings confirm that basic need satisfaction, within intimate relationships, is an important predictor of lowered depression among breast cancer survivors. [ABSTRACT FROM AUTHOR]

Most research on the psychological correlates of smoking behavior has focused on negative indices of wellness, but findings are mixed, contradictory, controversial, and, thus, inconclusive. This study, guided by self-determination theory, examined both positive (viz., vitality) and negative (viz., depressive symptoms) indices of psychological health as predictors of long-term tobacco abstinence in the context of a randomized clinical trial. It also examined autonomous self-regulation and cigarette use as predictors of psychological health. Results supported the proposed conditional indirect effect model in which change in cigarette use mediated the relation of change in autonomous self-regulation for smoking cessation to change in vitality, and this indirect effect was moderated by treatment condition. Further, change in vitality predicted long-term tobacco abstinence. Results for depressive symptoms were largely null. Discussion focuses on the importance of considering positive indices of psychological health for understanding the psychological correlates of smoking behavior. [ABSTRACT FROM AUTHOR]