Publications by authors named "Edward L Deci"

38 Publications

The Roles of Patients' Authenticity and Accepting External Influence, and Clinicians' Treatment Styles in Predicting Patients' Dental Anxiety and Avoidance of Dental Appointments.

Eur J Psychol 2020 Mar 3;16(1):45-61. Epub 2020 Mar 3.

Department of Business, Marketing and Law, University of South-Eastern Norway, Hønefoss, Norway.

A substantial proportion of adults suffer from high dental anxiety, which is related to poor oral health and functioning. Using authenticity theory and self-determination theory, we applied a model testing two moderated mediation hypotheses: (i) the negative indirect association between authenticity and avoiding dental appointments through dental anxiety would be more evident when clinicians provides higher levels of autonomy support; and (ii) the indirect positive association between accepting external influence and avoiding dental appointments through dental anxiety would be more evident when clinicians provides higher levels of controllingness. Participants (N = 208) responded to a survey with validated questionnaires. The model with hypotheses were tested using Structural Equation Modeling (SEM) in LISREL and Conditional Process Modeling (moderated mediation). The results supported our hypotheses. The SEM model tested was found to fit the data well. Patient's personality and dental clinic treatment environments predicted 38% of the variance in dental anxiety, which explained 38% of avoidance of treatment.
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http://dx.doi.org/10.5964/ejop.v16i1.1664DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7913025PMC
March 2020

A meta-analysis of self-determination theory-informed intervention studies in the health domain: effects on motivation, health behavior, physical, and psychological health.

Health Psychol Rev 2021 Jun 3;15(2):214-244. Epub 2020 Feb 3.

Department of Medicine, Psychology, and Psychiatry, Center for Community Health and Prevention, University of Rochester Medical Center, Rochester, USA.

There are no literature reviews that have examined the impact of health-domain interventions, informed by self-determination theory (SDT), on SDT constructs health indices. Our aim was to meta-analyse such interventions in the health promotion and disease management literatures. Studies were eligible if they used an experimental design, tested an intervention that was based on SDT, measured at least one SDT-based motivational construct, at least one indicator of health behaviour, physical health, or psychological health. Seventy-three studies met these criteria and provided sufficient data for the purposes of the review. A random-effects meta-analytic model showed that SDT-based interventions produced small-to-medium changes in most SDT constructs at the end of the intervention period, and in health behaviours at the end of the intervention period and at the follow-up. Small positive changes in physical and psychological health outcomes were also observed at the end of the interventions. Increases in need support and autonomous motivation (but not controlled motivation or amotivation) were associated with positive changes in health behaviour. In conclusion, SDT-informed interventions positively affect indices of health; these effects are modest, heterogeneous, and partly due to increases in self-determined motivation and support from social agents.
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http://dx.doi.org/10.1080/17437199.2020.1718529DOI Listing
June 2021

Autonomy-supportive dental treatment, oral health-related eudaimonic well-being and oral health: a randomized clinical trial.

Psychol Health 2019 12 31;34(12):1421-1436. Epub 2019 May 31.

University of Rochester, Rochester, NY, USA.

We tested the hypotheses that a dental intervention designed to promote oral care competence in an autonomy-supportive way, relative to standard care, would positively predict patients' perceived autonomy support from oral health-care professionals, increases in eudaimonic well-being (i.e. both personal growth and purposeful behaviour goals) and improved oral health (i.e. reduced dental bacterial plaque on tooth surface and reduced gingivitis) over 5.5 months. We also tested a self-determination theory model with the intervention positively predicting perceived autonomy support, which in turn would predict increases in eudemonic well-being, leading to improved oral health. A randomised two-group experiment was conducted at a dental clinic with 138 patients ( = 23.31 yr,  = 3.5). Variables were measured before and right after the intervention and 5.5 months later. Overall, the experiment and hypothesised process models received strong support. The effect sizes were large for perceived autonomy support, change in personal growth, change in dental plaque and change in gingivitis, whereas the effect size for purposeful behaviour was moderate. The measurement and structural equation models for the SDT process model received good fit. The current field experiment extends previous knowledge by showing that promoting patient oral care competence in an autonomy-supportive way improves oral health through patients' eudaimonic well-being.
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http://dx.doi.org/10.1080/08870446.2019.1613546DOI Listing
December 2019

Solitude as an Approach to Affective Self-Regulation.

Pers Soc Psychol Bull 2018 01 26;44(1):92-106. Epub 2017 Oct 26.

1 University of Rochester, NY, USA.

In this research, we showed that solitude generally has a deactivation effect on people's affective experiences, decreasing both positive and negative high-arousal affects. In Study 1, we found that the deactivation effect occurred when people were alone, but not when they were with another person. Study 2 showed that this deactivation effect did not depend on whether or not the person was engaged in an activity such as reading when alone. In Study 3, high-arousal positive affect did not drop in a solitude condition in which participants specifically engaged in positive thinking or when they actively chose what to think about. Finally, in Study 4, we found that solitude could lead to relaxation and reduced stress when individuals actively chose to be alone. This research thus shed light on solitude effects in the past literature, and on people's experiences when alone and the different factors that moderate these effects.
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http://dx.doi.org/10.1177/0146167217733073DOI Listing
January 2018

Outcomes of the Smoker's Health Project: a pragmatic comparative effectiveness trial of tobacco-dependence interventions based on self-determination theory.

Health Educ Res 2016 12 22;31(6):749-759. Epub 2016 Oct 22.

Department of Clinical and Social Sciences in Psychology, University of Rochester, Rochester, NY 14627, USA.

A pragmatic comparative effectiveness trial examined whether extending the duration of a cost-effective, intensive tobacco-dependence intervention designed to support autonomy will facilitate long-term tobacco abstinence. Participants were randomly assigned to one of three tobacco-dependence interventions based on self-determination theory, namely, Intensive Treatment (IT; six contacts over 6 months), Extended Need Support (ENS; eight contacts over 12 months) and Harm Reduction (HR; eight contacts over 12 months with medication use if willing to reduce cigarette use by half). Among participants who completed the interventions, analyses revealed beneficial effects of ENS (15.7 versus 3.8%; χ (1) = 6.92, P < 0.01) and HR (13.6 versus 3.8%; χ (1) = 5.26, P < 0.05), relative to IT, on 12-month prolonged abstinence from tobacco. Also, analyses revealed beneficial effects of ENS (77.7 versus 43.0%; χ (1) = 24.90, P < 0.001) and HR (84.0 versus 43.0%; χ (1) = 37.41, P < 0.001), relative to IT, on use of first-line medications for smoking cessation. Hence, two new interventions were found to be efficacious particularly among participants who completed the interventions. Smokers who stay in treatment for an additional 6 months may benefit from an additional two contacts with practitioners, and thus it seems reasonable for policy makers to offer additional contacts given the health benefits associated with prolonged tobacco abstinence.
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http://dx.doi.org/10.1093/her/cyw046DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5141968PMC
December 2016

Changes in return to work among patients in vocational rehabilitation: a self-determination theory perspective.

Disabil Rehabil 2017 10 7;39(20):2039-2046. Epub 2016 Nov 7.

b School of Business and Social Sciences, University College of Southeast Norway , Hønefoss , Norway.

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 Rehabilitation Vocational 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.
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http://dx.doi.org/10.1080/09638288.2016.1215559DOI Listing
October 2017

Predicting dental attendance from dental hygienists' autonomy support and patients' autonomous motivation: A randomised clinical trial.

Psychol Health 2017 02 26;32(2):127-144. Epub 2016 Oct 26.

b School of Business and Social Sciences , University College of Southeast Norway , Hønefoss , Norway.

Objective: To test the hypothesis that a Self-Determination Theory (SDT) intervention designed to promote oral health care competence in an autonomy-supportive way would predict change in caries competence relative to standard care. Further, to test the SDT process path-model hypotheses with: (1) the intervention and individual differences in relative autonomous locus of causality (RALOC) predicting increases in caries competence, which in turn would positively predict dental attendance; (2) RALOC negatively predicting dental anxiety, which would negatively predict dental attendance; (3) RALOC and caries disease referred to the dentist after an autonomy-supportive clinical exam directly positively predicting dental attendance; and (4) the intervention moderating the link between RALOC and dental attendance.

Design: A randomised two-group experiment was conducted at a dental clinic with 138 patients (M = 23.31 yr., SD = 3.5), with pre- and post-measures in a period of 5.5 months.

Results: The experimental model was supported. The SDT path model fit the data well and supported the hypotheses explaining 63% of the variance in dental attendance.

Conclusions: Patients personality (RALOC) and hygienists promoting oral health care competence in an autonomy-supportive way, performance of autonomy-supportive clinical exams and reductions of anxiety for dental treatment have important practical implications for patients' dental attendance.
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http://dx.doi.org/10.1080/08870446.2016.1244536DOI Listing
February 2017

Show them the money? The role of pay, managerial need support, and justice in a self-determination theory model of intrinsic work motivation.

Scand J Psychol 2015 Aug 24;56(4):447-57. Epub 2015 Mar 24.

Buskerud and Vestfold University College, Hønefoss, Norway.

The link between money and motivation has been a debated topic for decades, especially in work organizations. However, field studies investigating the amount of pay in relation to employee motivation is lacking and there have been calls for empirical studies addressing compensation systems and motivation in the work domain. The purpose of this study was to examine outcomes associated with the amount of pay, and perceived distributive and procedural justice regarding pay in relation to those for perceived managerial need support. Participants were 166 bank employees who also reported on their basic psychological need satisfaction and intrinsic work motivation. SEM-analyses tested a self-determination theory (SDT) model, with satisfaction of the competence and autonomy needs as an intervening variable. The primary findings were that amount of pay and employees' perceived distributive justice regarding their pay were unrelated to employees' need satisfaction and intrinsic work motivation, but procedural justice regarding pay did affect these variables. However, managerial need support was the most important factor for promoting need satisfaction and intrinsic work motivation both directly, indirectly, and as a moderator in the model. Hence, the results of the present organizational field study support earlier laboratory experiments within the SDT framework showing that monetary rewards did not enhance intrinsic motivation. This seems to have profound implications for organizations concerned about motivating their employees.
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http://dx.doi.org/10.1111/sjop.12211DOI Listing
August 2015

Diminished neural responses predict enhanced intrinsic motivation and sensitivity to external incentive.

Cogn Affect Behav Neurosci 2015 Jun;15(2):276-86

Baylor College of Medicine, Houston, TX, USA.

The duration and quality of human performance depend on both intrinsic motivation and external incentives. However, little is known about the neuroscientific basis of this interplay between internal and external motivators. Here, we used functional magnetic resonance imaging to examine the neural substrates of intrinsic motivation, operationalized as the free-choice time spent on a task when this was not required, and tested the neural and behavioral effects of external reward on intrinsic motivation. We found that increased duration of free-choice time was predicted by generally diminished neural responses in regions associated with cognitive and affective regulation. By comparison, the possibility of additional reward improved task accuracy, and specifically increased neural and behavioral responses following errors. Those individuals with the smallest neural responses associated with intrinsic motivation exhibited the greatest error-related neural enhancement under the external contingency of possible reward. Together, these data suggest that human performance is guided by a "tonic" and "phasic" relationship between the neural substrates of intrinsic motivation (tonic) and the impact of external incentives (phasic).
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http://dx.doi.org/10.3758/s13415-014-0324-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4412758PMC
June 2015

Competence-impeding electronic games and players' aggressive feelings, thoughts, and behaviors.

J Pers Soc Psychol 2014 Mar 30;106(3):441-57. Epub 2013 Dec 30.

Department of Clinical and Social Sciences, University of Rochester.

[Correction Notice: An Erratum for this article was reported in Vol 106(3) of Journal of Personality and Social Psychology (see record 2014-07574-006). In the article, the name of author Edward Deci was missing his middle name initial and should have read as Edward L. Deci. In addition, an incorrect version of figure 1 was published.] Recent studies have examined whether electronic games foster aggression. At present, the extent to which games contribute to aggression and the mechanisms through which such links may exist are hotly debated points. In current research we tested a motivational hypothesis derived from self-determination theory-that gaming would be associated with indicators of human aggression to the degree that the interactive elements of games serve to impede players' fundamental psychological need for competence. Seven studies, using multiple methods to manipulate player competence and a range of approaches for evaluating aggression, indicated that competence-impeding play led to higher levels of aggressive feelings, easier access to aggressive thoughts, and a greater likelihood of enacting aggressive behavior. Results indicated that player perceived competence was positively related to gaming motivation, a factor that was, in turn, negatively associated with player aggression. Overall, this pattern of effects was found to be independent of the presence or absence of violent game contents. We discuss the results in respect to research focused on psychological need frustration and satisfaction and as they regard gaming-related aggression literature.
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http://dx.doi.org/10.1037/a0034820DOI Listing
March 2014

How self-determined choice facilitates performance: a key role of the ventromedial prefrontal cortex.

Cereb Cortex 2015 May 2;25(5):1241-51. Epub 2013 Dec 2.

Tamagawa University Brain Science Institute, Tokyo 194-8610, Japan.

Recent studies have documented that self-determined choice does indeed enhance performance. However, the precise neural mechanisms underlying this effect are not well understood. We examined the neural correlates of the facilitative effects of self-determined choice using functional magnetic resonance imaging (fMRI). Participants played a game-like task involving a stopwatch with either a stopwatch they selected (self-determined-choice condition) or one they were assigned without choice (forced-choice condition). Our results showed that self-determined choice enhanced performance on the stopwatch task, despite the fact that the choices were clearly irrelevant to task difficulty. Neuroimaging results showed that failure feedback, compared with success feedback, elicited a drop in the vmPFC activation in the forced-choice condition, but not in the self-determined-choice condition, indicating that negative reward value associated with the failure feedback vanished in the self-determined-choice condition. Moreover, the vmPFC resilience to failure in the self-determined-choice condition was significantly correlated with the increased performance. Striatal responses to failure and success feedback were not modulated by the choice condition, indicating the dissociation between the vmPFC and striatal activation pattern. These findings suggest that the vmPFC plays a unique and critical role in the facilitative effects of self-determined choice on performance.
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http://dx.doi.org/10.1093/cercor/bht317DOI Listing
May 2015

An interview with Dr. Edward L. Deci, codeveloper of self-determination theory. Interview by Paul Terry.

Authors:
Edward L Deci

Am J Health Promot 2013 Jul-Aug;27(6):TAHP2-7

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November 2013

Self-Determination Theory Applied to Health Contexts: A Meta-Analysis.

Perspect Psychol Sci 2012 Jul;7(4):325-40

University of Rochester.

Behavior change is more effective and lasting when patients are autonomously motivated. To examine this idea, we identified 184 independent data sets from studies that utilized self-determination theory (SDT; Deci & Ryan, 2000) in health care and health promotion contexts. A meta-analysis evaluated relations between the SDT-based constructs of practitioner support for patient autonomy and patients' experience of psychological need satisfaction, as well as relations between these SDT constructs and indices of mental and physical health. Results showed the expected relations among the SDT variables, as well as positive relations of psychological need satisfaction and autonomous motivation to beneficial health outcomes. Several variables (e.g., participants' age, study design) were tested as potential moderators when effect sizes were heterogeneous. Finally, we used path analyses of the meta-analyzed correlations to test the interrelations among the SDT variables. Results suggested that SDT is a viable conceptual framework to study antecedents and outcomes of motivation for health-related behaviors.
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http://dx.doi.org/10.1177/1745691612447309DOI Listing
July 2012

Self-determination theory in health care and its relations to motivational interviewing: a few comments.

Int J Behav Nutr Phys Act 2012 Mar 2;9:24. Epub 2012 Mar 2.

Department of Clinical & Social Sciences in Psychology, University of Rochester, Rochester, NY 14627, USA.

The papers of this special issue have the dual focus of reviewing research, especially clinical trials, testing self-determination theory (SDT) and of discussing the relations between SDT and motivational interviewing (MI). Notably, trials are reviewed that examined interventions either for behaviors such as physical activity and smoking cessation, or for outcomes such as weight loss. Although interventions were based on and intended to test the SDT health-behavior-change model, authors also pointed out that they drew techniques from MI in developing the interventions. The current paper refers to these studies and also clarifies the meaning of autonomy, which is central to SDT and has been shown to be important for effective change. We clarify that the dimension of autonomy versus control is conceptually orthogonal to the dimension of independence versus dependence, and we emphasize that autonomy or volition, not independence, is the important antecedent of effective change. Finally, we point out that SDT and MI have had much in common for each has emphasized autonomy. However, a recent MI article seems to have changed MI's emphasis from autonomy to change talk as the key ingredient for change. We suggest that change talk is likely to be an element of effective change only to the degree that the change talk is autonomously enacted and that practitioners facilitate change talk in an autonomy supportive way.
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http://dx.doi.org/10.1186/1479-5868-9-24DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3312850PMC
March 2012

Self-determined motivational predictors of increases in dental behaviors, decreases in dental plaque, and improvement in oral health: a randomized clinical trial.

Health Psychol 2012 Nov 6;31(6):777-788. Epub 2012 Feb 6.

Department of Clinical and Social Sciences in Psychology, University of Rochester.

Objective: The present study tested the hypotheses that: (a) a dental intervention designed to promote dental care competence in an autonomy-supportive way, relative to standard care, would positively predict perceived clinician autonomy support and patient autonomous motivation for the project, increases in autonomous motivation for dental home care, perceived dental competence, and dental behaviors, and decreases in both dental plaque and gingivitis over 5.5 months; and (b) the self-determination theory process model with the intervention and individual differences in autonomy orientation positively predicting project autonomous motivation and increases in perceived dental competence, both of which would be associated with increases in dental behavior, which would, in turn, lead to decreased plaque and gingivitis.

Methods: A randomized two-group experiment was conducted at a dental clinic with 141 patients (Mage = 23.31 years, SD = 3.5), with pre- and postmeasures (after 5.5 months) of motivation variables, dental behaviors, dental plaque, and gingivitis.

Results: Overall, the experimental and hypothesized process models received strong support. The effect sizes were moderate for dental behavior, large for autonomous motivation for the project and perceived competence, and very large for perceived autonomy support, dental plaque, and gingivitis. A structural equation model supported the hypothesized process model.

Conclusions: Considering the very large effects on reductions in dental plaque and gingivitis, promoting dental care competence in an autonomy-supportive way, relative to standard care, has important practical implications for dental treatment, home care, and health.
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http://dx.doi.org/10.1037/a0027062DOI Listing
November 2012

The smoker's health project: a self-determination theory intervention to facilitate maintenance of tobacco abstinence.

Contemp Clin Trials 2011 Jul 5;32(4):535-43. Epub 2011 Mar 5.

University of Rochester, Healthy Living Center, Center for Community Health, Rochester, NY 14607, USA.

A previous randomized clinical trial based on self-determination theory (SDT) and consistent with the Public Health Service (PHS) Guideline for Treating Tobacco Use and Dependence demonstrated that an intensive intervention could change autonomous self-regulation and perceived competence, which in part facilitated long-term tobacco abstinence. The current article describes a pragmatic comparative effectiveness trial of three SDT-based intensive tobacco-dependence interventions. Eligible participants are randomized to one of the three treatment conditions designed to facilitate long-term maintenance of tobacco abstinence, namely, Community Care (CC), which includes the 6 month SDT-based intervention previously shown to promote autonomous self-regulation, perceived competence, medication use, and tobacco abstinence; Extended Need Support (ENS), which extends the 6 month SDT-based intervention to 12 months and trains an important other to provide support for smokers' basic psychological needs; and Harm Reduction (HR), which provides extended need support and recommends medication use for participants who do not want to stop smoking completely within 30 days but who are willing to reduce their cigarette use by half. The primary outcome is 12 month prolonged abstinence from tobacco, which is assessed one year following termination of treatment (two years post-randomization). Secondary outcomes include 7- and 30 day point prevalence tobacco abstinence, number of days using smoking-cessation medication, change in autonomous self-regulation and perceived competence, and perceived need support from important others.
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http://dx.doi.org/10.1016/j.cct.2011.03.002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3162229PMC
July 2011

Motivational determinants of integrating positive and negative past identities.

J Pers Soc Psychol 2011 Mar;100(3):527-44

Department of Psychology, University of Essex, Wivenhoe Park, Colchester, CO4 3SQ, United Kingdom.

Five studies examined whether quality of motivation (as individual differences and primed) facilitates or thwarts integration of positive and negative past identities. Specifically, more autonomously motivated participants felt closer to, and were more accepting of, both negative and positive past characteristics and central life events, whereas more control-motivated participants were closer to and more accepting of positive, but not negative, past characteristics and events. Notably, controlled motivation hindered participants' acceptance of their own negative identities but not of others' negative identities, suggesting that control-motivated individuals' rejection of negative past identities was an attempt to distance from undesirable parts of themselves. Defensive processes, reflected in nonpersonal pronouns and escape motives, mediated interaction effects, indicating that lower defense allowed fuller integration. Integration of both positive and negative past identities predicted indicators of well-being, namely, vitality, meaning, and relatedness satisfaction.
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http://dx.doi.org/10.1037/a0022150DOI Listing
March 2011

Person-level relatedness and the incremental value of relating.

Pers Soc Psychol Bull 2010 Jun 11;36(6):754-67. Epub 2010 May 11.

Northwestern University, Chicago, Illinois 60611, USA.

The concept of a human need for relatedness is among the oldest and most generative topics in psychology. Yet despite the considerable attention relatedness has received, some basic aspects of this important construct remain poorly understood. Specifically, the literature to this point has been inconclusive with regard to how one's lifetime experiences of relatedness may be related to how much individuals value additional or new experiences of relatedness. The present investigation directly addressed this question using a multimethod approach. Three studies found consistent support for a positive association between person-level relatedness and the incremental value of new relatedness experiences. That is, those who reported having experienced more relatedness in their lives nevertheless reported anticipating and extracting more affective value from additional social encounters. By contrast, those having experienced less relatedness in life reported less incremental value-a pattern consistent with a process of person-level accommodation or desensitization.
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http://dx.doi.org/10.1177/0146167210371622DOI Listing
June 2010

The Path Taken: Consequences of Attaining Intrinsic and Extrinsic Aspirations in Post-College Life.

J Res Pers 2009 Jun;73(3):291-306

Department of Clinical and Social Sciences in Psychology, University of Rochester.

Life goals, or aspirations, organize and direct behavior over extended periods of time. The present study, guided by self-determination theory, examined the consequences of pursuing and attaining aspirations over a one-year period in a post-college sample. Results indicated that placing importance on either intrinsic or extrinsic aspirations related positively to attainment of those goals. Yet, whereas attainment of intrinsic aspirations related positively to psychological health, attainment of extrinsic aspirations did not; indeed, attainment of extrinsic aspirations related positively to indicators of ill-being. Also as predicted, the association between change in attainment of intrinsic aspirations and change in psychological health was mediated by change in the satisfaction of the basic psychological needs for autonomy, competence, and relatedness. Discussion focuses on the idea that not all goal attainment is beneficial; rather, attainment of aspirations with different contents relates differentially to psychological health.
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http://dx.doi.org/10.1016/j.jrp.2008.09.001DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2736104PMC
June 2009

The emotional and academic consequences of parental conditional regard: comparing conditional positive regard, conditional negative regard, and autonomy support as parenting practices.

Dev Psychol 2009 Jul;45(4):1119-42

Department of Education, Ben-Gurion University of the Negev, Beer-Sheva, Israel.

The authors conducted 2 studies of 9th-grade Israeli adolescents (169 in Study 1, 156 in Study 2) to compare the parenting practices of conditional positive regard, conditional negative regard, and autonomy support using data from multiple reporters. Two socialization domains were studied: emotion control and academics. Results were consistent with the self-determination theory model of internalization, which posits that (a) conditional negative regard predicts feelings of resentment toward parents, which then predict dysregulation of negative emotions and academic disengagement; (b) conditional positive regard predicts feelings of internal compulsion, which then predict suppressive regulation of negative emotions and grade-focused academic engagement; and (c) autonomy support predicts sense of choice, which then predicts integrated regulation of negative emotions and interest-focused academic engagement. These findings suggest that even parents' use of conditional positive regard as a socialization practice has adverse emotional and academic consequences, relative to autonomy support.
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http://dx.doi.org/10.1037/a0015272DOI Listing
July 2009

The importance of supporting autonomy and perceived competence in facilitating long-term tobacco abstinence.

Ann Behav Med 2009 Jun 17;37(3):315-24. Epub 2009 Apr 17.

Department of Medicine, University of Rochester, R.C. Box 270266, Rochester, NY 14627-0266, USA.

Background: The Public Health Service (PHS) Guideline for Treating Tobacco Use and Dependence (Fiore et al. 2000) recommends supporting autonomy and perceived competence to facilitate tobacco abstinence.

Purpose: The aim of the study was to evaluate the effectiveness of an intensive tobacco-dependence intervention based on self-determination theory (SDT) and intended to support autonomy and perceived competence in facilitating long-term tobacco abstinence.

Methods: One thousand and six adult smokers were recruited into a randomized cessation-induction trial. Community care participants received cessation pamphlets and information on local treatment programs. Intervention participants received the same materials and were asked to meet four times with counselors over 6 months to discuss their health in a manner intended to support autonomy and perceived competence. The primary outcome was 24-month prolonged abstinence from tobacco. The secondary outcome was 7-day point prevalence tobacco abstinence at 24 months postintervention.

Results: Smokers in the intervention were more likely to attain both tobacco abstinence outcomes and these effects were partially mediated by change in both autonomous self-regulation and perceived competence from baseline to 6 months. Structural equation modeling confirmed the SDT model of health-behavior change in facilitating long-term tobacco abstinence.

Conclusions: An intervention based on SDT and consistent with the PHS Guideline, which was intended to support autonomy and perceived competence, facilitated long-term tobacco abstinence.
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http://dx.doi.org/10.1007/s12160-009-9090-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2819097PMC
June 2009

Aspiring to physical health: the role of aspirations for physical health in facilitating long-term tobacco abstinence.

Patient Educ Couns 2009 Feb 5;74(2):250-7. Epub 2008 Oct 5.

Department of Clinical and Social Sciences in Psychology, University of Rochester, Rochester, NY 14627, United States.

Objective: To assess aspirations for physical health over 18 months. To examine whether maintained importance of aspirations for physical health mediated and/or moderated the effect of an intensive intervention on long-term tobacco abstinence.

Methods: Participants were randomly assigned to an intervention based on self-determination theory or to community care, and provided data at baseline and at 18 and 30 months post-randomization.

Results: Aspirations for physical health were better maintained over 18 months among participants in the intervention (mean change=.05), relative to community care (mean change=-.13), t=2.66, p<.01. Maintained importance of aspirations for physical health partially mediated the treatment condition effects on seven-day point prevalence tobacco abstinence (z'=1.68, p<.01) and the longest number of days not smoking (z'=2.16, p<.01), and interacted with treatment condition to facilitate the longest number of days not smoking (beta=.08, p<.05).

Conclusion: Maintained importance of aspirations for physical health facilitated tobacco abstinence.

Practice Implications: Smokers may benefit from discussing aspirations for physical health within autonomy-supportive interventions. Patients may benefit from discussing aspirations during counseling about therapeutic lifestyle change and medication use.
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http://dx.doi.org/10.1016/j.pec.2008.08.015DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2660169PMC
February 2009

Adult attachment and psychological well-being in cancer caregivers: the mediational role of spouses' motives for caregiving.

Health Psychol 2008 Mar;27(2S):S144-54

Behavioral Research Center, American Cancer Society, Atlanta, GA 30303-1002, USA.

Objective: Caring for a spouse with cancer can be challenging on many levels. How caregivers adjust to this challenge may be influenced both by their personal orientation to the relationship and by their motives for providing care. In this study we examined the prediction of caregiver well-being from the relationship qualities specified by attachment theory and from motives specified by self-determination theory.

Design: Cross-sectional data reported here are from the American Cancer Society's Quality of Life Survey for Caregivers.

Main Outcome Measures: Three measures were included as indicators of the caregiver's psychological adjustment: benefit finding in cancer caregiving experience, life satisfaction, and depressive symptoms.

Results: In structural equation models, among both husband (n = 154) and wife (n = 160) caregivers, attachment security (assessed with respect to the spouse) related positively to autonomous motives for and finding benefit in caregiving; attachment anxiety related to introjected motives for caregiving and more depression. Among husbands (but not wives), autonomous motives also related to less depression, and introjected motives related to less life satisfaction and more depression. Among wives (but not husbands), autonomous motives related to greater benefit finding.

Conclusion: Variations in attachment orientations and in reasons for providing care are important elements in understanding the psychological well-being of cancer caregivers.
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http://dx.doi.org/10.1037/0278-6133.27.2(Suppl.).S144DOI Listing
March 2008

Self-regulation and the problem of human autonomy: does psychology need choice, self-determination, and will?

J Pers 2006 Dec;74(6):1557-85

Department of Clinical and Social Sciences in Psychology, University of Rochester, Rochester, NY 14627, USA.

The term autonomy literally refers to regulation by the self. Its opposite, heteronomy, refers to controlled regulation, or regulation that occurs without self-endorsement. At a time when philosophers and economists are increasingly detailing the nature of autonomy and recognizing its social and practical significance, many psychologists are questioning the reality and import of autonomy and closely related phenomena such as will, choice, and freedom. Using the framework of self-determination theory (Ryan & Deci, 2000), we review research concerning the benefits of autonomous versus controlled regulation for goal performance, persistence, affective experience, quality of relationships, and well-being across domains and cultures. We also address some of the controversies and terminological issues surrounding the construct of autonomy, including critiques of autonomy by biological reductionists, cultural relativists, and behaviorists. We conclude that there is a universal and cross-developmental value to autonomous regulation when the construct is understood in an exacting way.
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http://dx.doi.org/10.1111/j.1467-6494.2006.00420.xDOI Listing
December 2006

A self-determination multiple risk intervention trial to improve smokers' health.

J Gen Intern Med 2006 Dec;21(12):1288-94

University of Rochester, Rochester, NY, USA.

Background: Little is known about how interventions motivate individuals to change multiple health risk behaviors. Self-determination theory (SDT) proposes that patient autonomy is an essential factor for motivating change.

Objective: An SDT-based intervention to enhance autonomous motivation for tobacco abstinence and improving cholesterol was tested.

Design: The Smokers' Health Study is a randomized multiple risk behavior change intervention trial.

Setting: Smokers were recruited to a tobacco treatment center.

Patients: A total of 1.006 adult smokers were recruited between 1999 and 2002 from physician offices and by newspaper advertisements.

Interventions: A 6-month clinical intervention (4 contacts) to facilitate internalization of autonomy and perceived competence for tobacco abstinence and reduced percent calories from fat was compared with community care. Clinicians elicited patient perspectives and life strivings, provided absolute coronary artery disease risk estimates,enumerated effective treatment options, supported patient initiatives,minimized clinician control, assessed motivation for change, and developed a plan for change.

Outcome Measures: Twelve-month prolonged tobacco abstinence, and change in percent calories from fat and low-density lipoprotein-cholesterol (LDL-C) from baseline to 18 months. RESULTS- Intention to treat analyses revealed that the intervention significantly increased 12-month prolonged tobacco abstinence (6.2% vs 2.4%; odds ratio [OR]=2.7, P=.01, number needed to treat [NNT] =26), and reduced LDL-C (-8.9 vs -4.1 mg/dL; P=.05). There was no effect on percent calories from fat.

Conclusions: An intervention focused on supporting smokers'autonomy was effective in increasing prolonged tobacco abstinence and lowering LDL-C. Clinical interventions for behavior change may be improved by increasing patient autonomy and perceived competence.
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http://dx.doi.org/10.1111/j.1525-1497.2006.00621.xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1924739PMC
December 2006

Choice and ego-depletion: the moderating role of autonomy.

Pers Soc Psychol Bull 2006 Aug;32(8):1024-36

Department of Psychology, University of Rochester, NY 14627, USA.

The self-regulatory strength model maintains that all acts of self-regulation, self-control, and choice result in a state of fatigue called ego-depletion. Self-determination theory differentiates between autonomous regulation and controlled regulation. Because making decisions represents one instance of self-regulation, the authors also differentiate between autonomous choice and controlled choice. Three experiments support the hypothesis that whereas conditions representing controlled choice would be egodepleting, conditions that represented autonomous choice would not. In Experiment 3, the authors found significant mediation by perceived self-determination of the relation between the choice condition (autonomous vs. controlled) and ego-depletion as measured by performance.
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http://dx.doi.org/10.1177/0146167206288008DOI Listing
August 2006

On the benefits of giving as well as receiving autonomy support: mutuality in close friendships.

Pers Soc Psychol Bull 2006 Mar;32(3):313-27

Department of Psychology, University of Rochester, Rochester, NY 14627, USA.

Two studies examined autonomy support within close friendships. The first showed that receiving autonomy support from a friend predicted the recipient's need satisfaction within the relationship and relationship quality as indexed by emotional reliance, security of attachment, dyadic adjustment, and inclusion of friend in self and that there was significant mutuality of receiving autonomy support and of each other variable. The relations of perceived autonomy support to need satisfaction and relationship quality held for both female-female and male-male pairs across the two studies. The second study replicated and extended the first, showing that receiving autonomy support also predicted psychological health. Furthermore, giving autonomy support to a friend predicted the givers' experience of relationship quality over and above the effects of receiving autonomy support from the friend. When both receiving and giving autonomy support competed for variance in predicting well-being, giving, rather than receiving, autonomy support was the stronger predictor.
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http://dx.doi.org/10.1177/0146167205282148DOI Listing
March 2006

Testing a self-determination theory intervention for motivating tobacco cessation: supporting autonomy and competence in a clinical trial.

Health Psychol 2006 Jan;25(1):91-101

Department of Clinical and Social Science in Psychology.

A longitudinal randomized trial tested the self-determination theory (SDT) intervention and process model of health behavior change for tobacco cessation (N = 1006). Adult smokers were recruited for a study of smokers' health and were assigned to intensive treatment or community care. Participants were relatively poor and undereducated. Intervention patients perceived greater autonomy support and reported greater autonomous and competence motivations than did control patients. They also reported greater medication use and significantly greater abstinence. Structural equation modeling analyses confirmed the SDT process model in which perceived autonomy support led to increases in autonomous and competence motivations, which in turn led to greater cessation. The causal role of autonomy support in the internalization of autonomous motivation, perceived competence, and smoking cessation was supported.
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http://dx.doi.org/10.1037/0278-6133.25.1.91DOI Listing
January 2006

The antecedents and consequences of autonomous self-regulation for college: a self-determination theory perspective on socialization.

J Adolesc 2006 Oct 18;29(5):761-75. Epub 2006 Jan 18.

Department of Clinical and Social Sciences in Psychology, University of Rochester, Box 270266, Rochester, NY 14627, USA.

Using self-determination theory, two studies investigated the relations among perceived need support from parents, their adolescents' autonomous self-regulation for academics, and the adolescents' well-being. Study 1 indicated that perceived need support from parents independently predicted adolescents' well-being, although when mothers' and fathers' data were examined separately, the relation was stronger for mothers than for fathers. In Study 2, autonomous self-regulation for planning to attend college was a significant partial mediator of the relation of adolescents' perceived need support to well-being. Thus, perceived need support from parents does seem important for the development of adolescents' autonomous self-regulation and well-being.
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http://dx.doi.org/10.1016/j.adolescence.2005.11.009DOI Listing
October 2006

Promoting glycemic control through diabetes self-management: evaluating a patient activation intervention.

Patient Educ Couns 2005 Jan;56(1):28-34

Department of Clinical & Social Sciences in Psychology, University of Rochester, P.O. Box 270266, Rochester, NY 14627-0266, USA.

This study compared an activation intervention to passive education in a randomized attention-control trial of 232 patients with type 2 diabetes. The activation intervention was based on Expanding Patient Involvement in Care (EPIC) trials, and was compared to time-matched passive education viewing of ADA video-tapes. Patient demographics and clinical characteristics of their diabetes were assessed with questionnaires, active involvement was assessed via ratings of taped interactions between patients and providers, and serum samples were analyzed for HbA1c. Patients in the activation condition were rated as more actively involved in discussions of diabetes self-management, and rated active involvement was predictive of improvement in glycemic control. No effect of the activation intervention was found on HbA1c. Thus, the activation intervention increased the active involvement of patients with type 2 diabetes in visits with practitioners, and active involvement led to improved glycemic control. However, the activation intervention did not improve glycemic control directly.
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http://dx.doi.org/10.1016/j.pec.2003.11.008DOI Listing
January 2005
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