Motivation and anxiety for dental treatment: Testing a self-determination theory model of oral self-care behaviour and dental clinic attendance

The present study: (1) developed a Self-Regulation Questionnaire for Dental Treatment (SRQDT) based on Self-Determination Theory (SDT; Deci and Ryan, Psychol Inq 11:227–268, 2000), and (2) used it to test a SDT process model of oral self-care behaviours and dental clinic attendance. Patients’ perceptions of autonomy supportive (relative to controlling) dental professionals were expected to be positively associated with patients’ psychological needs satisfaction in treatment, which was expected to be positively related to relative autonomous motivation for dental treatment and perceived dental competence, and negatively related to anxiety for dental treatment. In turn, relative autonomous motivation for dental treatment and perceived dental competence were expected to be positively associated with oral self-care behaviours and dental clinic attendance. Anxiety for dental treatment was expected to be negatively related to dental clinic attendance and positively linked to putting off making a dental clinic appointment. Confirmatory factor analysis of the 5 factor SRQDT model fit the data very well, and a structural equation model supported the hypothesized process model.     

Dental anxiety,oral health‐related quality of life,and general well‐being: A self‐determination theory perspective

The aim of this study was to test a structural equation model (SEM) with the following hypotheses: (1) patients’ perceptions of oral health care professionals’ (i.e., dentists and dental hygienists) controlling interpersonal styles would positively predict patients’ dental anxiety through their basic psychological need frustration in treatment; (2) in turn, high dental anxiety would positively predict dysregulation of dental anxiety, which through a feedback loop contributes to perception of oral health care professionals’ controlling styles; and, (3) in addition, both dental anxiety and dysregulation of dental anxiety would predict poor Oral Health‐Related Quality of Life (OHRQoL) and subsequently poor general well‐being. A cross‐sectional study was conducted among 322 students at the University of Oslo. Participants responded to a survey with validated questionnaires. All variables in the model tested were acceptably normally distributed. The SEM did fit the data well and all hypotheses were supported. A bootstrapping procedure indicated that all indirect links in the model were supported. Analysis indicated that common method variance (CMV) did not seriously distort the results in this setting. Although the majority of oral health care professionals are perceived as being noncontrolling by their patients (51%), the proportion perceived as moderately (38%) or highly (11%) controlling represent a challenge for oral health care education and practice. It would be useful for oral health care professionals to be trained in avoiding a controlling treatment style.     

Oral health and dental well‐being: testing a self‐determination theory model

This study tested a self‐determination theory (SDT) process model of oral health and subjective dental well‐being. The results showed that: (1) patients' perceptions of autonomy‐supportive dental professionals were significantly positively predictive of patients' psychological needs satisfaction in treatment; (2) needs satisfaction was significantly related to perceived dental competence (positive), autonomous motivation (positive), and controlled motivation (negative) for dental care; (3) perceived competence was significantly positively, and controlled motivation was significantly negatively associated with self‐rated oral health and oral‐health‐related quality of life; (4) autonomous motivation for dental treatment was significantly positively associated with valuing continued dental treatment; and (5) the three oral‐health‐related variables were all significantly positively linked to subjective dental well‐being. A structural equation model supported the SDT process model.     

Motivation for Dental Home Care: Testing a Self‐Determination Theory Model1

The present research developed the Self‐Regulation for Dental Home Care Questionnaire (SRDHCQ), based on self‐determination theory (SDT; Deci & Ryan, 2000 ), and used it in an SDT process model of dental health behaviors and self‐rated oral health. In this model, patients' perceptions of autonomy‐supportive (relative to controlling) dental professionals were expected to positively predict patients' psychological needs satisfaction in treatment. Needs satisfaction was expected to be positively related to autonomous motivation for dental home care and perceived dental competence, which were expected to be positively associated with self‐rated oral health and dental health behaviors. Confirmatory factor analysis of the 5‐factor SRDHCQ model fit the data very well, and a structural equation model supported the hypothesized process model.     

Do perceived autonomy-supportive and controlling teaching relate to physical education students' motivational experiences through unique pathways? Distinguishing between the bright and dark side of motivation

ObjectivesGrounded in Self-Determination Theory (SDT), this study examined the mediating role of students' experiences of need satisfaction and need frustration in associations between perceived teaching style and students' motivation and oppositional defiance in the context of physical education. Specifically, we tested an integrated model including both a ‘bright’ path from perceived autonomy-supportive teaching through need satisfaction toward autonomous motivation and a ‘dark’ pathway from perceived controlling teaching through need frustration toward controlled motivation, amotivation, and oppositional defiance.DesignCross-sectional study.MethodsTo investigate the proposed paths structural equation modeling was used in a sample of 499 secondary school students (44% boys, M_age = 15.77 ± 1.16).ResultsWe found that perceived autonomy-supportive and controlling teaching, as well as need satisfaction and need frustration, constitute different constructs relating distinctively to motivational outcomes. Consistent with the notion of a bright and dark path, perceived autonomy support was related primarily to autonomous motivation, with need satisfaction mediating this association, whereas perceived controlling teaching was related primarily to controlled motivation and amotivation, through need frustration. Perceived controlling teaching also displayed a direct and unique relationship with oppositional defiance.ConclusionsTo more accurately capture the detrimental effects of controlling teaching, this teaching dimension along with its consequences in terms of need frustration and motivational outcomes needs to be studied in its own right. It is also discussed that effective teacher training may raise awareness among teachers about the motivational risks associated with controlling practices.     

Coping with dental treatment correlates of dispositional and domain specific monitoring and blunting

Abstract

Relations between coping style and several variables on an intermediary level were studied in a group of dentally anxious patients (N = 68) awaiting dental treatment. Monitoring was found to be positively related to the need of information: General dispositional monitoring was the best predictor of the need of information in case of more distant threat, whereas domain specific monitoring was the best predictor in case of imminent threat. Furthermore. dental trait anxiety was strongly related to early anticipatory tension, degree of anticipatory tension at several moments in time, and tension during treatment as perceived by the dentist, thereby overshadowing the weaker effects of coping style. Domain specific blunting was negatively related to desires for informational adaptations in the waiting room, and to question proneness as perceived by the dentist during treatment. It is concluded that, in order to study further effects of coping style, a sample homogeneous with respect to domain specific anxiety is needed.     

Motivational Predictors of Change in Oral Health: An Experimental Test of Self-Determination Theory

We tested the hypothesis that a psychosocial dental intervention formulated in terms of self-determination theory would increase patients’ perceived competence and autonomous motivation for dental care and would decrease their plaque and gingivitis over a seven month period, compared to standard dental treatment. We also tested a process model in which the intervention was expected to increase perceived dental competence and autonomous motivation, that they would be positively associated with oral health behaviors (i.e., brushing and flossing), which was expected to decrease plaque and, in turn, decrease gingivitis. We also examined whether: changes in perceived competence and autonomous motivation would mediate the effect of the intervention on dental-health behaviors; dental-health behaviors would mediate the links from changes in perceived competence and autonomous motivation to change in plaque; and change in plaque would mediate the relation of dental health behaviors to change in gingivitis. Finally, we examined the fit of the overall model with structural equation modelling. Results supported all predictions.

Identity styles and causality orientations: in search of the motivational underpinnings of the identity exploration process

This study examines relationships between constructs based on two perspectives on the development of self‐governance, namely Self‐Determination Theory (SDT; Deci & Ryan, 2000) and Berzonsky's (1990) identity style model. Theoretically predictable relationships are found between the three causality orientations defined by SDT (autonomous, controlled, and impersonal) and the three identity styles proposed by Berzonsky (informational, normative, diffuse–avoidant) in a sample of Belgian late adolescents. An autonomous causality orientation is positively related to an informational identity style and negatively related to a diffuse–avoidant style. A controlled orientation is positively associated with a normative identity style, and an impersonal orientation is positively related to a diffuse–avoidant identity style. Participants' gender does not moderate these relationships. The findings suggest that the causality orientations late adolescents employ may play an important role in how actively and thoroughly they explore identity‐relevant issues. Copyright © 2005 John Wiley & Sons, Ltd.     

Personality,motivational, and social cognition predictors of leisure-time physical activity

ObjectiveThe purpose of the present study was to investigate associations between personality traits of extraversion and neuroticism, autonomous motivation, and the Theory of Planned Behavior (TPB) constructs and leisure-time physical activity. The study examined whether autonomous motivation and the TPB constructs mediate the association between personality traits and physical activity, and whether personality traits moderate the relationship of autonomous motivation and the TPB constructs with physical activity.MethodsMiddle-aged women (N = 441) completed self-report measures of personality traits, autonomous motivation, attitudes, subjective norms, perceived behavioral control (PBC) and intention. Moderate-to-vigorous leisure-time physical activity (MVPA) was measured using accelerometers approximately seven weeks later. Participants’ past accelerometer-based MVPA was available from four years earlier.ResultsOnly autonomous motivation and past MVPA directly predicted MVPA. Neuroticism and past MVPA were indirectly related with MVPA through autonomous motivation. No support for a moderator role of personality traits was found.ConclusionsCurrent data suggest that autonomous motivation and past experience are prominent determinants of accelerometer-based leisure-time MVPA, but not beliefs and intentions.     

Predicting change in middle school students’ leisure-time physical activity participation: A prospective test of the trans-contextual model

We applied the trans-contextual model (TCM) to examine the effects of middle school students’ perceived autonomy support from their physical education (PE) teachers on autonomous motivation toward PE in school and, critically, autonomous motivation toward, and actual participation in, leisure-time physical activity (PA). The research adopted a three-wave prospective design enabling the modeling of change in the TCM constructs over time. Middle school students (N = 248) aged from 12 to 16 years reported their perceived autonomy support, autonomous motivation in PE, autonomous motivation toward leisure-time PA, attitudes, subjective norms, perceived behavioral control (PBC), intentions for PA in leisure-time, and leisure-time PA participation. The psychological constructs and leisure-time PA were measured at baseline (T0) and at a first follow-up occasion (T1) 5 weeks later. Another measure of PA was taken at a second follow-up occasion (T2) a further 5 weeks later. A single-indicator structural equation model using residualized change scores revealed that perceived autonomy support predicted autonomous motivation in PE (β = .345), and autonomous motivation in PE predicted autonomous motivation for leisure-time PA (β = .484). Autonomous motivation toward leisure-time PA predicted attitudes (β = .425), subjective norms (β = .264), and PBC (β = .517). Autonomous motivation toward leisure-time PA (β = .376), attitude (β = .231), and subjective norms (β = .185) predicted intentions toward leisure-time PA, and intentions predicted PA (β = .198). Findings extend research on the TCM by demonstrating its efficacy in predicting change in middle school students’ autonomous motivation across PE and leisure-time contexts, and accounting for change in intentions toward, and actual participation in, leisure-time PA.     

Determinants of physical activity among patients with type 2 diabetes: the role of perceived autonomy support,autonomous motivation and self-care competence

Based on self-determination theory (SDT), this study investigated, whether the three central SDT variables (perceived autonomy support, autonomous motivation and self-care competence), were associated with engagement in physical activity (PA) among patients with type 2 diabetes when the effect of a wide variety of other important life-context factors (perceived health, medication, duration of diabetes, mental health, stress and social support) was controlled for. Patients from five municipalities in Finland with registry-based entitlement to a special reimbursement for medicines used in the treatment of type 2 diabetes (n = 2866, mean age 63 years, 56% men) participated in this mail survey in 2011. Of all measured explanatory factors, autonomous motivation was most strongly associated with engagement in PA. Autonomous motivation mediated the effect of perceived autonomy support on patients’ PA. Thus, perceived autonomy support (from one’s physician) was associated with the patient’s PA through autonomous motivation. This result is in line with SDT. Interventions for improved diabetes care should concentrate on supporting patients’ autonomous motivation for PA. Internalizing the importance of good self-care seems to give sufficient energy to maintain a physically active lifestyle.     

Personality,social support and burnout among human service professionals in India

Recent research has investigated the relationship between personality and social support in predicting various forms of adjustment. This study explores this relationship in a sample of 137 human service professionals engaged in post‐degree clinical skills training at the Christian Counselling Centre in Vellore, India. The impact of certain forms of social support on burnout was examined, after controlling for the effect of the personality trait of anxiety. As hypothesized, perceived social support was negatively associated with burnout, even after controlling for the effects of anxiety. This pattern was strongest for the males in this sample. Emotional exhaustion and depersonalization were the components of burnout most strongly related to perceived support. The perception of support received from ‘work‐related’ and ‘other’ relationships made a stronger contribution than did ‘family’ or ‘social’ ties with respect to burnout. Implications for future cross‐cultural investigation of the relationships among personality, social support and adjustment are discussed. Copyright © 2003 John Wiley & Sons, Ltd.     

Reactance,autonomy and paths to persuasion: Examining perceptions of threats to freedom and informational value

Autonomy, often associated with an open and reflective evaluation of experience, is sometimes confused with reactance, which indicates resistance to persuasion attempts. Two studies examined a path model in which autonomy and reactance predicted motivation following the provision of anonymous or source-identified health-risk information, via the mediation of perceived threat to decision-making freedom and of perceived informational value. Study 1 (N = 122) investigated alcohol consumption. The results showed that autonomy was positively related to autonomous motivation and intentions to drink responsibly. Reactance negatively predicted autonomous motivation in the source-identified information condition but positively predicted autonomous motivation and intentions in the anonymous information condition. Reactance negatively predicted attitudes through the mediation of perceived threat to decision-making freedom. Study 2 (N = 145) tested our hypothesized model for smoking behavior and replicated several of the Study 1 findings. Implications for our understanding of autonomy, reactance, and responses to risk-information are discussed.     

Predicting moral attitudes and antisocial behavior in young team sport athletes: A self‐determination theory perspective

Identifying the factors associated with prosocial and antisocial behaviors in youth sport may provide evidence to inform interventions aimed at promoting prosocial behaviors and minimizing rule transgressions in young athletes. We investigated relations among social‐contextual factors (e.g., social support), personal motivational factors (e.g., psychological need satisfaction and motivation), young athletes’ attitudes toward prosocial (e.g., keeping winning in proportion) and antisocial (e.g., acceptance of cheating and gamesmanship) behaviors, and their actual rule violations during matches in two samples of athletes. Participants in Sample 1 were young team sport athletes (N = 355) and participants in Sample 2 were young male futsal players (N = 296). Athletes in Sample 1 completed validated self‐report measures of perceived autonomy support, basic need satisfaction, and autonomous and controlled motivation from self‐determination theory, moral attitudes, and past cheating behaviors. Athletes in Sample 2 completed identical measures and two additional behavioral measures: athletes’ self‐reported number of yellow cards received during competition in the last 6 months and the number of yellow cards athletes received from referees in the subsequent 2 months from competition records. We found significant relations between psychological need satisfaction and self‐determined motivation, and athletes’ moral attitudes in both samples. These effects held when statistically controlling for past behavior. Importantly, our prospective analysis of Sample 2 indicated that attitudes toward antisocial behaviors predicted athletes’ rule violations during subsequent tournament matches. Findings indicate that promoting autonomous motivation and need satisfaction through autonomy support may foster attitudes toward prosocial behaviors, and minimize rule transgressions, in young athletes.     

Repression and Coping Styles in Asthmatic Patients

The objectives of this study were to (a) determine prevalence of the dispositional repressive coping style as well as other situational coping styles in a sample of asthmatic patients and (b) to analyze the capacity of these styles to predict subsequent morbidity (emergency room visits or hospitalizations due to asthma) during a 12-month follow-up. A sample of 75 adult asthmatic patients was selected and information about sociodemographics, asthma severity, and patient’s perception of illness severity was collected. Repressive coping style was defined by a combination of scores obtained on the Trait Anxiety Inventory and the Marlowe-Crowne Social Desirability Scale. Coping styles were assessed with the dispositional version of the Coping Orientation to Problems Experienced Inventory. Eighteen patients (24%) were classified as repressors. Repressor asthmatics obtained scores significantly lower on Emotion-Focused Coping compared to non-repressors (F _(1,72) = 5.15, p = .026). Patients who perceived their asthma as severe reported to use Emotion-Focused Coping more than those who judged it as mild or moderate (F _(2,71) = 4.83, p = .011). A higher use of Denial (an Emotion-Focused strategy of coping) explained 8% of variance of the frequency of emergency room visits during the 12-month follow-up. The prevalence of repressive coping style in the asthmatic population is similar to that registered in other populations of chronic patients, and it is also associated with the tendency to report a lower use of strategies traditionally considered as maladaptive. The use of Emotion-Focused Coping strategies seems to be related to a worse perception of the physical status, and among this group of strategies, Denial also could favor a poor clinical course in bronchial asthma.     

The Relationship Between Parenting and the Economic Orientation and Behavior of Norwegian Adolescents

Little is known about the economic socialization of children and adolescents and the role of parents in this process. The authors’ purpose was to explore the role of parenting in the intergenerational transfer of economic orientation and economic behavior. More specifically, they studied the link between four parenting dimensions (parental warmth–responsiveness, behavioral control, psychological control, autonomy granting), three parenting styles (authoritative, authoritarian, and neglectful) and adolescents’ conscientiousness, future time perspective, and present hedonistic orientation. The authors also studied the relationships between these dispositions and the adolescents’ spending preferences and ability to control spending. They used data collected from 14–16-year-olds (n = 597) and their parents (n = 469) in Norway. Results showed that adolescents who perceived their parents as psychologically controlling were less future oriented and conscientious, and were more present hedonistic oriented than others, while adolescents who perceived their parents as responsive, autonomy granting, and controlling of behavior were more future orientated and conscientious than others. Adolescents’ scores for conscientiousness and future orientation were negatively associated with preferences for spending and positively with the ability to control spending, while the opposite relationships were found with respect to a present hedonistic orientation. Parental style was also found to be important for the future educational plans of adolescents, and plans for higher education were more frequent among adolescents who characterized their parents as authoritative than among those who perceived their parents as neglectful. Implications of the findings for economic socialization are discussed.     

Linking exercise and causality orientations to change in well‐being among older adults: does change in motivational variables play a role?

A self‐determination theory process model of change in well‐being was tested among older adults in a 16‐week randomized exercise‐trial (n = 118, M = 74.3 years, SD = 4.6, 68% females). The exercise intervention increased participants' autonomous motivation and perceived competence over the first 7 weeks. Moreover, autonomous orientation gave rise to perceived competence, while impersonal orientation was related to increased controlled motivation. Changes in motivational variables were positively related to changes in vitality over the trial, while change in controlled motivation was negatively related to changes in vitality and subjective well‐being. Bootstrapping analyses supported an indirect exercise–vitality path through autonomous motivation and perceived competence, and an indirect autonomous orientation–vitality path through perceived competence.     

自我决定理论:一个积极的人格视角

自我决定理论是有关人格和动机的理论。自我决定理论认为人的动机是一个在自主性或自我决定维度上的连续体,三种基本需要和个人的因果定向影响外在动机的内化和自主性动机的形成,人格整合和成长的过程,就是自我决定的过程。自我决定理论在教育、医疗、体育和组织等领域得到了广泛的应用。最后,文章回顾了自我决定理论在中国的研究情况,并对该领域需要进一步研究的问题做了讨论。     

The mediational role of motivation in the model of motor development in childhood: A longitudinal study

The aim of this study was twofold: first, to examine the stability of the hypothesized conceptual model of motor development (without and with including various types of motivation) when children are followed up one-year later, and second to examine longitudinally whether changes in one model variable predict changes in other variables, according to the hypothesized pathways in the model. A sample of 361 Spanish students (50.7% girls, 8–11 years old) voluntarily participated in this study. In relation to the first aim, structural equation modeling revealed the expected positive relationship between the model variables in both measurement times. That is: actual motor competence (MC) predicted physical activity (PA) (p < .001), perceived MC mediated the relationship between actual MC and PA (p < .001), and autonomous motivation mediated the relationship between perceived MC and PA (p < .05). Moreover, the comparison of the invariance analysis showed non-practical differences between the unconstrained model and the constrained model, supporting the stability of the model over time. In relation to the second aim, the hypothesized model in Time 2 controlling for Time 1 values showed that changes in children’s actual MC positively predicted changes in their perceived MC (p < .001), which in turn, predicted changes in their autonomous motivation (p < .001), and PA (p < .001) at Time 2. Based on these findings Physical Education teachers are recommended to foster children’s actual and perceived MC as well as their autonomous motivation over time in order to promote PA strategies for lifelong health.     

Differences in Unit Cohesion and Combat-Related Mental Health Problems Based on Attachment Styles in US Military Veterans

This study explored the differences in perceived unit cohesion, trauma symptoms, depression symptoms, and anxiety symptoms controlling for childhood trauma, based on attachment style in US military veterans. Previous studies have reported that higher levels of military unit cohesion, bonding through the social relationships between service members and their larger units, and secure attachment, are negatively associated with trauma symptoms, depression symptoms, and anxiety symptoms in veterans. This study examined mental health distress symptoms as well as military unit cohesion across attachment styles. Results suggest mean differences in trauma symptoms, depression symptoms, and anxiety symptoms across attachment styles. However, there was no difference in perceived unit cohesion across the four attachment styles. Those using fearful-avoidant attachment styles reported the highest mean trauma, depression, and anxiety symptoms followed by those using a dismissing-avoidant attachment style. Those using a secure attachment style reported the least mean trauma, depression, and anxiety symptoms. Implications for assessing and treating avoidant type attachment styles are discussed.