Computer-assisted intervention improves patient-centered diabetes care by increasing autonomy support.

Objective: To determine if a patient-centered, computer-assisted diabetes care intervention increased perceived autonomy support, perceived competence (from self-determination theory), and if these constructs mediated the effect of the intervention on ADA/NCQA recommended diabetes care outcomes. Design: A randomized controlled trial of 866 adult type 2 diabetes patients in heterogeneous primary care settings in Colorado. Main Outcome Measures: Perceived autonomy support, perceived competence, patient satisfaction, glycemic control (HbA1c), ratio of total to HDL cholesterol, diabetes distress, and depressive symptoms. Results: The computer-assisted intervention increased patient perception of autonomy support relative to a computer-based control condition ( p = .05). Change in perceived competence partially mediated the effects of increased autonomy support on the change in lipids, diabetes distress, and depressive symptoms. The construct of autonomy support was found to be separate from that of patient satisfaction. Conclusions: A patient-centered, computer-assisted intervention was effective in improving diabetes self-management outcomes, in part, because it increased patients' perception that their autonomy was supported which changed perceived competence. These findings support the self-determination model for health behavior change and the chronic care model and support the further study of the use of these technologies to motivate patients to improve their health outcomes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Testing a Self-Determination Theory Process Model for Promoting Glycemic Control Through Diabetes Self-Management.

A longitudinal study tested the self-determination theory (SDT) process model of health behavior change for glycemic control within a randomized trial of patient activation versus passive education. Glycosylated hemoglobin for patients with Type 2 diabetes (n=159) was assessed at baseline, 6 months, and 12 months. Autonomous motivation and perceived competence were assessed at baseline and 6 months, and the autonomy supportiveness of clinical practitioners was assessed at 3 months. Perceptions of autonomy and competence were promoted by perceived autonomy support, and changes in perceptions of autonomy and competence, in turn, predicted change in glycemic control. Self-management behaviors mediated the relation between change in perceived competence and change in glycemic control. The self-determination process model fit the data well. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

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

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. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Facilitating autonomous motivation for smoking cessation.

Physicians used either an autonomy-supportive or a controlling interpersonal style to counsel smokers based on National Cancer Institute guidelines. Physician autonomy support was rated from audiotapes, and patients' perceived competence and autonomous motivation for quitting were self-reported on questionnaires. Validated point prevalences for 6, 12, and 30 months and for continuous cessation were examined. The intervention did not have a direct effect on quit rates; however, structural equation modeling supported the self-determination process model of smoking cessation. The model indicated that the autonomy-supportive intervention was rated as more autonomy supportive, that rated autonomy support predicted autonomous motivation, and that autonomous motivation predicted cessation at all points in time. Perceived competence contributed independent variance to cessation only at 6 months. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Internalization of biopsychosocial values by medical students: A test of self-determination theory.

Two studies tested self-determination theory with 2nd-year medical students in an interviewing course. Study 1 revealed that (a) individuals with a more autonomous orientation on the General Causality Orientations Scale had higher psychosocial beliefs at the beginning of the course and reported more autonomous reasons for participating in the course, and (b) students who perceived their instructors as more autonomy-supportive became more autonomous in their learning during the 6-month course. Study 2, a 30-month longitudinal study, revealed that students who perceived their instructors as more autonomy-supportive became more autonomous in their learning, which in turn accounted for a significant increase in both perceived competence and psychosocial beliefs over the 20-week period of the course, more autonomy support when interviewing a simulated patient 6 months later, and stronger psychosocial beliefs 2 years later. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The study of compensation systems through the lens of self-determination theory: Reconciling 35 years of debate.

Although compensation specialists generally argue for incentive systems that link rewards to performance, self-determination theory argues that such contingent rewards can have detrimental effects on autonomous motivation. The authors present a model of the motivational effects of compensation systems that attempts to reconcile the self-determination theory view and the literature on compensation. This model evaluates how compensation system characteristics, such as the amount and variability of pay, can influence the satisfaction of the needs for autonomy, competence, and relatedness, which in turn influence autonomous work motivation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Does pay for performance increase or decrease perceived self-determination and intrinsic motivation?

Laboratory and field studies examined the relationships of reward for high performance with perceived self-determination and intrinsic motivation. Study 1 found that pay for meeting a performance standard had positive effects on college students' perceived self-determination and competence, expressed task enjoyment, and free time spent performing the task. Furthermore, reward's incremental effect on expressed task enjoyment was mediated by perceived self-determination and competence. Study 2 established that perceived self-determination mediated positive relationships between employees' performance-reward expectancy and perceived organizational support, positive mood at work, and job performance. Study 3 demonstrated that performance-reward expectancy was positively related to employees' expressed interest in daily job activities, with this relationship being greater among employees having a high desire for control. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological Needs and Threat to Safety: Implications for Staff and Patients in a Psychiatric Hospital for Youth.

For psychiatric care workers and administrators, physical threat from behaviorally dysregulated patients is an important issue tied to many others, including workers' job satisfaction, motivation, well-being, and attitude toward patients. Yet, the impact of threats to physical safety may be offset by factors in the clinical environment. The authors tested hypotheses derived from self-determination theory concerning the relations of workplace need satisfaction and perceived threat to motivation, attitudes, and well-being among clinical staff within an adolescent psychiatric inpatient hospital. Also tested were relations between need satisfaction and treatment motivation among adolescent patients. To improve the experience of psychiatric workers and their patients, clinical staff and their administrators must attend to the satisfaction of needs for autonomy, relatedness, and competence. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A motivational model of rural students' intentions to persist in, versus drop out of, high school.

Using self-determination theory, the authors tested a motivational model to explain the conditions under which rural students formulate their intentions to persist in, versus drop out of, high school. The model argues that motivational variables underlie students' intentions to drop out and that students' motivation can be either supported in the classroom by autonomy-supportive teachers or frustrated by controlling teachers. LISREL analyses of questionnaire data from 483 rural high school students showed that the provision of autonomy support within classrooms predicted students' self-determined motivation and perceived competence. These motivational resources, in turn, predicted students' intentions to persist, versus drop out, and they did so even after controlling for the effect of achievement. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Autonomy and Competence in German and American University Students: A Comparative Study Based on Self-Determination Theory.

According to self-determination theory (R. M. Ryan & E. L. Deci, 2000), supports for autonomy and competence are essential for growth and well-being in any learning environment. Educational contexts differ in their relative support for these 2 needs. The authors examined the role of autonomy and competence in 2 German and 2 American university settings, as they were predicted to differ in terms of their relative emphasis on competence versus autonomy. Invariance analyses supported the construct comparability of the measures and demonstrated that German students felt significantly more autonomous and less competent than American students. Perceived pressures and positive informational feedback were modeled as antecedents of autonomy and competence, and well-being was examined as a consequence. The hypothesized model was generally supported across the 4 samples. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Favoriser la motivation optimale et la santé mentale dans les divers milieux de vie.

Self-determination theory (SDT) differentiates motivation, with autonomous and controlled motivations constituting the key, broad distinction. Research has shown that autonomous motivation predicts persistence and adherence and is advantageous for effective performance, especially on complex or heuristic tasks that involve deep information processing or creativity. Autonomous motivation is also reliably related to psychological health. Considerable research has found interpersonal contexts that facilitate satisfaction of the basic psychological needs for competence, autonomy, and relatedness to enhance autonomous motivation, which comprises intrinsic motivation and well-internalized extrinsic motivation. SDT has been applied in varied cultures and in many life domains, and research is reviewed that has related autonomous and controlled motivation to education, parenting, work, health care, sport, and close relationships. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Experiences of Autonomy and Control Among Chinese Learners: Vitalizing or Immobilizing?

Various cross-cultural researchers state that autonomy is not valued in Eastern cultures and, hence, is unlikely to predict optimal study functioning and well-being. In contrast, self-determination theory (SDT; R. M. Ryan & E. L. Deci, 2000) maintains that autonomous or volitional study motivation is universally important and should predict better learning and higher well-being, even among Chinese students. Two studies were conducted to shed light on this controversial issue. Findings from both studies indicated that autonomous study motivation positively predicts adaptive learning attitudes, academic success, and personal well-being, whereas controlled motivation was associated with higher drop-out rates, maladaptive learning attitudes, and ill-being. In addition, Study 2 revealed that parental autonomy support versus psychological control is related to more adaptive learning strategies and higher well-being and that these effects were mediated by students' relative autonomy for studying. The importance of defining autonomy as an intraindividual, phenomenological experience versus an interpersonal, culturally bounded value is discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Reaching one's personal goals: A motivational perspective focused on autonomy.

The present article reviews recent research on motivational factors that influence the success of personal goals. Although achieving progress on personal goals is made difficult by limitations in self-regulatory strength, it is argued that individuals who feel autonomous regarding their goals will benefit in distinct ways. The issue of autonomy concerns whether a goal reflects an individual's interests and personal values versus whether it is adopted because of social pressures or expectations of what an individual "should do." Recent research indicates that autonomous goal motivation can lead directly to greater goal progress by allowing individuals to exert more effort, experience less conflict, and feel a greater sense of readiness to change their behaviour. It also allows individuals to make better use of implementation plans specifying how, when, and where they will enact goal-directed behaviours. Support from other people (health care providers, etc.) can play a vital role in facilitating goal pursuits, especially when such support enhances feelings of autonomy. Successful goal progress results in enhanced positive affect and reduced negative affect, particularly if the goal pursuits involved satisfaction of intrinsic psychological needs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Can self-determination theory explain what underlies the productive, satisfying learning experiences of collectivistically oriented Korean students?

Recognizing recent criticisms concerning the cross-cultural generalizability of self-determination theory (SDT), the authors tested the SDT view that high school students in collectivistically oriented South Korea benefit from classroom experiences of autonomy support and psychological need satisfaction. In Study 1, experiences of autonomy, competence, and relatedness underlaid Korean students’ most satisfying learning experiences, and experiences of low autonomy and low competence underlaid their least satisfying learning experiences. In Study 2, psychological need satisfaction experiences were associated with productive (achievement and engagement) and satisfying (intrinsic motivation and proneness to negative affect) student outcomes. Study 3 replicated and extended Study 2’s structural equation modeling findings by showing that the hypothesized model explained students’ positive outcomes even after controlling for cultural and parental influences, including the collectivistic value orientation. Study 4 replicated the earlier cross-sectional findings with a semester-long prospective 3-wave design. The authors discuss how the findings support the motivation theory’s cross-cultural generalizability. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Facilitating optimal motivation and psychological well-being across life's domains.

[Correction Notice: An erratum for this article was reported in Vol 49(3) of Canadian Psychology/Psychologie canadienne (see record 2008-10897-013). Figure 1 on page 17 was incorrect. The correct figure is printed in the text.] Self-determination theory (SDT) differentiates motivation, with autonomous and controlled motivations constituting the key, broad distinction. Research has shown that autonomous motivation predicts persistence and adherence and is advantageous for effective performance, especially on complex or heuristic tasks that involve deep information processing or creativity. Autonomous motivation is also reliably related to psychological health. Considerable research has found interpersonal contexts that facilitate satisfaction of the basic psychological needs for competence, autonomy, and relatedness to enhance autonomous motivation, which comprises intrinsic motivation and well-internalized extrinsic motivation. SDT has been applied in varied cultures and in many life domains, and research is reviewed that has related autonomous and controlled motivation to education, parenting, work, health care, sport, and close relationships. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Correction to Deci and Ryan.

Reports an error in "Facilitating optimal motivation and psychological well-being across life's domains" by Edward L. Deci and Richard M. Ryan (Canadian Psychology/Psychologie Canadienne, 2008[Feb], Vol 49[1], 14-23). Figure 1 on page 17 was incorrect. The correct figure is printed in the text. (The following abstract of the original article appeared in record 2008-03783-002.) Self-determination theory (SDT) differentiates motivation, with autonomous and controlled motivations constituting the key, broad distinction. Research has shown that autonomous motivation predicts persistence and adherence and is advantageous for effective performance, especially on complex or heuristic tasks that involve deep information processing or creativity. Autonomous motivation is also reliably related to psychological health. Considerable research has found interpersonal contexts that facilitate satisfaction of the basic psychological needs for competence, autonomy, and relatedness to enhance autonomous motivation, which comprises intrinsic motivation and well-internalized extrinsic motivation. SDT has been applied in varied cultures and in many life domains, and research is reviewed that has related autonomous and controlled motivation to education, parenting, work, health care, sport, and close relationships. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Academic motivation in university: The role of basic psychological needs and identity formation.

This study was an investigation of the relationship between psychological need fulfillment, psychosocial development, and academic motivation in university students. Two models were tested. The 1st model, derived from developmental theories, proposed that basic psychological needs of autonomy, competence, and relatedness would predict identity and intimacy achievement, which would, in turn, predict academic intrinsic motivation. A 2nd model, based on self-determination theory, proposed that identity and intimacy would predict academic motivation and that this relationship would be mediated by basic psychological needs. Results from path analyses supported the model derived from self-determination theory over the model derived from developmental theories. Competence and identity were found to be the 2 constructs most strongly associated with academic motivation. These findings support the view that identity formation plays a critical role in facilitating academic motivation in university. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A self-determination theory perspective on parenting.

This article describes research on parenting that supports children's need for autonomy. First, the authors define parental autonomy support and distinguish it from permissiveness or independence promotion. The authors also define psychologically controlling parenting and distinguish it from behavioral control (structure). Second, the authors present studies examining how parental autonomy support promotes healthy development. Indeed, clear and consistent positive effects arise from different types of studies, conducted with children of various ages. Parent observation studies suggest that parental autonomy support is associated with infants' motivation and toddlers' internalization. Parent interview studies reveal that an autonomy-supportive parental attitude relates to children's adjustment at school. Children self-report studies demonstrate a clear link between perceptions of parental autonomy support and psychosocial functioning amongst adolescents. Third, the correlates and precursors of parental psychological control and autonomy support are presented, with a special focus on parents' trust in their children's ability to develop in an autonomous manner. Finally, ideas for future research are suggested. Although self-determination theory is not strictly a developmental theory, it seems highly pertinent to the socialization of children, their internalization and development. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Pressure from above and pressure from below as determinants of teachers' motivation and teaching behaviors.

When teachers are more supportive of autonomy and less controlling, students demonstrate higher levels of intrinsic motivation and self-determination. The purpose of this study was to examine social-contextual conditions that led teachers (N=254) who taught classes from Grades 1 to 12 to be more autonomy supportive versus controlling with their students. Using structural equation modeling, the authors observed that the more teachers perceive pressure from above (they have to comply with a curriculum, with colleagues, and with performance standards) and pressure from below (they perceived their students to be nonself-determined), the less they are self-determined toward teaching. In turn, the less they are self-determined toward teaching, the more they become controlling with students. (PsycINFO Database Record (c) 2010 APA, all rights reserved)