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Copyright of Environmental & Social Management Journal / Revista de Gestão Social e Ambiental is the property of Environmental & Social Management Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: Motivation to change is an important predictor for treatment outcomes in individuals with anorexia nervosa (AN), however, the existence and clinical relevance of distinct motivational dimensions are understudied. This study aimed to structurally validate the AN Stage of Change Questionnaire (ANSOCQ) in the Italian adult AN population to identify separate motivational dimensions and their association with clinical variables and outcomes. Method: Inpatients and outpatients with AN (N = 300) completed the ANSOCQ and measures assessing eating and depressive psychopathology. Unique Variable Analysis and Exploratory Graph Analysis were employed to identify dimensions in the network structure of ANSOCQ. Cross‐sectional associations with clinical variables were assessed in the whole sample. Predictive value on weight and psychopathology was assessed in inpatients. Results: Two dimensions were identified, one comprising items relative to weight gain, and the second items regarding attitudes towards eating, body, and emotional problems. Feelings associated with eating resulted as most central in the network. Higher scores in the first dimension and ANSOCQ total predicted weight gain during hospitalisation. No significant predictors emerged for changes in eating psychopathology. Discussion: These findings confirm the robust psychometric properties of ANSOCQ and provide support for the use of its subdimensions in clinical practice. Highlights: Motivation to change is an important predictor of clinical improvement in individuals with anorexia nervosa (AN). The AN Stages of Change is a reliable tool for assessing motivation, and valuable clinical information can be obtained from its structure.In this study, we utilise an innovative method based on network analysis to assess motivational dimensions and their associations with weight gain and psychopathology in the Italian population.Two main dimensions emerged, one pertaining to weight gain and significantly associated to inpatient weight increase, and the second regarding attitudes towards eating, body, and emotional problems. The application of network analysis to motivation to change introduces a novel and potentially valuable model for future investigations. [ABSTRACT FROM AUTHOR]

Objective: Motivation to change has been suggested to significantly impact treatment outcomes in eating disorders (EDs). This review will investigate factors associated with motivation to change in EDs with the aim of supporting clinicians to be aware and sensitive to factors that might obstruct recovery and to inform motivation‐based interventions. Method: Using PRISMA guidelines, this article identified 24 studies through database searches meeting eligibility criteria. Only correlates of motivation were identified, limiting the ability of this review to identify causal relationships. Factors that changed alongside changes in motivation were identified from longitudinal studies. Results: This review identified factors such as individual characteristics, co‐morbid psychopathology, lack of treatment autonomy and relationships with others to be associated with motivation to change in individuals with EDs. In addition, motivation to change significantly increased alongside self‐esteem and identity re‐negotiation when measured longitudinally. Discussion: Motivational interviewing can typically focus on exploring ambivalence to treatment, identifying goals and values, and increasing self‐efficacy. However, this review identifies individual and relational factors to be particularly significant and may obstruct recovery from an ED. As such, evidence‐based targets have been identified to inform clinicians and motivation‐based interventions. Public significance: Knowledge of factors associated with motivation to change in EDs is important to understand those who may have poorer treatment outcomes. Motivation may be improved by supporting individuals' relationship with others and tailoring interventions according to temperament and personality traits. Utilizing an individual's social support as they enter ED treatment may be effective in maximizing motivation to recover. [ABSTRACT FROM AUTHOR]

AbstractBackground: Stress and mental health difficulties are common burdens on college students. College counseling centers have been overrun by demand. Thus, self-help interventions may offer a promising alternative to traditional college counseling services. Methods: The current study examined the influence of perceived stress, motivation to change, and self-efficacy beliefs on college students’ use of self-help resources, to determine whether these factors would predict follow-up with self-help recommendations. Results: Results of stepwise linear regression models suggest that perceived stress and self-efficacy did not predict self-help resource utilization. Different types of self-help recommendations did not predict different levels of follow-up. However, motivation to change was a significant predictor college students’ self-help resource use, and this variable was particularly important when self-help recommendations were less structured. Conclusions: These findings can help to predict which college students are likely to make use of self-help resources, and inform targeted individual treatment. [ABSTRACT FROM AUTHOR]

Background: Research suggests that many people enrolled in internet-based mental health interventions drop out without completing the program. We implemented an efficacious internet-based self-help tool for people affected by skin picking disorder, aiming to evaluate the impact of an early withdrawal in terms of self-efficacy and treatment motivation. Method: We compared skin picking symptomatology (SPS), skin picking related self-efficacy (SP-SE) and motivation to change (SP-MtC) of 208 completers (52%) vs. 192 non-completers at 12-weeks post-assessment. Results: The decrease in SPS was significantly greater for completers (n = 208; M = 13.34; SD = 4.72) compared to non-completers (n = 192; M = 14.35; SD = 4.94; Cohen's d = -.39) at post-assessment. SP-SE increased significantly more for program completers (M = 31.72; SD = 6.50) compared to non-completers (M = 28.25; SD = 6.30; Cohen's d =.66) at post-assessment. SP-MtC significantly decreased in both groups, with higher scores for completers across all assessments (dpre-post =.06). Conclusions: Internet-based self-help tools can effectively reduce symptomatology. Participants, who do not complete the program, report lower treatment motivation and treatment-oriented self-efficacy, potentially reducing their help-seeking efforts. Treatment providers need to consider how to address these potentially adverse effects. [ABSTRACT FROM AUTHOR]

Whilst research has demonstrated the influence of individual and social identities on drinking‐related beliefs and behaviours, none evaluates how identities' incompatibilities are associated with mental health, current drinking status nor intentions, and motivations to change drinking behaviour. The current study explored how variability in incompatibilities between the social identities of being a drinker and a Christian related to mental health, alcohol use behaviour, and intentions to change drinking behaviour. A cross‐sectional online survey (via a recruitment platform, Prolific) recruited n = 180 US resident Christians who drank alcohol (56.4% male, 46.6% female, mean age = 37 years). Increased incompatibility between identities moderated the effect of current Christian identity on drinking change motivations—with the strongest links amongst those with the highest levels of incompatibility. A similar effect was also shown for increasing incompatibility between perceptions of the self as an individual and drinking behaviour (self/drinker incompatibility). The relationship between Christian identity on current drinking behaviour was also shown to be moderated by decreased Christian/drinker identity incompatibility but not self/drinker incompatibility. No relationships were identified for general mental well‐being. The study highlights that differences in the protective role of religious identities likely depend on how they relate to others, and the key role of identity incompatibility. [ABSTRACT FROM AUTHOR]

Given the high levels of inactivity and sedentary lifestyle in the general population and the barriers (including motivational ones) to the practice of regular physical activity, our study aims to evaluate the physical activity levels (PAL), sitting time (SIT), and motivation to change (MTC) lifestyle in a group of volunteer adults participating in an online survey promoted in some Italian regions. From December 2022 to March 2023, 127 adults (65 men and 62 women, mean age=40.17±14.83 years), volunteers, were involved in this study. Participants were invited to complete one-time online survey. General information, anthropometric, and questionnaire measures were collected. According to inclusion criteria, four participants were excluded; here we present results for 123 subjects. Data were studied for active/inactive and gender subgroups. Finally, the PAL and SIT categories were linked to motivational data. 54.8% of the participants did not report particular pathologies. 52.8% of participants replied that they regularly exercised. 44.4% engaged in physical activity alone, while 27% did so with friends, and 23.8% with a kinesiologist. Differences were observed both in the energy expenditure due to vigorous PA and in total energy expenditure. Regarding SIT, there were no differences between genders during weekdays. All the sample presented a high percentage in contemplation status but had medium scores in preparation and maintenance status. A statistically significant difference was observed in the contemplation state: we found higher average values regarding self-efficacy and readiness to change in men. It is necessary to plan campaigns to raise awareness and monitor the population's lifestyles beginning in the first decades of adulthood, promoting healthy lifestyle education initiatives to control the risk of non-communicable diseases. [ABSTRACT FROM AUTHOR]

Aim: Cigarette smoking is an addictive behavior that requires high motivation to change, a phenotype related to the functional activity of the brain. The study aims to examine motivation to change among cigarette smokers and to study the association between functional brain activity and motivation to change smoking behaviors. Methods: Motivation to change smoking behaviors of 107 current smokers receiving services in a university hospital was obtained using the Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES). Brain activities related to motivation to change were also explored in a subgroup using functional magnetic resonance imaging (fMRI). Results: The results showed that most of the current smokers (n = 68, 63.6%) were low motivated to change despite receiving health-related services. Brain activities in the left of the temporal, frontal gyrus, and superior medial gyrus of smokers with motivation were greater activated than those without. In contrast, the brain activities in the left precentral gyrus and bilateral paracentral lobules of smokers without motivation were greater activated. Conclusions: These preliminary results show the differences in brain activities between smokers with and without motivation to change and warrant further research to see if motivated smokers can quit smoking using a series of strategies based on their functional activities of the brain.

BackgroundFindings have been mixed as to whether brief intervention (BI) is appropriate and effective for individuals with more severe alcohol use problems. Motivation to change drinking has been supported as a mechanism of behavior change for BI. This exploratory study examined aspects of motivation as mechanisms of clinical response to BI and alcohol problem severity as a moderator of treatment effects.MethodsNon-treatment-seeking heavy drinkers (average age = 35 years; 57% male) were randomized to receive BI (n = 27) or attention-matched control (n = 24). Three indices of motivation to change were assessed at baseline and post-intervention: importance, confidence, and readiness. Moderated mediation analyses were implemented with treatment condition as the focal predictor, changes in motivation as mediator, 1-month follow-up drinks per day as the outcome, and an alcohol severity factor as second-stage moderator.ResultsAnalysis of importance displayed a significant effect of intervention condition on importance (p

Copyright of Revista Internacional de Investigación en Adicciones is the property of Centros de Integracion Juvenil A.C. (CIJ) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Motivation is considered essential in the treatment of anorexia nervosa (AN). However, the in-session nature of, and variables associated with, changes in motivation are only partially understood in this population. The aim of this study was to conduct an exploratory investigation of the in-session nature of motivation to change in people during cognitive behavioural therapy for anorexia nervosa (CBT-AN). Thirty-eight therapy-session transcripts from nine participants, collected as part of a larger multi-site randomised control trial, were analysed using inductive thematic analysis. Two superordinate themes were generated: (i) betwixt and between; and (ii) rhythms of motivation. Two concurrent yet distinct rhythms of motivation were observed within and across participant sessions, with shifts in motivation occurring alongside identity (re)negotiations. Findings highlight the complex and multifaceted nature of the in-session processes of motivational change in persons with AN, and support previous literature suggesting factors independent of treatment may facilitate tipping points of change. Furthermore, this study proposes that an integrated or dual-wave model of motivation may assist clinicians in understanding how they can better facilitate and support motivation for change in clients with AN during treatment. What is already known about this topic: Enhancing motivation is considered essential for improving treatment outcomes. Motivation is conceptualised as a dynamic process; however, it is typically assessed through quantitative self-report measures at set points during treatment. The in-session dynamics of motivation to change are poorly understood. What this topic adds: In-session motivation to change is a complex, multifaceted process closely associated with individual identity (re)negotiations. There may be dual processes of motivation occurring during treatment that are influenced by factors independent of treatment. A proposal for an integrated model of motivation for anorexia nervosa. [ABSTRACT FROM AUTHOR]

A program evaluation of a community outpatient mental health program was conducted as part of a required course in Spalding University's School of Professional Psychology. Specifically, the program evaluation examined how the client-specific factors of motivation to change were related to attendance and participation in services. Motivation to change was assessed by surveying program participants utilizing the University of Rhode Island Change Assessment (URICA). Students hypothesized stage of change would be significantly correlated with attendance rates. Results indicate stage of change was related to attendance, with pre-contemplation scores negatively associated with attendance although most of the specific analyses were not statistically significant. Students' experiences and feedback regarding conducting the program evaluation are discussed. [ABSTRACT FROM AUTHOR]

Background: Brief interventions represent a promising psychological intervention targeting individuals with heavy alcohol use. Motivation to change represents an individual's openness to engage in a behavior change strategy and is thought to be a crucial component of brief interventions. Neuroimaging techniques provide a translational tool to investigate the neurobiological mechanisms underlying potential mediators of treatment response, including motivation to change. Therefore, this study aimed to examine the effect of a brief intervention on motivation to change drinking behavior and neural alcohol taste cue reactivity. Methods: Non-treatment-seeking heavy drinkers were randomized to receive a brief drinking intervention (n = 22) or an attention-matched control (n = 24). Three indices of motivation to change were assessed at baseline and after the intervention or control session: importance, confidence, and readiness. Immediately following the intervention or control session, participants also underwent an functional magnetic resonance imaging (fMRI) during which they completed an alcohol taste cues paradigm. Results: There was a significant effect of the brief intervention on increasing ratings of importance of changing drinking behavior, but not on ratings of confidence or readiness to change. Ratings of importance after the intervention or control session were associated with neural alcohol taste cue reactivity, but notably, this effect was only significant for participants who received the intervention. Individuals in the intervention condition showed a positive association between ratings of importance and activation in the precuneus, posterior cingulate, and insula. Conclusions: The brief drinking intervention was successful at improving one dimension of motivation to change among non-treatment-seeking heavy drinkers. The brief intervention moderated the relationship between ratings of importance and brain activation in circuitry associated with interoceptive awareness and self-reflection. Together, findings represent an initial step toward understanding the neurobiological mechanisms through which a brief intervention may improve motivation to change.

This nonexperimental field study examined the relationship between participant reported experiences of relational depth (RD) with their individual counselors in substance use disorder (SUD) treatment and participant reported motivation to change substance use. Participants in the study were clients enrolled in inpatient and outpatient levels of substance use disorder treatment. [ABSTRACT FROM AUTHOR]

Based on the findings about the importance of social support network in the success of treatment and long term recovery, this article will provide an insight of the successful elements in addiction individual and group counseling interaction through which addicts manage to overcome the denial of addiction, to accept the recovery program, to go through the stages of recovery, and to identify appropriate research methods for understanding the phenomenon of interaction in recovery from addictions. This exploratory study will attempt to identify an innovative perspective of the aspects pertaining to the recovery from addiction which are susceptible to be disclosed primarily by using methods inspired by the analysis of interactions. The method used in research is qualitative focus group with addictions counsellors and people in recovery, working in a counseling center. Using the application of ELAN software to annotate and transcribe interactions from the video and audio recordings, it will situate the research on addiction and recovery from addiction in the larger field of investigations on communication processes in human interactions in various cultural, social and professional contexts. [ABSTRACT FROM AUTHOR]

Abstract Background Findings have been mixed as to whether brief intervention (BI) is appropriate and effective for individuals with more severe alcohol use problems. Motivation to change drinking has been supported as a mechanism of behavior change for BI. This exploratory study examined aspects of motivation as mechanisms of clinical response to BI and alcohol problem severity as a moderator of treatment effects. Methods Non-treatment-seeking heavy drinkers (average age = 35 years; 57% male) were randomized to receive BI (n = 27) or attention-matched control (n = 24). Three indices of motivation to change were assessed at baseline and post-intervention: importance, confidence, and readiness. Moderated mediation analyses were implemented with treatment condition as the focal predictor, changes in motivation as mediator, 1-month follow-up drinks per day as the outcome, and an alcohol severity factor as second-stage moderator. Results Analysis of importance displayed a significant effect of intervention condition on importance (p

Background: College student-athletes are a high-risk population for both pain and alcohol use. Although a growing literature indicates that pain motivates alcohol consumption, no studies have tested associations between pain and alcohol in college student-athletes. Methods and Results: Among National Collegiate Athletic Association Division I student-athletes at a large public university (N = 65; 48% Female), nearly all student-athletes (97%) reported alcohol use and 65% reported pain due to an athletic injury. Pain intensity was positively associated with greater motivation to reduce drinking prior to receiving a brief alcohol intervention. Among females, pain intensity was associated with lower self-reported alcohol consumption. Among male athletes, pain-related interference was associated with greater alcohol-related problems and lower perceived ability to deal with alcohol-related situations. Conclusion: Results provide initial evidence that pain may be important to consider when addressing alcohol use among student-athletes. [ABSTRACT FROM AUTHOR]

Plusieurs auteurs identifient la motivation au changement comme un aspect important de l'intervention auprès d'individus atteints d'anorexie mentale. Le Anorexia Nervosa Stages of Change Questionnaire (ANSOCQ) a été développé afin d'évaluer la motivation à changer spécifiquement chez cette population. Cette étude visait à valider une version francophone du ANSOCQ. Quatre-vingt-deux adolescents atteints d'anorexie mentale, ou d'un trouble de la conduite alimentaire non spécifié, ont rempli l'ANSOCQ, l' University o f Rhode Island Change Assessment Scale , le Motivation Stages of Change for Adolescents Recovering from an Eating Disorder et l' Eating Disorder Inventory-3 au début de leur hospitalisation. Cinquante-deux ont répondu aux mêmes questionnaires à la fin de leur hospitalisation. L'ANSOCQ a montré une excellente cohérence interne et une grande convergence entre ses sous-échelles. Sa validité a été soutenue par des associations à d'autres questionnaires portant sur la motivation au changement. De même, les sous-échelles du ANSOCQ étaient associées différemment à l'intensité du trouble de la conduite alimentaire et des difficultés psychosociales associées. Ces résultats appuient la qualité psychométrique de cette version francophone de l'ANSOCQ. La pertinence de distinguer les trois sous-échelles du test semble en outre prometteuse étant donné les différences observées entre celles-ci. Numerous authors regard motivation to change as a key feature in the treatment of individuals with anorexia nervosa. Although several questionnaires are available to assess motivation to change, most of them were not intended for adolescents nor individuals with anorexia nervosa. The Anorexia Nervosa Stages of Change Questionnaire (ANSOCQ) was developed to assess motivation to change specifically in individuals with anorexia nervosa. This study aimed to validate a French translation of the ANSOCQ based on the three-factor model identified elsewhere. Eighty adolescents suffering from anorexia nervosa and two from an eating disorder not otherwise specified were recruited at their arrival in a specialized eating disorder inpatient treatment program. Fifty-two adolescents participated again at the time of their discharge. Respondents completed the ANSOCQ, the University of Rhode Island Change Assessment Scale, a single item derived from the Motivation Stages of Change for Adolescents Recovering from an Eating Disorder, and the Eating Disorder Inventory-3. Cronbach's Alpha, Pearson's and Spearman's correlations, ANOVA and multiple regressions were performed. The global scale and subscales of the ANSOCQ demonstrated excellent internal consistency (α ≥ 0.82). The global scale was significantly correlated with both the URICA (r = 0.46) and the MSCARED (r s = 0.68). Participants' scores on the three subscales of the ANSOCQ were significantly higher at the end of their hospitalization (ps < 0.05), especially for the Ego-Alien Aspects subscale. Youths' scores on the Weight Gain subscale were significantly lower than their scores on both Eating, Shape, and Weight Concerns and Ego-Alien Aspects subscales (ps < 0.05). The ANSOCQ subscales significantly explained 52% and 41% of variance on the Eating Disorder Risk Composite Scale and the General Psychological Maladjustment Composite Scale, respectively. Furthermore, while the Weight Gain subscale was uniquely related to the former scale (β = −0.38), the Eating, Shape, and Weight Concerns subscale was uniquely associated with the latter scale (β = −0.39). These results support the psychometric qualities of this French translation of the ANSOCQ. Given the differences observed in the present study, the use of the ANSOCQ subscales also seems promising. It is possible that adolescents report higher motivation to change aspects of their difficulties that they recognize more, that are associated with fewer secondary benefits, and that entails greater unwanted repercussions. However, further studies are needed to confirm the factorial structure of the ANSOCQ. [ABSTRACT FROM AUTHOR]

Background: Interventions are required that address delays in treatment-seeking and low treatment coverage among people consuming methamphetamine., Objective: We aim to determine whether a self-administered smartphone-based intervention, the "S-Check app" can increase help-seeking and motivation to change methamphetamine use, and determine factors associated with app engagement., Methods: This study is a randomized, 28-day waitlist-controlled trial. Consenting adults residing in Australia who reported using methamphetamine at least once in the last month were eligible to download the app for free from Android or iOS app stores. Those randomized to the intervention group had immediate access to the S-Check app, the control group was wait-listed for 28 days before gaining access, and then all had access until day 56. Actual help-seeking and intention to seek help were assessed by the modified Actual Help Seeking Questionnaire (mAHSQ), modified General Help Seeking Questionnaire, and motivation to change methamphetamine use by the modified readiness ruler. χ 2 comparisons of the proportion of positive responses to the mAHSQ, modified General Help Seeking Questionnaire, and modified readiness ruler were conducted between the 2 groups. Logistic regression models compared the odds of actual help-seeking, intention to seek help, and motivation to change at day 28 between the 2 groups. Secondary outcomes were the most commonly accessed features of the app, methamphetamine use, feasibility and acceptability of the app, and associations between S-Check app engagement and participant demographic and methamphetamine use characteristics., Results: In total, 560 participants downloaded the app; 259 (46.3%) completed eConsent and baseline; and 84 (32.4%) provided data on day 28. Participants in the immediate access group were more likely to seek professional help (mAHSQ) at day 28 than those in the control group (n=15, 45.5% vs n=12, 23.5%; χ 2 =4.42, P=.04). There was no significant difference in the odds of actual help-seeking, intention to seek help, or motivation to change methamphetamine use between the 2 groups on the primary logistic regression analyses, while in the ancillary analyses, the imputed data set showed a significant difference in the odds of seeking professional help between participants in the immediate access group compared to the waitlist control group (adjusted odds ratio 2.64, 95% CI 1.19-5.83, P=.02). For participants not seeking help at baseline, each minute in the app increased the likelihood of seeking professional help by day 28 by 8% (ratio 1.08, 95% CI 1.02-1.22, P=.04). Among the intervention group, a 10-minute increase in app engagement time was associated with a decrease in days of methamphetamine use by 0.4 days (regression coefficient [β] -0.04, P=.02).1 =4.42, P=.04). There was no significant difference in the odds of actual help-seeking, intention to seek help, or motivation to change methamphetamine use between the 2 groups on the primary logistic regression analyses, while in the ancillary analyses, the imputed data set showed a significant difference in the odds of seeking professional help between participants in the immediate access group compared to the waitlist control group (adjusted odds ratio 2.64, 95% CI 1.19-5.83, P=.02). For participants not seeking help at baseline, each minute in the app increased the likelihood of seeking professional help by day 28 by 8% (ratio 1.08, 95% CI 1.02-1.22, P=.04). Among the intervention group, a 10-minute increase in app engagement time was associated with a decrease in days of methamphetamine use by 0.4 days (regression coefficient [β] -0.04, P=.02)., Conclusions: The S-Check app is a feasible low-resource self-administered intervention for adults in Australia who consume methamphetamine. Study attrition was high and, while common in mobile health interventions, warrants larger studies of the S-Check app., Trial Registration: Australian New Zealand Clinical Trials Registry ACTRN12619000534189; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=377288&isReview=true., (©Krista J Siefried, Florence Bascombe, Brendan Clifford, Zhixin Liu, Peter Middleton, Frances Kay-Lambkin, Jack Freestone, Daniel Herman, Michael Millard, Maureen Steele, Liam Acheson, Carl Moller, Nicky Bath, Nadine Ezard. Originally published in JMIR mHealth and uHealth (https://mhealth.jmir.org), 03.07.2024.)

Introduction: Anorexia nervosa (AN) is a serious mental disorder that typically manifests in adolescence. Motivation to change is an important predictor for treatment outcome in adolescent AN, even though its development over the often long therapeutic process, with transitions between treatment settings, has not yet been studied. In this pilot study, the course of motivation to change and its effect on treatment outcome were investigated over the course of a step-down treatment approach during a 12-month observation period. Methods: Twenty-one adolescents admitted to inpatient treatment because of AN received multidisciplinary home treatment (HoT) with several weekly visits after short inpatient stabilization. Eating disorder (ED-)specific cognitive [Eating Disorder Inventory 2 (EDI-2) subscales] and physical [% expected body weight (%EBW)] illness severity and motivation to change [Anorexia Nervosa Stages of Change Questionnaire (ANSOCQ)] were assessed at the time of admission, discharge from hospital, at the end of HoT, and at a 12-month follow-up. Changes in motivation over time and its relationship with treatment outcome were investigated. Results: Mean motivation to change improved significantly over the course of treatment from the contemplation stage [2nd stage, mean ANSOCQ sum score 47.26 (SD 17.60)] at admission to the action stage [4th stage, mean ANSOCQ sum score 77.64 (SD 18.97)] at the end of HoT (p < 0.001) and remained stable during the follow-up period. At each assessment, higher motivation to change was significantly correlated with lower ED-specific cognitive illness severity (Spearman ρs: −0.53 to −0.77, all p < 0.05). Only pretreatment motivation to change significantly predicted ED-specific cognitive illness severity after the first inpatient treatment phase when taking prior illness severity into account. Conclusions: Motivation to change is an important aspect of treatment success in adolescent AN, especially in the early phase of treatment. In addition, home treatment contributed significantly to a higher motivation. Further longitudinal research into how motivation to change in adolescent patients with AN is related to outcome in this often severe and enduring disease and into targeted therapeutic strategies and interventions that reliably enhance the motivation to change in adolescent patients with AN seems promising. [ABSTRACT FROM AUTHOR]

Introduction: Anorexia nervosa (AN) is a serious mental disorder that typically manifests in adolescence. Motivation to change is an important predictor for treatment outcome in adolescent AN, even though its development over the often long therapeutic process, with transitions between treatment settings, has not yet been studied. In this pilot study, the course of motivation to change and its effect on treatment outcome were investigated over the course of a step-down treatment approach during a 12-month observation period.Methods: Twenty-one adolescents admitted to inpatient treatment because of AN received multidisciplinary home treatment (HoT) with several weekly visits after short inpatient stabilization. Eating disorder (ED-)specific cognitive [Eating Disorder Inventory 2 (EDI-2) subscales] and physical [% expected body weight (%EBW)] illness severity and motivation to change [Anorexia Nervosa Stages of Change Questionnaire (ANSOCQ)] were assessed at the time of admission, discharge from hospital, at the end of HoT, and at a 12-month follow-up. Changes in motivation over time and its relationship with treatment outcome were investigated.Results: Mean motivation to change improved significantly over the course of treatment from the contemplation stage [2nd stage, mean ANSOCQ sum score 47.26 (SD 17.60)] at admission to the action stage [4th stage, mean ANSOCQ sum score 77.64 (SD 18.97)] at the end of HoT (p < 0.001) and remained stable during the follow-up period. At each assessment, higher motivation to change was significantly correlated with lower ED-specific cognitive illness severity (Spearman ρs: −0.53 to −0.77, all p < 0.05). Only pretreatment motivation to change significantly predicted ED-specific cognitive illness severity after the first inpatient treatment phase when taking prior illness severity into account.Conclusions: Motivation to change is an important aspect of treatment success in adolescent AN, especially in the early phase of treatment. In addition, home treatment contributed significantly to a higher motivation. Further longitudinal research into how motivation to change in adolescent patients with AN is related to outcome in this often severe and enduring disease and into targeted therapeutic strategies and interventions that reliably enhance the motivation to change in adolescent patients with AN seems promising.

Objective: Social learning models of intimate partner violence (IPV) suggest that perpetration is associated with a tendency to anticipate more positive, and fewer negative, outcomes of abusive behaviors. However, relatively little research has examined perpetrators' beliefs about the effects of engaging in IPV. The Outcome Expectancies of Partner Abuse (OEPA) scale (Meis et al., Assessment, 2010, 17, 30) was developed to assess positive and negative anticipated outcomes of engaging in IPV. The present study sought to confirm the OEPA factor structure, examine its associations with a range of clinically important variables, and highlight the potential implications for abuse interventions. Method: Participants were men presenting for treatment at a community abuse intervention program (N = 305). We conducted confirmatory factor analysis (CFA) on the OEPA and correlated participants' ratings of positive and negative outcome expectancies with measures of emotion regulation, mental health, relationship functioning and abusive behavior, IPV attitudes, and criminal charges. Results: CFA supported the 22-item, two-factor structure of the OEPA. Positive outcome expectancies were associated with higher IPV perpetration, posttraumatic stress disorder (PTSD) symptoms, anger expression, emotion dysregulation, more prior arrests for partner abuse, and lower readiness to change. Negative outcome expectancies, in contrast, were associated with higher emotional awareness, negative IPV reactions, and readiness to change. Conclusions: The OEPA has a clear two-factor structure and reliably assesses both positive and negative outcome expectancies. Positive expectancies regarding the effects of abuse, in particular, are linked to greater IPV perpetration and clinical problems that predict poorer response to IPV treatment. [ABSTRACT FROM AUTHOR]

Background: Alcohol dependence is a complex psychological disorder whose phenomenology changes as the disorder progresses. Neuroscience has provided a variety of theories and evidence for the development, maintenance, and severity of addiction; however, clinically, it has been difficult to evaluate alcohol use disorder (AUD) severity.Objective: This study seeks to evaluate and validate a data-driven approach to capturing alcohol severity in a community sample.Method: Participants were non-treatment seeking problem drinkers (n = 283). A structural equation modeling approach was used to (a) verify the latent factor structure of the indices of AUD severity; and (b) test the relationship between the AUD severity factor and measures of alcohol use, affective symptoms, and motivation to change drinking.Results: The model was found to fit well, with all chosen indices of AUD severity loading significantly and positively onto the severity factor. In addition, the paths from the alcohol use, motivation, and affective factors accounted for 68% of the variance in AUD severity. Greater AUD severity was associated with greater alcohol use, increased affective symptoms, and higher motivation to change.Conclusion: Unlike the categorical diagnostic criteria, the AUD severity factor is comprised of multiple quantitative dimensions of impairment observed across the progression of the disorder. The AUD severity factor was validated by testing it in relation to other outcomes such as alcohol use, affective symptoms, and motivation for change. Clinically, this approach to AUD severity can be used to inform treatment planning and ultimately to improve outcomes. © 2013 Moallem, Courtney, Bacio and Ray.

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Background: Adolescent substance use is highly prevalent and problematic; it has been reported as one of the most pertinent leading health concerns in the United States. The current longitudinal study examined the presence of peer and parental interpersonal relationship consequences (IP) as a motivating factor in activating coping skills to decrease the frequency of adolescent substance use, while further evaluating the role of impulsivity within that process. Objectives: Two main hypotheses were proposed: (1) IP will decrease substance use frequency mediated by increases in motivation and temptation coping; and (2) impulsivity will moderate the link between coping and substance use frequency. Participants included 343 adolescents between the ages of 13-19 (M = 16.23) referred to Project READY, a school-based substance use intervention. Assessments were completed during Sessions 1 and 4 of the intervention. Results: Serial mediation analyses indicated temptation coping, baseline alcohol use, and Time 2 marijuana use were the only statistically significant predictors of Time 2 alcohol use. Temptation coping and baseline marijuana use were the only statistically significant predictors of Time 2 marijuana use. Conclusions: Once adolescents' baseline and concurrent substance use were incorporated into the model, there was no statistical significance of the indirect effects. Results provided a stronger examination of the factors related to long-term substance use among adolescents. Knowing that temptation coping and baseline substance use levels were significant predictors of time 2 substance use independent of interpersonal consequences and motivation to change provides a structural frame and highlights need for early intervention. [ABSTRACT FROM AUTHOR]

Objectives: The objective of this study was to examine the predictive validity of the Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES) among Alaska Native and American Indian (ANAI) people with an alcohol use disorder. Methods: The sample was 170 ANAI adults with an alcohol use disorder living in Anchorage, Alaska who were part of a larger alcohol intervention study. The primary outcome of this study was alcohol use as measured by mean urinary ethyl glucuronide (EtG). EtG urine tests were collected at baseline and then up to twice a week for four weeks. We conducted bivariate linear regression analyses to evaluate associations between mean EtG value and each of the three SOCRATES subscales (Recognition, Ambivalence, and Taking Steps) and other covariates such as demographic characteristics, alcohol use history, and chemical dependency service utilization. We then performed multivariable linear regression modeling to examine these associations after adjusting for covariates. Results: After adjusting for covariates, mean EtG values were negatively associated with the Taking Steps (P=0.017) and Recognition (P=0.005) subscales of the SOCRATES among ANAI people living in Alaska. We did not find an association between mean EtG values and the Ambivalence subscale (P=0.129) of the SOCRATES after adjusting for covariates. Conclusions: Higher scores on the Taking Steps and Recognition subscales of the SOCRATES at baseline among ANAI people predicted lower mean EtG values. This study has important implications for communities and clinicians who need tools to assist ANAI clients in initiating behavior changes related to alcohol use. [ABSTRACT FROM AUTHOR]

L'alliance de travail est un prédicteur important des résultats de l'intervention auprès d'adultes et d'adolescents. L'établissement de l'alliance de travail avec les adolescents pose certains défis particuliers, notamment parce que la consultation est fréquemment initiée par un tiers, que leur motivation à changer est souvent faible et que l'intervention est parfois imposée. Identifier les facteurs susceptibles d'influencer la qualité de l'alliance de travail dans ce contexte est donc important. Cette étude vise à examiner les liens entre quatre caractéristiques individuelles et la qualité de l'alliance de travail précoce chez des adolescentes placées en centres éducatifs. Quarante-six adolescentes (12–17 ans) recrutées dans différents centres montréalais ont répondu à cinq questionnaires autorapportés évaluant la motivation au changement, le sentiment d'efficacité personnelle, l'attitude envers l'autorité, les difficultés comportementales présentées et la qualité perçue de l'alliance de travail. Les résultats d'une régression multiple suggèrent que la motivation au changement et le sentiment d'efficacité personnelle expliquent 39,5 % (p < 0,01) de la variance de la qualité perçue de l'alliance de travail. Ces résultats soulignent l'intérêt de ces variables comme cibles thérapeutiques potentielles pour favoriser une alliance de travail positive auprès d'adolescentes en centres éducatifs. The working alliance is an important predictor of the outcomes of intervention with adults and adolescents. Establishing the working alliance with adolescents involves some specific challenges. Indeed, the consultation among this population is often initiated by a third party, who is usually a parent or an authority figure. The intervention may even be imposed on the youth if his behaviour involves significant risks to himself or others, as is the case in rehabilitation centres. In addition, it is also important to note that their motivation to change is often low at the beginning of the intervention, which makes the development of the working alliance even more complex. Therefore, it seems relevant to identify factors that may influence the quality of the working alliance, especially when it is a coercive intervention such as in rehabilitation centres. This study aims to examine the links between some personal characteristics and the quality of the early working alliance among adolescent girls placed in rehabilitation centres. The four personal characteristics investigated are: motivation to change, self-efficacy, attitude towards authority figures and behavioural difficulties. Forty-six adolescent girls (12–17 years old) were recruited at the time of their admission to one of the rehabilitation centres located in Montreal. They all completed five self-reported questionnaires: the Working Alliance Inventory Short, the University of Rhode Island Change Assessment Scale, the Self-Efficacy Questionnaire for Children, the Attitudes to Formal Authority Questionnaire, and the Youth Self Report. The results indicated that motivation for change (β =.55) and sense of self-efficacy (β =.36) are the variables most closely related to the quality of the perceived working alliance at the beginning of the intervention. Motivation to change and self-efficacy explained 39.5% (p <.01) of the variance of the perceived quality of the working alliance. Attitude towards authority and behavioural problems were not significantly associated with the quality of the working alliance. These findings are consistent with those of other studies conducted with adults or young people in other contexts. Our results suggest that motivation to change and self-efficacy are therapeutic targets to consider in order to promote the establishment of a positive working alliance at the beginning of an intervention with adolescent girls placed in rehabilitation centres. [ABSTRACT FROM AUTHOR]

Purpose: Kentucky experiences a disproportionate burden of substance use disorder (SUD), particularly in rural areas of the state. Multiple factors increase vulnerability to SUD and limit access to services in rural communities. However, the recent implementation and expansion of syringe service programs (SSPs) in rural Kentucky may provide a leverage point to reach at‐risk people who inject drugs (PWID). Methods: Data were collected as part of an ongoing NIDA‐funded study designed to examine uptake of SSPs among PWID in Appalachian Kentucky. Using Respondent Driven Sampling (RDS), the study enrolled a sample of 186 PWID SSP attenders across 3 rural Appalachian Kentucky counties and conducted face‐to‐face interviews regarding health behaviors, injecting practices, SSP utilization, and treatment services. Using logistic regression analyses, we examined consistent SSP use, as well as importance and confidence to reduce substance use as predictors of current treatment participation. Findings: For the prior 6 months, 44.6% of the sample reported consistent SSP use. Consistent use of SSPs was associated with treatment participation in the unadjusted logistic regression models. Significant predictors of treatment participation in the adjusted model included high confidence to reduce substance use, and not reporting primary methamphetamine injection. Conclusions: Rurally located SSPs may play an important role in supporting confidence and motivation to change substance use behaviors among PWID impacted by SUD. SSPs may be critical venues for integration and expansion of prevention, health promotion, and treatment linkage services for this underserved population. [ABSTRACT FROM AUTHOR]

Elena Fiabane,1,2 Marcella Ottonello,1,3 Valeria Zavan,4 Caterina Pistarini,1 Ines Giorgi5 1Department of Physical and Rehabilitation Medicine, ICS Maugeri Spa SB, Institute of Genoa Nervi, Genoa, 2Department of Brain and Behavioral Sciences, University of Pavia, Pavia, 3Department of Medicine, PhD Program in Advance Sciences and Technologies in Rehabilitation Medicine and Sport, Università di Tor Vergata, Rome, 4Alcohol Unit, Addiction Department, Alessandria, 5Psychology Unit, ICS Maugeri Spa SB, Scientific Institute of Pavia, Pavia, Italy Background: An inpatient 28-day rehabilitation program for alcohol dependence is focused on detoxification, enhancing motivation to change, and coping strategies for the management of emotional distress and temptation to drink. The aims of the present study were to investigate 1) changes over time in motivation to change, anxiety, and depression in individuals undergoing residential rehabilitation treatment for alcohol addiction, and 2) which pretreatment factors are associated with posttreatment temptation to drink.Methods: We assessed 432 patients diagnosed with alcohol dependence based on the Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition, Text Revision) consecutively recruited from seven residential rehabilitation centers in Northern Italy. Patients were assessed by means of self-report questionnaires at the beginning of rehabilitation (pretreatment) and before their hospital discharge (posttreatment) regarding motivation to change and self-efficacy (motivation assessment of change – alcoholism version), readiness to change and temptation to drink (visual analog scales), and depression and anxiety (cognitive behavioral assessment – outcome evaluation).Results: Results showed an overall improvement in motivation to change and a significant reduction over time in depression and anxiety levels for the total sample, particularly patients with low baseline level of temptation to drink. Multivariate linear regression analysis revealed that significant predictors of posttreatment temptation to drink were polysubstance dependence (p

Abstract Background Understanding motivation to change is a key issue in both the assessment and the treatment of eating disorders. Therefore, sound instruments assessing this construct are of great help to clinicians. Accordingly, the present study analysed the psychometric properties of the Anorexia Nervosa Stages of Change Questionnaire (ANSOCQ), including its relation to coping style and self-esteem. Methods N = 92 adolescents referred to an eating disorders outpatient clinic meeting criteria for anorexia nervosa gave written informed consent to participate in this study and completed the ANSOCQ, the Eating Disorder Inventory, the Eating Attitudes Test, the Body Image Questionnaire, two questionnaires measuring Self-Related Cognitions and the Coping Across Situations Questionnaire. After a treatment period of nine months, clinical anorexia nervosa diagnosis and the body mass index were re-assessed. In addition to exploratory factor analysis, correlational analysis was used to test for the convergent validity of the ANSOCQ and logistic regression analysis was used to test its predictive validity. Results The ANSOCQ had good psychometric properties. Factor analysis yielded two meaningful factors labelled as ‘weight gain and control’ and ‘attitudes and feelings’. Internal consistencies of the two factors amounted to Cronbach’s alpha = .87 and .76, respectively. Significant correlations with other scales measuring eating disorder psychopathology were indicative of meaningful construct validity. Higher motivation to change was related to higher self-esteem and a more active coping style. Higher (positive) ANSOCQ total scores predicted remission of anorexia nervosa after nine months of treatment. A higher score on ‘attitudes and feelings’ was a protective factor against drop-out from intervention. Conclusions The ANSOCQ is a clinically useful instrument for measuring motivation to change in adolescents with AN. Two factorial dimensions explain most of the variation. Self-esteem and coping style are relevant additional constructs for the understanding of the motivation to change in anorexia nervosa. Trial registration NCT02828956 . Retrospectively registered July 2016

Background: Brief interventions represent a promising psychological intervention targeting individuals with heavy alcohol use. Motivation to change represents an individual’s openness to engage in a behavior change strategy and is thought to be a crucial component of brief interventions. Neuroimaging techniques provide a translational tool to investigate the neurobiological mechanisms underlying potential mediators of treatment response, including motivation to change. Therefore, this study aimed to examine the effect of a brief intervention on motivation to change drinking behavior and neural alcohol taste cue reactivity.Methods: Non–treatment-seeking heavy drinkers were randomized to receive a brief drinking intervention (n = 22) or an attention-matched control (n = 24). Three indices of motivation to change were assessed at baseline and after the intervention or control session: importance, confidence, and readiness. Immediately following the intervention or control session, participants also underwent an functional magnetic resonance imaging (fMRI) during which they completed an alcohol taste cues paradigm.Results: There was a significant effect of the brief intervention on increasing ratings of importance of changing drinking behavior, but not on ratings of confidence or readiness to change. Ratings of importance after the intervention or control session were associated with neural alcohol taste cue reactivity, but notably, this effect was only significant for participants who received the intervention. Individuals in the intervention condition showed a positive association between ratings of importance and activation in the precuneus, posterior cingulate, and insula.Conclusions: The brief drinking intervention was successful at improving one dimension of motivation to change among non–treatment-seeking heavy drinkers. The brief intervention moderated the relationship between ratings of importance and brain activation in circuitry associated with interoceptive awareness and self-reflection. Together, findings represent an initial step toward understanding the neurobiological mechanisms through which a brief intervention may improve motivation to change.

College student cannabis use is at an all-time high. Although frequent heavy cannabis use is related to cannabis problems, perceived risk of cannabis use is rapidly decreasing. Yet, it is unknown whether specific domains of risk perceptions (general and domain-specific risk, risk to others and personal risk) are related to more cannabis use or related problems. Thus, among 130 undergraduates who reported past-month cannabis use, the present study conducted secondary analyses to test whether, for both perceived risk to others and perceived personal risk: (1) general perceived risk was associated with cannabis-related outcomes (i.e., use, negative consequences, cannabis use disorder (CUD) symptoms, motivation to change), (2) seven specific domains of perceived risk were related to cannabis outcomes, and (3) domain-specific perceived risk was related to cannabis use frequency. General perceived risk to others was negatively associated with cannabis use frequency whereas general perceived personal risk was positively associated with cannabis-related negative consequences, CUD symptoms, and importance and readiness to change. Greater legal and withdrawal/dependence risks were uniquely related to several outcomes (e.g., CUD symptoms). Participants who used cannabis frequently perceived more personal risk in most risk domains and less general risk to others than those who used infrequently. Findings suggest personal risk is an important component to consider when assessing perceived risk of cannabis use and focusing on both general and domain-specific risks may provide valuable insight for future prevention and intervention efforts., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 Authors et al.)

Objective: The aim of this study was to explore characteristics and treatment‐seeking intentions of consumers accessing an online resource for eating disorders support, Reach Out and Recover (ROAR). Factors associated with treatment‐seeking intent among visitors to ROAR were also examined. Method: Participants were 200 visitors to the website aged 18 to 60 plus. The majority of participants (93.5%) identified as women. Responses to self‐report questions assessing treatment‐seeking intention, eating disorder symptoms and their impact on health, and attitudes to treatment were collected. Results: Participants experienced a range of eating disorder symptoms, yet the majority (86.0%) was not receiving treatment. Importantly, of those not in treatment, the majority (82.6%) indicated that they planned to get treatment. In addition, more than half of participants (52.9%) downloaded a report to present to their health practitioner to facilitate communication with a health professional. Intention to seek treatment and download of the report were positively associated with motivation to change, confidence to achieve change, greater frequency of binge eating, and greater recognition of the impact of eating disorder symptoms on relationships and well‐being but not with stigma or ambivalence. Discussion: Study findings indicated that the ROAR website was accessed by individuals for whom it was designed, namely those experiencing eating disorder symptoms who are not receiving treatment. Encouragingly, participants had strong intentions to seek treatment, and the majority downloaded a report that could be used to facilitate the first step toward treatment. Greater focus on enhancing motivation and confidence to change may further promote treatment‐seeking. [ABSTRACT FROM AUTHOR]

This paper reviews the available research on the predictors of parental engagement in preventive and therapeutic psychological interventions that target mental health problems in children. Based on previous literature, seven predictors concerning parental motivation to engage are considered: perceived child problems, perceived parenting, attributions of problems, self-efficacy, expectations about treatment, perceived obstacles and global motivation to engage. PRISMA guidelines for systematic review were used to conduct the literature search. Thirty-seven studies that examined prospective relations between parental cognitions evaluated at the beginning of the intervention and parental engagement during the intervention were included. Most studies focused on the parents' perception of the child's problems and of parenting, with fewer studies examining the role of the other parental cognitions. The results suggest that the psychological dimensions proposed in motivational models may play an important role in understanding parental engagement in preventive and therapeutic psychological interventions. [ABSTRACT FROM AUTHOR]

The decisional balance inventory (DBI) test is a valuable tool to assess motivation to change; we consider its application in enhancing motivation of losing weight. Our aim is the translation, cultural adaption and validation in Italian of this test originally designed and drafted in English. The questionnaire has been translated according to an English → Italian → Italian → English algorithm with reconciliation of the differences. Pilot study and retests were performed on 47 cases [body mass index (BMI) ≥30 kg/m2] and 15 controls (BMI value between 18.5 and 25 kg/m2). The internal consistency of the Italian version of DBI test, was satisfied (Cronbach α 0.87 on patients); test-retest shows a good concordance in pilot [Lin’s concordance correlation coefficient (CCC) 0.79; 95% confidence interval (CI) 0.68-0.90] and in patient sample (Lin’s CCC 0.83; 95% CI: 0.67 0.99).Our study demonstrated the trans-cultural adaptation and validation of DBI test in Italian.

Objectives: Trajectories of change accompanying alcohol‐specialized care can be affected by numerous variables. Massive urges to drink can substantially hamper personal motivation to change. However, time perspective could also play an indirect role in this association. This research explores whether time perspectives mediates the relationship between inclinations to use or not to use alcohol and patients' motivation to change. Design: The sample included 150 outpatients in care for their problematic alcohol use. Models of mediation were planned. Results: At the entry in care, three specific time perspectives, Past Negative, Present Fatalistic, and Future, acted as discrete mediators. Conclusions: These findings highlight underlying mechanisms connecting inclinations to use or to avoid the substance and the patient's motivation to change. Time perspective could also be an interesting intervention target in existing alcohol‐specialized treatment programs. [ABSTRACT FROM AUTHOR]

Objective: We prospectively examined whether subjective intoxication serves as a risk factor for experiencing alcohol-induced blackouts. We then examined whether subjective intoxication and/or blackouts predicted motivation to decrease their drinking, and whether this motivation to change would promote future changes in drinking behavior.Method: Participants (N=1854, 62.1% female, 53.2% Caucasian, Mage=21.8) were recruited the summer prior to matriculating into a large, public university to complete a 6-year longitudinal study. Self-reported motivation to decrease their drinking behavior, their frequency of blackouts, quantity of alcohol consumption, and subjective intoxication (i.e., feeling drunk) were assessed annually during the transition out of college (Years 4-6).Results: In a cross-lagged model, subjective intoxication (i.e., feeling drunk) prospectively predicted experiencing blackouts (p<0.001). Controlling for both objective (e.g., quantity) and subjective intoxication, blackouts at Year 4 predicted greater motivation to decrease drinking behavior at Year 5 (p<0.01), but this motivation did not predict less quantity of alcohol use by Year 6 (p=0.076).Conclusions: Subjective intoxication is a robust predictor of blackouts across time. Additionally, blackouts are modest, developmentally-limited predictors of motivation to change drinking behavior, but blackouts do not predict future behavior change. [ABSTRACT FROM AUTHOR]

More than 60% of general hospital patients report ≥ 2 health risk behaviors (HRBs), i.e. tobacco smoking, at-risk alcohol use, unhealthy diet, and/or insufficient physical activity. This study investigates a) the association between numbers of HRBs and motivation to change, b) patient preferences for receiving feedback on HRBs, and c) patients' expected gain in quality of life if behavior change made. In 2020/2021, 256 18–64-year-old general hospital patients (72.1% of eligibles) reported on their motivation to change each of their HRBs. Associations between HRB number and motivation were assessed using multivariate linear regressions. Participants ranked HRBs concerning their interest in receiving feedback and concerning their expected gain in quality of life if behavior change occurred. Higher HRB number was negatively related to motivation among at-risk alcohol users (p = 0.034); 24.6% expected gain in their quality of life from behavior change. Participants overall appeared more favorable to feedback about vegetable/fruit intake and physical activity. Unhealthier lifestyle may be accompanied by decreased motivation to change in at-risk alcohol users. In case of co-occurring HRBs, asking patients for expected gain in quality of life may help guiding intervention target. Relying on patient selection only, may often leave substance-use unaddressed. • The more health risk behaviors the lower the motivation to change alcohol use. • Patients (also with low motivation) are open for feedback on health risk behaviors. • Expected gain in quality of life can help focusing multi-behavior interventions. • Relying on patient preference for feedback only may leave substance-use unaddressed. [ABSTRACT FROM AUTHOR]

Pregnancy is a period, which is an opportunity for any change due to its character and effect of the baby-to-be on its mother, including a change in smoking behaviour. A pregnant woman usually wishes that her baby is healthy and smoking is generally known, from professional and daily press, to represent a significant health risk for both a pregnant woman and her unborn baby. Pregnancy offers a motivation shift for many women, which helps them to quit smoking and continue with their abstinence during pregnancy. Pregnancy is the most opportune period and a unique chance for motivation of pregnant women to cease smoking, as most women accept health perspectives of protection of their motherhood. It was discovered that even the fact that the future baby will see its mother smoking motivated women to quit smoking. Methods. Quantitative questionnaire survey. The questionnaire consists of parts dealing with anamnesis, motivation for change of smoking behaviour and Fagerström test of nicotine addiction. The motivation part was inspired by Reasons for Quitting Scale (RFQ). Evaluation took place by means of descriptive statistics and nonparametric statistic tests. Sample. The work analyses two groups of pregnant women - electronic group (collection by means of a web form, N = 96) and clinical group (collection on the Gynaecological-birth Clinic of the 1st Faculty of Medicine and General University Hospital in Prague, N = 40). The groups are divided into 4 subgroups according to the current smoking behaviour of the respondents. Respondents fill in a different extent of the questionnaire according to their current smoking behaviour. Results. Prevalence of smoking in pregnancy is 21 % in the electronic group and a 8 % in the clinical group. All respondents with smoking in their anamnesis made a change in their smoking behaviour related to pregnancy (ceased smoking or limited their smoking). The crucial motive for change of smoking habits in pregnancy is the health of the unborn baby. Motivation of women from various groups of smoking behaviour differs at least in the dimension of internal motivation. A half of women, who keep smoking in pregnancy, show just a little or none physical addiction to nicotine. Discussion. A high difference in prevalence between both study groups can be explained by the size of the groups, which also represents a certain limitation for the study results. The difference may also be caused by the fact that findings related to the electronic group may be burdened by the manner of their collection. A problem related to quitting smoking in pregnancy, the existence of which was confirmed, is continued abstinence after giving birth, when both the motives from the external surroundings and pregnancy-specific motives cease to apply. It might be assumed that women, who do not quit smoking in pregnancy despite its high motivation potential, will not quit smoking, as they are heavily addicted to nicotine and they are not able to quit smoking because of their physical addiction. However, study findings do not support this assumption. A half of the respondents, who did not quit smoking in pregnancy, shows just a little or none physical addiction to nicotine. In these women, the obstacles too difficult to overcome in their efforts to quit smoking are the psychosocial addiction components rather than a physical addiction to nicotine. Conclusion. All respondents with smoking in their anamnesis made a change in their smoking behaviour (ceased smoking or limited their smoking). Therefore, pregnancy really is a period with a strong motivation potential for change of smoking habits of a woman - a mother to be.