Lack of life goals and motivation

Motivation, health-related lifestyles and depression among university students: A longitudinal analysis

Type of study: non-rct observational study

Number of citations: 32

Year: 2018

Authors: G. Piumatti

Journal: Psychiatry Research

Journal ranking: Q1

Key takeaways: Higher motivation in university students predicts lower depression after one year, making it a better predictor of mental health than health-related risk factors.

A meta-analysis of the dark side of the American dream: Evidence for the universal wellness costs of prioritizing extrinsic over intrinsic goals.

Type of study: meta-analysis

Number of citations: 39

Year: 2022

Authors: E. Bradshaw, James H. Conigrave, Ben A. Steward, Kelly A Ferber, Philip D Parker, Richard M. Ryan

Journal: Journal of personality and social psychology

Journal ranking: Q1

Key takeaways: Prioritizing extrinsic goals over intrinsic ones is universally detrimental to well-being, with a link between extrinsic aspirations and ill-being being universally negative.

Abstract: Self-determination theory holds that the intrinsic and extrinsic content of people's aspirations differentially affect their wellness. An evidence base spanning nearly 30 years indicates that focusing on intrinsic goals (such as for growth, relationships, community giving, and health) promotes well-being, whereas a focus on extrinsic goals (such as for wealth, fame, and beauty) deters well-being. Yet, the evidence base contains exceptions, and some authors have argued that focusing on extrinsic goals may not be universally detrimental. We conducted a systematic review and used multilevel meta-analytic structural equation modeling to evaluate the links between intrinsic and extrinsic aspirations with indices of well-being and ill-being. Across 92 reports (105 studies), 1,808 effects, and a total sample of N = 70,110, we found that intrinsic aspirations were linked positively with well-being, r = 0.24 [95% CI 0.22, 0.27], and negatively with ill-being, r = -0.11 [-0.14, -0.08]. When the variety of extrinsic aspiration scoring methods were combined, the link with well-being was not statistically significant, r = 0.02 [-0.02, 0.06]. However, when extrinsic aspirations were evaluated in terms of their predominance in the overall pattern of aspiring the effect was universally detrimental, linking negatively to well-being, r = -0.22 [-0.32, -0.11], and positively to ill-being, r = 0.23 [0.17, 0.30]. Meta-analytic conclusions about the associations between goal types and wellness are important because they inform how individuals could shape aspirations to support their own happiness and how groups and institutions can frame goals such that their pursuit is for the common good. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Effects of Goal-Striving Stress on the Mental Health of Black Americans∗

Type of study: non-rct observational study

Number of citations: 75

Year: 2008

Authors: Sherrill L. Sellers, H. Neighbors

Journal: Journal of Health and Social Behavior

Journal ranking: Q1

Key takeaways: Goal-striving stress negatively impacts mental health in black Americans, with higher stress levels affecting happiness, life satisfaction, and self-esteem, and poverty status moderating this relationship.

Abstract: Although many scholars have theorized about how responding to the stress of blocked opportunities can affect the well-being of black Americans, few scholars have empirically examined the relationships between striving efforts, personal goals, and mental health among black Americans. This investigation examines the relationship between goal-striving stress and mental health in a national sample of black Americans. Results indicate that goal-striving stress is significantly related to lower levels of happiness, life satisfaction, self-esteem, and higher levels of psychological distress. We find that poverty status moderates the relationship between goal-striving stress and mental health. Compared to poorer persons, individuals above poverty with high goal-striving stress have significantly lower levels of happiness and life satisfaction. Overall, the findings provide a more complete context for understanding associations among socio-economic status, goal-striving stress, and adverse mental health outcomes among black Americans.

Achievement motivation and mental health among medical postgraduates: the chain mediating effect of self-esteem and perceived stress

Type of study: non-rct observational study

Number of citations: 1

Year: 2024

Authors: Mu-yun Ma, Yao Li, Li Guo, Guan-e Yang

Journal: Frontiers in Psychology

Journal ranking: Q2

Key takeaways: Achievement motivation in medical postgraduate students is linked to better mental health through increased self-esteem and reduced perceived stress.

Abstract: Introduction Medical postgraduates generally experience high levels of depression and anxiety. Previous studies have investigated the impact of various achievement motivations on depression/anxiety among medical students. Methods This study focused on self-esteem and perceived stress, examining the internal mechanisms through which achievement motivation affects depression/anxiety. 530 medical postgraduate students (66.04% female and 33.96% male) were administered the Achievement Goal Orientation Scale, Self-Esteem Scale, Perceived Stress Scale, and Depression-Anxiety-Stress Scale. Results Results indicated that: (1) mastery-approach goals were negatively correlated with depression/anxiety; mastery-avoidance goals were positively correlated with depression/anxiety; performance-avoidance goals positively predicted depression/anxiety; (2) self-esteem mediated the relationship between achievement motivation and depression/anxiety; (3) perceived stress played a mediating role in the relationship between achievement motivation and depression/anxiety; (4) self-esteem and perceived stress played a chain mediating role in the relationship between achievement motivation and depression/anxiety; (5) there was no significant linear correlation between mastery-approach goals and depression/anxiety. Discussion Although this study employed a cross-sectional design and self-report scales, both of which have certain limitations, the findings still hold significant theoretical and practical implications. The research reveals a mediating pathway between achievement goals and mental health, offering new insights into mental health education for medical graduate students.

Effects of Goals on Wellbeing

Type of study:

Number of citations: 0

Year: 2021

Authors: M. Sirgy

Journal:

Journal ranking: brak

Key takeaways: Setting goals with high positive valence and achieving them leads to increased wellbeing and positive mental health.

Abstract: I discuss in this chapter the effects of goals on happiness, subjective wellbeing and positive mental health. The focus is on a variety of ways that people set their goals biased by goal valence (i.e., they set life goals that are high in positive valence). Goals with high positive valence can be set using meaningful goals, abstract goals, motivational goals, approach goals, goals associated with deprived needs, autonomous goals, and goals related to flow. They set goals that are likely to be met (high goal expectancy). They do so by choosing adaptable goals, goals that are congruent with cultural norms and personal motives and resources, goals that are realistic, and goals involving little or no role conflict. Also, they plan strategies and tactics that they execute to achieve their life goals. This is done by committing to goal attainment and persist goal pursuit in light of failure. Concrete thinking also plays an important role in goal implementation. Goal attainment results in increased levels of wellbeing and positive mental health. Goal attainment occurs through recognition of attainment and perception of progress.

Persistence and Disengagement in Personal Goal Pursuit.

Type of study: literature review

Number of citations: 84

Year: 2021

Authors: V. Brandstätter, K. Bernecker

Journal: Annual review of psychology

Journal ranking: Q1

Key takeaways: Persistence and timely disengagement from personal goals are core components of successful self-regulation, impacting well-being and performance.

Abstract: Persistence in and timely disengagement from personal goals are core components of successful self-regulation and therefore relevant to well-being and performance. In the history of motivation psychology, there has been a clear emphasis on persistence. Only recently have researchers become interested in goal disengagement, as mirrored by the amount of pertinent research. In this review, we present an overview of the most influential motivational theories on persistence and disengagement that address situational and personal determinants, cognitive and affective mechanisms, and consequences for well-being, health, and performance. Some of these theories use a general approach, whereas others focus on individual differences. The theories presented incorporate classical expectancy-value constructs as well as contemporary volitional concepts of self-regulation. Many of the theoretical approaches have spread to applied fields (e.g., education, work, health). Despite numerous important insights into persistence and disengagement, we also identify several unresolved research questions. Expected final online publication date for the Annual Review of Psychology, Volume 73 is January 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

Doprinos životnih ciljeva nekim aspektima mentalne dobrobiti i zdravlju

Type of study:

Number of citations: 0

Year: 2016

Authors: Ivana Tucak Junaković

Journal:

Journal ranking: brak

Key takeaways: Life goals, particularly altruism and achievement, positively impact psychological well-being and health, with life satisfaction, self-esteem, and integrity being the best predictors.

Abstract: Numerous studies have found that life goals contribute to well-being and health, while the absence of life goals, ambivalence, or conflict regarding them has been linked to a variety of negative effects on physical and mental health. The purpose of this study was to determine the contribution of the importance of life goals of power, achievement, intimacy, and altruism to some aspects of psychological well-being (i. e. life satisfaction, self-esteem, and integrity) and general health status, together with the control of some sociodemographic variables. Three hundred adults, aged 25 to 75 years, from different regions of Croatia took part in the study. The results have shown that four categories of life goals correlated positively and mainly significantly with the examined aspects of psychological well-being and self-rated health. After controlling the contribution of some sociodemographic variables, the examined life goals together with regression analysis explained a statistically significant, even though modest, proportion of life satisfaction variance, self-esteem, integrity, and health. At the same time, altruism and achievement goals were shown to be the best general predictors of examined aspects of psychological well-being and health.

The Mediating Role of Coping Strategies on the Relationships Between Goal Motives and Affective and Cognitive Components of Subjective Well-Being

Type of study: non-rct observational study

Number of citations: 15

Year: 2019

Authors: P. Sanjuan, María Ávila

Journal: Journal of Happiness Studies

Journal ranking: Q1

Key takeaways: Autonomously motivated goals and problem-solving coping strategies improve subjective well-being.

Abstract: Subjective well-being (SWB) comprises both a cognitive component or life satisfaction, and an affective component or predominance of positive over negative affect. Engaging in meaningful goals and using effective coping are two factors with great impact on the development of SWB. Self-Determination Theory (SDT) postulates that goal can be pursued through autonomous and controlled motives (AM and CM respectively). AM are based on personal interest, enjoyment, or perceived importance while CM are driven by internal or external pressures and contingencies related to social approval. Moreover, from SDT has been proposed that only the attainment of autonomously motivated goals raises well-being. The main objective of the current study was to analyse whether coping strategies mediated the relationship between goal motives and SWB. Two hundred and five people (120 male and 85 female) answered questionnaires to assess different variables of interest in group sessions. Path analysis showed that CM had direct and indirect effects on negative affect, and that the latter are through the use of avoidance coping strategies. CM had direct effect on life satisfaction, and AM had direct effect on positive and negative affect. We discussed that both well-being and mental health promotion programs should encourage people to pursue goals by autonomous motives, and help them to replace avoidant strategies by those aimed at problem solving. Likewise, we point out the convenience of assessing goal progress, analysing specific coping strategies developed for each goal, and studying separately the affective and cognitive components of SWB.

Identifying academic motivation profiles and their association with mental health in medical school

Type of study: non-rct observational study

Number of citations: 3

Year: 2023

Authors: Barnabás Oláh, Á. Münnich, K. Kósa

Journal: Medical Education Online

Journal ranking: Q1

Key takeaways: Academic motivation profiles in medical students can predict their mental health, with low self-determination leading to increased psychological distress and decreased life satisfaction.

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

Emotional clarity in daily life is associated with reduced indecisiveness and greater goal pursuit.

Type of study: non-rct observational study

Number of citations: 1

Year: 2024

Authors: Nathaniel S. Eckland, Rebecca L Feldman, H. W. Hallenbeck, Renee J Thompson

Journal: Emotion

Journal ranking: Q1

Key takeaways: Momentary emotional clarity in daily life is associated with reduced indecisiveness and increased goal pursuit, without a link between indecisiveness and goal pursuit.

Abstract: Affect-as-information theory posits that understanding of one's emotions (i.e., emotional clarity) can be leveraged to make decisions and attain goals. Furthermore, recent work has emphasized the dynamic nature of emotional clarity and its fluctuations in daily life. Therefore, we sought to test how momentary emotional clarity, experienced in everyday life, would be associated with levels of indecisiveness and goal pursuit. Following affect-as-information, we hypothesized that emotional clarity would be associated with lower indecisiveness but greater goal pursuit. We also hypothesized that indecisiveness would be associated with less goal pursuit with momentary emotional clarity being a potential moderator of this association. Adults (N = 215, Mage = 44.3) experiencing a range of depression, a disorder characterized by indecisiveness, completed a self-report measure of indecisiveness and 2 weeks of experience sampling assessing momentary emotional clarity, goal pursuit, and negative affect. Momentary emotional clarity showed robust links to lower indecisiveness and greater goal pursuit that were not accounted for by negative affect. We did not observe a link between indecisiveness and goal pursuit. Emotional clarity appears to play a role in motivational and cognitive processes that unfold in daily life. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Health and goal-directed behavior: The nonconscious regulation and motivation of goals and their pursuit

Type of study:

Number of citations: 126

Year: 2007

Authors: H. Aarts

Journal: Health Psychology Review

Journal ranking: Q1

Key takeaways: Nonconscious goal pursuit plays a crucial role in shaping and maintaining health behaviors, with affect playing a crucial role in modulating motivation and goal regulation.

Abstract: Abstract Modern research in the domain of health psychology considers goals to play a pivotal role in shaping, changing and maintaining behaviors related to health. Whereas the common view on this topic assumes that goal pursuit is governed by a conscious intentional process, recent research indicates that goal pursuit can emerge without involvement of conscious intent. This paper discusses key findings of this research on nonconscious goal pursuit, and attempts to promote a more comprehensive understanding and examination of the role of goals in human behavior, self-regulation and health. Specifically, it addresses (1) the role of habits and planning; (2) the human capacity to go beyond habits nonconsciously by regulating goals without awareness of the activation and operation of the goal; and (3) the fundamental role of affect in nonconsciously modulating the motivation of goals and their pursuit.

The nonconscious cessation of goal pursuit: when goals and negative affect are coactivated.

Type of study: non-rct experimental

Number of citations: 217

Year: 2007

Authors: H. Aarts, R. Custers, R. Holland

Journal: Journal of personality and social psychology

Journal ranking: Q1

Key takeaways: Negative affect can cause the nonconscious cessation of goal pursuit, affecting motivation and decision-making.

Abstract: Extending on the recent investigation into the implicit affective processes underlying motivation and decision making, 5 studies examined the role of negative affect in moderating goal priming effects. Specifically, experimental effects on measures that typify motivational qualities of goal systems, such as keeping a goal at a heightened level of mental accessibility and exerting effort to work for a goal and experiencing desire to attain the goal, showed that the motivation and resultant operation of social goals cease when these goals are primed in temporal proximity of negatively valenced information. These goal cessation effects resulting from the mere coactivation of a goal and negative affect are discussed against the background of present research on nonconscious goal pursuit and the role of accessibility and desirability in the regulation of automatic goal-directed behavior.

The Motivational Consequences of Life Satisfaction

Type of study: non-rct experimental

Number of citations: 41

Year: 2017

Authors: Maike Luhmann, M. Hennecke

Journal: Motivation Science

Journal ranking: Q1

Key takeaways: Life satisfaction positively influences individuals' motivation to influence their life circumstances through the adoption of personal goals.

Abstract: Previous research indicates that high levels of life satisfaction are associated with positive outcomes in various life domains, but the mechanisms underlying these associations are largely unclear. In this article, we argue that life satisfaction is associated with motivational consequences that may explain its positive effects on major life outcomes. This hypothesis was tested in 7 correlational and experimental studies that examined desire for change and goal orientation as motivational and volitional outcomes. Across studies, people low in life satisfaction reported a greater desire to change their life circumstances as well as a greater orientation toward change and a weaker orientation toward stability than people high in life satisfaction, statistically controlling for affect. These findings contribute to life-satisfaction research by providing initial evidence on the motivational consequences of life satisfaction and adding to the growing literature on the functional distinction between life satisfaction and affect. Furthermore, these findings contribute to motivation science by showing that motivational processes do not just arise in the presence, but also in the absence of a perceived negative discrepancy between one’s desired and one’s actual state. Together, these studies suggest that life satisfaction is an important factor in motivating people to influence their life circumstances through the adoption of personal goals.

The Relationship between College Students’ Mental Health Status, Achievement Motivation and Life Satisfaction

Type of study:

Number of citations: 0

Year: 2020

Authors: Xue Pi

Journal: Advances in Psychology

Journal ranking: brak

Key takeaways: Achievement motivation directly affects college students' psychological health, with life satisfaction playing a key intermediary role in improving their mental health.

Abstract: Society is in urgent need of the pillars of high cultural literacy; the physical and mental quality of college students has an important impact on the development of all aspects of society. This research used questionnaire survey, using the symptom checklist, the achievement motivation scale and the college students’ life satisfaction scale table to test in universities. This study was to probe the relationship between university students' mental health status, achievement motivation and life satisfaction. The main results were: there are significant differences in majors about college students’ psychological health status. Science departments are less than history departments; College students in disparate grades are very different. There are significant differences in gender about students’ achievement motivation level. There are significant differences in majors about college students’ achievement motivation level. The pursuit of success and achievement motivation on mental health status showed significant negative predictive effect. Achievement motivation has direct effect on psychological health, and could have the effect on mental health through the intermediary role of life satisfaction. We aimed to improve college students’ life satisfaction to improve psychological health.

Well-being as a resource for goal reengagement: Evidence from two longitudinal studies.

Type of study: non-rct observational study

Number of citations: 24

Year: 2020

Authors: Claudia M. Haase, T. Singer, R. Silbereisen, J. Heckhausen, C. Wrosch

Journal: Current Opinion in Organ Transplantation

Journal ranking: Q2

Key takeaways: Well-being, including positive emotions and a sense of purpose, positively predicts increased capacity for goal reengagement after goal failure.

Abstract: After goal failure, some individuals are able to engage in new, meaningful goals, while others have trouble doing so. Little is known about what predicts individual differences in the capacity to reengage in new goals. Building on affective and motivational science frameworks, the present 2 studies examined the hypothesis that well-being predicts positive changes in goal reengagement capacities. Study 1 was a 2-wave longitudinal study of Canadian young adults attending university. Study 2 was a 3-wave longitudinal study of German young adults transitioning from university into work. Across studies, we examined well-being (i.e., positive affect, satisfaction with life, purpose in life, negative affect [Study 1], depressive symptoms [Study 2]); goal adjustment (i.e., goal reengagement, goal disengagement); and goal-self-concordance (Study 2). Study 1 showed that positive affect, satisfaction with life, and purpose in life predicted increases in goal reengagement capacities. Study 2 replicated these findings and further showed that increases in goal self-concordance mediated these associations. Across studies, well-being (but not negative affect or depressive symptoms) predicted increases in goal reengagement (but not goal disengagement) capacities. Findings remained stable when controlling for sociodemographic characteristics. Together, these studies point to well-being as a resource for adaptive motivational development.

Relationship Between Achievement Motivation, Mental Health and Academic Success in University Students

Type of study: non-rct observational study

Number of citations: 44

Year: 2021

Authors: Parinaz Mahdavi, A. Valibeygi, M. Moradi, S. Sadeghi

Journal: Community Health Equity Research & Policy

Journal ranking: Q3

Key takeaways: Higher achievement motivation in medical students leads to better academic performance, while mental health is significantly correlated with achievement motivation but not directly with educational success.

Abstract: Students of medical sciences are under intense mental stress induced by medical training system and are more likely to develop psychological and mental disorders. These psychological disorders may influence their performance in different aspects of life including their study. The aim of the present study is to assess the possible relationships between mental health, achievement motivation, and academic achievement and to study the effect of background factors on mentioned variables. The sample group consists of students of Kurdistan University of medical sciences. 430 students at Kurdistan University of Medical Sciences were selected randomly to participate in the present cross-sectional study in 2016. We used General Health Questionnaire (GHQ) and Achievement motivation test (AMT) as the measures of our study. Our findings indicated that mental health is significantly correlated with achievement motivation (p < .001), but has no correlation with educational success (p = .37). Also, a significant relationship was observed between achievement motivation and academic achievement (p = .025). GHQ was not correlated with demographic factors, while academic achievement and achievement motivation are associated with the field of study and marital status respectively. Conclusively, students who are more motivated to achieve their educational and academic goals, will be more likely to be successful in their education and have stronger academic performance. Also, students with more appropriate mental health status will have higher level of motivation in their education and studies. These findings reflect the importance of maintaining the medical field students’ motivation and its role in their academic success.

Does Goal Conflict Necessarily Undermine Wellbeing? A Moderated Mediating Effect of Mixed Emotion and Construal Level

Type of study: non-rct observational study

Number of citations: 8

Year: 2021

Authors: Wujun Sun, Zeqing Zheng, Yuan Jiang, Li Tian, P. Fang

Journal: Frontiers in Psychology

Journal ranking: Q2

Key takeaways: Goal conflict does not necessarily impair life satisfaction, but it can reduce it through mixed emotions, with a higher construal level mitigating the adverse effects of mixed emotions.

Abstract: Development occurs through the process of setting and working toward goals, in which individuals are often working toward multiple goals that are likely to conflict with one another. Although motivation theories hold that goal conflict is a kind of potential stress that may damage individuals’ mental health and wellbeing, the empirical research results on the relationship between goal conflict and wellbeing are quite different. There may be unknown factors affecting the relationship between the two. Against this background, we conducted the exploration of the relationship between goal conflict and life satisfaction, mainly by analyzing the moderated mediating effect of mixed emotions and construal level. The results showed that the goal conflict did not directly affect life satisfaction (β = −0.01, p > 0.5) but indirectly influenced life satisfaction through mixed emotions (β = −0.17, p < 0.001). The construal level moderated the relationship between mixed emotions and life satisfaction (β = −0.08, p < 0.01), and the higher construal level will predict higher life satisfaction especially when mixed emotions were low (M − SD) or medium (M). Therefore, the hypothesis of moderated mediating effect is verified, and we can draw the following conclusions: (1) Goal conflict does not necessarily impair life satisfaction. (2) Goal conflict impairs life satisfaction conditional on the fact that it triggers mixed emotions. Since mixed emotions are often accompanied by feelings of ambivalence and discomfort, they reduce the individual’s evaluation of life satisfaction. (3) In the path of goal conflict reducing life satisfaction through mixed emotions, the higher construal level mitigates the adverse effects of mixed emotions to some extent.

Examining the influence of mental health and structural determinants of health on the stage of motivational readiness for health behaviour changes: A path analysis study

Type of study: non-rct observational study

Number of citations: 0

Year: 2024

Authors: Irene Gómez-Gómez, M. L. Rodero-Cosano, J. Bellón, Edurne Zabaleta-Del-Olmo, J. Maderuelo-Fernández, P. Moreno-Peral, R. Magallón-Botaya, B. Oliván-Blázquez, M. Casajuana-Closas, Tomàs López-Jiménez, B. Bolibar, Joan Llobera, Ana Clavería, Alvaro Sanchez-Perez, Emma Motrico

Journal: Journal of Health Psychology

Journal ranking: Q2

Key takeaways: Depression and anxiety negatively impact motivational readiness for healthy diet and physical activity, while women, workers, and older adults with higher health-related quality of life are more likely to engage in these behaviors.

Abstract: This study explores the influence of mental health and structural determinants of health on motivational readiness for health behaviour change in 1462 Spanish primary healthcare users. Chi-square test and structural equation modelling were performed. Results showed that depression and anxiety were negatively associated with being in the action stages of motivational readiness for a healthy diet and physical activity. This association was statistically significant only for motivational readiness for a healthy diet and depression ( β = − 0 . 076 ; p = 0 . 046 ). Furthermore, women and workers were more likely to be in the action stages of motivational readiness for a healthy diet while older adults and adults with higher health-related quality of life were more likely to be in the action stages of motivational readiness for physical activity. The present study suggests that structural (being older, being a woman and being employed) and intermediary (suffering from depression and higher health-related quality of life) determinants of health influence motivational readiness for health behaviour changes.

Drinking to Cope is Uniquely Associated with Less Specific and Bleaker Future Goal Generation in Young Hazardous Drinkers

Type of study: non-rct observational study

Number of citations: 1

Year: 2023

Authors: Ruichong Shuai, Bella Magner-Parsons, L. Hogarth

Journal: Journal of Psychopathology and Behavioral Assessment

Journal ranking: Q2

Key takeaways: Drinking to cope with negative emotions leads to less detailed and bleaker future goals in young hazardous drinkers, but not due to reduced effort in writing goals.

Abstract: Groups with mental health and/or substance use problems generate less detailed descriptions of their future goals. As substance use to cope with negative affect is common to both groups, this characteristic might be uniquely associated with less specific goal descriptions. To test this prediction, 229 past year hazardous drinking undergraduates aged 18-25 years wrote about three positive future life goals in an open-ended survey, before reporting their internalizing (anxiety and depression) symptoms, alcohol dependence severity and motivations for drinking: coping, conformity, enhancement and social. Future goal descriptions were experimenter-rated for detail specificity, and participant-self-rated for positivity, vividness, achievability, and importance. Effort in goal writing was indexed by time spent writing and total word count. Multiple regression analyses revealed that drinking to cope was uniquely associated with the production of less detailed goals, and lower self-rated positivity and vividness of goals (achievability and importance were also marginally lower), over and above internalizing symptoms, alcohol dependence severity, drinking for conformity, enhancement and social motives, age, and gender. However, drinking to cope was not uniquely associated with reduced effort in writing goals: time spent and word count. In sum, drinking to cope with negative affect is a unique characteristic predicting the generation of less detailed and bleaker (less positive and vivid) future goals, and this is not due to lower effort in reporting. Future goal generation may play a role in the aetiology of comorbidity of mental health and substance use problems, and therapeutic targeting of goal generation might benefit both conditions.The online version contains supplementary material available at 10.1007/s10862-023-10032-0.

Brain mechanisms underlying apathy

Type of study:

Number of citations: 127

Year: 2018

Authors: Campbell J Le Heron, Clay B. Holroyd, J. Salamone, M. Husain

Journal: Journal of Neurology, Neurosurgery, and Psychiatry

Journal ranking: Q1

Key takeaways: Apathy is a neuropsychiatric syndrome characterized by a loss of motivation and reduced goal-directed behavior, with disruption of a common systems-level mechanism potentially underlining its development.

Abstract: The past few decades have seen growing interest in the neuropsychiatric syndrome of apathy, conceptualised as a loss of motivation manifesting as a reduction of goal-directed behaviour. Apathy occurs frequently, and with substantial impact on quality of life, in a broad range of neurological and psychiatric conditions. Apathy is also consistently associated with neuroimaging changes in specific medial frontal cortex and subcortical structures, suggesting that disruption of a common systems-level mechanism may underlie its development, irrespective of the condition that causes it. In parallel with this growing recognition of the clinical importance of apathy, significant advances have been made in understanding normal motivated behaviour in humans and animals. These developments have occurred at several different conceptual levels, from work linking neural structures and neuromodulatory systems to specific aspects of motivated behaviour, to higher order computational models that aim to unite these findings within frameworks for normal goal-directed behaviour. In this review we develop a conceptual framework for understanding pathological apathy based on this current understanding of normal motivated behaviour. We first introduce prominent theories of motivated behaviour—which often involves sequences of actions towards a goal that needs to be maintained across time. Next, we outline the behavioural effects of disrupting these processes in animal models, highlighting the specific effects of these manipulations on different components of motivated behaviour. Finally, we relate these findings to clinical apathy, demonstrating the homologies between this basic neuroscience work and emerging behavioural and physiological evidence from patient studies of this syndrome.

Emotion, motivation, decision-making, the orbitofrontal cortex, anterior cingulate cortex, and the amygdala

Type of study:

Number of citations: 100

Year: 2023

Authors: E. Rolls

Journal: Brain Structure & Function

Journal ranking: Q1

Key takeaways: A unified theory of emotion and motivation suggests that the orbitofrontal cortex, anterior cingulate cortex, and amygdala are involved in eliciting emotions when rewards or punishers are received, simplifying our understanding of these brain structures.

Abstract: The orbitofrontal cortex and amygdala are involved in emotion and in motivation, but the relationship between these functions performed by these brain structures is not clear. To address this, a unified theory of emotion and motivation is described in which motivational states are states in which instrumental goal-directed actions are performed to obtain rewards or avoid punishers, and emotional states are states that are elicited when the reward or punisher is or is not received. This greatly simplifies our understanding of emotion and motivation, for the same set of genes and associated brain systems can define the primary or unlearned rewards and punishers such as sweet taste or pain. Recent evidence on the connectivity of human brain systems involved in emotion and motivation indicates that the orbitofrontal cortex is involved in reward value and experienced emotion with outputs to cortical regions including those involved in language, and is a key brain region involved in depression and the associated changes in motivation. The amygdala has weak effective connectivity back to the cortex in humans, and is implicated in brainstem-mediated responses to stimuli such as freezing and autonomic activity, rather than in declarative emotion. The anterior cingulate cortex is involved in learning actions to obtain rewards, and with the orbitofrontal cortex and ventromedial prefrontal cortex in providing the goals for navigation and in reward-related effects on memory consolidation mediated partly via the cholinergic system.

Apathy in Parkinson's disease: clinical features, neural substrates, diagnosis, and treatment

Type of study:

Number of citations: 394

Year: 2015

Authors: J. Pagonabarraga, J. Kulisevsky, A. Strafella, P. Krack

Journal: The Lancet Neurology

Journal ranking: Q1

Key takeaways: Apathy in Parkinson's disease is highly prevalent and negatively affects quality of life for patients and caregivers, with neural disruptions in the brain contributing to apathy.

Cognitive control, motivation and fatigue: A cognitive neuroscience perspective

Type of study:

Number of citations: 38

Year: 2022

Authors: A. Kok

Journal: Brain and Cognition

Journal ranking: Q1

Key takeaways: Fatigue affects cognitive control, motivation, and dopamine systems in the brain, affecting decision-making and affecting goal-directed behavior.

Cumulative stress in childhood is associated with blunted reward-related brain activity in adulthood.

Type of study: non-rct observational study

Number of citations: 157

Year: 2016

Authors: J. Hanson, Dustin Albert, Anne-Marie R. Iselin, J. Carré, K. Dodge, A. Hariri

Journal: Social cognitive and affective neuroscience

Journal ranking: Q1

Key takeaways: Cumulative life stress in childhood is associated with blunted reward-related brain activity in adulthood, potentially contributing to reduced motivation and increased negative mood.

Abstract: Early life stress (ELS) is strongly associated with negative outcomes in adulthood, including reduced motivation and increased negative mood. The mechanisms mediating these relations, however, are poorly understood. We examined the relation between exposure to ELS and reward-related brain activity, which is known to predict motivation and mood, at age 26, in a sample followed since kindergarten with annual assessments. Using functional neuroimaging, we assayed individual differences in the activity of the ventral striatum (VS) during the processing of monetary rewards associated with a simple card-guessing task, in a sample of 72 male participants. We examined associations between a cumulative measure of ELS exposure and VS activity in adulthood. We found that greater levels of cumulative stress during childhood and adolescence predicted lower reward-related VS activity in adulthood. Extending this general developmental pattern, we found that exposure to stress early in development (between kindergarten and grade 3) was significantly associated with variability in adult VS activity. Our results provide an important demonstration that cumulative life stress, especially during this childhood period, is associated with blunted reward-related VS activity in adulthood. These differences suggest neurobiological pathways through which a history of ELS may contribute to reduced motivation and increased negative mood.

Goal-striving tendencies moderate the relationship between reward-related brain function and peripheral inflammation

Type of study: non-rct observational study

Number of citations: 13

Year: 2021

Authors: I. Chat, R. Nusslock, D. Moriarity, Corinne P. Bart, N. Mac Giollabhui, Katherine S. F. Damme, Ann L. Carroll, G. Miller, L. Alloy

Journal: Brain, Behavior, and Immunity

Journal ranking: Q1

Key takeaways: Goal-striving tendencies can moderate the relationship between reward-related brain function and inflammation, with both blunted and elevated reward function being associated with inflammation.

Motivated with joy or anxiety: Does approach-avoidance goal framing elicit differential reward-network activation in the brain?

Type of study: non-rct experimental

Number of citations: 2

Year: 2024

Authors: Michiko Sakaki, Kou Murayama, Keise Izuma, R. Aoki, Yukihito Yomogita, Ayaka Sugiura, Nishad Singhi, M. Matsumoto, Kenji Matsumoto

Journal: Cognitive, Affective & Behavioral Neuroscience

Journal ranking: Q1

Key takeaways: Approach goals increase positive emotions and intrinsic motivation more strongly than avoidance goals, while avoidance goals cause stronger anxiety and disappointment, with distinct reward-network activation in the brain.

Abstract: Psychological research on human motivation repeatedly observed that approach goals (i.e., goals to attain success) increase task enjoyment and intrinsic motivation more strongly than avoidance goals (i.e., goals to avoid failure). The present study sought to address how the reward network in the brain-including the striatum and ventromedial prefrontal cortex-is involved when individuals engage in the same task with a focus on approach or avoidance goals. Participants reported stronger positive emotions when they focused on approach goals, but stronger anxiety and disappointment when they focused on avoidance goals. The fMRI analyses revealed that the reward network in the brain showed similar levels of activity to cues predictive of approach and avoidance goals. In contrast, the two goal states were associated with different patterns of activity in the visual cortex, hippocampus, and cerebellum during success and failure outcomes. Representation similarity analysis further revealed shared and different representations within the striatum and vmPFC between the approach and avoidance goal states, suggesting both the similarity and uniqueness of the mechanisms behind the two goal states. In addition, the distinct patterns of activation in the striatum were associated with distinct subjective experiences participants reported between the approach and the avoidance conditions. These results suggest the importance of examining the pattern of striatal activity in understanding the mechanisms behind different motivational states in humans.

Dissociable encoding of motivated behavior by parallel thalamo-striatal projections

Type of study:

Number of citations: 5

Year: 2024

Authors: Sofia Beas, Isbah Khan, Cl Gao, Gabriel Loewinger, Emma Macdonald, Alison Bashford, Shakira Rodriguez-Gonzalez, Francisco Pereira, Mario A. Penzo

Journal: Current Biology

Journal ranking: Q1

Key takeaways: The paraventricular nucleus of the thalamus plays a crucial role in shaping motivated behaviors by projecting to the nucleus accumbens, guiding actions based on internal drivers.

Reconciling psychological and neuroscientific accounts of reduced motivation in aging

Type of study: non-rct experimental

Number of citations: 7

Year: 2021

Authors: Alexander Soutschek, Alexandra Bagaïni, T. Hare, P. Tobler

Journal: Social Cognitive and Affective Neuroscience

Journal ranking: Q1

Key takeaways: The frontopolar cortex, involved in cost-benefit weighting, switches from reward-seeking to cost avoidance in effort-based decisions with age, reconciling psychological and neuroscientific perspectives on reduced motivation.

Abstract: Abstract Motivation is a hallmark of healthy aging, but the motivation to engage in effortful behavior diminishes with increasing age. Most neurobiological accounts of altered motivation in older adults assume that these deficits are caused by a gradual decline in brain tissue, while some psychological theories posit a switch from gain orientation to loss avoidance in motivational goals. Here, we contribute to reconcile the psychological and neural perspectives by providing evidence that the frontopolar cortex (FPC), a brain region involved in cost–benefit weighting, increasingly underpins effort avoidance rather than engagement with age. Using anodal transcranial direct current stimulation together with effort–reward trade-offs, we find that the FPC’s function in effort-based decisions remains focused on cost–benefit calculations but appears to switch from reward-seeking to cost avoidance with increasing age. This is further evidenced by the exploratory, independent analysis of structural brain changes, showing that the relationship between the density of the frontopolar neural tissue and the willingness to exert effort differs in young vs older adults. Our results inform aging-related models of decision-making by providing preliminary evidence that, in addition to cortical thinning, changes in goal orientation need to be considered in order to understand alterations in decision-making over the life span.

Consciousness, Attention, and the Motivation-Affect System

Type of study:

Number of citations: 5

Year: 2023

Authors: T. Cochrane

Journal: Journal of Consciousness Studies

Journal ranking: Q1

Key takeaways: The motivation-affect system controls 'alerting attention' to prioritize goals and stimuli, influencing the global workspace theory of consciousness and its phenomenal characteristics.

Abstract: It is an important feature of creatures like us that our various motivations compete for control over our behaviour, including mental behaviour such as imagining and attending. In large part, this competition is adjudicated by the stimulation of affect — the intrinsically pleasant or unpleasant aspects of experience. In this paper I argue that the motivation-affect system controls a sub-type of attention called 'alerting attention' to bring various goals and stimuli to consciousness and thereby prioritize those contents for action. This view allows me to flesh out the global workspace theory of consciousness, as well as some of the phenomenal characteristics of conscious experience.

Motivational states activate distinct hippocampal representations to guide goal-directed behaviors

Type of study: non-rct experimental

Number of citations: 160

Year: 2009

Authors: P. Kennedy, M. Shapiro

Journal: Proceedings of the National Academy of Sciences

Journal ranking: Q1

Key takeaways: Motivation and memory are coordinated in the brain, guiding goal-directed behaviors through distinct representations in the hippocampus.

Abstract: Adaptive behaviors are guided by motivation and memory. Motivational states specify goals, and memory can inform motivated behavior by providing detailed records of past experiences when goals were obtained. These 2 fundamental processes interact to guide animals to biologically relevant targets, but the neuronal mechanisms that integrate them remain unknown. To investigate these mechanisms, we recorded unit activity from the same population of hippocampal neurons as rats performed identical tasks while either food or water deprived. We compared the influence of motivational state (hunger and thirst), memory demand, and spatial behavior in 2 tasks: hippocampus-dependent contextual memory retrieval and hippocampus-independent random foraging. We found that: (i) hippocampal coding was most strongly influenced by motivational state during contextual memory retrieval, when motivational cues were required to select among remembered, goal-directed actions in the same places; (ii) the same neuronal populations were relatively unaffected by motivational state during random foraging, when hunger and thirst were incidental to behavior, and signals derived from deprivation states thus informed, but did not determine, hippocampal coding; and (iii) “prospective coding” in the contextual retrieval task was not influenced by allocentric spatial trajectory, but rather by the animal's deprivation state and the associated, non-spatial target, suggesting that hippocampal coding includes a wide range of predictive associations. The results show that beyond coding spatiotemporal context, hippocampal representations encode the relationships between internal states, the external environment, and action to provide a mechanism by which motivation and memory are coordinated to guide behavior.

Context, emotion, and the strategic pursuit of goals: interactions among multiple brain systems controlling motivated behavior

Type of study: literature review

Number of citations: 172

Year: 2012

Authors: A. Gruber, R. J. McDonald

Journal: Frontiers in Behavioral Neuroscience

Journal ranking: Q1

Key takeaways: Multiple brain systems interact to control motivated behavior, with the emotional system regulating behavior based on stimulus valence and the goal-directed system guiding actions in complex contexts.

Abstract: Motivated behavior exhibits properties that change with experience and partially dissociate among a number of brain structures. Here, we review evidence from rodent experiments demonstrating that multiple brain systems acquire information in parallel and either cooperate or compete for behavioral control. We propose a conceptual model of systems interaction wherein a ventral emotional memory network involving ventral striatum (VS), amygdala, ventral hippocampus, and ventromedial prefrontal cortex triages behavioral responding to stimuli according to their associated affective outcomes. This system engages autonomic and postural responding (avoiding, ignoring, approaching) in accordance with associated stimulus valence (negative, neutral, positive), but does not engage particular operant responses. Rather, this emotional system suppresses or invigorates actions that are selected through competition between goal-directed control involving dorsomedial striatum (DMS) and habitual control involving dorsolateral striatum (DLS). The hippocampus provides contextual specificity to the emotional system, and provides an information rich input to the goal-directed system for navigation and discriminations involving ambiguous contexts, complex sensory configurations, or temporal ordering. The rapid acquisition and high capacity for episodic associations in the emotional system may unburden the more complex goal-directed system and reduce interference in the habit system from processing contingencies of neutral stimuli. Interactions among these systems likely involve inhibitory mechanisms and neuromodulation in the striatum to form a dominant response strategy. Innate traits, training methods, and task demands contribute to the nature of these interactions, which can include incidental learning in non-dominant systems. Addition of these features to reinforcement learning models of decision-making may better align theoretical predictions with behavioral and neural correlates in animals.

Amygdala in Action: Functional Connectivity during Approach and Avoidance Behaviors

Type of study: non-rct experimental

Number of citations: 4

Year: 2021

Authors: Joana Leitão, M. Burckhardt, Patrik Vuilleumier

Journal: Journal of Cognitive Neuroscience

Journal ranking: Q1

Key takeaways: Amygdala-medial prefrontal interactions capture the subjective relevance of ongoing events, driving attentional, executive, and motor circuits for successful goal pursuit regardless of approach or avoidance directions.

Abstract: Abstract Motivation is an important feature of emotion. By driving approach to positive events and promoting avoidance of negative stimuli, motivation drives adaptive actions and goal pursuit. The amygdala has been associated with a variety of affective processes, particularly the appraisal of stimulus valence that is assumed to play a crucial role in the generation of approach and avoidance behaviors. Here, we measured amygdala functional connectivity patterns while participants played a video game manipulating goal conduciveness through the presence of good, neutral, or bad monsters. As expected, good versus bad monsters elicited opposing motivated behaviors, whereby good monsters induced more approach and bad monsters triggered more avoidance. These opposing directional behaviors were paralleled by increased connectivity between the amygdala and medial brain areas, such as the OFC and posterior cingulate, for good relative to bad, and between amygdala and caudate for bad relative to good monsters. Moreover, in both conditions, individual connectivity strength between the amygdala and medial prefrontal regions was positively correlated with brain scores from a latent component representing efficient goal pursuit, which was identified by a partial least squares analysis determining the multivariate association between amygdala connectivity and behavioral motivation indices during gameplay. At the brain level, this latent component highlighted a widespread pattern of amygdala connectivity, including a dorsal frontoparietal network and motor areas. These results suggest that amygdala-medial prefrontal interactions captured the overall subjective relevance of ongoing events, which could consecutively drive the engagement of attentional, executive, and motor circuits necessary for implementing successful goal-pursuit, irrespective of approach or avoidance directions.

Positive affect as implicit motivator: on the nonconscious operation of behavioral goals.

Type of study: non-rct experimental

Number of citations: 585

Year: 2005

Authors: R. Custers, H. Aarts

Journal: Journal of personality and social psychology

Journal ranking: Q1

Key takeaways: Positive affect plays a key role in nonconscious goal pursuit, increasing motivation to achieve desired behavioral states.

Abstract: Recent research has revealed that nonconscious activation of desired behavioral states--or behavioral goals--promotes motivational activity to accomplish these states. Six studies demonstrate that this nonconscious operation of behavioral goals emerges if mental representations of specific behavioral states are associated with positive affect. In an evaluative-conditioning paradigm, unobtrusive linking of behavioral states to positive, as compared with neutral or negative, affect increased participants' wanting to accomplish these states. Furthermore, participants worked harder on tasks that were instrumental in attaining behavioral states when these states were implicitly linked to positive affect, thereby mimicking the effects on motivational behavior of preexisting individual wanting and explicit goal instructions to attain the states. Together, these results suggest that positive affect plays a key role in nonconscious goal pursuit. Implications for behavior-priming research are discussed.

Brain stimulation over dorsomedial prefrontal cortex modulates effort-based decision making

Type of study: non-rct experimental

Number of citations: 20

Year: 2022

Authors: Alexander Soutschek, Lidiia Nadporozhskaia, Patricia Christian

Journal: Cognitive, Affective & Behavioral Neuroscience

Journal ranking: Q1

Key takeaways: Midfrontal theta brain stimulation increases the motivation to engage in goal-directed mental effort, shifting the starting bias towards high reward-high effort options without affecting working memory performance.

Abstract: Abstract Deciding whether to engage in strenuous mental activities requires trading-off the potential benefits against the costs of mental effort, but it is unknown which brain rhythms are causally involved in such cost-benefit calculations. We show that brain stimulation targeting midfrontal theta oscillations increases the engagement in goal-directed mental effort. Participants received transcranial alternating current stimulation over dorsomedial prefrontal cortex while deciding whether they are willing to perform a demanding working memory task for monetary rewards. Midfrontal theta tACS increased the willingness to exert mental effort for rewards while leaving working memory performance unchanged. Computational modelling using a hierarchical Bayesian drift diffusion model suggests that theta tACS shifts the starting bias before evidence accumulation towards high reward-high effort options without affecting the velocity of the evidence accumulation process. Our findings suggest that the motivation to engage in goal-directed mental effort can be increased via midfrontal tACS.

Learning is shaped by abrupt changes in neural engagement

Type of study: non-rct experimental

Number of citations: 55

Year: 2020

Authors: Jay A. Hennig, E. Oby, Matthew D. Golub, Lindsay Bahureksa, P. Sadtler, Kristin M. Quick, S. Ryu, E. Tyler-Kabara, A. Batista, S. Chase, Byron M. Yu

Journal: Nature Neuroscience

Journal ranking: Q1

Key takeaways: Changes in internal states, even unrelated to goal-seeking behavior, can systematically influence how behavior improves with learning.

Life goals as a driving force in traumatic brain injury rehabilitation: a longitudinal dyadic perspective

Type of study: non-rct observational study

Number of citations: 5

Year: 2022

Authors: Iben Husted Nielsen, I. Poulsen, Kristian Larsen, Niels Sandholm Larsen

Journal: Brain Injury

Journal ranking: Q2

Key takeaways: Life goals are a key motivation in traumatic brain injury rehabilitation, and involving both survivors and family caregivers in goal setting increases rehabilitation success.

Abstract: ABSTRACT Background Traumatic brain injury significantly impacts survivors and their families. Rehabilitation following traumatic brain injury is often complex due to the physical, psychological, and socio-economic problems survivors face. Life goals are considered a motivational factor in rehabilitation. Objective The aim was to explore expectations, problems, and strategies for goal setting in survivors of traumatic brain injury and their family caregivers for one-year during rehabilitation. Methods A longitudinal qualitative study using dyadic interviews with survivors and family caregivers was carried out at three time points during the first year following traumatic brain injury. Data was analyzed according to Braun and Clarke’s thematic analysis. Results Eight survivors of traumatic brain injury and their family caregivers completed 24 interviews. Three themes and one sub-theme were identified: 1) life goals as a driving force (subtheme: dyadic discrepancies and conflicts); 2) conflicts between specific, measurable, achievable, realistic, and timed (SMART) goals and life goals; and 3) changing perceptions of the impact of impairments. Conclusions Life goals are important motivation in the rehabilitation process. Health care professionals must integrate life goals and rehabilitation goals (i.e. SMART goals) to decrease barriers and survivor ambivalence about rehabilitation. Involving both survivors and family caregivers in goal setting increases rehabilitation success.

Sense of Purpose in Life and Cardiovascular Disease: Underlying Mechanisms and Future Directions

Type of study: literature review

Number of citations: 97

Year: 2019

Authors: Eric S. Kim, Scott W. Delaney, L. Kubzansky

Journal: Current Cardiology Reports

Journal ranking: Q1

Key takeaways: A higher sense of purpose in life may reduce the risk of developing cardiovascular disease through psychological and social resources, health behaviors, and direct effects on biological pathways.

Abstract: Purpose of ReviewIn this review, we synthesize recent research that has reported associations of a higher sense of purpose in life with reduced risk of developing cardiovascular disease (CVD), and then explore mechanisms that might underlie these associations.Recent FindingsAccumulating observational and experimental evidence suggests that having a higher sense of purpose might influence CVD risk through three pathways: (1) enhancement of other psychological and social resources that buffer against the cardiotoxic effects of overwhelming stress; (2) indirect effects through health behaviors; and (3) direct effects on biological pathways.SummaryA sense of purpose in life is emerging as an independent risk factor for incident CVD. A key remaining question is whether purpose causally effects CVD risk; in the “Future Research Directions” section, we focus on work needed to establish causality and provide suggestions for next steps.

How motivation affects cardiovascular response : mechanisms and applications

Type of study:

Number of citations: 84

Year: 2012

Authors: R. Wright, G. Gendolla

Journal:

Journal ranking: brak

Key takeaways: Motivational factors, such as effort, incentives, and goals, influence cardiovascular responses, potentially affecting heart disease development and progression.

Abstract: Cardiovascular (CV) response consists of changes in CV parameters such as heart rate, blood pressure, and heart contraction force in reaction to an event or set of events. It is significant for multiple reasons, perhaps most notably because research suggests that it affects the development and progression of heart disease. Disease models vary, but most assume that characteristically strong and prolonged CV responses confer health risk. Psychologists have long suspected linkages between motivational variables and CV response. However, formal study of the linkages was limited for many years. Motivationally based CV response research now flourishes, with researchers in various disciplines considering the role of relevant variables such as effort, incentives, and goals. This book conveys the amount and diversity of motivationally based CV response research that currently is being conducted. Chapters discuss mechanisms of motivational influence on CV response and apply motivational approaches to studying CV response in different life circumstances. Health implications are considered throughout. The volume will appeal to scholars and practitioners in numerous specialty areas, including motivation, emotion, psychophysiology, medical/health psychology, social/personality psychology and human factors/ergonomics. It will be a vital research source and could serve as a text or supplement in classes that address motivational, psychophysiological and health issues.

Importance of Lifestyle Modification on Cardiovascular Risk Reduction: COUNSELING STRATEGIES TO MAXIMIZE PATIENT OUTCOMES.

Type of study:

Number of citations: 45

Year: 2020

Authors: B. Franklin, J. Myers, P. Kokkinos

Journal: Journal of Cardiopulmonary Rehabilitation and Prevention

Journal ranking: Q1

Key takeaways: Lifestyle modification, through counseling strategies like the 5A's and motivational interviewing, can significantly reduce cardiovascular risk and improve patient outcomes.

Abstract: This commentary builds on the unhealthy lifestyle habits, population health, risk factors as harbingers of cardiovascular disease, current provider counseling practices, assessing patient readiness to change, and research-based interventions to facilitate behavior change (eg, the 5A's, motivational interviewing, and overcoming inertia with downscaled goals).

Effectiveness of motivational interviewing on lifestyle modification and health outcomes of clients at risk or diagnosed with cardiovascular diseases: A systematic review.

Type of study: systematic review

Number of citations: 77

Year: 2016

Authors: W. W. M. Lee, K. C. Choi, R. W. Y. Yum, D. Yu, S. Chair

Journal: International journal of nursing studies

Journal ranking: Q1

Key takeaways: Motivational interviewing may be more effective than usual care in changing smoking habits and improving depression in clients with cardiovascular diseases.

Association of Achievement of the American Heart Association's Life's Essential 8 Goals With Incident Cardiovascular Diseases in the SHFS

Type of study: non-rct observational study

Number of citations: 6

Year: 2024

Authors: Pyone Yadanar Paing, A. Littman, Jessica A Reese, C. Sitlani, Jason G Umans, Shelley A. Cole, Ying Zhang, Tauqeer Ali, A. Fretts

Journal: Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease

Journal ranking: Q1

Key takeaways: Achievement of the American Heart Association's Life's Essential 8 goals is associated with lower risk of cardiovascular diseases, emphasizing the need for comprehensive public health interventions targeting cardiovascular health promotion in American Indian communities.

Abstract: Background Cardiovascular disease (CVD) is a leading cause of morbidity and mortality in American Indian people. In 2022, the American Heart Association developed the Life's Essential 8 goals to promote cardiovascular health (CVH) for Americans, composed of diet, physical activity, nicotine exposure, sleep, body mass index, blood lipids, blood pressure, and blood glucose. We examined whether achievement of Life's Essential 8 goals was associated with incident CVD among SHFS (Strong Heart Family Study) participants. Methods and Results A total of 2139 SHFS participants without CVD at baseline were included in analyses. We created a composite CVH score based on achievement of Life's Essential 8 goals, excluding sleep. Scores of 0 to 49 represented low CVH, 50 to 69 represented moderate CVH, and 70 to 100 represented high CVH. Incident CVD was defined as incident myocardial infarction, coronary heart disease, congestive heart failure, or stroke. Cox proportional hazard models were used to examine the relationship of CVH and incident CVD. The incidence rate of CVD at the 20‐year follow‐up was 7.43 per 1000 person‐years. Compared with participants with low CVH, participants with moderate and high CVH had a lower risk of incident CVD; the hazard ratios and 95% CIs for incident CVD for moderate and high CVH were 0.52 (95% CI, 0.40–0.68) and 0.25 (95% CI, 0.14–0.44), respectively, after adjustment for age, sex, education, and study site. Conclusions Better CVH was associated with lower CVD risk which highlights the need for comprehensive public health interventions targeting CVH promotion to reduce CVD risk in American Indian communities.

A Randomized Controlled Trial of a Motivational Interviewing Intervention to Improve Whole-Person Lifestyle

Type of study: rct

Number of citations: 7

Year: 2020

Authors: Amanda T. Sawyer, Jo Wheeler, Pamela J Jennelle, J. Pepe, Patricia S. Robinson

Journal: Journal of Primary Care & Community Health

Journal ranking: Q1

Key takeaways: Motivational interviewing can improve overall health and reduce cardiovascular disease risk profile in patients with metabolic syndrome.

Abstract: The purpose of this randomized controlled trial was to examine the effects of a motivational interviewing intervention to improve whole-person lifestyle and reduce cardiovascular disease risk profile. A sample of 111 adults with type 2 diabetes and/or hypertension was recruited from a primary care physician practice. The intervention was facilitated by a program specialist trained in motivational interviewing. Outcomes included body mass index, cholesterol, hemoglobin A1c, blood pressure, waist circumference, wellness scores, and substance use. Differences in the changes in body mass index and waist circumference existed between the intervention and control groups after 6 months. In the intervention group, the proportion of high wellness scores increased after the program. A whole-person lifestyle intervention with motivational interviewing for patients with metabolic syndrome can improve one’s health in terms of components in the cardiovascular disease risk profile, as well as overall wellness. Efforts to improve the health of these patients may incorporate motivational interviewing to guide goal setting and address mental and spiritual health in addition to physical health.

Motivational orientation mediates the association between depression and cardiovascular reactivity to acute psychological stress.

Type of study: non-rct observational study

Number of citations: 10

Year: 2020

Authors: Tracey M Keogh, S. Howard, Adam O'Riordan, S. Gallagher

Journal: Psychophysiology

Journal ranking: Q1

Key takeaways: Depression is linked to blunted cardiovascular reactivity to stress, mediated by intrinsic motivation, rather than extrinsic motivation.

Abstract: Recent theoretical developments in cardiovascular reactivity research suggest the association between depression and blunted reactions to stress is linked to motivational factors. Thus, the present study aimed to test whether the association between depressive symptoms and cardiovascular reactivity to acute stress was mediated by motivation; be it intrinsic or extrinsic motivation. One hundred and eighty-two healthy young adults completed measures of motivation (Global Motivation Scale; GMS), and depression (Hospital Anxiety and Depression Scale; HADS) and had their blood pressure and heart rate monitored throughout a standardised stress testing protocol. Results indicated that depression was negatively associated with both systolic blood pressure (SBP) and heart rate (HR) reactions to the stress task (all ps < .05), such that those who reported higher depressive symptomology displayed a blunted response. Furthermore this relationship was mediated by intrinsic, but not extrinsic motivation; the blunted responses were less pronounced through intrinsic motivation. The present findings add extensively to existing research and confirm that motivation is an underlying mechanism linking depression and cardiovascular reactivity.

Achieving Cardiovascular Risk Management Goals and Patient Quality of Life

Type of study: non-rct observational study

Number of citations: 1

Year: 2024

Authors: A. Kosobucka-Ozdoba, Łukasz Pietrzykowski, P. Michalski, J. Ratajczak, K. Grzelakowska, M. Kasprzak, Jacek Kubica, A. Kubica

Journal: Journal of Cardiovascular Development and Disease

Journal ranking: Q1

Key takeaways: Controlling cardiovascular risk factors and engaging in health-promoting behaviors positively impacts the quality of life for patients without a history of atherosclerotic CVD.

Abstract: (1) Background: Eliminating or reducing the severity of modifiable risk factors of cardiovascular disease (CVD) and undertaking health-promoting behaviors is the basis for prevention. (2) Methods: This study included 200 subjects without a history of CVD, aged 18 to 80 years, who had been diagnosed with hypertension, hypercholesterolemia, or diabetes 6 to 24 months before study enrolment. (3) Results: The median 10-year CV risk assessed by the SCORE2 and SCORE2-OP algorithms was 3.0 (IQR 1.5–7.0). An increase in mean cardiovascular risk in the range from low and moderate to very high was associated with a decrease in quality of life both in individual subscales and the overall score. The median number of controlled risk factors was 4.0 (IQR 3.0–5.0). As the mean number of controlled risk factors increased, the quality of life improved in both of HeartQoL questionnaire subscales (emotional p = 0.0018; physical p = 0.0004) and the overall score (global p = 0.0001). The median number of reported health-promoting behaviors undertaken within 3 years before study enrolment was 3.0 (IQR 2.0–4.0). The highest quality of life in each of the studied dimensions was found in people who reported undertaking three health-promoting behaviors. (4) Conclusions: Controlling CVD risk factors and undertaking health-promoting behaviors has a positive impact on the quality of life of patients without a history of atherosclerotic CVD.

Influence of Self-Efficacy and Motivation to Follow a Healthy Diet on Life Satisfaction of Patients with Cardiovascular Disease: A Longitudinal Study

Type of study: non-rct observational study

Number of citations: 16

Year: 2020

Authors: Rosario Castillo-Mayén, Cristina Cano-Espejo, Bárbara Luque, E. Cuadrado, Tamara Gutiérrez-Domingo, Alicia Arenas, Sebastián J Rubio, J. Delgado-Lista, P. Pérez-Martínez, C. Tabernero

Journal: Nutrients

Journal ranking: Q1

Key takeaways: Self-efficacy and motivation to follow a healthy diet positively impact life satisfaction in cardiovascular patients over time, suggesting psychological interventions may be beneficial.

Abstract: Today, cardiovascular disease has a great impact on the global population due to its high prevalence. One challenge that cardiovascular patients face to achieve a better prognosis is to follow a healthy diet. This study focused on psychological factors linked to adaptation to a healthy diet in these patients. The main objective was to analyze the interrelationship between motivation to follow a healthy diet and self-efficacy to adhere to the Mediterranean diet with life satisfaction over time. The sample consisted of cardiovascular patients who were assessed at three measurement moments (NT1 = 755; NT2 = 593; NT3 = 323, average interval time: nine months). Correlation analyses showed that self-efficacy, motivation, and life satisfaction followed a pattern of positive relations across the three measurements. A time effect over the study variables was also observed. The results of path analyses showed that self-efficacy positively predicted autonomous motivation, which in turn was associated with patients’ life satisfaction. This interrelation was stable over a period of 18 months. Moreover, life satisfaction predicted self-efficacy nine months later. Psychological interventions might be a positive resource for cardiovascular patients, since psychological variables influence their life satisfaction and their subsequent quality of life in their new health condition.

Diminished cardiovascular stress reactivity is associated with lower levels of social participation.

Type of study: non-rct observational study

Number of citations: 10

Year: 2019

Authors: N. John-Henderson, Cory J. Counts, Courtney S. Sanders, Annie T. Ginty

Journal: Journal of psychosomatic research

Journal ranking: Q1

Key takeaways: Diminished cardiovascular reactivity is associated with lower levels of social participation, potentially reflecting deficits in motivational functioning.

Cardiovascular disease, self-care and emotional regulation processes in adult patients: balancing unmet needs and quality of life

Type of study: non-rct observational study

Number of citations: 14

Year: 2022

Authors: E. Cilli, J. Ranieri, Federica Guerra, Claudio Ferri, D. Di Giacomo

Journal: BioPsychoSocial Medicine

Journal ranking: Q2

Key takeaways: Emotional dysregulation in cardiovascular disease patients can negatively impact quality of life, with psychological screening being an effective tool for detecting predictive factors and improving self-care empowerment.

Abstract: Abstract Background Cardiovascular disease is a chronic non-communicable illness that causes more than half of all deaths across Europe. Unhealthy lifestyle, inadequate adherence to medical prescriptions, themselves associated with psycho-emotional disorders are considered risk factors for reduced quality of life as well physical condition. Objective Aim of our study was to understand predictive factors for disease management by evaluating psychological aspects, self-care processes and emotional regilati0on in CVD outpatients. Methods An observational study was conducted. Sixty-one patients, age 18–75 years (M 56.4 ± sd 12.0), diagnosed with CVD participated in the study. The psychological battery was administered during clinical follow-up oriented to detect emotional and psychological dimensions as well adaptive behavioral and quality of life by standardized questionnaire/scales. Results Finding showed that emotional dysregulation might influence QoL, particularly significant effect of awareness (β= 0.022; SE = 1.826; p &lt; 0.002), goals (β = - 0.54; SE = 1.48; p &lt; 0.001) and clarity (β = - 0.211; SE = 2.087; p &lt; 0.003). The results also suggest that the mediated effect accounted for awareness index was 18.7% ( R 2 = 0.187) of the variance; goals index 62.8% ( R 2 = 0.628) of the variance and, then significant mediated effect of clarity was 58.8% ( R 2 = 0.588) of the variance. This evidence suggests that the relationship between triggers and QoL is mediated by emotional dysregulation indexes. Conclusion In clinical practice psychological screening can be an effective tool for detecting predictive factors in the management of the CVD patient's health and adherence to medical treatment: the screening of predictive psychological factors for allowing a good clinical condition management and a self-care empowerment aimed at increasing psychological well-being and the Quality of Life by planning adequate integrated and multidisciplinary support.

Trait and state approach-motivated positive affects interactively influence stress cardiovascular recovery.

Type of study: rct

Number of citations: 11

Year: 2019

Authors: Yi Qin, Wei Lü, B. Hughes, Lukasz D. Kaczmarek

Journal: International journal of psychophysiology : official journal of the International Organization of Psychophysiology

Journal ranking: Q2

Key takeaways: State-motivated positive affect prolongs stress cardiovascular recovery, with individuals low in sensation seeking experiencing delayed recovery compared to those high in sensation seeking.

Goal setting within cardiac care: the effect of linking life goals to health goals on intention to change lifestyle in patients

Type of study: rct

Number of citations: 0

Year: 2022

Authors: R. IJzerman, V. Janssen, R. van der Vaart, I. van den Broek, E. Dusseldorp, R. Kraaijenhagen, T. Reijnders, W. S. O. Scholte op Reimer, A. Evers

Journal: European Journal of Preventive Cardiology

Journal ranking: Q1

Key takeaways: Linking life goals to health goals improves intention to change lifestyle in patients with cardiovascular disease, but only benefits those with high education levels.

Abstract: Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Dutch Heart Foundation and ZonMw Goal setting within cardiac care: the effect of linking life goals to health goals on intention to change lifestyle in patients. Initiating and maintaining a healthy lifestyle is difficult and often needs several attempts. Reaching health goals may become easier if linked to life goals (see Fig.1). Life goals, also described as abstract, long-term goals, reflect objectives that matter to people personally. Guidelines recommend goal setting to realise behaviour change in patients with cardiovascular disease (CVD). However, research is inconclusive about whether positive effects of lifestyle interventions can be attributed to linking life goals to health goals or to other intervention elements. This experimental study examines the effect of linking a life goal to a health goal on intention to change lifestyle in patients with CVD. Research panel members of a CVD patient association were recruited for the online study via advertisement on the association’s website. Patients were randomised and controlled into two groups: setting a health goal (HG) and setting a health goal linked to a life goal (+LG). Based on the Theory of Planned Behavior (see Fig.2) and previous research, main outcome measure ‘intention to change lifestyle’ was assessed using a visual analogue scale ranging 0-10 (low to high). Effect of group (HG vs +LG) on intention to change lifestyle (high vs low) was analysed using logistic regression. Gender, age, education level, and type of CVD were entered as possible effect modifiers. Patients (N=628) were mostly male (61%), with a mean age of 69±35 years, and medium (33%) or high (47%) education level. In both groups, HG and +LG, 47% of the patients expressed high intention to change lifestyle. Logistic regression showed no effect of group (HG vs +LG) on intention, OR:0.98 (95%CI: 0.72–1.35, p=0.92). Only education level appeared to be an effect modifier, X²(2):8.2, p=0.02; showing that linking a life goal to a health goal was effective in patients with a high education level. Contrary to this, setting a life goal negatively affected intention in patients with a low education level. Among patients with a high education level, percentage of 'high intention' was higher in the +LG group (57%) than in the HG group (45%). In contrast, among patients with a low education level, percentage of 'high intention' was higher in the HG group (48%) than in the +LG group (36%). This study showed no main effect of linking a life goal to a health goal on patients’ intention to change lifestyle. Education level was found to be a significant effect modifier. Patients with a high education level significantly benefitted from linking a life goal to a health goal. Patients with lower education levels benefitted most from setting only a health goal. In conclusion, within practice, health care providers may personalise their approach towards goal setting based on patients’ education level.

The role of motivation and the regulation of eating on the physical and psychological health of patients with cardiovascular disease

Type of study: non-rct observational study

Number of citations: 29

Year: 2015

Authors: Camille Guertin, M. Rocchi, L. Pelletier, Claudie Émond, G. Lalande

Journal: Journal of Health Psychology

Journal ranking: Q2

Key takeaways: Self-determined motivation in patients with cardiovascular disease leads to increased self-efficacy and a healthy diet, improving their physical health and life satisfaction.

Abstract: This study tested a longitudinal motivation model for healthy eating in patients with cardiovascular disease, using self-determination and social-cognitive theories. A total of 513 patients completed measures of eating habits, global motivation, motivation for eating, self-efficacy for eating and life satisfaction, immediately after a major cardiac incident and at three times during a year (e.g. 2008–2009). Physiological indicators were measured to examine how they predicted the participants’ physical health. Results found participants with self-determined motivation were more likely to develop a sense of self-efficacy towards eating and a healthy diet, which had beneficial effects on their physical health and life satisfaction.

Effect of sleep and fatigue on cardiovascular performance in young, healthy subjects

Type of study: non-rct observational study

Number of citations: 6

Year: 2022

Authors: L. Castelli, D. Walzik, N. Joisten, M. Watson, A. Montaruli, M. Oberste, E. Roveda, P. Zimmer

Journal: Physiology & Behavior

Journal ranking: Q2

Key takeaways: Chronic inadequate sleep quality negatively impacts cardiovascular performance in males, while fatigue is more significant in females.

Effectiveness of motivational interviewing on anxiety, depression, sleep quality and quality of life in heart failure patients: secondary analysis of the MOTIVATE-HF randomized controlled trial

Type of study: rct

Number of citations: 27

Year: 2021

Authors: P. Rebora, Valentina Spedale, G. Occhino, M. Luciani, R. Alvaro, E. Vellone, B. Riegel, D. Ausili

Journal: Quality of Life Research

Journal ranking: Q1

Key takeaways: Motivational interviewing may improve disease-specific quality of life in heart failure patients, but its effectiveness on anxiety, depression, sleep quality, and overall health remains unclear.

Abstract: Abstract Purpose Anxiety, depression, poor sleep quality and lower quality of life (QOL) are associated with worse outcomes in heart failure (HF) patients. Motivational interview (MI) has been effective in different patient populations to promote self-care. However, its effect on anxiety, depression, sleep quality and QOL in HF patients is unknown. The aim of this study was to evaluate the effect of MI on anxiety, depression, sleep quality and QOL over 12 months from the intervention. Methods This was a planned, secondary outcome analysis of the MOTIVATE-HF study, a three-arm randomized controlled trial (1:1:1) evaluating the effect of MI in improving self-care in HF patients. In Arm 1, the patient received MI, while in Arm 2, the patient and the caregiver received MI. Arm 3, the control group, received standard treatment. Endpoints were evaluated with the Hospital Anxiety and Depression Scale (HADS), the Pittsburgh Sleep Quality Index (PSQI), the 12-Item Short-Form Health Survey (SF-12) and the Kansas City Cardiomyopathy Questionnaire (KCCQ) every three months for one year. Results We enrolled and randomized 510 HF patient and caregiver dyads (155 dyads in Arm 1, 177 dyads in Arm 2, and 178 dyads in Arm 3). A total of 238 HF patients and 235 caregivers completed the 12-month trial. No significant changes were seen in anxiety, depression and sleep quality over time among the three study arms, but disease-specific QOL improved in the intervention groups, especially in Arm 2. Conclusion Clinicians may want to include both patients and caregivers when providing MI interventions. Further research is needed to investigate the required intensity of MI to be effective on sleep quality, anxiety and depression (ClinicalTrials.gov Identifier: NCT02894502).

A critical examination of the relationship between cardiovascular health, cognition, and dementia risk.

Type of study:

Number of citations: 0

Year: 2025

Authors: Joshua L Gills, O. Bubu

Journal: Journal of Alzheimer's disease : JAD

Journal ranking: Q1

Key takeaways: Poor cardiovascular health in middle age is linked to increased risk of cognitive impairment and Alzheimer's disease.

Abstract: Poor cardiovascular health is strongly linked to increased risk of cognitive impairment and Alzheimer's disease and related dementias. This commentary discusses Yang and associates' work on the associations between cardiovascular health in middle age, as defined by Life Essential 8 scores, and later digital cognitive performance and incident Alzheimer's disease. We examine the strengths and weaknesses of their study within the broader research context. We emphasize the potential significance of sleep and stress the need for longitudinal studies incorporating robust neuropsychiatric methodologies, advanced neuroimaging techniques, and diverse participant samples to enhance the reliability and generalizability of results.

Exercise motivation in patients with heart failure

Type of study: non-rct observational study

Number of citations: 0

Year: 2020

Authors: L. Klompstra, T. Jaarsma, A. Strömberg, M. V. D. Wal

Journal: European Heart Journal

Journal ranking: Q1

Key takeaways: Lower quality of life, lower self-efficacy, experiencing shortness of breath, having COPD, and lower educational level decrease exercise motivation in heart failure patients.

Abstract: Being physically active is important for patients with heart failure (HF) to improve clinical outcome, however, adherence to exercise is low (<50%). To tailor intervention that increase physical activity, it is important to know what motivates HF patients to exercise. Therefore, the aim of the study is to describe motivations of HF patients to exercise and describe variables that are related to their exercise motivation. This is a cross-sectional analysis of baseline data of 605 patients with HF (mean age 67±12, 71% male, 60%NYHA I/II) who were included in the HF-Wii study. Stepwise regression modelling was used with exercise motivation as dependent variable. Exercise motivation was measured with the Exercise Motivation Index, including 15 statements with answers ranging from 0 (not important) to 4 (extremely important), with 3 subscales (physical, psychological and social motivation). Based on previous research the following predictors were included in the model: quality of life (MLwHFQ), self-efficacy (Exercise self-efficacy scale), cognition (MoCA), depression (HADs), sleeping difficulties (MISS), HF symptoms (fatigue, shortness of breath), age, gender, NYHA-class, comorbidity and educational level. Mean total motivation to exercise was 2.3±0.9 and physical and psychological motivation were rated as the more important (2.7±0.9 and 2.5±0.9) than social motivation (1.8±1.1). Motivation statements that were considered extremely important were being healthier (55% rated 4), slow down the ageing process (38% rated 4) and increasing well-being (31% rated 4). From the multiple linear regression model lower quality of life (β=−0.31, P<0.0001), lower self-efficacy (β=0.16, P<0.0001), experiencing shortness of breath (β=−0.28, P<0.0001), having COPD (β=−0.14, P=0.001) and low educational level (β=−0.09, P<0.028) were predictors related to lower motivation. This model explained 17% of the exercise motivation variability (p<0.0001). Cognition, sleeping difficulties, age, gender, NYHA-class and experiencing fatigue were not significantly related to motivation. Lower quality of life, lower self-efficacy, experiencing shortness of breath, having COPD and lower educational level, decreases the motivation to exercise and may therefore be considered as barriers for exercise. These barriers should be assessed and considered when motivating patients to become more physically active. Type of funding source: None

Lifestyle-related habits and factors before and after cardiovascular diagnosis: a case control study among 2,548 Swedish individuals

Type of study: non-rct observational study

Number of citations: 9

Year: 2023

Authors: A. Lönn, Lena V. Kallings, Gunnar Andersson, Sofia Paulsson, Peter Wallin, Jane Salier Eriksson, E. Ekblom-Bak

Journal: The International Journal of Behavioral Nutrition and Physical Activity

Journal ranking: Q1

Key takeaways: A cardiovascular event may increase motivation to improve lifestyle habits, but the prevalence of unhealthy habits remains high, emphasizing the need for improved primary and secondary CVD prevention.

Abstract: Abstract Background Healthy lifestyle habits are recommended in prevention of cardiovascular disease (CVD). However, there is limited knowledge concerning the change in lifestyle-related factors from before to after a CVD event. Thus, this study aimed to explore if and how lifestyle habits and other lifestyle-related factors changed between two health assessments in individuals experiencing a CVD event between the assessments, and if changes varied between subgroups of sex, age, educational level, duration from CVD event to second assessment and type of CVD event. Methods Among 115,504 Swedish employees with data from two assessments of occupational health screenings between 1992 and 2020, a total of 637 individuals (74% men, mean age 47 ± SD 9 years) were identified having had a CVD event (ischemic heart disease, cardiac arrythmia or stroke) between the assessments. Cases were matched with controls without an event between assessments from the same database (ratio 1:3, matching with replacement) by sex, age, and time between assessment ( n = 1911 controls). Lifestyle habits included smoking, active commuting, exercise, diet, alcohol intake, and were self-rated. Lifestyle-related factors included overall stress, overall health (both self-rated), physical capacity (estimated by submaximal cycling), body mass index and resting blood pressure. Differences in lifestyle habits and lifestyle-related factors between cases and controls, and changes over time, were analysed with parametric and non-parametric tests. Multiple logistic regression, OR (95% CI) was used to analyse differences in change between subgroups. Results Cases had, in general, a higher prevalence of unhealthy lifestyle habits as well as negative life-style related factors prior to the event compared to controls. Nevertheless, cases improved their lifestyle habits and lifestyle factors to a higher degree than controls, especially their amount of active commuting ( p = 0.025), exercise ( p = 0.009) and non-smoking ( p &lt; 0.001). However, BMI and overall health deteriorated to a greater extent ( p &lt; 0.001) among cases, while physical capacity ( p &lt; 0.001) decreased in both groups. Conclusion The results indicate that a CVD event may increase motivation to improve lifestyle habits. Nonetheless, the prevalence of unhealthy lifestyle habits was still high, emphasizing the need to improve implementation of primary and secondary CVD prevention.