Beyond Intrinsic Motivation: Why Researchers Should Consider the Full Motivation Continuum in Games for Health Research.

Research within the domain of games for health has predominantly focused on individuals' intrinsic motivation characterized by an inherent enjoyment of the activity. Despite the apparent benefits of intrinsic motivation, we argue that it is imperative to adopt a more nuanced and refined perspective on motivation. Relying on the motivation continuum as outlined within Self-Determination Theory, research within this domain needs to distinguish between both intrinsic and extrinsic (i.e., external, introjected, identified, and integrated regulation) types of motivation. Researchers should, therefore, embrace instruments that assess a broader continuum of motivation rather than just intrinsic motivation alone. By doing so, future research can yield more insight into what fosters autonomous forms of motivation in the field of health-related games, including intrinsic and identified and integrated regulation.

How Do Late Adults Experience Meaning During the COVID-19 Lockdown? The Role of Intrinsic Goals.

Late adults differ in the degree to which their mental health is impacted by the COVID-19 crisis, with interindividual differences in their capacity to mobilize coping resources playing an important role. Therefore, the search for inner sources of resilience is important to understand late adults' adaptation to this crisis. Based on Goal Content Theory, a mini-theory within the broader Self-Determination Theory, this study aimed to examine whether older adults' valuation and attainment of intrinsic goals represent such a source of resilience. Intrinsic goals would form a solid foundation to experience a sense of meaning during this crisis, which, in turn, relates to higher well-being (i.e., life satisfaction and vitality) and lower ill-being (i.e., symptoms of depression, anxiety, and loneliness). During the second month of the lockdown period in Belgium, 693 older adults (Mage = 70.06, SD = 4.48, range: 65-89 years, 62.1% female) filled out online questionnaires concerning the study variables. Structural equation modeling showed that intrinsic goal attainment and goal importance related positively to experiences of meaning in life which, in turn, were related to higher levels of well-being and lower levels of ill-being. No evidence was found for an interaction effect between intrinsic goal attainment and goal importance. Supporting late adults' pursuit and attainment of meaningful intrinsic goals relates to their well-being and may potentially strengthen their resilience in times of crisis.

A moment of autonomy support brightens adolescents' mood: Autonomy support, psychological control and adolescent affect in everyday life.

This experience sampling study examined whether autonomy-supportive and psychologically controlling interactions with parents are intertwined with adolescents' momentary affect. For 7 days (in 2020), 143 adolescents (Mage = 15.82; SDage = 1.75; 64% girls; 95% European, 1% African, 3% unknown) reported 5 or 6 times a day how they felt and how interactions with parents were experienced. Preregistered dynamic structural equation models on 1439 (including 532 adjacent) parent-adolescent interactions revealed significant within-family associations: Adolescents experienced more positive affect during and following autonomy-supportive interactions, and vice versa. Adolescents felt more negative affect during and 3 h before psychologically controlling interactions. Between-family associations showed significant linkages between parenting and affect. These findings show that a moment of autonomy support can alter adolescents' everyday well-being.

Validating the German Short Basic Psychological Need Satisfaction and Frustration Scale in Individuals with Depression.

Satisfaction and frustration of the needs for autonomy, competence, and relatedness, as assessed with the 24-item Basic Psychological Need Satisfaction and Frustration Scale (BPNSFS), have been found to be crucial indicators of individuals' psychological health. To increase the usability of this scale within a clinical and health services research context, we aimed to validate a German short version (12 items) of this scale in individuals with depression including the examination of the relations from need frustration and need satisfaction to ill-being and quality of life (QOL). This cross-sectional study involved 344 adults diagnosed with depression (Mage (SD) = 47.5 years (11.1); 71.8% females). Confirmatory factor analyses indicated that the short version of the BPNSFS was not only reliable, but also fitted a six-factor structure (i.e., satisfaction/frustration X type of need). Subsequent structural equation modeling showed that need frustration related positively to indicators of ill-being and negatively to QOL. Surprisingly, need satisfaction did not predict differences in ill-being or QOL. The short form of the BPNSFS represents a practical instrument to measure need satisfaction and frustration in people with depression. Further, the results support recent evidence on the importance of especially need frustration in the prediction of psychopathology.

The Mediating Role of Rumination in the Relation between Basic Psychological Need Frustration and Depressive Symptoms.

Research within the framework of Basic Psychological Need Theory (BPNT) finds strong associations between basic need frustration and depressive symptoms. This study examined the role of rumination as an underlying mechanism in the association between basic psychological need frustration and depressive symptoms. A cross-sectional sample of N = 221 adults (55.2% female, mean age = 27.95, range = 18-62, SD = 10.51) completed measures assessing their level of basic psychological need frustration, rumination, and depressive symptoms. Correlational analyses and multiple mediation models were conducted. Brooding partially mediated the relation between need frustration and depressive symptoms. BPNT and Response Styles Theory are compatible and can further advance knowledge about depression vulnerabilities.

The role of emotion regulation in mental health during the COVID-19 outbreak: A 10-wave longitudinal study.

The COVID-19 pandemic elicited a lot of concerns among citizens, thereby potentially compromising their well-being. This study sought to examine the role of individuals' emotion regulation styles (i.e., emotional dysregulation, emotional suppression, and emotional integration) in handling these concerns and their experiences of well-being (i.e., satisfaction with life and sleep quality) and ill-being (i.e., anxiety and depressive symptoms). The study had a unique 10-wave longitudinal design (N = 986; Mage  = 41.28; 76% female) and was conducted during the outbreak of the pandemic in March-May 2020. Multilevel analyses showed, first, that weekly variation in COVID-19 related concerns related negatively to weekly variation in well-being and positively to weekly variation in ill-being. Second, at the between-person level, emotional dysregulation and suppression related positively to between-person vulnerability in ill-being and lower well-being (across all waves). Third, between-person differences in emotional dysregulation amplified the strength of the within-person association between concerns and depressive complaints and lowered life satisfaction. Unexpectedly, integrative emotion regulation amplified the strength of the within-person association between concerns and anxiety. The discussion focuses on the critical role of emotion regulation in handling the uncertainty elicited by the pandemic and provides directions for further research.

The validation of the Norwegian Basic Psychological Need Satisfaction and Frustration Scale: A stratified sampling procedure.

This study aimed to validate the Norwegian version of the Basic Psychological Need Satisfaction and Frustration Scale (BPNSFS) and to examine its relations with indicators of well-being and ill-being. Additionally, despite the vast number of studies employing the BPNSFS, norms related to the BPNSFS are currently lacking. Therefore, we also aimed to provide normative data for this scale. Data were collected among a representative sample of 326 participants (M age = 42.90 years, SD = 14.76; range 18-70) in Norway, of which 49.7% was female. Results yielded evidence for a six-factor structure (i.e., combining satisfaction/frustration with the type of need) and showed the subscales to be highly reliable. Subsequent structural equation modeling showed that both need satisfaction and need frustration related strongly to vitality, life satisfaction, and internalizing symptoms, but in opposite ways. Norm scores were provided, thereby differentiating between women and men and different age groups. These findings support the use of the Norwegian BPNSFS and provide researchers and professionals with normative data on the most widely used tool to assess individuals' satisfaction and frustration of the basic psychological needs for autonomy, competence, and relatedness.

Basic psychological need satisfaction and frustration in major depressive disorder.

Basic psychological needs theory postulates that a social environment that satisfies individuals' three basic psychological needs of autonomy, competence, and relatedness leads to optimal growth and well-being. On the other hand, the frustration of these needs is associated with ill-being and depressive symptoms foremost investigated in non-clinical samples; yet, there is a paucity of research on need frustration in clinical samples. Survey data were compared between adult individuals with major depressive disorder (MDD; n = 115; 48.69% female; 38.46 years, SD = 10.46) with those of a non-depressed comparison sample (n = 201; 53.23% female; 30.16 years, SD = 12.81). Need profiles were examined with a linear mixed model (LMM). Individuals with depression reported higher levels of frustration and lower levels of satisfaction in relation to the three basic psychological needs when compared to non-depressed adults. The difference between depressed and non-depressed groups was significantly larger for frustration than satisfaction regarding the needs for relatedness and competence. LMM correlation parameters confirmed the expected positive correlation between the three needs. This is the first study showing substantial differences in need-based experiences between depressed and non-depressed adults. The results confirm basic assumptions of the self-determination theory and have preliminary implications in tailoring therapy for depression.

Do Psychological Needs Play a Role in Times of Uncertainty? Associations with Well-Being During the COVID-19 Crisis.

Across the world, measures were taken to contain the spreading of the COVID-19 virus. Many of these measures caused a sudden rupture in people's daily routines, thereby eliciting considerable uncertainty and potentially also hampering the satisfaction of individuals' psychological needs for autonomy, relatedness, and competence. Drawing upon Maslow's Hierarchical Need Theory and Self-Determination Theory, this study examined the unique role of felt insecurity and the psychological needs, as well as their dynamic interplay, in the prediction of mental health. A large and heterogeneous sample of adults (N = 5118; Mage = 43.45 years) was collected during the first ten days of the lockdown period in Flanders, Belgium. A subsample (N = 835, Mage = 41.39) participated during a second wave one week later. Hierarchical regression analyses indicated that felt insecurity, need satisfaction and need frustration all independently predicted various positive (life satisfaction, sleep quality) and negative indicators depressive symptoms, anxiety) of mental health, with little systematic evidence for interactions between the predictors. The pattern of findings obtained concurrently largely held in the longitudinal analyses. Finally, results showed that associations between felt insecurity and lower concurrent and prospective mental health were partially mediated by need satisfaction and frustration, with especially psychological need frustration predicting changes in mental health over time. Overall, the findings suggest that satisfaction of the psychological needs for autonomy, competence, and relatedness is not just a 'luxury good'. Satisfaction of these needs is important also in times of insecurity, while need frustration represents a risk factor for maladjustment during such times.

The role of ego integrity and despair in older adults' well-being during the COVID-19 crisis: the mediating role of need-based experiences.

The COVID-19 pandemic has affected people across the world, with important heterogeneity among older adults in how they respond to the challenges associated with this crisis. Relying on a cross-fertilization between Erikson's personality theory and self-determination theory, this study aimed to examine possible sources of resilience (i.e., ego integrity and need satisfaction) and vulnerability (i.e., despair) in older adults' (mal) adjustment, thereby additionally considering the role of multiple risk and protective factors (e.g., gender and marital status). During the second month of the lockdown period in Belgium, 693 older adults (M age = 70.06, SD = 4.48, range: 65-89 years, 62.1% female) filled out online questionnaires concerning the study variables, while also completing assessments of several important sociodemographic factors. Structural equation modeling suggested that both ego integrity and despair related to indicators of well-being and psychological distress through experienced need satisfaction. Additionally, we found several factors to protect (e.g., higher perceived income) or diminish (e.g., being widowed) older adults' well-being during these challenging times, with little evidence for a moderating role of these factors in associations between the psychological variables. Theoretical and practical implications of these results are discussed.

Parenting and Child Personality as Modifiers of the Psychosocial Development of Youth with Cerebral Palsy.

This two-year longitudinal study addressed the joint contribution of parent-rated parenting behaviors and child personality on psychosocial outcomes in 118 families of children with Cerebral Palsy (M age Time 1 = 10.9 years old, 64.4% boys). Latent change modeling revealed intra-individual changes in children's psychosocial development as internalizing and externalizing behaviors increased from the first to the second assessment and psychosocial strengths increased from the second to the third assessment, whereas externally controlling and autonomy-supportive parenting behavior remained stable over time. Externally controlling parenting related to higher levels of, and increases in behavioral problems, with these associations being most pronounced among children low on Extraversion, Conscientiousness, or Imagination. Autonomy-supportive parenting related to higher levels of psychosocial strengths, with this association being most pronounced among children high on Emotional Stability.

Risk and Resilience Predictors of Recovery After Spinal Fusion Surgery in Adolescents.

OBJECTIVE: This prospective study examined risk and resilience predictors of pain and functional recovery in the first 6 months after spinal fusion surgery in adolescents. METHODS: Adolescents with adolescent idiopathic scoliosis undergoing spinal fusion surgery (n=100, aged 12 to 18 y, 77% girls) completed assessments before surgery and at 3 weeks, 6 weeks, and 6 months after surgery. Recovery trajectories in pain, health-related quality of life (HRQOL), and objectively registered physical activity were identified. Presurgical pain catastrophizing and pain intensity (risk), and psychological flexibility, and postsurgical pain acceptance (resilience) were examined as predictors of recovery. RESULTS: Latent growth class analyses revealed 4 distinct pain recovery trajectories (ie, Severe-Moderate [11%, n=9], Mild-No [58%, n=49], Moderate-Mild [24%, n=20], and Moderate-Severe [7%, n=6] pain trajectory), 2 HRQOL recovery trajectories; 2 trajectories characterizing recovery in average daily physical activity at moderate-to-vigorous intensity (MVPA); and 3 trajectories characterizing recovery in total physical activity volume characterized by the average daily number of steps. Subsequent multivariate analyses of variance revealed that presurgical pain intensity (partial η2=0.21, P<0.001) and pain catastrophizing (partial η2=0.13, P<0.01) were both predictive of poorer recovery in HRQOL, and pain catastrophizing additionally predicted poorer pain recovery (partial η2=0.15, P<0.05). Psychological flexibility (partial η2=0.25, P<0.001) and postsurgical pain acceptance (partial η2=0.07, P<0.05) were predictive of more favorable recovery trajectories in HRQOL, and psychological flexibility additionally predicted more favorable recovery trajectories in postsurgical pain (partial η2=0.15, P<0.05). Daily MVPA trajectories were not significantly predicted by any of the hypothesized factors, while presurgical pain catastrophizing levels were predictive of a delayed recovery trajectory in the daily amount of steps (partial η2=0.17 P<0.01). CONCLUSIONS: Presurgical screening could include assessment of pain intensity, pain catastrophizing, psychological flexibility, and pain acceptance to identify adolescents who are at risk for poorer recovery. These are potentially modifiable factors that can be targeted in presurgical interventions to prevent poor and foster adaptive outcomes after major surgery in adolescents.

The role of parents' autonomy support and psychological control in sibling relationship functioning through children's need-based experiences.

This study aimed to examine whether parents' autonomy support and psychological control during sibling conflict would relate to children's need-based experiences and relationship functioning within the sibling relationship. Two siblings (Mage  = 8.61 years, SD = 0.91 and Mage  = 10.50 years, SD = 0.94) of 205 families filled out questionnaires. Results showed that parental autonomy support related positively to siblings' relationship satisfaction via children's need satisfaction. Additionally, fathers' psychological control related negatively to provided autonomy support and positively to provided psychological control from one sibling to the other (as reported by the other sibling) and negatively to satisfaction with this relationship via need frustration. These findings highlight the importance of the quality of parents' involvement during sibling conflict.

Parental identity as a resource for parental adaptation during the COVID-19 lockdown.

The lockdown measures that were taken to contain the worldwide outbreak of COVID-19 caused many parents to stay at home with their children. This unusual situation created both risks and opportunities for families. In the present study, we examined the role of parental identity as a resource for parental adaptation during this challenging period, thereby considering both parenthood experiences and parents' general mental health while also taking into account the cumulative risk to which parents were exposed (e.g., single parenthood). Furthermore, to shed light on the mechanisms behind the effects of parental identity, this study addressed the mediating role of parental satisfaction of their basic psychological needs for autonomy, competence, and relatedness. During the lockdown period in Belgium, 492 parents (88% mothers, Mage = 44 years, 63.7% in intact family, 31.2% with a university degree) completed online questionnaires on parental identity, need-based experiences, positive and negative parenthood experiences, and mental health. Several weeks earlier, these participants also rated their mental health and a variety of risks they were exposed to as part of a larger study. Results showed that a clear and self-endorsed parental identity was related to better parental adaptation, with parental need satisfaction playing a mediating role in these associations. Moreover, these associations remained significant after controlling for the prior levels of parental mental health and for cumulative risk. Overall, findings suggest that parental identity serves as a source of resilience in an uncertain period such as the COVID-19 pandemic. Practical implications and directions for future research are discussed. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

"How to unlock myself from boredom?" The role of mindfulness and a dual awareness- and action-oriented pathway during the COVID-19 lockdown.

Although the COVID-19 crisis is a distressing situation entailing greater boredom and lower life satisfaction, there is considerably heterogeneity in people's reaction patterns. In a sample of 1455 participants (M age  = 50.70, 70% female), collected during the second lockdown in Belgium, we sought to examine an integrative process model, thereby distinguishing between an awareness- (i.e., decentering vs. ruminating) and an action-oriented (i.e., self-motivating strategies vs. lack of strategies) pathway to account for the association between dispositional mindfulness and participants' psychological functioning. In conjunction, both pathways were found to, respectively, partial and full account for the association between mindfulness and boredom and life satisfaction. The findings highlight, first, the importance of taking an observing stance towards negative experiences instead of being directly immersed in them. Second, congruent with the Self-Determination Theory, they suggest that not all self-motivating action strategies can be considered equal, as autonomy- and control-oriented self-motivating strategies to handle boredom episodes were differentiated related to boredom and life satisfaction.

Negative Controlling Parenting and Child Personality as Modifiers of Psychosocial Development in Youth with Autism Spectrum Disorder: A 9-Year Longitudinal Study at the Level of Within-Person Change.

This nine-year longitudinal study addresses the joint contribution of parent-rated negative controlling parenting and child personality on psychosocial outcomes in 141 families of children with autism spectrum disorder (83% boys, mean age Time 1 = 10.1). Latent change modeling revealed substantial variation in within-person change in parenting and psychosocial outcomes across a six- and three-year-interval. Over time, negative controlling parenting and child personality were consistently related to externalizing problems, whereas child personality was differentially related to internalizing problems and psychosocial strengths. Three personality-by-parenting interactions were significant, suggesting that children with less mature personality traits show more externalizing behaviors in the presence of controlling parenting. This study identified both parenting and child personality as important modifiers of developmental outcomes in youth with autism.

Live well and die with inner peace: The importance of retrospective need-based experiences, ego integrity and despair for late adults' death attitudes.

Given that prior research has provided evidence for the role of late adults' attitudes towards death in their mental health, we sought to understand its underlying sources. Guided by Self-Determination Theory and Erikson's theory of psychosocial development, two cross-sectional studies examined whether older individuals' psychological need-based experiences, as accumulated during life, relate to their death attitudes and whether their experienced ego integrity and despair play an intervening role in these associations. Whereas Study 1 (N = 394 late adults; Mage = 75.14; SD = 6.52; 62.9 % female) involved an assessment of need satisfaction only, in Study 2 (N = 126 late adults; Mage = 78.09; SD = 7.17; 61.9 % female) both need satisfaction and need frustration were assessed. Structural equation modeling showed that, across studies, experienced need satisfaction related positively to ego integrity and negatively to despair. Need frustration was related to despair only. In turn, ego integrity related positively to death acceptance and negatively to death anxiety, while despair related positively to death anxiety. Finally, the contribution of need satisfaction to death attitudes was mostly mediated by individuals' ego integrity. Theoretical and practical implications of these results are discussed.

Towards a detailed understanding of preschool children's memory-related functioning and emotion regulation: The role of parents' observed reminiscence style, memory valence, and parental gender.

This study examined the role of parents' reminiscing style in preschoolers' memory-related functioning and general emotion regulation. In 87 families, each parent rated their child's (Mage = 4.07 years, SD = 0.80) emotion regulation and discussed a positive and a negative memory with their child (resulting in 275 conversations). Multilevel analyses showed that children's rated engagement during the conversation was higher when parents were observed to use autonomy-supportive, elaborative, and positive evaluative reminiscing, while children's rated disaffection was predicted by low autonomy support, low elaboration, and negative evaluation. Parental positive evaluation also related positively to children's memory performance. With respect to emotion regulation, only parents' negative evaluation when talking about negative memories related to higher emotional lability. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Nurses' interaction styles when supporting patients in self-management: A profile approach.

BACKGROUND: The rising attention to participation and self-regulation in chronic care requires nurses to move towards an approach in which patients' perspectives and choices are central, and in which patients' competency is fostered. According to Self-Determination Theory, nurses can differ in the way they interact with patients living with a chronic illness. That is, they can interact in an autonomy-supportive, controlling, structuring or chaotic way. However, in practice, nurses often use these styles side by side depending on personal and situational demands. OBJECTIVE: Rooted in Self-Determination Theory, this study sought to identify distinct profiles among nurses involving the co-occurrence of autonomy support, structure, control and chaos (aim 1), and to examine whether such profiles are meaningfully driven by nurse-related indicators (aim 2). DESIGN: A cross-sectional design with latent profile analysis. METHODS: Data were collected using validated self-report questionnaires among nurses counselling chronically ill patients (N = 389). Latent profile analysis was performed to shed light on how nurses use different styles side by side; and subsequent MANCOVA testing was used to examine differences between the profiles in terms of nurse-related indicators. RESULTS: Four profiles could be identified, each characterised by a unique combination of differing degrees of autonomy support, structure, control and chaos. The profiles included a motivating profile (20.31%) characterised by the dominant presence of autonomy support and structure; a demotivating chaotic profile (17.74%) characterised by the dominant presence of chaos; an active profile (24.17%) where all styles were highly present; and an undifferentiated profile (37.79%) characterised by an average presence of all styles. These four profiles were meaningfully related to a set of nurse-related indicators. Multivariate analysis (Pillai's Trace test = .38, F(15, 756) = 7.28; p < .001; η2 = .13) indicated that job competency, job autonomy and high-quality motivation were most elevated in the motivating profile. CONCLUSION: Profiling has supported our understanding of the natural co-occurrence of more motivating and demotivating styles among nurses when counselling patients in self-managing their life with chronic illness. The pattern of retained profiles indicates that, for some nurses, it will be important to move away from controlling or chaotic interactions. Future intervention development should augment nurses' competence levels and high-quality motivation, with attention to reduce the pressure in nurses to act in a result-based manner. Profiling can also be valuable to better assign nurses to an employment in chronic care, and to support their personal professional growth.

Are the benefits of autonomy satisfaction and the costs of autonomy frustration dependent on individuals' autonomy strength?

OBJECTIVE: From a self-determination theory perspective, individuals are assumed to benefit and suffer from, respectively, the satisfaction and frustration of the psychological need for autonomy, even if they score low on autonomy strength. Yet, previous studies on need strength are scarce, operationalized need strength differently, and produced inconsistent findings. METHOD: In two studies among 224 South African adults (Mage = 24.13, SD = 4.25; 54.0% male) and 156 Belgian prisoners (Mage = 38.60, SD = 11.68; 88.5% male), we investigated the moderating role of autonomy valuation and desire in the relations of autonomy satisfaction and frustration with a variety of well-being and ill-being indicators. RESULTS: Study 1 provided some evidence for the moderating role of mostly explicit autonomy desire (rather than explicit autonomy valuation). In Study 2, neither explicit nor implicit autonomy desire played a consistent moderating role. CONCLUSIONS: Overall, these findings are congruent with a moderate (albeit not with a strong) interpretation of the universality claim made within self-determination theory, provide initial evidence for a differentiation between deficit-based and growth-oriented interpersonal differences in need strength, and indicate that the potential moderating role of need strength deserves continued attention before any firm conclusions can be drawn.