| Author: | Hui, Yu Ling Karen |
| Title: | Emotional and cognitive processes associated with the statements of motivational interviewing |
| Advisors: | Chan, Chetwyn (RS) Siu, Andrew (RS) |
| Degree: | Ph.D. |
| Year: | 2022 |
| Subject: | Motivational interviewing Patients -- Psychology Behavior modification Hong Kong Polytechnic University -- Dissertations |
| Department: | Department of Rehabilitation Sciences |
| Pages: | xiv, 160 pages : color illustrations |
| Language: | English |
| Abstract: | Motivational interviewing (MI) has been shown to be effective in facilitating positive behavioral changes. This thesis aims to explore the linguistic effects of MI statements. The paper-based thesis has three parts. The first part is a literature review, including the theoretical background of motivational interviewing. The second and third parts are studies employing behavioral and psychophysiological approaches to test linguistic effects in individuals involved in work injuries. The first part of the study involved a comprehensive review of the theoretical basis and mental processes of motivational interviewing. The results of the review suggest a dual process of decision making is likely to be the most appropriate for explaining the MI effects on the facilitation of individuals' changes in behaviors. Under this model, the MI statements' content and the usage of the MI statements by the change agent (or therapists) impact individuals' emotional perception and cognitive evaluation. The individuals' perceptions, followed by their evaluation process, facilitate decision making in regard to behavioral changes. The theoretical framework and mental processes developed in this part of the research guided the design and implementation of the behavioral and neurophysiological studies on MI statements. The behavioral study aimed to understand how the contents of MI statements would influence the participants' emotional responses, as well as the emotional and appraisal processes involved in decision making. A total of 83 injured workers completed an MI statement response task. Among them, 30 were classified as being in the precontemplation (PC) stage and 53 were classified as being in the contemplation/preparation/action stages of change readiness (RD). Participants were asked to respond to short statements containing MI-consistent or MI-inconsistent keywords in regard to returning to work. The PC group showed significantly slower mean reaction times (diff.: 674 ms, t = 2.56, p = 0.013) and lower mean contextual ratings (diff.: -0.44, t = -2.882, p = 0.005) than the RD group. There was a significant correlation between the reaction times and the contextual ratings (r = -0.277, p = 0.011). The results indicate that a simple glimpse of MI-consistent linguistic content seemed sufficient to influence the participants' responses. Among different factors, top-down influences, such as those related to readiness for change, showed significant modulations in terms of how the MI-consistent content was perceived. The psychophysiological study aimed to use event-related potential to investigate the neural processes associated with the perception of the linguistic contents of the MI statements. The participants were 30 individuals with work injuries in the PC (n = 15) or RD (n = 15) stages of change readiness. Participants read short MI-consistent, MI-inconsistent, or control statements, during which electroencephalogram signals were captured over the scalp. Between-condition contrasts showed non-significant results of N400. A late positive complex (LPC) with peak latency at 705 ms elicited at the frontal region showed significant Group × Condition interaction effects. The amplitudes in the PC group were more positive than in the RD group, with the highest positive values occurring in the MI-consistent condition. The findings of the study suggest that the effects of the MI statements are likely to relate to the processing and perhaps also the appraisal of the participants' emotional contents (i.e., LPC), rather than their semantic contents (i.e., N400). Future studies could investigate how the saliency of the MI statements influences actual behavioral changes in motivational interviewing. This study's findings indicate that individuals are sensitive to verbal scripts or words that are MI consistent. The between-group differences in the amplitudes of the frontally distributed late-positive complex suggest that viewing MI-consistent words involves the processing and appraisal of emotions, particularly those related to decision making elicited by these words. The top-down processes involve individuals' attention and perceptions of emotion, while the appraisal process is likely to reflect the consistency between the words' linguistic meaning and the individuals' internal value. Internal value in this context was the individuals' readiness to return to work after a work injury. The neural processes underlying the viewing of the MI-consistent words suggest that the reaction times taken to respond to these words may be a plausible method of measuring the effect of motivational interviewing. The main limitation of this study lies in the lack of behavioral changes among the participants (i.e., the actual return to work) as a variable. As a result, it was unclear how the behavioral and neurophysiological results reflect the clinical outcomes of motivational interviewing. Future studies could investigate whether or not viewing MI-consistent scripts/words can be an alternative to therapy-based MI. |
| Rights: | All rights reserved |
| Access: | open access |
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