The p.r.i.m.e. theory of motivation and its

application to health behaviour

Robert WestUniversity College LondonLondon September 2005

Outline

Theory development and testing in psychologyThe need for a synthetic theory of motivationOverview of the theoryImplications of the theory for health behaviour

What makes a good theory?

A scientific theory is a coherent description of ways in which entities interact with the aim of explaining a set of observationsA good theory:• is parsimonious, comprehensible, complete and not

contradicted by known facts• generates novel and useful ideas for new

observations, other theories or applications

Theory development

Theories should be developed and amended only insofar as the existing body of theory is found to be inadequate.This may happen if:• there are important, relevant unexplained

observations• existing theories are contradicted by observations• existing theories conflict with each other• existing theories can be simplified

What has happened in psychologyThese principles have been violated to a very large degreePlethora of theories many of which are minor semantic variations on others and few of which match up even to an intelligent common-sense analysisTheories are making little progress to incremental science

Process of theory development in psychology

Researcher has an idea …

… claims support for the theory using weak methods

… promulgates the theory and gathers a following

Theories of motivation: Humans as animals

Operant learning• Focuses on development

of habitual actions through reward and punishment

Classical conditioning• Focuses on attachment of

motivational significance to stimuli through association with other stimuli

Drive theory• Focuses on operation of

biological drives and their influence on subjective states and behaviour

Mook, D. G. (1996). Motivation: the Organization of Action. New Yotk, W. W. Norton.

Theories of motivation: Humans as rational decision makers

Expectancy value theories• Focus on conscious

comparison of likely costs and benefits of actions

Multi-attribute utility theories• Focus on conscious

comparison of positive and negative features of options

A rational addiction modelfocuses on thinking and choice

Baron, J. (2000). Thinking and Deciding. Cambridge, Cambridge University Press.

Theories of motivation: Humans as emotive decision makers

Conflict theoryFocuses on conscious decision-making processes under the influence of emotion

Self-control theoryFocuses on conscious decision-making under the influence of desires, urges and restraint

The ‘affect heuristic’Focuses on intuitive versus analytical judgement

A compulsion mode of addictionfocuses on the need for self-control in the face of powerfulcravings

Baumeister, R. F., T. F. Heatherton, et al. (1994). Losing Control.San Diego, Academic Press.

Theories used in health psychologyHealth Belief ModelTheory of Planned BehaviourTranstheoretical model of behaviour changeHealth Locus of ControlSocial Learning TheoryProtection Motivation TheorySelf-Regulatory Model of Illness BehaviourAttribution TheoryCognitive Dissonance TheoryProtection Motivation TheoryImplementation Intention TheoryHealth Action Process ApproachSelf-labelling theory

Baum, A., Newman, S., Weinman, J., West, R. and McManus, C (Eds.) (1997) Cambridge Handbook of Psychology, Health and Medicine. CUP

A simplistic model of human motivation

Sometimes people act on impulse and sometimes they consider their actionsWhen they consider their actions they weigh up:• what they want to do and/or • what they feel they ought to doWhat they want to do generally involves achieving pleasure or satisfaction and avoiding or escaping from harmWhat they ought to do generally involves evaluating the consequences of actions or working out what to do to meet particular goals, valued outcomes or moral precepts

Simplistic model of motivation

Impulse

Want

Ought

Consideration

Info

rmatio

n

Behaviour

Why do more people not adopt more healthy lifestyles?

Behaviours that are boring, or unpleasant but promote health lose out to those that

are habitual, enjoyable or meet immediate needs unless the individual is sufficiently motivated

to do what they ‘ought’

Scientific theories must be able to do better than this

As long as we do not have a synthetic theory that captures habit learning, drives, emotions and decision making in a coherent framework we will continue with a patchwork of theories

that fail even to reach common-sense understanding

The p.r.i.m.e. theoryA synthetic theory: integrates plans, decisions, emotions, desires, drives, habits and impulsesConcepts are at the psychological level of analysis but provide a pegboard for physiological, sociological and economic theoriesViews motivation from a distance and so only describes the main features but stated in terms that allows closer inspection of any of its elementsNot contradicted by existing observations

Distance and detail

p.r.i.m.e. theory

instrumentallearning

dopamine-rewardsystem

Theme 1: The structure of the motivational system

The motivational system: 1

Responses

Impulses Inhibitions

The

inte

rnal

envi

ronm

ent

(drive

s,

arousa

l,

emotional

sta

tes)

Ext

ernal

envi

ronm

ent

(stim

uli,

trigger

s, info

rmat

ion)

The motivational system: 2

Responses

Impulses Inhibitions

Motives

The

inte

rnal

envi

ronm

ent

(drive

s,

arousa

l,

emotional

sta

tes)

Ext

ernal

envi

ronm

ent

(stim

uli,

trigger

s, info

rmat

ion)

The motivational system: 3

Responses

Impulses Inhibitions

Motives

Evaluations

The

inte

rnal

envi

ronm

ent

(drive

s,

arousa

l,

emotional

sta

tes)

Ext

ernal

envi

ronm

ent

(stim

uli,

trigger

s, info

rmat

ion)

The motivational system: 4

Responses

Impulses (urges) and inhibitions (restraint)

Motives (desires)

Evaluations (beliefs)

Plans

The

inte

rnal

envi

ronm

ent

(drive

s, a

rousa

l,

emotional

sta

tes,

idea

s)

Ext

ernal

envi

ronm

ent

(stim

uli,

trigger

s, info

rmat

ion)

Five levels of motivation

p r i m e

Plans: mental representations of future actions + degree of commitment

Responses: Starting stopping and modifying actions

Impulses/inhibitions: can be consciously experienced as urges

Motives: can be consciously experienced as desires

Evaluations: evaluative beliefs

Motivation as it is experiencedPlans

Impulses

Generalised emotional states

Motives

Evaluations

Drives

Arousal

I intend …

I have an urge to …

I am (happy, sad)

I want …

I believe …

I need …

I am (calm, edgy, tired)

Targeted emotional states I (like, dislike) …

Impulses

a. Responses at each moment arise from integration of impulses and inhibitory forces operating at the time

b. Impulses and inhibitory forces compete and summate to create a ‘resultant’ that triggers and energises the response

c. When brought to conscious awareness impulses are felt as ‘urges’

d. Impulses decay rapidly in the absence of input from stimuli or other parts of the motivational system

Motives

a. Motives are representations of something and a valence (attraction or repulsions) attaching to it

b. Motives can only influence responses via their effect on impulses

c. When motives compete the most powerful one generates the impulse or inhibitory responses

d. When brought to conscious awareness motives are experienced as feeling of ‘want’ or ‘desire’

Evaluationsa. Evaluations are beliefs which state or imply a

value attaching to somethingb. Types of evaluation include:

global (good or bad), aesthetic (pleasing or displeasing), functional (performing well or badly), ethical (right or wrong)utilitarian (useful or detrimental)

c. Evaluations influence impulses through motives and emotional states

d. Competing evaluations motivate attempts at resolution (analytical and intuitive)

PlansPlans are mental representations of actions, starting conditions and an associated level of commitmentPlans arise when an evaluation or motive cannot be acted upon immediately for whatever reasonPlans need to be remembered and create evaluations or motives in order to influence responsesThe motive to enact a plan at a given time competes with other motives in the generation of impulses and inhibitions

Emotional statesThere are two types:• generalised: happiness, distress etc.• targeted: liking, disliking, hating, lovingThese interact and are influenced by and influence evaluations, motives and impulsesIn general positive generalised emotional states lead to positive targeted ones which lead to positive motives; similarly with negative onesExpectations create emotional states directly (e.g. anxiety, pleasurable anticipation) as does positive and negative violation of expectancy

Drives

Drives are states of motivational tension that are relieved by consummatory actionsThere are homeostatic (e.g. hunger) and non-homeostatic drives (e.g. expressive drive)Drives can be brought to conscious awareness by their strength and ‘reminders’Drives have direct links to impulses and motives

Arousal

Arousal is a generalised state of energy imparted to the motivational systemIt is affected by emotional states and drivesIt ‘bathes’ the whole motivational system in a fluid matrix of influenceIt affects the sensitivity of all elements of the motivational system to other elements and stimuli

Stimuli/informationStimuli/information consists of a fluid matrix that bathes the whole motivational systemIt has the capacity to influence every element of the motivational system directly and through other elementsIt can be construed as a parallel system: ‘the representational system’It is made up of simple interoceptive and exteroceptive stimuli and ‘mental representations’ of varying levels of complexity, symbolism and completeness

Theme 2: Focus on the momentThe concept of ‘the moment’ is central to this theoryThe fluid matrix of forces that is the motivational system influence actions at the timeThis means that evaluations, wants, emotional states, impulses and plans have no existence when they are not active; what exists is the ‘potential’ for them to be generated in some formConsistency in the way we react to circumstances arises out of this potential

Implications of focusing on the moment

This is very different from assuming that beliefs etc. have enduring existence because:• these elements are generated differently in

different contexts (e.g. depending on the social situation)

• ‘not thinking’ about things has a central place in explaining and predicting actions (e.g. disregarding future harms)

Theme 3: Neural plasticityMomentum and inertia• Once started, actions have momentum that gives them a

priority over impulses to begin new actions; initiating an action requires a specific force to overcome inertia

Habituation/sensitisation• Mere repetition and continuation of a stimulus affects its

emotive and motivational effectMemory• All mental representations can be regenerated in some

form in the presence of cuesAssociative learning• Pavlovian and instrumental learning lead stimuli to acquire

motivational and emotive properties and make actions and mental processes more ‘habitual’

Theme 4: Identity and self-control

We form mental representations of ourselves with all its associated emotional states and evaluationsAt times when we form mental representations of ourselves we are ‘self-conscious’Self-control is the influence of mental representations involving ourselves and evaluations and motives that we ascribe to ourselves in the motivational systemFor self-control to operate we must be self-conscious; there must be a representation of ourselves as we are and how we want to be

Mental effort and motivational resources

The exercise of self-control requires ‘effort’Expenditure of effort induces fatigue which depletes motivational resourcesMotivational resources are depleted by negative emotional states and physical fatigue

Theme 5: The ‘unstable mind’The fly-by-wire brain: the brain has evolved to be inherently unstable• this makes it highly adaptable

and creative• but it needs constant

balancing input to keep it from veering off in unwanted directions

This is similar to modern fighter aircraft whose airframes are designed to be unstable and require constant input from computers to keep them on course

Simple examples

State of the motivational system

Balancing inputs

Balancing inputs

State of the motivational system

Balancing inputs

Balancing inputs

Balancing inputs Majorevent

Balancing inputs

State of the motivational system

Balancing inputs

Balancing inputsBalancing inputs

Triggerstimulus

Balancing inputs

State of the motivational system

Lack of balancing inputs

Balancing inputs

Balancing inputs

Waddington’s epigenetic landscape

Chreods

Genotype

Environmental forces

Examples of dynamic patterns

Critical periods: points where the chreods fork

Deep chreods: small forceswill not lead to escape; the system will settle back once they are removed; but if the system is on the cusp a small force will tip it into a new path

Environmental forces

Manifestations of the unstable mind interacting with epigenesis

Sensory deprivation effects‘Groupthink’Development of compulsive behavioursDevelopment of superstitious behavioursDevelopment of neurotic patterns of thought and emotionOutbursts‘Environmental schizophrenia’

Epigenetic landscape as metaphor

The landscape is only a metaphorUltimately a more complete and formal model will be provided by ‘chaos theory’ of which ‘catastrophe theory’ is a special caseChaos theory involves iterative application of non-linear equations to systems to explain complex natural phemonena

Lorenz attractors in Chaos theory

Attractors are states that a systemsettles into but there remains thepossibility of ‘chaotic’ switches betweenapparently stable states as a result offurther iterations or small changesin parameters

Lorenz attractors are one type ofattractor (see diagram)

Mental states (e.g. smoker non-smoker)appear to show this kind of pattern ofchange

A model of behaviour change

Promoting change: principles

For control of behaviour:• apply maximum tolerable motivational

pressure and often as possible• restrict/provide opportunities/triggers

To achieve self-sustaining change:• change identity/self-concept• where possible train new habits of thought

and action

Putting it together in brief educational interventions

Educational interventions should:• induce a feeling of desire or need to change• translate that into an impulse to initiate a

change before it dissipates• create a lasting commitment to the change

based on a shift of identity• trigger supporting activities that can sustain

the plan and regenerate it when appropriate

Motivation to stopMotivational ‘tension’

Time

Action threshold

Low level of motivation Rising motivational ‘tension’

TriggerChange in internalor external environment

Action

A replacement for the TTM

The 3 Ts model for promoting behaviour changeCreate motivational tensionApply triggers to createbe ready with immediate treatment to assist with maintaining the change