Using Motivation to Understand Treatment and Decision-Making

D'Elia, Alessia

Please use this identifier to cite or link to this item: http://hdl.handle.net/11375/27953

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DC Field	Value	Language
dc.contributor.advisor	Samaan, Zainab	-
dc.contributor.author	D'Elia, Alessia	-
dc.date.accessioned	2022-10-07T16:20:09Z	-
dc.date.available	2022-10-07T16:20:09Z	-
dc.date.issued	2022	-
dc.identifier.uri	http://hdl.handle.net/11375/27953	-
dc.description.abstract	Background: Mental health challenges continue to impact Canadians, with major depression, bipolar disorder and substance use among the leading causes of disability. Depressive disorders are often associated with diminished motivation. In contrast, substance use has been described as a “motivated behaviour”, where use of drugs is associated with specific goals; motivation may therefore help explain health behaviours like vaping. This thesis studies motivation and mental illness, by assessing treatments for patients who lack motivation, and characterizing motives for behaviour. Methods: A pilot trial (RCT) was conducted to determine the feasibility of a trial to test the effects of behavioural activation (BA) in patients with major depressive disorder (MDD) (n=20). The full RCT was conducted to test the effectiveness of BA (n=169). Next, a protocol for a systematic review is described which explores outcomes used in trials for bipolar disorder type 1. Finally, a mixed-methods study was undertaken to identify vaping perceptions in patients with opioid use disorder (OUD) who vape (n=41). Results: The pilot RCT demonstrated the feasibility for a full trial. The full RCT revealed that behavioural approaches may produce improvements in depression and quality of life (QoL) for patients with diminished motivation. Finally, the mixed-methods study identified 14 themes, revealing that vaping is convenient, common among youth, and a tool for smoking cessation. Discussion: The pilot and full RCT trials reveal that BA has positive effects on depression and QoL in patients with depression, specifically showing significant improvements compared to waitlist. The mixed-methods study of vaping provides a lens through which vaping behaviours in the OUD population can be understood, generating evidence which can inform cessation efforts. Conclusions: These works highlight how motivation can be intervened upon through treatment, and harnessed to better understand health decisions, with the overall objective of improving care within psychiatric populations.	en_US
dc.language.iso	en_US	en_US
dc.subject	mental health	en_US
dc.subject	opioid use disorder	en_US
dc.subject	major depressive disorder	en_US
dc.subject	randomized controlled trial	en_US
dc.subject	mixed-methods	en_US
dc.subject	vaping	en_US
dc.subject	behavioural activation	en_US
dc.subject	patient-important outcomes	en_US
dc.subject	quality of life	en_US
dc.subject	harm reduction	en_US
dc.title	Using Motivation to Understand Treatment and Decision-Making	en_US
dc.title.alternative	USING MOTIVATION TO UNDERSTAND TREATMENT AND DECISION-MAKING IN PSYCHIATRIC ILLNESS	en_US
dc.type	Thesis	en_US
dc.contributor.department	Neuroscience	en_US
dc.description.degreetype	Dissertation	en_US
dc.description.degree	Doctor of Philosophy (PhD)	en_US
dc.description.layabstract	Mental health challenges continue to impact Canadians, with major depression, bipolar disorder and substance use among the leading causes of disability. Depression and bipolar disorders are often associated with diminished motivation. Substance use, however, has been described as a “motivated behaviour”, where the use of drugs is associated with specific goals, such as motivations to reduce negative feelings, achieve pleasure, and perhaps most importantly, avoid withdrawal. By assessing potential treatments for patients who lack motivation, and characterizing patient motives for health decisions like vaping, the following thesis aims to study motivation and mental illness from several perspectives. Study findings suggest that behavioural approaches can produce meaningful improvements for patients with diminished motivation, and identify several motivators for engagement with vaping behaviours, both of which have implications for mental illness treatment and policy building. Taken together, this work aims to generate evidence to improve treatment and enhance harm reduction approaches.	en_US
Appears in Collections:	Open Access Dissertations and Theses

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