The energization of health-behavior change: Examining the associations among autonomous self-regulation, subjective vitality, depressive symptoms, and tobacco abstinence

Abstract

Most research on the psychological correlates of smoking behavior has focused on negative indices of wellness, but findings are mixed, contradictory, controversial, and, thus, inconclusive. This study, guided by self-determination theory, examined both positive (viz., vitality) and negative (viz., depressive symptoms) indices of psychological health as predictors of long-term tobacco abstinence in the context of a randomized clinical trial. It also examined autonomous self-regulation and cigarette use as predictors of psychological health. Results supported the proposed conditional indirect effect model in which change in cigarette use mediated the relation of change in autonomous self-regulation for smoking cessation to change in vitality, and this indirect effect was moderated by treatment condition. Further, change in vitality predicted long-term tobacco abstinence. Results for depressive symptoms were largely null. Discussion focuses on the importance of considering positive indices of psychological health for understanding the psychological correlates of smoking behavior.

Keywords:

• depressive symptoms
• self-determination theory
• tobacco abstinence
• vitality

Trial Registration::

• ClinicalTrials.gov number NCT00178685

Acknowledgements

This research was supported in part by grants from the National Institute of Mental Health (R01-MH59594) and the National Cancer Institute (R01-CA106668) to Dr. Williams.

Notes

Notes

1. Separate conditional indirect effect models were used to examine changes in vitality and depressive symptoms.

2. Although the association between ASR and depressive symptoms has been found to be negative, it typically is small in magnitude and does not always reach conventional levels of significance.

3. The means and standard deviations presented in Tables 1 and 2 appear different because the descriptive statistics in Table 2 were computed using the entire sample of participants, whereas the descriptive statistics in Table 1 were computed separately within community care and the intensive intervention.

4. Although the interaction did not predict the mediator, we deemed it appropriate to examine the conditional indirect effects, as they were the focus of our hypothesis (K. Preacher, personal communication, November 13, 2009).

5. A significant unconditional indirect effect is not a prerequisite for testing conditional indirect effects (Preacher et al., 2007).