W. Miles Cox

Bangor University

Background: Obesity has been shown to have many deleterious physical and psychological consequences. Objective: This study examined the effectiveness of adding the Life Enhancement and Advancement Program (LEAP) to a weight management program. Design: To evaluate the different components of a weight loss program, this study included four groups: (1...

Objective: Two brief computerized motivational interventions for excessive-drinking university students were evaluated. Method: Participants (N = 88, females = 61.5%, mean age = 21.05 years) were randomly assigned to a control group or one of two experimental groups: Computerized Brief Intervention (CBI) or Computerized Brief Intervention-Enhanced...

Objective A study was conducted to examine relationships among university students’ self-regulation, motivational structure, and alcohol consumption. Method Participants were student drinkers (N = 105, females = 77.7%, mean age = 19.82 years) who completed a demographics questionnaire, the Alcohol Use Questionnaire, Short Self-Regulation Questionn...

Background and aims: Substance use disorders (SUD) are associated with cognitive deficits that are not always addressed in current treatments, and this hampers recovery. Cognitive training and remediation interventions are well suited to fill the gap for managing cognitive deficits in SUD. We aimed to reach consensus on recommendations for develop...

Becoming committed to a new health-related goal and pursuing it is difficult for many people. The present study (a) developed and tested the psychometric properties of a brief Goal Ambivalence Scale (GAS) in a sample of dieters and (b) tested the effectiveness of providing dieters with feedback on their scores on the GAS. In Study 1, dieters (n = 3...

Consistent with cognitive models of social anxiety, socially anxious individuals show cognitive biases that magnify their perceived level of threat in the environment. Objectives The first objective was to determine whether attentional bias for socially threatening stimuli occurs after concomitant depression has been controlled. The second objecti...

Background and Aims Substance use disorders (SUD) are associated with cognitive deficits that are not always addressed in current treatments, and this hampers recovery. Cognitive training and remediation interventions are well suited to fill the gap for managing cognitive deficits in SUD. We aimed to reach consensus on recommendations for developin...

Alcohol problems tend to run in families. To separate genetic and environmental causes of alcoholism, adoption and twin studies have been conducted. Adoption studies have found that adoptees with a biological alcoholic parent have a higher rate of alcoholism than those whose biological parents were not alcoholic. Twin studies have compared rates of...

People drink alcohol to regulate their emotions—to make themselves feel better or to feel less bad. Regulating emotions entails making decisions about what goals to pursue, both in the shorter term and over a lifetime. Human brains evolved to maximize the pleasure of our emotional states through this decision-making process. In the case of consumin...

When a person drinks alcohol, it enters the stomach and small intestine, where it is absorbed into the bloodstream. The rate of absorption, which is affected by various factors (such as the concentration of alcohol in the drink and characteristics of the drinker and how he or she drinks the alcohol), determines how intoxicated the person becomes. A...

The goals that people are motivated to pursue are guided by their expectancies of what the pursuit is likely to bring them. Research on these have led to a consensus regarding four kinds of motives: (1) social motives, as for engaging with family and friends; (2) enhancement motives, as for activities that lift one’s spirits and provide emotional s...

In this chapter, beverage alcohol is defined, as are the four main categories of it (beer, wine, fortified wine, distilled spirits), which vary in the concentration of alcohol that each contains. Drinking alcohol can induce optimism and euphoria and reduce tension and stress; hence, it is widely used and abused in many countries around the world. W...

The chapter reviews ways in which people can come to control their alcohol consumption. Given the person’s goal choices and pursuits, expectancies, values, and emotions, what needs to happen to control alcohol consumption? Expectancy X Value theory suggests ways to think about how alcohol fits into the drinker’s set of goals and daily activities. T...

There are strong sociocultural and environmental influences on drinking behavior. This is apparent when we observe vastly different drinking patterns across different cultures and within the same culture. One major influence is religion, with some religions prohibiting the consumption of alcohol. Certain geographical areas (e.g., the Mediterranean...

People’s use of alcohol is related in a variety of ways to their personality traits. Such traits include the person’s tendencies to become disappointed or depressed in the face of failures (high neuroticism) and their tendencies to blame themselves, others, or circumstances. Part of depression is rumination, as in involuntarily continuing to think...

Background: There is consistent evidence that community and clinical samples of individuals with an alcohol use disorder (AUD) have attentional biases toward alcohol cues. The alcohol attentional control training program (AACTP) has shown promise for retraining these biases and decreasing alcohol consumption in community samples of excessive drinke...

Background There have been two kinds of methods for assessing individuals' motivation and their goal-striving behavior. The idiographic method obtains respondents' individual descriptions of their behavior or inner experiences. The nomothetic approach uses a standardized questionnaire in which respondents select from a set of alternatives. Idiograp...

Introduction: Alcohol dependence is one of the most common substance use disorders, and novel treatment options are urgently needed. Neurofeedback training (NFT) based on real-time functional magnetic resonance imaging (rtf-MRI) has emerged as an attractive candidate for add-on treatments in psychiatry, but its use in alcohol dependence has not be...

Evaluation of an Acceptance-based 12-Session group programme for people in recovery from substance dependency. An evidence-based approach that draws on service users' lived experience.

Objectives Mutual-aid groups are a central part of many individuals’ recovery journeys from substance addiction, and this research aimed to identify the key ingredients of a diverse range of recovery groups. Methods Individuals from 30 different substance addiction recovery groups across the UK (N = 151, 66% male, M age = 42.5 years) completed a s...

Overconsumption of alcohol is a major problem in western society. Why do people drink excessively despite overwhelming negative consequences? Choosing to drink is determined by the several psychological systems undergirding any motivated behavior. Drinkers’ expectations of stronger positive and weaker negative affect from drinking are the most prox...

Background: There have been two methods of gaining retrospective self-report estimates of alcohol consumption, quantity frequency (QF) and retrospective diary (RD), offering distinct advantages and disadvantages. The typical and atypical drinking diary (TADD) was developed to benefit from each method’s advantages. Objectives: To compare estimates o...

Background: There have been two methods of gaining retrospective self-report estimates of alcohol consumption, Quantity- Frequency (QF) and Retrospective Diary (RD), offering distinct advantages and disadvantages. The Typical and Atypical Drinking Diary (TADD) was developed to benefit from each method’s advantages. Objectives: to compare estimates...

Measurement of cognitive bias typically relies on laboratory-based tasks. In order for cognitive bias measures to be useful outside of laboratory settings, a simple measure is required which does not rely on precise measurement tools, for example, precise reaction time measurement (which can be done only with specialized software typically running...

Research on addiction recovery often focuses on traditional and well-established groups such as Alcoholics Anonymous or SMART Recovery. Recently, another type of recovery group has emerged within communities. These groups are based around social activities and have not been studied in the literature. This study qualitatively identified individuals’...

Introduction and Aims The Recovery Strengths Questionnaire (RSQ) is a 15‐item self‐report questionnaire that assesses an addicted individual's recovery strengths. This study aimed to validate the RSQ as a measure of recovery capital. Design and Methods As part of a larger study, 151 participants in addiction recovery groups from across the UK comp...

Background: There are two main categories of retrospective self-report alcohol consumption measures: summary and daily drinking. Time-efficient summary measures have been criticized for being less able to capture sporadic and unpatterned drinking. A novel retrospective summary measure, the Typical and Atypical Drinking Diary (TADD), may produce mor...

We developed a smart phone application to measure participants' food-reward perceptions and eating behavior in their naturalistic environment. Intensity ratings (0 - not at all to 10 - very strongly) of perceived anticipation of food (wanting) and food enjoyment at endpoint of intake (liking) were recorded as they occurred over a period of 14 days....

Certain people are at risk for using alcohol or other drugs excessively and for developing problems with their use. Their susceptibility might arise from a variety of factors, including their genetic make-up, brain chemistry, family background, personality and other psychological variables, and environmental and sociocultural variables. Moreover, a...

Background: Real-time functional magnetic resonance imaging (rtfMRI) is used for neurofeedback training (NFT). Preliminary results suggest that it can help patients to control their symptoms. This study uses rtfMRI NFT for relapse prevention in alcohol dependence. Methods/design: Participants are alcohol-dependent patients who have completed a d...

This chapter presents the motivational and goal theory of current concerns in relation to addiction and choice. A current concern is an individual’s motivational state from the point of becoming committed to pursuing a particular goal until the goal is reached or the pursuit is relinquished. During this time, the current concern guides the person’s...

Objective: Attentional bias for drug-related stimuli (Drug-AB) has been shown to play an important role in drug abuse, drug treatment, and relapse. This study sought to retrain Drug-AB using the Drug Attention Control Training Program (Drug-ACTP) on a sample of Iranian drug abusers. Method: The experimental group (n = 24) received 3 sessions of...

The present chapter first argues how having a goal for procuring alcohol or other substances leads to the development of a time-binding, dynamic, and goal oriented motivational state termed current concern, as the origin of substance-related attentional bias. Next, it discusses the importance of attentional bias in the development, continuation of,...

Two cognitive-motivational variables that help to solidify drinkers' intentions to drink are their alcohol attentional bias and their maladaptive motivation. The Alcohol Attention Control Training Programme (AACTP) was designed to rectify the former, and the Life Enhancement and Advancement Programme (LEAP) was designed to rectify the latter. The p...

In a laboratory-based experiment, Professor Miles Cox (Bangor University) and his former PhD student Dr Javad S. Fadardi (now at Ferdowsi University of Mashhad, Iran) demonstrated that a laboratory-based training technique can help individuals reduce their drinking urges and actual drinking behaviours.1 This was achieved by training participants to...

If a person expects that (a) drinking alcohol or using another addictive substance will enhance positive affect or reduce negative affect, and (b) there is a strong likelihood that these desirable consequences will occur if the substance is used, that person is likely to form a goal of using the substance. The theoretical framework presented here p...

Objective : The aim of the study was to determine whether experimental manipulation of sense of control would change moderate drinkers’ (N = 106) task-specific motivational structure and explicit and implicit determinants of their urge to drink alcohol. Method : The effects of various levels of information-enhancement and goal-setting on participa...

When a person has a goal of drinking alcohol or using another addictive substance, the person appears to be automatically distracted by stimuli related to the goal. Because the attentional bias might propel the person to use the substance, an intervention might help modify it. In this article, we discuss techniques that have been developed to help...

There are high rates of treatment non-completion for personality disorder and those who do not complete treatment have poorer outcomes. A goal-based motivational interview may increase service users’ readiness to engage with therapy and so enhance treatment retention. We conducted a feasibility study to inform the design of a randomized controlled...

IntroductionAlcohol Use from a Motivational PerspectiveThe Motivational ModelThe Motivation to ChangeReferences

Alcohol Use from a Motivational PerspectiveThe Motivational ModelThe Motivation to ChangeReferences

Theoretical Bases for Motivational CounselingAssessing MotivationIntervention Techniques for Motivational CounselingTechniques Supplementary or Alternative to SMCFuture DirectionsReferences

Revised and updated to reflect the most recent developments in the field, the second edition of the Handbook of Motivational Counseling presents comprehensive coverage of the development and identification of motivational problems and the most effective treatment techniques. Equips clinicians with specific instructions for enhancing clients' motiva...

The Tripartite: Emotion, Cognition, and MotivationConclusions References

Alcohol Abuse and DependenceUsing Systematic Motivational Counseling with Alcohol-Dependent Clients: Initial Steps and OverviewPreliminary Counseling ComponentsGoal-Setting ComponentsSubsequent Counseling ComponentsLife Enhancement and Advancement ProgramOther Experiences Using SMCReferences

Motivation is a pervasive force that can affect well-being in a variety of life situations, from the more minor through to the ability to overcome addictions and other serious psychological problems. This book presents empirically supported theories (featuring current concerns theory), questionnaires based on these theories (highlighting the Motiva...

Studies suggest that motivational structure and personality play important roles in goal-seeking behaviour. We studied the relationship among motivational structure indices (its derived factor scores) and the MMPI-2 validity and clinical scales. Participants were alcohol abusers (187 males; mean of age = 40.37) who completed a demographic informati...

The course to alcohol dependence often starts with a preclinical period of heavy drinking. The present article reports functional magnetic resonance imaging data showing that even this pattern of alcohol consumption is associated with maladaptive neural responses to alcohol and other stimuli. When participants were confronted with visual cues relat...

Rates of non-completion of treatments for personality disorder are high and there are indications that those who do not complete treatment have worse outcomes than those who do. Improving both cost-efficiency and client welfare require attention to engaging people with personality disorder in treatment. A motivational interview, based on the Person...

There is evidence that exerting self-control during alcohol craving can diminish performance on subsequent tasks that require self-control. Based on the resource depletion model (Muraven and Baumeister, 2000), we examined the influence of alcohol cue exposure on detoxified alcohol-dependent patients' ability to inhibit ongoing responses. Twenty alc...

The study had three objectives: (1) to assess relationships between personality characteristics and alcohol consumption and alcohol-related problems among university students who drink alcohol excessively; (2) to assess relationships between motivational structure and alcohol consumption and problems among students who consume excessive amounts of...

The aim of this study was to determine how sense of control and intrinsic motivation are related to university students' motivational structure and alcohol consumption. Participants were 94 university students who completed the Personal Concerns Inventory, Shapiro Control Inventory, Helplessness Questionnaire, Intrinsic-Extrinsic Aspirations Scale,...

To study the incidence of self-reported potentially problematic behaviors among college students in The Netherlands, we revised and translated into Dutch the Problem History Questionnaire, which had been used in a similar study in the United States. The questionnaire was administered to 468 Dutch college students (110 males, 353 females) during fou...

Measuring offenders’ motivation for treatment is important, yet few measures exist. The Personal Concerns Inventory (PCI), a goal-based assessment, was adapted for offenders by including items relating to offending and prison. The psychometric properties of the resulting Personal Concerns Inventory: Offender Adaptation (PCI-OA) were examined with 1...

The aims of the research were to (a) compare the alcohol attentional bias (AAB) of social, hazardous, and harmful drinkers and (b) assess the effects of alcohol attention-control training on the AAB and alcohol consumption of hazardous and harmful drinkers. Participants were social drinkers (N = 40), hazardous drinkers (N = 89), and harmful drinker...

Prior studies aimed at explaining cognitive–motivational reasons for drinking have focused on either cognitive or motivational factors, but not on both. This study examined the ability of both alcohol-attentional bias and motivational structure to predict alcohol consumption. Participants were university students (N = 87) who completed a battery of...

A wealth of research from the past two decades shows that addictive behaviors are characterized by attentional biases for substance-related stimuli. We review the relevant evidence and present an integration of existing theoretical models to explain the development, causes, and consequences of addiction-related attentional biases. We suggest that t...

The purpose of this study was to identify cognitive (alcohol attentional bias, AAB) and motivational (motivational structure, MS; readiness to change, RTC) predictors of changes in excessive drinking. One hundred fifty-eight excessive drinkers not in treatment were administered a test battery and were re-tested 3 and 6 months later. The tests inclu...

The Muller-Lyer illusion is a visual illusion in which a horizontal shaft with an inward-pointing chevron (fins-out) affixed to each end is perceived longer than a shaft with outward-pointing chevrons (fins-in). The goal of this study was to compare the effects of experience and knowledge about the Muller-Lyer illusion on participants' perceptual p...

Recent studies have investigated the role of attentional biases and memory in alcohol and other drugs of dependence and the relationship between the motivation to use alcohol or other drugs and vigilance for relevant stimuli in alcohol and drug dependence. Based on this research, we describe relationships among motivation, memory, and attentional b...

A systematic review of the evidence on substance misuse prevalence in patients with traumatic brain injury (TBI) and outcomes associated with this population is presented. Building upon an earlier review of the area by Corigan (1995), this review is limited to research published between 1994 and 2004. Psycinfo and Medline abstract databases were se...

Measuring offenders' motivation for treatment is important for selection and monitoring treatment engagement, yet few psychometrically robust measures of motivation exist. The Personal Concerns Inventory (PCI) was developed to assess motivation to change in people with addictive behaviours. It focuses on identifying goals in a wide variety of life...

Decisions about using addictive substances are influenced by distractions by addiction-related stimuli, of which the user might be unaware. The addiction-Stroop task is a paradigm used to assess this distraction. The empirical evidence for the addiction-Stroop effect is critically reviewed, and meta-analyses of alcohol-related and smoking-related s...

(1) To examine whether or not motivational interviewing (MI) is more efficacious than no intervention in reducing alcohol consumption; (2) to examine whether or not MI is as efficacious as other interventions. A literature search followed by a meta-analytic review of randomized control trials of MI interventions. Aggregated between-group effect siz...

This study evaluated whether alcohol attentional bias is an artifact of excessive drinkers' impaired cognitive functioning, which adversely affects their performance on the classic Stroop test (a measure of inhibitory control) and the Shipley Institute of Living Scale (SILS; a measure of verbal and abstraction ability). Both tests measure aspects o...

This article summarizes a symposium on new ways to change implicit alcohol-related cognitions, presented at the 2005 Annual Meeting of the Research Society on Alcoholism in Santa Barbara, California, organized by Wiers and Cox. During the past few years, research has demonstrated that implicit cognitions predict unique variance in prospective alcoh...

Relationships among reasons for drinking, alcohol consumption, and drinking-related problems were assessed among secondary-school students (N=328) and university students (N=74) in North Wales, United Kingdom, and results were compared with results from North America. The ability of drinking reasons to predict drinking problems was tested in both a...

The motivational theory of current concerns accounts for attentional focus on stimuli related to a person's goal pursuits. When people actively pursue a goal of using addictive substances in order to regulate their affective states, they have a current concern for procuring and using the substance. A current concern is a latent, time-binding, goal-...

The chapter considers the use of individualized versus generalized stimuli to assess implicit cognitive processes in addictive behaviors. Most studies have used generalized stimuli that were not specifically selected for each participant. A major advantage of doing so is that compiling the stimuli is straightforward. A uniform set of addiction-rela...

Motivation Formally DefinedThe Centrality of Motivation in Brain and MindImportant Distinctions Regarding MotivationGoal Pursuits and the Concept of Current ConcernGoals and EmotionsHow Goal Pursuits BeginHow Goal Pursuits UnfoldHow Goal Pursuits EndMotivational StructureIncentives, Goals, Well-Being, and the Sense that One's Life is MeaningfulRefe...

Motivational Measurement in Historical PerspectiveMotivational Structure QuestionnairePersonal Concerns InventoryPersonal Aspirations and Concerns InventoryConclusions References

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Challenges and Solutions in Assessing Reliability of THEMSQFactor Structure of MSQ and PCI ScalesEvidence on the Validity of MSQ-Like InstrumentsSummaryAcknowledgmentsReferences

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To assess whether selected characteristics of problem drinkers influence treatment goal recommendations - abstinence or controlled drinking - by healthcare providers in the UK and the US. Sixteen case-histories, composed with varying information regarding the clients' level of problem severity, degree of social support and sex, were read by 41 UK a...

The effects of Systematic Motivational Counseling (SMC) on adults following traumatic brain injury (TBI) were assessed. The sample comprised 40 participants in the SMC Group who received 12 individual SMC sessions and 54 participants in the Comparison Group who received no motivational or substance-abuse treatment. Both groups received rehabilitati...

The effects of university students' habitual drinking practices and experimental alcohol cue exposure on their attentional bias for alcohol-related stimuli were assessed. Participants were exposed in vivo to either an alcoholic or non-alcoholic beverage immediately prior to completing a cognitively demanding emotional Stroop task that uses alcohol-...