Motivation and Emotion

, Volume 36, Issue 3, pp 268–286 | Cite as

The importance of perceived autonomy support for the psychological health and work satisfaction of health professionals: Not only supervisors count, colleagues too!

  • Elise MoreauEmail author
  • Geneviève A. Mageau
Original Paper


Previous studies show that supervisors’ autonomy-supportive style predicts greater psychological health (Baard et al. in J Appl Soc Psychol 34:2045–2068, 2004; Blais and Brière 1992; Lynch et al. in Prof Psychol Res Pract 36:415–425, 2005) and lower psychological distress (Deci et al. in Personal Soc Psychol Bull 27:930–942, 2001). The goal of the present study is to extend these results and investigate the contribution of colleagues’ perceived autonomy support in the prediction of health professionals’ work satisfaction and psychological health. The combined impact of supervisors’ and colleagues’ perceived autonomy support is also examined. A sample of 597 health professionals from the province of Quebec (Canada) completed a questionnaire, which included measures of perceived supervisors’ and colleagues’ autonomy support and outcome variables. Results confirm that supervisors’ and colleagues’ perceived autonomy support predict health professionals’ work satisfaction and psychological health. Results also show that colleagues’ perceived autonomy support adds to the prediction of health professionals’ work satisfaction, subjective well-being, and suicidal ideation above and beyond supervisors’ perceived autonomy support.


Health professionals Autonomy support Psychological health Work satisfaction Intent to leave Supervisors Colleagues Medicine Dentists Veterinarians Self-determination theory 



We would like to thank all health professionals who participated in the present study for their time and cooperation. We also want to acknowledge the “Ordre des dentistes du Québec” [Quebec Order of Dentists], the “Ordre des médecins vétérinaires du Québec” [Quebec Order of Medical Veterinarians], the “Fédération des médecins résidents du Québec” [Quebec Federation of Medical Residents], the “Association des étudiants en médecine dentaire de l’Université de Montréal” [Dental Students Association of the University of Montreal], the “Association des étudiants en médecine dentaire de l’Université Laval” [Dental Students Association of the Université Laval], the “Fédération médicale étudiante du Québec” [Quebec Federation of Medical Students], and the “Faculté de médecine vétérinaire de l’Université de Montréal” [Faculty of Veterinary Medicine of the University of Montreal] for their help with the data collection. This research was facilitated by doctoral scholarships from the Social Sciences and Humanities Research Council of Canada (SSHRC), the “Fonds québécois de la recherche sur la société et la culture” (FQRSC) and the “Institut de recherche Robert-Sauvé en santé et en sécurité au travail” (IRSST) to the first author and funded by a grant from the FQRSC to the second author.


  1. Ahola, K., & Hakanen, J. (2007). Job strain, burnout, and depressive symptoms: A prospective study among dentists. Journal of Affective Disorders, 104, 103–110.PubMedCrossRefGoogle Scholar
  2. Anderson, N. H. (1968). Likableness rating of 555 personality-trait words. Journal of Personality and Social Psychology, 9, 272–279.PubMedCrossRefGoogle Scholar
  3. Assor, A., Kaplan, H., & Roth, G. (2002). Choice is good, but relevance is excellent: Autonomy-enhancing and suppressing teacher behaviours predicting students’ engagement in schoolwork. British Journal of Educational Psychology, 72, 261–278.PubMedCrossRefGoogle Scholar
  4. Baard, P. P., Deci, E. L., & Ryan, R. M. (2004). Intrinsic need satisfaction: A motivational basis of performance and well-being in two work settings. Journal of Applied Social Psychology, 34, 2045–2068.CrossRefGoogle Scholar
  5. Baldwin, P. J., Dodd, M., & Wrate, R. W. (1997). Young doctors’ health-I. How do working conditions affect attitudes, health and performance? Social Science and Medicine, 45, 35–40.PubMedCrossRefGoogle Scholar
  6. Baran, R. B. (2005). Myers Briggs Type Indicator, burnout, and satisfaction in Illinois dentists. General Dentistry, 53, 228–234.PubMedGoogle Scholar
  7. Bartram, D. J., Yadegarfar, G., & Baldwin, D. S. (2009). Psychosocial working conditions and work-related stressors among UK veterinary surgeons. Occupational Medicine, 59, 334–341.PubMedCrossRefGoogle Scholar
  8. Beck, A. T., Kovacs, M., & Weissman, A. (1979). Assessment of suicidal intention: The scale for suicide ideation. Journal of Consulting and Clinical Psychology, 47, 343–352.PubMedCrossRefGoogle Scholar
  9. Black, A. E., & Deci, E. L. (2000). The effects of instructors’ autonomy support and students’ autonomous motivation on learning organic chemistry: A self-determination theory perspective. Science Education, 84, 740–756.CrossRefGoogle Scholar
  10. Blais, M. R., & Brière, N. M. (1992). On the mediational role of feelings of self-determination in the workplace: Further evidence and generalization. Unpublished manuscript, Université du Québec à Montréal, Canada.Google Scholar
  11. Blais, M. R., Lachance, L., Forget, J., Richer, S., & Dulude, D. M. (1991). L’échelle de satisfaction globale au travail [Work Satisfaction Scale]. Poster presented at the 1991 Annual Congress of the Société québécoise pour la recherche en psychologie. Trois-Rivières, Quebec, Canada.Google Scholar
  12. Blais, M. R., Vallerand, R. J., Pelletier, L. G., & Brière, N. M. (1989). L’Échelle de satisfaction de vie: Validation canadienne-française du “Satisfaction with Life Scale” [French-Canadian validation of the Satisfaction With Life Scale]. Canadian Journal of Behavioural Science, 21, 210–233.CrossRefGoogle Scholar
  13. Bourassa, M., & Baylard, J. F. (1994). Stress situations in dental practice. Journal of the Canadian Dental Association, 60, 65–67.PubMedGoogle Scholar
  14. Boxer, P. A., Burnett, C., & Swanson, N. (1995). Suicide and occupation: A review of the literature. Journal of Occupational and Environmental Medicine, 37, 442–452.PubMedCrossRefGoogle Scholar
  15. Brewin, C. R., & Firth-Cozens, J. (1997). Dependency and self-criticism as predictors of depression in young doctors. Journal of Occupational Health Psychology, 2, 242–246.PubMedCrossRefGoogle Scholar
  16. Brown, S., & Gunderman, R. B. (2006). Viewpoint: Enhancing the professional fulfillment of physicians. Academic Medicine, 81, 577–582.PubMedCrossRefGoogle Scholar
  17. Buchbinder, S. B., Wilson, M., Melick, C. F., & Powe, N. R. (2001). Primary care physician job satisfaction and turnover. American Journal of Managed Care, 7, 701–713.PubMedGoogle Scholar
  18. Cable, D. M., & Judge, T. A. (1996). Person-organization fit, job choice decisions, and organizational entry. Organizational Behavior and Human Decision Processes, 67, 294–311.CrossRefGoogle Scholar
  19. Chirkov, V. I., & Ryan, R. M. (2001). Parent and teacher autonomy-support in Russian and U.S. adolescents: Common effects on well-being and academic motivation. Journal of Cross-Cultural Psychology, 32, 618–635.CrossRefGoogle Scholar
  20. Clark, D. C., Salazar-Gruesco, E., Grabler, P., & Fawcett, J. (1984). Predictors of depression during the first 6 months of internship. American Journal of Psychiatry, 141, 1095–1098.PubMedGoogle Scholar
  21. Cohen, J., Cohen, P., West, S. G., & Aiken, L. S. (2003). Applied multiple regression/correlation analysis for the behavioral sciences (3rd ed.). Mahwah, NJ: Lawrence Erlbaum Associates.Google Scholar
  22. Cohen, J. S., & Patten, S. (2005). Well-being in residency training: A survey examining resident physician satisfaction both within and outside of residency training and mental health in Alberta. BMC Medical Education, 5, 21.PubMedCrossRefGoogle Scholar
  23. Collier, V. U., McCue, J. D., Markus, A., & Smith, L. (2002). Stress in medical residency: Status quo after a decade of reform? Annals of Internal Medicine, 136, 384–390.PubMedGoogle Scholar
  24. Council on Scientific Affairs. (1987). Results and implications of the AMA-APA Physician mortality project. Stage II. JAMA, 257, 2949–2953.CrossRefGoogle Scholar
  25. Croucher, R., Osborne, D., Marcenes, W., & Sheiham, A. (1998). Burnout and issues of the work environment reported by general dental practitioners in the United Kingdom. Community Dental Health, 15, 40–43.PubMedGoogle Scholar
  26. Daugherty, S. R., Baldwin, D. C., Jr., & Rowley, B. D. (1998). Learning, satisfaction, and mistreatment during medical internship: A national survey of working conditions. JAMA, 279, 1194–1199.PubMedCrossRefGoogle Scholar
  27. de Man, A. F., Balkou, S., & Iglesias, R. (1987). A French-Canadian adaptation of the scale for suicide ideation. Canadian Journal of Behavioural Science, 19, 50–55.CrossRefGoogle Scholar
  28. de Man, A. F., Leduc, C. P., & Labrèche-Gauthier, L. (1993). A French-Canadian scale for suicide ideation for use with adolescents. Canadian Journal of Behavioral Science, 25, 126–134.CrossRefGoogle Scholar
  29. deCharms, R. (1968). Personal causation. New York: Academic.Google Scholar
  30. Deci, E. L., Connell, J. P., & Ryan, R. M. (1989). Self-determination in a work organization. Journal of Applied Psychology, 74, 580–590.CrossRefGoogle Scholar
  31. Deci, E. L., Eghrari, H., Patrick, B. C., & Leone, D. R. (1994). Facilitating internalization: The self-determination theory perspective. Journal of Personality, 62, 119–142.PubMedCrossRefGoogle Scholar
  32. Deci, E. L., La Guardia, J. G., Moller, A. C., Scheiner, M. J., & Ryan, R. M. (2006). On the benefits of giving as well as receiving autonomy support: Mutuality in close friendships. Personality and Social Psychology Bulletin, 32, 313–327.PubMedCrossRefGoogle Scholar
  33. Deci, E. L., & Ryan, R. M. (1985). Intrinsic motivation and self-determination in human behavior. New York: Plenum.Google Scholar
  34. Deci, E. L., & Ryan, R. M. (1987). The support of autonomy and the control of behavior. Journal of Personality and Social Psychology, 53, 1024–1037.PubMedCrossRefGoogle Scholar
  35. Deci, E. L., & Ryan, R. M. (2000). The “what” and “why” of goal pursuits: Human needs and the self-determination of behavior. Psychological Inquiry, 11, 227–268.CrossRefGoogle Scholar
  36. Deci, E. L., Ryan, R. M., Gagné, M., Leone, D. R., Usunov, J., & Kornazheva, B. P. (2001). Need satisfaction, motivation, and well-being in the work organizations of a former eastern bloc country: A cross-cultural study of self-determination. Personality and Social Psychology Bulletin, 27, 930–942.CrossRefGoogle Scholar
  37. Denton, D. A., Newton, J. T., & Bower, E. J. (2008). Occupational burnout and work engagement: a national survey of dentists in the United Kingdom. British Dental Journal, 205, 382–383.CrossRefGoogle Scholar
  38. Diener, E., Emmons, R. A., Larsen, R. J., & Griffin, S. (1985). The satisfaction with life scale. Journal of Personality Assessment, 49, 71–75.PubMedCrossRefGoogle Scholar
  39. Ducharme, L. J., Knudsen, H. K., & Roman, P. M. (2008). Emotional exhaustion and turnover intention in human service occupations: The protective role of coworker support. Sociological Spectrum, 28, 81–104.CrossRefGoogle Scholar
  40. Dunlap, J., & Stewart, J. (1982). Survey suggests less stress in group offices. Dental Economics, 72, 46–54.PubMedGoogle Scholar
  41. Dyrbye, L. N., Thomas, M. R., & Shanafelt, T. D. (2006). Systematic review of depression, anxiety, and other indicators of psychological distress among U.S. and Canadian medical students. Academic Medicine, 81, 354–373.PubMedCrossRefGoogle Scholar
  42. Eckleberry-Hunt, J., Lick, D., Boura, J., Hunt, R., Balasubramaniam, M., Mulhem, E., et al. (2009). An exploratory study of resident burnout and wellness. Academic Medicine, 84, 269–277.PubMedCrossRefGoogle Scholar
  43. Ey, S., Henning, K. R., & Shaw, D. L. (2000). Attitudes and factors related to seeking mental health treatment among medical and dental students. Journal of College Student Psychotherapy, 14, 23–39.CrossRefGoogle Scholar
  44. Firth-Cozens, J. (1987). Emotional distress in junior house officers. British Medical Journal, 295, 533–536.PubMedCrossRefGoogle Scholar
  45. Firth-Cozens, J. (2000). New stressors, new remedies. Occupational Medicine, 50, 199–201.PubMedCrossRefGoogle Scholar
  46. Firth-Cozens, J. (2001). Interventions to improve physicians’ well-being and patient care. Social Science and Medicine, 52, 215–222.PubMedCrossRefGoogle Scholar
  47. Ford, C. V., & Wentz, D. K. (1984). The internship year: A study of sleep, mood states, and psychophysiologic parameters. Southern Medical Journal, 77, 1435–1442.PubMedCrossRefGoogle Scholar
  48. Fournier, S., Nolet, K., Dupré, M. P., Scavone, G., Ranger, F., Koestner, R., et al. (2010, May). Construction and validation of the perceived parental autonomy support scale (P-PASS). Paper presented at the 4th international conference on self-determination theory. Ghent University, Belgium.Google Scholar
  49. Fritschi, L., Morrison, D., Shirangi, A., & Day, L. (2009). Psychological well-being of Australian veterinarians. Australian Veterinary Journal, 87, 76–81.PubMedCrossRefGoogle Scholar
  50. Gagné, M., Koestner, R., & Zuckerman, M. (2000). Facilitating acceptance of organizational change: The importance of self-determination. Journal of Applied Social Psychology, 30, 1843–1852.CrossRefGoogle Scholar
  51. Gardner, D. H., & Hini, D. (2006). Work-related stress in the veterinary profession in New Zealand. New Zealand Veterinary Journal, 54, 119–124.PubMedCrossRefGoogle Scholar
  52. Godwin, W. C., Starks, D. D., Green, T. G., & Koran, A., 3rd. (1981). Identification of sources of stress in practice by recent dental graduates. Journal of Dental Education, 45, 220–221.Google Scholar
  53. Goebert, D., Thompson, D., Takeshita, J., Beach, C., Bryson, P., Ephgrave, K., et al. (2009). Depressive symptoms in medical students and residents: A multischool study. Academic Medicine, 84, 236–241.PubMedCrossRefGoogle Scholar
  54. Goldberg, D. P., Gater, R., Sartorius, N., Ustun, T. B., Piccinelli, M., Gureje, O., et al. (1997). The validity of two versions of the GHQ in the WHO study of mental illness in general health care. Psychological Medicine: A Journal of Research in Psychiatry and the Allied Sciences, 27, 191–197.CrossRefGoogle Scholar
  55. Goldberg, D. P., & Hillier, V. F. (1979). A scaled version of the General Health Questionnaire. Psychological Medicine, 9, 139–145.PubMedCrossRefGoogle Scholar
  56. Grolnick, W. S. (2003). The psychology of parental control: How well-meant parenting backfires. Mahwah, NJ: Erlbaum Publishers.Google Scholar
  57. Gurland, S. T., & Grolnick, W. S. (2003). Children’s expectancies and perceptions of adults: Effects on rapport. Child Development, 74, 1212–1224.PubMedCrossRefGoogle Scholar
  58. Hafen, M., Jr., Reisbig, A. M., White, M. B., & Rush, B. R. (2006). The first-year veterinary student and mental health: The role of common stressors. Journal of Veterinary Medical Education, 35, 102–109.CrossRefGoogle Scholar
  59. Hardré, P. L., & Reeve, J. (2009). Training corporate managers to adopt a more autonomy-supportive motivating style toward employees: An intervention study. International Journal of Training and Development, 13, 165–184.CrossRefGoogle Scholar
  60. Hardy, M. A. (1993). Regression with dummy variables. Newbury Park, CA: Sage.Google Scholar
  61. Heath, T. J. (2002a). Longitudinal study of veterinarians from entry to the veterinary course to ten years after graduation: Career paths. Australian Veterinary Journal, 80, 468–473.PubMedCrossRefGoogle Scholar
  62. Heath, T. J. (2002b). Longitudinal study of veterinarians from entry to the veterinary course to 10 years after graduation: Attitudes to work, career and profession. Australian Veterinary Journal, 80, 474–478.PubMedCrossRefGoogle Scholar
  63. Hem, E., Haldorsen, T., Aasland, O. G., Tyssen, R., Vaglum, P., & Ekeberg, O. (2005). Suicide rates according to education with a particular focus on physicians in Norway 1960–2000. Psychological Medicine: A Journal of Research in Psychiatry and the Allied Sciences, 35, 873–880.CrossRefGoogle Scholar
  64. Hendrie, H. C., Clair, D. K., Brittain, H. M., & Fadul, P. E. (1990). A study of anxiety/depressive symptoms of medical students, house staff, and their spouses/partners. Journal of Nervous and Mental Disease, 178, 204–207.PubMedCrossRefGoogle Scholar
  65. Henning, K., Ey, S., & Shaw, D. (1998). Perfectionism, the impostor phenomenon and psychological adjustment in medical, dental, nursing and pharmacy students. Medical Education, 32, 456–464.PubMedCrossRefGoogle Scholar
  66. Hurwitz, T. A., Beiser, M., Nichol, H., Patrick, L., & Kozak, J. (1987). Impaired interns and residents. Canadian Journal of Psychiatry, 32, 165–169.Google Scholar
  67. Jackson, C. (2007). The General Health Questionnaire. Occupational Medicine, 57, 79.CrossRefGoogle Scholar
  68. Joussemet, M., Landry, R., & Koestner, R. (2008). A self-determination theory perspective on parenting. Canadian Psychology, 49, 194–200.CrossRefGoogle Scholar
  69. Kasser, V. G., & Ryan, R. M. (1999). The relation of psychological needs for autonomy and relatedness to vitality, well-being, and mortality in a nursing home. Journal of Applied Social Psychology, 29, 935–954.CrossRefGoogle Scholar
  70. Kassirer, J. P. (1998). Doctor discontent. New England Journal of Medicine, 339, 1543–1545.PubMedCrossRefGoogle Scholar
  71. Kennedy, S., Goggin, K., & Nollen, N. (2004). Adherence to HIV medications: Utility of the theory of self-determination. Cognitive Therapy and Research, 28, 611–628.CrossRefGoogle Scholar
  72. Kent, G. (1987). Stress amongst dentists. In R. Payne & J. Firth-Cozens (Eds.), Stress in health professionals (pp. 127–149). Oxford, England: Wiley.Google Scholar
  73. Koestner, R., Ryan, R. M., Bernieri, F., & Holt, K. (1984). Setting limits on children’s behavior: The differential effects of controlling versus informational styles on intrinsic motivation and creativity. Journal of Personality, 52, 233–248.CrossRefGoogle Scholar
  74. Linehan, M. M. (1981). A social-behavioral analysis of suicide and parasuicide: Implications for clinical assessment and treatment. In J. F. Clarkin & H. Glazer (Eds.), Depression: Behavioral and directive treatment strategies (pp. 229–294). New York: Garland.Google Scholar
  75. Lynch, M. F., Jr., Plant, R. W., & Ryan, R. M. (2005). Psychological needs and threat to safety: Implications for staff and patients in a psychiatric hospital for youth. Professional Psychology: Research and Practice, 36, 415–425.CrossRefGoogle Scholar
  76. Mageau, G. A., Ranger, F., Joussemet, M., Koestner, R., Moreau, E., & Forest, J. (2011). Construction and validation of the perceived parental autonomy support scale (P-PASS). Manuscript submitted for publication, University of Montreal, Quebec, Canada.Google Scholar
  77. Mageau, G. A., & Vallerand, R. J. (2003). The coach-athlete relationship: A motivational model. Journal of Sport Sciences, 21, 883–904.CrossRefGoogle Scholar
  78. Maranda, M. F., Gilbert, M. A., St-Arnaud, L., & Vézina, M. (2006). La détresse des médecins: Un appel au changement. [Physicians’ distress: A call for change]. Quebec, Canada: Les Presses de l’Université Laval.Google Scholar
  79. Martini, S., Arfken, C. L., & Balon, R. (2006). Comparison of burnout among medical residents before and after the implementation of work hours limits. Academic Psychiatry, 30, 352–355.PubMedCrossRefGoogle Scholar
  80. Maslach, C., & Jackson, S. E. (1982). Burnout in health professions: A social psychological analysis. In G. S. Sanders & J. Suls (Eds.), Social psychology of health and illness (pp. 227–251). Hillsdale, NJ: L. Erlbaum Associates.Google Scholar
  81. Maslach, C., Jackson, S. E., & Leiter, M. P. (1997). Maslach burnout inventory: Third edition. In C. P. Zalaquett & R. J. Wood (Eds.), Evaluating stress: A book of resources (pp. 191–218). Lanham, MD: Rowman and Littlefield Publishers Inc.Google Scholar
  82. Massé, R., Poulin, C., Dassa, C., Lambert, J., Bélair, S., & Battaglini, A. (1998). The structure of mental health: Higher-order confirmatory factor analyses of psychological distress and well-being measures. Social Indicators Research, 45, 475–504.CrossRefGoogle Scholar
  83. Moreau, E., & Mageau, G. A. (2011a). Conséquences et corrélats associés au soutien à l’autonomie dans divers domaines de vie. [Consequences and Correlates of Autonomy Support in Various Life Domains]. Manuscript submitted for publication, University of Montreal, Quebec, Canada.Google Scholar
  84. Moreau, E., & Mageau, G. A. (2011b). Promoting the psychological health of medical residents: The importance of autonomy support, self-concordance, and self-awareness. Manuscript submitted for publication, University of Montreal, Quebec, Canada.Google Scholar
  85. Muthén, B., & Kaplan, D. (1985). A comparison of methodologies for the factor analysis of non-normal Likert variables. British Journal of Mathematical and Statistical Psychology, 38, 171–189.CrossRefGoogle Scholar
  86. Myers, H. L., & Myers, L. B. (2004). ‘It’s difficult being a dentist’: Stress and health in the general dental practitioner. British Dental Journal, 197, 89–93.PubMedCrossRefGoogle Scholar
  87. Ng, T. W. H., & Sorensen, K. L. (2008). Toward a further understanding of the relationships between perceptions of support and work attitudes. Group and Organization Management, 33, 243–268.CrossRefGoogle Scholar
  88. Niemiec, C. P., Lynch, M. F., Vansteenkiste, M., Bernstein, J., Deci, E. L., & Ryan, R. M. (2006). The antecedents and consequences of autonomous self-regulation for college: A self-determination theory perspective on socialization. Journal of Adolescence, 29, 761–775.PubMedCrossRefGoogle Scholar
  89. O’Keefe, J. P. (2002). De l’aide lorsqu’on en a le plus besoin. [Help when we need it most]. Journal de l’Association Dentaire Canadienne, 68, 215.Google Scholar
  90. O’Reilly, C. A., Chatman, J., & Caldwell, D. F. (1991). People and organizational culture: A profile comparison approach to assessing person-organization fit. Academy of Management Journal, 34, 487–516.CrossRefGoogle Scholar
  91. Pelletier, L. G., & Vallerand, R. J. (1996). Supervisors’ beliefs and subordinates’ intrinsic motivation: A behavioral confirmation analysis. Journal of Personality and Social Psychology, 71, 331–340.CrossRefGoogle Scholar
  92. Puriene, A., Aleksejuniene, J., Petrauskiene, J., Balciuniene, I., & Janulyte, V. (2008). Self-perceived mental health and job satisfaction among Lithuanian dentists. Industrial Health, 46, 247–252.PubMedCrossRefGoogle Scholar
  93. Rada, R. E., & Johnson-Leong, C. (2004). Stress, burnout, anxiety and depression among dentists. Journal of the American Dental Association, 135, 788–794.PubMedGoogle Scholar
  94. Reijula, K., Rasanen, K., Hamalainen, M., Juntunen, K., Lindbohm, M. L., Taskinen, H., et al. (2003). Work environment and occupational health of Finnish veterinarians. American Journal of Industrial Medicine, 44, 46–57.PubMedCrossRefGoogle Scholar
  95. Reynolds, W. M. (1991). Psychometric characteristics of the Adult Suicidal Ideation Questionnaire in college students. Journal of Personality Assessment, 56, 289–307.PubMedCrossRefGoogle Scholar
  96. Roca, J. C., & Gagné, M. (2008). Understanding e-learning continuance intention in the workplace: A self-determination theory perspective. Computers in Human Behavior, 24, 1585–1604.CrossRefGoogle Scholar
  97. Roth, L. M., Markova, T., Monsur, J. C., & Severson, R. K. (2009). Effects of implementation of a team model on physician and staff perceptions of a clinic’s organizational and learning environments. Family Medicine, 41, 434–439.PubMedGoogle Scholar
  98. Ryan, R. M. (2005). The developmental line of autonomy in the etiology, dynamics, and treatment of borderline personality disorders. Development and Psychopathology, 17, 987–1006.PubMedCrossRefGoogle Scholar
  99. Ryan, R. M., Mims, V., & Koestner, R. (1983). Relation of reward contingency and interpersonal context to intrinsic motivation: A review and test using cognitive evaluation theory. Journal of Personality and Social Psychology, 45, 736–750.CrossRefGoogle Scholar
  100. Schernhammer, E. S., & Colditz, G. A. (2004). Suicide rates among physicians: A quantitative and gender assessment (meta-analysis). American Journal of Psychiatry, 161, 2295–2302.PubMedCrossRefGoogle Scholar
  101. Schotte, D. E., & Clum, G. A. (1982). Suicide ideation in a college population: A test of a model. Journal of Consulting and Clinical Psychology, 50, 690–696.PubMedCrossRefGoogle Scholar
  102. Shanafelt, T. D., Bradley, K. A., Wipf, J. E., & Back, A. L. (2002). Burnout and self-reported patient care in an internal medicine residency program. Annals of Internal Medicine, 136, 358–367.PubMedGoogle Scholar
  103. Simpson, R., Beck, J., Jakobsen, J., & Simpson, J. (1983). Suicide statistics of dentists in Iowa, 1968 to 1980. Journal of the American Dental Association, 107, 441–443.PubMedGoogle Scholar
  104. Soenens, B., Vansteenkiste, M., Lens, W., Luyckx, K., Goossens, L., Beyers, W., et al. (2007). Conceptualizing parental autonomy support: adolescent perceptions of promotion of independence versus promotion of volitional functioning. Developmental Psychology, 43, 633–646.PubMedCrossRefGoogle Scholar
  105. Sotile, W., & Sotile, M. O. (2002). The resilient physician: Effective emotional management for doctors and their medical organizations. Chicago, IL: American Medical Association Press.Google Scholar
  106. Stack, S. (1996). Suicide risk among dentists: A multivariate analysis. Deviant Behavior, 17, 107–117.CrossRefGoogle Scholar
  107. Stack, S. (2001). Occupation and suicide. Social Science Quarterly, 82, 384–396.CrossRefGoogle Scholar
  108. Thoits, P. A. (1985). Social support and psychological well-being: Theoretical possibilities. In I. G. Sarason & B. R. Saranson (Eds.), Social support: Theory, research, and applications (pp. 51–72). Dordrecht, Netherlands: Martinus Nijhoff.Google Scholar
  109. Thomas, N. K. (2004). Resident burnout. JAMA, 292, 2880–2889.PubMedCrossRefGoogle Scholar
  110. Tyssen, R., Hem, E., Gude, T., Grønvold, N. T., Ekeberg, Ø., & Vaglum, P. (2009). Lower life satisfaction in physicians compared with a general population sample: A 10-year longitudinal, nationwide study of course and predictors. Social Psychiatry and Psychiatric Epidemiology, 44, 47–54.PubMedCrossRefGoogle Scholar
  111. Tyssen, R., Hem, E., Vaglum, P., Grønvold, N. T., & Ekeberg, Ø. (2004). The process of suicidal planning among medical doctors: Predictors in a longitudinal Norwegian sample. Journal of Affective Disorders, 80, 191–198.PubMedCrossRefGoogle Scholar
  112. Tyssen, R., & Vaglum, P. (2002). Mental health problems among young doctors: An updated review of prospective studies. Harvard Review of Psychiatry, 10, 154–165.PubMedCrossRefGoogle Scholar
  113. Tyssen, R., Vaglum, P., Grønvold, N. T., & Ekeberg, Ø. (2000). The impact of job stress and working conditions on mental health problems among junior house officers. A nationwide Norwegian prospective cohort study. Medical Education, 34, 374–384.PubMedCrossRefGoogle Scholar
  114. Tyssen, R., Vaglum, P., Grønvold, N. T., & Ekeberg, Ø. (2001). Suicidal ideation among medical students and young physicians: A nationwide and prospective study of prevalence and predictors. Journal of Affective Disorders, 64, 69–79.PubMedCrossRefGoogle Scholar
  115. Vallerand, R. J. (1989). Toward a methodology for the transcultural validation of psychological questionnaires: Implications for research in the French language. Canadian Psychology, 30, 662–680.CrossRefGoogle Scholar
  116. Vansteenkiste, M., Simons, J., Lens, W., Sheldon, K. M., & Deci, E. L. (2004). Motivating learning, performance, and persistence: The synergistic effects of intrinsic goal contents and autonomy-supportive contexts. Journal of Personality and Social Psychology, 87, 246–260.PubMedCrossRefGoogle Scholar
  117. Vansteenkiste, M., Simons, J., Lens, W., Soenens, B., & Matos, L. (2005). Examining the motivational impact of intrinsic versus extrinsic goal framing and autonomy-supportive versus internally controlling communication style on early adolescents’ academic achievement. Child Development, 76, 483–501.PubMedCrossRefGoogle Scholar
  118. Ware, J. E., Jr., & Sherbourne, C. D. (1992). The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Medical Care, 30, 473–483.PubMedCrossRefGoogle Scholar
  119. Wasserman, I. M. (1992). Economy, work, occupation, and suicide. In R. W. Maris, A. L. Berman, J. T. Maltsberger, & R. I. Yufit (Eds.), Assessment and prediction of suicide (pp. 520–539). New York: Guilford Press.Google Scholar
  120. Watson, D., Clark, L. A., & Tellegen, A. (1988). Development and validation of brief measures of positive and negative affect: The PANAS scales. Journal of Personality and Social Psychology, 54, 1063–1070.PubMedCrossRefGoogle Scholar
  121. Williams, G. C., Cox, E. M., Kouides, R., & Deci, E. L. (1999). Presenting the facts about smoking to adolescents: Effects of an autonomy-supportive style. Archives of Pediatrics and Adolescent Medicine, 153, 959–964.PubMedGoogle Scholar
  122. Williams, G. C., & Deci, E. L. (1996). Internalization of biopsychosocial values by medical students: A test of self-determination theory. Journal of Personality and Social Psychology, 70, 767–779.PubMedCrossRefGoogle Scholar
  123. Williams, G. C., & Deci, E. L. (2001). Activating patients for smoking cessation through physician autonomy support. Medical Care, 39, 813–823.PubMedCrossRefGoogle Scholar
  124. Williams, G. C., Freedman, Z. R., & Deci, E. L. (1998a). Supporting autonomy to motivate patients with diabetes for glucose control. Diabetes Care, 21, 1644–1651.PubMedCrossRefGoogle Scholar
  125. Williams, G. C., Grow, V. M., Freedman, Z. R., Ryan, R. M., & Deci, E. L. (1996). Motivational predictors of weight loss and weight-loss maintenance. Journal of Personality and Social Psychology, 70, 115–126.PubMedCrossRefGoogle Scholar
  126. Williams, G. C., Lynch, M. F., McGregor, H. A., Ryan, R. M., Sharp, D., & Deci, E. L. (2006). Validation of the “Important Other” climate questionnaire: Assessing autonomy support for health-related change. Families, Systems, & Health, 24, 179–194.CrossRefGoogle Scholar
  127. Williams, G. C., McGregor, H. A., King, D., Nelson, C. C., & Glasgow, R. E. (2005). Variation in perceived competence, glycemic control, and patient satisfaction: Relationship to autonomy support from physicians. Patient Education and Counseling, 57, 39–45.PubMedCrossRefGoogle Scholar
  128. Williams, G. C., Rodin, G. C., Ryan, R. M., Grolnick, W. S., & Deci, E. L. (1998b). Autonomous regulation and long-term medication adherence in adult outpatients. Health Psychology, 17, 269–276.PubMedCrossRefGoogle Scholar
  129. Williams, G. C., Wiener, M. W., Markakis, K. M., Reeve, J., & Deci, E. L. (1994). Medical students’ motivation for internal medicine. Journal of General Internal Medicine, 9, 327–333.PubMedCrossRefGoogle Scholar
  130. World Health Organization (2009, October). Mental health: A state of well-being. Retrieved November 16, 2009, from
  131. Zeldman, A., Ryan, R. M., & Fiscella, K. (2004). Motivation, autonomy support, and entity beliefs: Their role in methadone maintenance treatment. Journal of Social and Clinical Psychology, 23, 675–696.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  1. 1.Department of PsychologyUniversity of MontrealMontrealCanada

Personalised recommendations