{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,10]],"date-time":"2025-06-10T04:06:40Z","timestamp":1749528400596,"version":"3.41.0"},"reference-count":59,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,4,3]],"date-time":"2025-04-03T00:00:00Z","timestamp":1743638400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000890","name":"National Multiple Sclerosis Society","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000890","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Clin Psychol"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Despite disease modifying therapies' (DMT) demonstrated efficacy for treating relapsing MS, around 40% of patients discontinue use. This study aimed to understand the mechanism of action of Motivational Interviewing plus cognitive behavioral therapy (MI\u2010CBT) in a previously conducted randomized controlled trial in which the MI\u2010CBT intervention successfully promoted DMT re\u2010initiation of participants compared to a treatment as usual (TAU) condition.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This secondary analysis (<jats:italic>N<\/jats:italic>\u2009=\u200991) explored changes in motivation (a single item motivation \u201cruler\u201d [Mot\u2206], and the Brief Motivation Scale [BMS\u2206]), autonomous motivation (AR\u2206), personal control (PC\u2206), treatment control (TC\u2206), and confidence to reinitiate (Con\u2206) as potential mediators of the treatment effect, using logistic regression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Logistic regression analysis including all potential mediators as predictors of initiation indicated the BMS\u2206 was the only statistically significant predictor (<jats:italic>OR<\/jats:italic>\u2009=\u20091.61, <jats:italic>p<\/jats:italic> = 0.010). When BMS\u2206 was removed Mot\u2206 (<jats:italic>OR<\/jats:italic>\u2009=\u20091.22, <jats:italic>p<\/jats:italic>\u2009=\u20090.002) and PC\u2206 (<jats:italic>OR<\/jats:italic>\u2009=\u20091.67, <jats:italic>p<\/jats:italic>\u2009=\u20090.002) were statistically significant predictors of initiation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The MI\u2010CBT intervention appeared to work primarily by increasing motivation to initiate DMT.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jclp.23796","type":"journal-article","created":{"date-parts":[[2025,4,5]],"date-time":"2025-04-05T01:17:20Z","timestamp":1743815840000},"page":"609-618","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Mechanisms of Action of Combination Motivational Interviewing\u2010Cognitive Behavior Therapy for Reversing Medication Non\u2010Adherence in Patients With Multiple Sclerosis"],"prefix":"10.1002","volume":"81","author":[{"given":"Rachel","family":"Schoor","sequence":"first","affiliation":[{"name":"Department of Psychology University of Missouri\u2010Kansas City Kansas City Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jared M.","family":"Bruce","sequence":"additional","affiliation":[{"name":"Departments of Biomedical and Health Informatics Neurology, Psychiatry, and University Health, University of Missouri\u2010Kansas City Kansas City Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vincent S.","family":"Staggs","sequence":"additional","affiliation":[{"name":"Departments of Biostatistics &amp; Epidemiology Core, School of Medicine University of Missouri\u2010Kansas City Kansas City Missouri USA"},{"name":"Center for Children's Healthy Lifestyles &amp; Nutrition Children's Mercy Hospital Kansas City Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew T.","family":"Fox","sequence":"additional","affiliation":[{"name":"Division of Health Services and Outcomes Research Children's Mercy Hospital Kansas City Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amanda","family":"Bruce","sequence":"additional","affiliation":[{"name":"Center for Children's Healthy Lifestyles &amp; Nutrition Children's Mercy Hospital Kansas City Missouri USA"},{"name":"Department of Pediatrics University of Kansas Medical Center Kansas City Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sharon","family":"Lynch","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Kansas Medical Center Kansas City Kansas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Delwyn","family":"Catley","sequence":"additional","affiliation":[{"name":"Center for Children's Healthy Lifestyles &amp; Nutrition Children's Mercy Hospital Kansas City Missouri USA"},{"name":"Division of Health Services and Outcomes Research Children's Mercy Hospital Kansas City Missouri USA"},{"name":"Department of Pediatrics, School of Medicine University of Missouri\u2010Kansas City Kansas City Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,4,3]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1037\/0022-006X.71.5.862"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1037\/0003-066X.37.2.122"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/1940-0640-7-8"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/1352458519864681"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10865-015-9694-6"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrneurol.2011.106"},{"key":"e_1_2_9_8_1","unstructured":"Catley D. 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