Treatment Self-Regulation Questionnaire – TSRQ [AQ-58]

Description

The Treatment Self-Regulation Questionnaire (TSRQ) is a psychometric instrument based on Self-Determination Theory. It assesses the reasons individuals adopt or maintain particular health-related behaviors, such as following medical advice, taking medication, improving diet, exercising, quitting smoking, or participating in treatment programs.

The TSRQ does not measure a stable personality trait. Instead, it evaluates motivation within a specific behavioral and healthcare context. Therefore, the wording of its items may be adapted to the particular health behavior under investigation.

Purpose

The primary purpose of the TSRQ is to assess the quality of motivation underlying treatment adherence and health behavior change. It mainly examines:

  • Autonomous regulation: The behavior is personally meaningful and consistent with the individual’s values and goals.
  • Controlled regulation: The behavior is driven by external demands, rewards, pressure, guilt, or fear of disapproval.
  • Amotivation: The individual perceives no clear reason, purpose, or expected benefit from performing the behavior.

Autonomous motivation is generally associated with greater persistence, better treatment adherence, more effective self-management, and improved health outcomes.

Scoring

Respondents indicate the extent to which each proposed reason reflects their motivation, usually using a Likert-type response scale. The exact number of items and response options may differ depending on the TSRQ version and the health behavior being assessed.

Scores are typically calculated separately for each subscale by averaging the corresponding items. Higher scores indicate a stronger presence of the respective regulatory style. A single overall score is generally not recommended because autonomous motivation, controlled motivation, and amotivation represent distinct dimensions.

Statistical Analysis

The statistical analysis of TSRQ data may include descriptive statistics, frequency distributions, and internal consistency estimates for each subscale. Differences between demographic or clinical groups can be investigated using appropriate parametric or nonparametric tests.

Associations between motivational regulation, treatment adherence, self-management, psychological well-being, and clinical outcomes may be examined through correlation, regression, or mediation analyses. The factorial structure can be evaluated using exploratory or confirmatory factor analysis, while measurement invariance can be tested when comparing different populations or groups.

Psychometric Evaluation

When the TSRQ is adapted to a new language, population, or therapeutic context, its psychometric properties should be reassessed. The evaluation may include internal consistency, test–retest reliability, construct validity, convergent validity, criterion-related validity, and measurement invariance.

Pilot testing is also recommended to examine item clarity, cultural appropriateness, and relevance to the target health behavior. Further information and versions of the instrument are available through the official Self-Determination Theory Website.

References

DeVellis, R. F. (2017). Scale development: Theory and applications (4th ed.). SAGE Publications.

Fowler, F. J., Jr. (2014). Survey research methods (5th ed.). SAGE Publications.

Levesque, C. S., Williams, G. C., Elliot, D., Pickering, M. A., Bodenhamer, B., & Finley, P. J. (2007). Validating the theoretical structure of the Treatment Self-Regulation Questionnaire (TSRQ) across three different health behaviors. Health Education Research, 22(5), 691–702.

Ryan, R. M., & Connell, J. P. (1989). Perceived locus of causality and internalization: Examining reasons for acting in two domains. Journal of Personality and Social Psychology, 57(5), 749–761.

Ryan, R. M., & Deci, E. L. (2000). Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. American Psychologist, 55(1), 68–78.

Williams, G. C., Freedman, Z. R., & Deci, E. L. (1998). Supporting autonomy to motivate patients with diabetes for glucose control. Diabetes Care, 21(10), 1644–1651.