Introduction
The Treatment Self-Regulation Questionnaire (TSRQ) is a self-report measure of why people engage in health-related behaviors, such as entering treatment or following a treatment regimen. It assesses how autonomous a person's motivation is. Williams, Grow, Freedman, Ryan and Deci introduced it in 1996, and the original study has received more than 2,600 citations.
The Treatment Self-Regulation Questionnaire distinguishes autonomous regulation from controlled regulation, two forms of motivation described in self-determination theory. This guide covers its versions, scoring, reliability evidence and applications in health behavior research.
Key Features of the Treatment Self-Regulation Questionnaire (TSRQ)
Purpose and Use
The TSRQ asks why people engage in a healthy behavior, enter treatment for a medical condition, try to change an unhealthy behavior, or follow a treatment regimen. Each version assesses how far a person's motivation for the behavior is relatively autonomous.
Because the Treatment Self-Regulation Questionnaire focuses on a specific behavior, its wording varies with the behavior under study.
Target Population
The TSRQ targets adults aged 18 years and older. Its original versions addressed patients with diabetes and patients with morbid obesity who took part in a weight-loss program.
Structure
Three versions of the scale exist, each with a different number of stems and items:
Version
Stems
Items
Health behaviors of patients with diabetes
2
19
Participation in a very low-calorie, medically supervised weight-loss program by patients with morbid obesity
4
18
The same weight-loss program, given several months after it began
2
13
Most versions have two subscales: Autonomous Regulation and Controlled Regulation. Overall, the items cover reasons for health behavior change. They assess whether treatment-related behaviors are autonomously regulated, introjected, externally regulated, or amotivated across tobacco use, diet and physical activity.
Scoring Method
Respondents rate each item on a 7-point Likert-type scale from 1 ("not at all true") to 7 ("very true"). Subscale scores are the mean of the items within each subscale:
Autonomous motivation: the average of the responses to the autonomous items.Controlled motivation: the average of the responses to the controlled items.For full scoring details, see the complete TSRQ document on the Self-Determination Theory website.
Administration Format
The TSRQ is a self-report questionnaire, so respondents complete it themselves. They rate each reason for their behavior on the 7-point scale described above.
Applications of the Treatment Self-Regulation Questionnaire (TSRQ)
The TSRQ supports research and practice in health behavior:
Predicting adherence: in its original application, it helped predict adherence and long-term weight-loss maintenance among adults in a behavioral weight-management program.Health behavior research: assessing motivation for tobacco use, diet and physical activity.Treatment motivation: distinguishing autonomous from controlled reasons for engaging in treatment.Languages and availability
Researchers have studied a Portuguese version for physical activity, the TSRQ-PA.
The questionnaire and its scoring instructions are available on the Self-Determination Theory website. The original article was published by the American Psychological Association, and reuse permissions for it are available through the Copyright Clearance Center.
Reliability and Validity
Reported Cronbach's alpha values are 0.80–0.86 for Controlled Reasons and 0.81–0.85 for Autonomous Reasons. Furthermore, the original application showed a clear two-factor structure, separating autonomous from controlled motivation.
Validation studies:
Motivational predictors of weight loss and weight-loss maintenance (Williams et al., 1996): study linkLimitations and Considerations
Users should consider the following points:
Autonomous subscale consistency: in the original study, the Autonomous Reasons subscale showed relatively modest internal consistency.New populations: interpretation in new populations should consider subsequent validation evidence.Behavior-specific wording: the wording changes with the behavior under study, so each adaptation targets a specific behavior.Other Versions And Related Questionnaires
Besides the three original versions, a 15-item version of the TSRQ also exists. In addition, the following questionnaires are similar or complementary:
General Causality Orientations Scale (GCOS)Health Care Climate Questionnaire (HCCQ)Health Locus of Control Scale (HLOC)Additional Resources
Self-regulation questionnaires on the Self-Determination Theory website: linkYou can access the complete TSRQ, including scoring, as a PDF through this linkFor inquiries, the contact reference is Geoffrey C. Williams, Department of Psychology, University of Rochester, Rochester, New York 14627, USA.Browse more psychology questionnaires in the ResRef database.Frequently Asked Questions (FAQ)
What does the Treatment Self-Regulation Questionnaire measure?The TSRQ measures why people engage in health behaviors or treatment. Specifically, it separates autonomous motivation from controlled motivation, the two main subscales in most versions.
How is the TSRQ scored?Items use a 7-point scale from 1 ("not at all true") to 7 ("very true"). The autonomous items are averaged into one score, and the controlled items are averaged into another.
Which versions of the TSRQ exist?Three original versions exist: a 19-item diabetes version, an 18-item weight-loss program version, and a 13-item version given months into the program. A 15-item version is also available.
Who can complete the TSRQ?The TSRQ is designed for adults aged 18 and older. Because its wording follows the target behavior, researchers choose or adapt the version that matches the behavior they study.
A Word from ResRef About the Treatment Self-Regulation Questionnaire (TSRQ)
The TSRQ is a brief self-report instrument designed to distinguish autonomous from controlled motivation for engaging in treatment-related behaviors. In its original application, it demonstrated a clear two-factor structure and was useful for predicting adherence and long-term weight-loss maintenance among adults in a behavioral weight-management program. The Autonomous Reasons subscale showed relatively modest internal consistency in the original study, so interpretation should consider subsequent validation evidence when applied in new populations.
References
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(1), 115–126. https://doi.org/10.1037/0022-3514.70.1.115Marques, M., De Gucht, V., Maes, S., Gouveia, M. J., & Leal, I. (2012). Psychometric Properties of the Portuguese Version of the Treatment Self-Regulation Questionnaire for Physical Activity (TSRQ - PA). Psychology, Community & Health, 1(2), 212–220. https://doi.org/10.5964/pch.v1i2.32