Chapter 5: Motivational and Needs-Based Theories

This chapter is focused on the second of the four identified theoretical constructs for behaviors: Motivational and Needs-Based Theories (MNBT).  Behavioral categories emanating from MNBT are the result of impairment / changes in our motivational and needs-based drives. Such impairments can be a consequence of dysregulation of normal physiology or structural decline, as is the case in cognitive impairments.  In order to understand the implications of the impairment in motivation and needs-based drives on the generation of behaviors, it is imperative to understand the role of these drives in individuals with normal cognitive function.


Needs and Motivation

All people will experience basic, innate needs in their life that require fulfillment. This can include physiological needs, such as a need for nutrition, sex, rest, social and mental stimulation, belongingness needs, such as a need for affiliation, acceptance and inclusion, and security needs, which can be physical or psychological.

  • Needs: Physiological or psychological deficiencies / imbalances.

Motivation is a force that causes arousal, direction and voluntary action. It is motivation which drives us to meet and satisfy a need. This is considered our motivational drive.

  • Drives: Motives that drive us to meet and satisfy a need to achieve a goal.


  • Needs and Motivation Coexist


Needs and Dementia

In moderate-to-severe stages of dementia/major neurocognitive disorder (D/NCD), people may not be able to meet higher level needs such as:

  • Esteem: Respect for others, self-respect, recognition
  • Self-Actualization: Reaching max potential, doing your best


Motivational Circuitry and Dementia

Our motivational circuitry (MC) controls motivational energy and drives our needs fulfillment. Behaviors in D/NCD can arise when cognitive decline has resulted in impaired MC. These behaviors can appear as:

Click on each of these behaviors to learn more about their appearance and meaning.


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