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Summary Exam 2 Addiction & Compulsive Disorders UvA Year 2
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Summary of Addiction & Compulsive Disorders Exam 2
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W1.1ARTICLE BY ADRIAANSE ET AL. (2011) – BREAKING HABITS WITH
IMPLEMENTATION INTENTIONS: A TEST OF UNDERLYING PROCESSES
Habits and implementation intentions seem to instigate similar automatic responses that differ
only in origin, and based on this similarity, it has been suggested that implementation
intentions could be used not only to promote the initiation of new, wanted behaviours but also
to break existing unwanted habits
- Habits: Develop as people repeatedly perform a specific behaviour in a stable
situation, after which the co-occurrence between the situation and the behaviour is
strengthened to the extent that when the situation is encountered, the behaviour
follows automatically
- Implementation intentions: Simple action plans stipulating ‘where’, ‘when’ and ‘how’
one will perform an intended behaviour → Counter-habitual implementation
intentions: Specifically designed to disrupt or replace existing habits or automatic
behaviours (E.g.: ‘If I am watching television and I want a snack, then I will reach for
the fruit bowl and take an apple instead of crisps’)
Prior research does not address the cognitive effects of formulating counter-habitual
implementation intentions → Two hypotheses as to why counter-habitual implementation
intentions may be helpful:
1. Horse race hypothesis: The counter-habitual implementation intention cancels out the
cognitive advantage of habitual responses by creating an equally strong association
between the cue and the specified response in the intention
2. The counter-habitual implementation intentions inhibit the habitual response by
interfering with the alternative response specified in the intention → Goal-systems
theory: Posits that means that are instrumental in attaining a goal are connected to this
goal by a facilitative link, whereas the connection between two alternative means to
achieve the same goal is inhibitory (i.e. if a goal activates one means, the activation of
an alternative means for this goal is inhibited)
Study 1: Researchers investigated the effectiveness of counter-habitual implementation
intentions by comparing the accessibility of habitual responses and alternative responses when
encountering a cue
- Participants formed implementation intentions to replace one habitual behaviour (i.e.
eating/drinking ‘unhealthy’ snacks/drinks) with a corresponding alternative behaviour,
after which they responded to words related to their habitual and alternative
behaviours in a primed lexical decision task
- Results showed that forming counter-habitual implementation intentions diminished
the cognitive advantage of habitual responses over alternative responses
- Limitations:
- The study did not evaluate how strongly participants were committed to
actually implementing intentions outside of the experimental setting
- The habitual and alternative means that participants generated for each of the
situations were in general equally ‘healthy’ or ‘unhealthy’
,Study 2: Researchers investigated the effectiveness of counter-habitual implementation
intentions by comparing the accessibility of habitual responses and alternative responses when
encountering a cue
- The procedure was highly similar to study 1, except that participants were asked to
generate healthier alternatives for their habits, and the study also included measures to
assess habit strength and healthiness of the means
- Results of study 2 replicated results from study 1 and extended those previous findings
by showing that the effect of implementation intentions can also be found when the
intentions are aimed at replacing an unhealthy habit with a healthier alternative
- Limitations:
- The present study does not rule out the possibility that similar effects could be
obtained by merely instructing participants to form strong intentions rather
than by formulating implementation intentions
Study 3: Researchers compared the implementation intention-condition to an ‘intention only’-
condition
- Participants chose their habitual snack and its critical cue, then formulated intentions
to eat less of it, with one group also generating counter-habitual implementation
intentions, after which they were administered a primed lexical decision task
- Results showed that counter-habitual implementation intentions weakened the mental
link between critical situations and habitual responses, even with strong habits,
demonstrating the effectiveness of implementation intentions
CHAPTER 16 (VERHOEVEN & DE WIT) – THE ROLE OF HABITS IN
MALADAPTIVE BEHAVIOUR AND TECHNIQUE INTERVENTIONS
Habits: Learned sequences of acts that have become automatic responses to specific cues, and
are functional in obtaining certain goals or end states
1. Repetition
2. Context stability
3. Automaticity – (Un)intentionality, (un)controllability, (lack of) awareness and
efficiency (Bargh)
Competition with goal-directed processes → The degree to which behaviour is habitual is
determined by the relative strengths of goal-directed and habitual processes
Outcome-devaluation paradigm: Experimental paradigm that demonstrates that after extensive
training of a lever press response to obtain food, animals are unable to immediately, flexibly
adjust their behaviour when the outcome no longer constitutes a goal → Slips-of-action test:
Participants learn to associate cues with specific responses that lead to rewards, after which
some cues change to signal negative outcomes, where participants must continue responding
to cues linked with rewards while avoiding those linked with negative outcomes
Habit propensity: An individual’s tendency to form habits, particularly in response to repeated
behaviours or stimuli – Suggests how quickly and strongly someone may develop habitual
responses compared to others
, Habits in mental disorders:
- Dysfunctional cortico-striatal networks may be implicated in compulsive behaviour,
which have also been shown to play a role in the balance between goal-directed and
habitual control
- Many mental disorders are characterised by impaired executive control functions, and
executive functions are likely to play a pivotal role in goal-directed control
- Mental disorders commonly co-occur with stress, which has also been shown to lead
to increased reliance on habits
Therapeutic interventions that target habits:
- Habit discontinuity hypothesis: Old S‐R habits can be disrupted by a change in
context, thereby providing a window of opportunity for adapting behaviour in light of
one’s current goals – Habits are contextually dependent
- Implementation intentions – Two underlying mechanisms:
1. The specified situation becomes highly accessible
2. The desirable response is triggered in an automated fashion when the specific
situation is encountered
Traits that predict the efficacy of implementation intentions:
- Negative effect:
- Socially prescribed perfectionism: A preoccupation to reach ideals and
standards set by significant others
- Urgency: The tendency to act impulsively under circumstances when negative
affect is experienced
- Positive effect:
- Low executive functioning → Implementation intentions can be used to boost
performance on executive functioning tasks
Ways to incorporate implementation intentions into CBT:
- Functional analysis: Specifies antecedents, behaviours and consequences, and is used
to better understand the meaning of maladaptive behaviour to inform treatment goals
- Motivational interviewing techniques
- Increasing participants’ insight into the triggers of their unwanted behaviour
- Combining add-on treatments that target habitual processes with implementation
intentions (such as Cognitive Bias Modification)
Formulating multiple plans jeopardises the effectiveness of implementation intentions – A
sequential approach must be used!
BACKGROUND MODULE CANVAS
Instant habit theory: Implementation intentions are effective because they establish a clear
association between specific cues in the environment and the desired behaviour, essentially
programming the mind to automatically execute the desired action when encountering those
cues – The behaviour becomes more automatic and effortless, as individuals no longer need to
rely solely on conscious decision-making or willpower to initiate the behaviour (Gollwitzer)
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