Case uitwerking
Problem 3. Dual processes
- Instelling
- Maastricht University (UM)
GGZ2029. Addiction. Problem 3 uitgewerkt: Dual processes. De aantekeningen uit de tutorial zijn met groen toegevoegd. Voor alle taken, zie de bundel.
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Problem 3. Dual processesLearning goals
What are dual processes, how do they work and what is the role of self-control in it?
Hofmann, W., Friese, M., & Wiers, R. W. (2008). Impulsive versus reflective influences on
health behavior: A theoretical framework and empirical review. Health Psychology Review,
111-137.
Abstract
Health behavior seems to be governed not only by reasoned attitudes and goal-directed
behavior but also by impulsive influences. The notion of a conflict between reflective and
impulsive processing which is incorporated in prominent dual-system accounts may yield
important benefits for the understanding and prediction of health-related behavior. A basic
framework for the prediction of health-related behaviour is suggested which combines (a)
reflective influences (as measured via self-report), (b) impulsive influences (as measured via
implicit measures), and (c) situational or dispositional moderators that shift the weight
between reflective and impulsive influences.
Impulsive vs reflective influences on health behaviour: a theoretical framework and empirical
review
People time and again experience that sticking to a preconceived plan may fail in the heat of
temptation: Some end up eating or drinking more than they admit is good for them, some
consume toxic substances, and some embark on sexual adventures with unknown risks.
Pleasurable as they are for the moment, such behaviors often lead to negative health
outcomes in the long run, ranging from regret the next day to premature death.
Many health-related problems can be framed in terms of a conflict between immediate
impulses on the one hand and reasoned attitudes and standards to restrain behavior on the
other. In the temptation scenario there exists a conflict between a positively valenced
impulse and standards to refrain from acting on the impulse. Likewise, there are also
scenarios, referred to as heroism scenarios, in which an impulse may carry a negative
hedonic value by signaling uneasiness, harm, or danger to the organism and this negative
impulse has to be overcome for a greater good such as health. Whether we deal with the
temptation or the heroism scenario, both cases share the same underlying structure of a
conflict between an impulse and the call for self-control to overcome the impulse in the way
implied by one’s reasoned attitudes or restraint standards.
The integrative models of health behavior should not only specify the kinds of psychological
constructs that relate to the self-control aspect (e.g., reasoned attitudes, behavioral
intentions, restraint standards) but also psychological constructs that relate to the hedonic,
impulsive influences on everyday health behaviors.
,Self-control and health behaviors
One common element of models concerned with health-related decisions and behaviour is
the assumption that health behavior is the result of cognitive appraisal processes of the (a)
expectancy and value of potential health threats and (b) possible coping responses. From
these appraisal processes, a behavioral decision to reduce the health threat may be formed.
Importantly, these decisions and the resulting goal-directed behavior are typically seen as
reasoned, conscious, and intentional acts that require a person’s volitional control or
willpower in order to be effective. The willpower is needed for effective self-regulation in
many health-related domains. The use of self-control seems to make self-regulatory
resources run out which get supplemented only after some time has elapsed (which results
in for instance more alcohol consumption). There is also evidence for long-term negative
effects on self-regulatory capacity as a consequence of alcohol or drug abuse during
adolescence.
Conscientiousness-related traits were negatively correlated with a host of risky health
behaviors (such as excessive alcohol use, unhealthy eating, tobacco use, or risky sex) and
positively correlated with beneficial health behaviors (such as exercising). Trait self-control,
defined as a chronic tendency “to override (substitute) or inhibit (not doing/taking
something) undesired behavioral tendencies (such as impulses) and to refrain from acting on
them”, was negatively related to undesirable health problems such as eating disorders,
substance abuse, and other psychological disorders such as depression. In turn, impulsivity
(the generalized tendency to act without deliberation) has been found to be positively
associated with problematic health behaviour. These individual differences in impulsivity
have been proposed to be based on a behavioral approach or behavioral activation system.
Scarce evidence for impulsive influences
The determinants and processes by which impulses exert an influence on health behavior
have received much less attention. Impulses have three features:
1. Impulses are specific rather than unspecific, arising when global motivations (e.g.
hunger) meet specific activating stimuli in the environment (e.g. food). In contrast, the
trait of impulsivity refers to a chronic and general tendency to act on impulses.
2. An impulse typically possesses a strong incentive value consisting of a primitive hedonic
component.
3. An impulse typically includes a behavioural tendency to act, often an urge to approach or
consume the temptation at hand.
The personality approach may best be complemented by a process-oriented approach that
spells out in more detail when and why individual health behavior is determined by
impulsive or reflective influences, respectively.
A dual-system framework of impulsive vs reflective influences on health behaviour
Dual-system models appear to be well-suited as frameworks that integrate both reflective
and impulsive influences on health behavior. These models share the assumption that
structurally different systems of information processing underlie the production of impulsive
versus reasoned forms of behavior. Some authors have also proposed that distinct brain
areas underlie these systems.
, Impulsive influences on health behaviour
Impulses are assumed to be triggered in the impulsive system from the activation of
associative clusters in long-term memory in close interaction with perceptual stimulus input.
These associative clusters have been created or strengthened by temporal or spatial co-
activation of external stimuli, affective reactions, and associated behavioral tendencies, thus
reflecting the learning history of the organism. The learned behavioural schema and
associative clusters can be reactivated quickly by perceptual input in close interaction with
internal triggering conditions such as hunger, thirst, or other inner states of homoeostatic
dysregulation. These associative clusters ‘‘prepare’’ the organism to evaluate and respond to
the environment quickly in accordance with one’s needs and previous learning experiences.
The associative clusters are assumed to form gradually over time. Moreover, associative
processes are generally assumed to be independent of conscious awareness and of one’s
personal endorsement of an association as true or false. Most importantly, impulsive
processes of behavior determination are assumed to operate in an effortless manner. So,
impulses are assumed to activate associated behavioral schemas in the motor cortex of the
brain no matter whether cognitive resources are momentarily available or not.
As suggested by dual-systems models, a good measure of impulse should use the associative
structure that generates hedonic or behavioral reactions triggered by stimulus encounter.
Because the generation of impulses is assumed to occur in the absence of conscious control,
impulse assessment should also minimize interference from consciously controlled
processing.
Reflective influences on health behaviour
Most uninhibited impulses interfere with long-term goals or generate interpersonal conflict
at some point. For this reason, self-control belongs to the key competencies of everyday
functioning. Taking a dual-systems perspective, the reflective system employs higher-order
mental operations which provide a fairly large and flexible degree of control over decisions
and actions. These operations include executive functions such as making reasoned
judgments and evaluations, putting together strategic action plans for goal-pursuit, and
inhibiting or overriding prepotent responses (e.g. impulses or habits). They are achieved
through relatively slow controlled processes based on symbolic representations and
operations. The RIM assumes that the reflective system generates behavioral decisions
which in turn activate corresponding behavioral schemas in the motor cortex.
However, the judgmental and behavioral flexibility provided by the reflective system has a
severe disadvantage: the cognitive resources available for reflective operations are assumed
to be subject to situational or dispositional limitations. If cognitive resources are situationally
or chronically reduced, individuals may (a) fail to detect discrepancies between a given
restraint goal and the actual state and/or (b) fail to inhibit or override impulsive influences
violating these standards.
Explicit measures of verbal self-reports are appropriate.
Conflicts between the impulsive and the reflective system
Often, the behavioral implications instigated in the impulsive system may be compatible
with reasoned action. For many health-related behaviors, however, there are circumstances
in which the behavioral implications of the two systems are incompatible. Which of the two
forces will win the upper hand eventually? Both systems access a common final mechanism
for open behavior execution: the activation of behavioral schemas. Which behavioral
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