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Summary Addiction & Compulsive Disorders: implementation intentions, eating disorders, pathological gambling & OCD

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This summary is based on the learning objectives of the lectures and contains college notes, slides & literature. It is about the subjects implementation intentions, eating disorders, pathological gambling and the symptomatology & treatment and the role of habits in obsessive-compulsive disorder.

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Module 6 – Implementation intentions
1. Name and explain different methods for measuring habits [paraphrasing and
analyzing]

Measure whether behavior is habitual with the outcome-devaluation test, but this is only in the
lab while you really want to measure it in real-life!

Self-report measures:

• Self-Report Habit Index is the most used
o Self-Report Behavioral Automaticity Index: subscale of SRHI
o About the subjective experience of habit
o Disadvantages:
▪ Subjective
▪ Self-report of automatic behavior; habits are mostly unconscious
• Frequency measures: about the frequency of past behavior
o Past frequency x context stability measure
• Response generating measure: response frequency measure
o Ask how often they do something and answer as quick as possible
o Assumption is that are shorter reaction time = stronger habit

Field experiment:

• Snacking habits: research by Neal et al.
o In which 98 cinema-visitors were offered popcorn that was either fresh or stale
and they needed to indicate how frequently they ate popcorn in movie theaters
in the past. -> Afterwards, the amount of popcorn eaten was measured
o Results:
▪ In the cinema context; low and moderate habit participants ate more
fresh popcorn, but high habit participants ate equal amounts of stale
and fresh popcorn
▪ Meeting room context: all participants ate more fresh than stale popcorn
o Indicates that the context is very important in habit behavior

Primed-lexical-decision task

,Prime = part of the stimulus of the Stimulus-Response association
Target word – stimulus or neutral / non-word
Add other target words than the one you are interested in, so you can discriminate the stimulus

• These are your control trials, which could be:
o Lecture -> beer
o Bar -> coffee

Quicker response to the S-R association indicates a habit, such as; lecture -> coffee

Example studies:

• Habits in transport:
o Method:
▪ Phase 1: habit strength measures of car use (past frequency & response
frequency) vs alternatives
▪ Phase 2: transport diary
o Results:
▪ Habit is the best predictor of car use
▪ There is a habit x intention interaction: intention is only predictive when
the habit is weak!
• Habits in snacking:
o Method:
▪ Phase 1: habit strength measure and intention regarding snacking
▪ Phase: snack diary
o Results:
▪ Habit strength is the best predictor of unhealthy snacking




2. Compare and assess the reliability and relevance of these different methods
[analyzing and evaluating]

Self-report measures are effective, but have disadvantages:

- Subjectivity
- Habits are automatic and mostly unconscious

Outcome-devaluation: only in the lab

Field experiments are the most relevant for generalizing to real-life because it is conducted in
real life and with real cues

Primed lexical-decision task: more control over the environment, thus also more reliable than
field experiments

, 3. Describe what implementation intentions (II's) are and explain two working
mechanisms [paraphrasing]

Implementation intentions are if-then plans that link a critical cue to an instrumental action

• If I am in situation X, then I will perform action Y

-> This is different from a goal intention, which sounds more like: 'I will eat more fruit'

You can see that there are two working mechanisms in these intentions: the if-component and
the then-component:




The if-component is important for heightened cue accessibility:

• It makes the intention more specific
• It also causes quicker detection of the situation

The then-component helps you create a strong link between the stimulus and the response:

• Automatic activation of instrumental response
• Effective handling



4. Describe how II's can be used to form new habits and break existing ones
[paraphrasing]

Implementation intentions promote the intitation of desired behavior (healthier eating patterns,
more physical activity etc.) and reduce undesired behavior (smoking, unhealthy snacking).

Both habits and implementation intentions are mediated by the S-R association and there is a
similar automatic response, but they are established in a different manner:

• Habit: by repetition
• II: conscious planning

II's promote behavioral repetition in a stable context, so also gradual habit formation. A new
habit is created.

Implementation intentions can overrule habits in several processes:

, - The formation of a counterhabitual II cancels out the cognitive advantage of the habitual
over the alternative means
- The new association between the situation and the alternative response may be
stronger than the old association of the habit.
o But it can never really outrun the activation of the habitual response without any
changes to the situation-habitual response association
- Counterhabitual II may inhibit the habitual resposne because it interferes with the
alternative response specified in the II
o Goal systems theory: if a goal activates one means, the activation of an
alternative mean for this goal is inhibited

There are seven steps in behavior change:

1. Choose a behavior that you are highly motivated to change
a. Strong intention and intrinsic motivation are crucial for effectiveness of II
b. Motivational interviewing can be helpful
2. Determine the critical cue: in which situation do you carry out the habit?
a. What is going to be the 'if'-component?
b. Can be external or internal cue
c. Situational cues: 'if I come home...' -> you're in a certain situation
d. Motivational cues: 'if I am bored..' -> comparable to internal cues
e. Most effective when a personal motivational cue is used
3. Can the critical cue easily be avoided/changed?
a. Habit discontinuity hypothesis
b. Stimulus control
c. Change the context to promote the desired behavior: example is placing fruit in
prominent places to nudge healthy choices in school canteens
4. Link the right action to your critical cue
a. Which 'then'?
b. Important: 'If I watch TV and I feel like snacking, then I won't eat cookies'
i. This is not effective, because you still think about cookies
ii. Also called a negation II
c. This relates to the Ironic Process Theory: attempts to suppress a thought
actually render it more salient and makes one more conscious of it
d. Negation II is worse than goal intention and replacement II in reducing unhealthy
habit frequency
i. Negation II = If ..., then NOT -> heightens the accessibility to the habit
and leads to more habitual behavior
ii. Replacement II is preferable = If ..., then... [alternative]
e. Replacement II's weaken the old habit and strengthen the new habit, which
causes the habitual response to haven no cognitive advantage
5. Continue to monitor your behavior and adjust your plan if it is no longer optimal
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