Implementation intentions: can they be used to prevent and treat addiction? - summary of chapter 29 of Handbook of implicit cognition and addiction

Handbook of implicit cognition and addiction
Chapter 29
Implementation intentions: can they be used to prevent and treat addiction?

Abstract

Forming an implementation intention involves an individual planning when, where, and how to perform a specific behaviour. Implementation behaviours could be employed to successfully link critical environmental cues to non-addictive behaviour or techniques to refuse the addictive substance. They could inhibit addiction-related cognitions, maintain self-regulatory resources, promote adherence to treatment, or deal effectively with internal factors.

What are implementation intentions?

Implementation intentions involves an individual deciding when, where, and how they will perform a behaviour. It takes the form of an if-then plan that links behaviour or cognitive response to a good opportunity to act as a means to achieve a goal.

Through implementation intentions, individuals commit themselves to act when faced with a certain situation in a particular manner.

Why are implementation intentions necessary?

Implying motivational intentions are insufficient to tackle addiction.

How do implementation intentions work?

Deciding in advance the context in which to act allows one to select an appropriate situation that prompts few competing goals. Choosing a specific context increases the accessibility to environmental cues that eases detection of critical opportunities to act even when busy with other tasks.

Making decisions enhances the accessibility of decision-consistent information. Implementation intention change behaviour through this heightened accessibility of environmental cues. Once the opportunity to act is detected, implementation intentions automatize behaviour within the preplaned context. Action intention becomes immediate, efficient, and occurs outside conscious awareness.

Implementation intentions change behaviour by helping the identification of good opportunities to act by heightening the accessibility of environmental cues. These environmental features then cue behaviour so that it occurs immediately, efficiently, and without conscious awareness.

Applications

Health behaviour

Implementation intentions increase the performance of important health behaviours (like eating behaviours).

Preventing addiction

To prevent addictive behaviours, strategies must be able to promote actions that hinder the development of problematic behaviour.

Even if an individual possesses an intention to refrain from drug use, encountering drug cues may trigger urges that temporarily override the intention to remain abstinent and prompt relapse. Deciding when and where the urges are likely to occur and planning how to stop oneself from entering these situations or how to get out of them could prove helpful.

Treating addiction

Implementation intentions can be used to reduce the performance of unhealthy, drug-related behaviour.

The reduced intake could serve as an important step in the elimination of addiction and relapse prevention.

Implementation intention have been shown to be more effective when behaviour is enjoyable.

Studies using addicts and clinical samples

Frontal regions of the brain are involved in decision making and judging the future consequences of one’s actions. Long-term exposure to particular drugs reduces neural processing within these regions. This dysfunction reduces cognitive inhibitory control and increases impulsivity, which can encourage compulsive, addictive behaviour and reflects a general lack of conscious control of action and poor decision making and judgment.

Implementation intentions can be effective within frontal lobe patients.

Implementation intentions could be a useful self-regulatory strategy with automatic effects that could help organize the habitual performance. It frees up cognitive resources.

Implementation intentions, self-regulation and addiction

Self-regulation controls one’s own responses.

Conflicting goals often contribute to self-regulation failures. To obtain long-term benefits, one must sustain high self-regulatory levels to resist temptation and ignore or avoid cues that trigger the addictive behaviour. Self-regulation is a limited resources that becomes depleted after drug use. Once self-regulatory capacity is emptied following an initial act of self-control (ego depletion), an individual can become vulnerable to impulsive behaviours.

As a strategy that prevents ego-depletion and offsets its negative effects, this is evidence for the use of implementation intentions in preventing or treating addictive behaviours.

Implementation intentions speed up goal completion by reducing the number of interruptions incurred. This effect could emerge through selection of the most appropriate environment, or by cognitive inhibition of distracting stimuli. Implementation intentions can be used to automatically elicit behaviour that deals with precipitating risk factors or inhibit addictive cognitions.

Thoughts about an object when one actively tries to suppress such cognition under high cognitive load increase by ironic effects. Implementation intentions can block habitual cognitive and emotional responses without causing ironic effects.

Planning is effective in that consideration of many situations and instrumental behaviours can be made. Since planning occurs in advance, when encountering the situation few cognitive resources should be required, so in fact, that action initiation may be automatic.

Implementation intentions and addiction: issues

Can implementation intentions lead to objective changes in health behaviour?

More studies are necessary to incorporate objective measures within long-term interventions.

Can implementation intentions change complex behaviours?

Implementation intention might require additional interventions to be effective for more complex behaviours. Implementation intentions that specify how to perform a behaviour become particularly important for complex behaviours that may be acted on in a variety of ways.

Under which circumstances are implementation intentions most likely to work?

Implementation intentions are most likely to work when: intentions are strong, and/or when goals are intrinsically motivated.

Collaborative implementation intentions

Collaborative implementations intentions involves an individual deciding, with another person, the context in which they will perform a behaviour together. Partner involvement increased ratings of enjoyment, which can increase the implementation intention success and makes planning sound.

Internal cues

An implementation intention may be more reliable in promoting behaviour when it is based on an internal cue (as the external cue might not occur). But, more research is needed.

Can implementation intentions break habits?

To overcome habits, the automatic effects of implementation intentions must be strong enough to overcome the automatically associated with competing habits.

Implementation intentions protect ongoing goal pursuit form competing habits. Supplementing a goal with an implementation intention prevents antagonistic habits, activated unconsciously via priming procedures, from derailing goal-striving.