Module 6: Implementation Intention

Question 1

What is the aim of habit-based interventions?

Answer 1

To promote lasting behaviour change by building desirable habits, or breaking undesired ones

Question 2

Self-report habit index

Answer 2

Rate on a scale of the extent to which they do a behaviour frequently, automatically, and that is difficult not to do. Includes the self-report behavioural automaticity index.

Question 3

Implementation intention

Answer 3

‘if-then’ plans that can help people achieve their goals by specifying critical situations and linking these to the desired behavior. These work better than goal intentions

Question 4

Which theory can explain why implementation intention works so well?

Answer 4

These describe the desired stimulus-response habit, which forms a mental association between critical cues and the desired behaviour resulting in automatic behaviour as II focusses on the critical cues

Question 5

How do habits form?

Answer 5

When people repeatedly perform a specific behaviour in a stable situation to pursue their goals which creates a mental association between the situation and behaviour, leading to the behaviour following automatically. Habitual control found to be most difficult to self-regulate

Question 6

Which approach to change habits is not practical?

Answer 6

By removing or avoiding the critical stimulus which elicits the habitual response

Question 7

Why is planning goals in an implementation intention helpful?

Answer 7

• specifies a situation to act on intentions in advance to make the mental representation highly accessible
• control of behaviour linked to specific situational cue which results in automatic elicitation of goal directed behaviour
• found to be promote intended behaviours

Question 8

Why can implementation intention be used to break habits?

Answer 8

They result in similar automatic responses that differ in origin, and intentions can link new desired behaviour to a situation which previously triggered habitual behaviour. Has been found to be effective in changing several types of behaviour

Question 9

How can implementation intentions overrule habits?

Answer 9

A counterhabitual implementation intentions cancels out the cognitive advantage of the habitual over the alternative. This could be because there is a new association between the situation and the alternative response which could be stronger, but goals system theory is better. This is that a response in line with a goal is connected by a facilitative link, but two alternative responses for the same goal is inhibitory and so their activation is also inhibitory

Question 10

Method and results of study 2

Answer 10

Same method as study 1 except participants were asked to generate alternative means which were healthier and habit strength was assessed like frequency and stability. Habitual means were stronger than alternative means. Habitual means were rated as less healthy than alternative means. The type of means on reaction times was nonsignificant. So habitual means were not more accessible after counter-habitual implementation intentions

Question 10

Study 1 method and results

Answer 10

Participants completed a means generation task to provide a habitual and alternative means for snacking at home and drinking in a bar and then had to generate implementation intentions to replace each behaviour. ZThey were asked to repeat the plan and envision themselves acting out the plan. They completed a primed lexical decision task, were they had to categorize words as being word or nonword. They found that the reaction time was nonsignificant depending on the habitual or alternative means

Question 10

Limitations of study 1

Answer 10

• goal commitment was not assessed
• habitual and alternative means were equally healthy or unhealthy

Question 11

Study 3 method

Answer 11

Implementation intention condition was compared to an intention only condition and personal critical cues were used. This study only looked at the goal of changing snacking and describe the critical situation and then formulated an implementation intention. Then also assessed the hedonic value of certain means. Had strong intentions to snack less and habitual snack and alternative rated as having a high hedonic value. Found that participants reacted quicker to habitual means compared to alternative means

Question 12

What is found by comparing all these studies?

Answer 12

Critical cues should be personal.
Cues can be equally accessible, the alternative means are not more accessible. But what leads to a new habit is forming a stronger goal intention. Also a strong goal implementation is needed to activate alternative means

Question 13

Limitations of research

Answer 13

• only women included
• investigating cognitive and behavioural effects so should related cognitive effects to behavioural outcomes
• little is known about the exact underlying processes to overrule habitual responses
• critical cues might be more difficult to identify for certain habits than others as requires enough introspection

Question 14

Definitions of habits and automaticity

Answer 14

Habits involve repetition, context stability (presence of certain cues) and automaticity. Automaticity involves: uncontrollability, unintentionality, lack of awareness and efficiency

Question 15

Self-report measures

Answer 15

Frequency* context measure which is frequency of past behaviour with stability of circumstances. Does reliably predict behaviour but does not incorporate automaticity like lack of awareness and uncontrollability. Led to development of self-report habit index and self-report behavioural automaticity index. Can be applied to real-life behaviours but can be difficult to answer due to lack of awareness.

Question 16

Outcome-devaluation paradigm in humans

Answer 16

When offered popcorn to eat which was stale or fresh, those who ate popcorn often continued to eat it no matter the condition but for those who did not eat popcorn before depended on how fresh it was. But findings like these failed to replicate-> unclear about habits and link to over-training

Question 17

How has the study of habits been used to investigate individual differences?

Answer 17

Through linking at habit propensity , when certain cues were said to have less points but continuing to press suggests slips of action. Linked to white matter pathways between cortical and striatal brain areas.

Question 18

How could research of habits be applied to a clinical setting?

Answer 18

To translate paradigm into everyday habits but unethical and difficult to test, so instead use of SRHI to measure uncontrollability of maladaptive behaviours is used.

Question 19

What is the role of habits in mental disorders?

Answer 19

Habits are performed in stable triggers and can be linked to attentional processes and maladaptive thought patterns. Can occur despite awareness of negative consequences. Linked to dysfunctional corticostriatal networks. Repeated consumption of alcohol can lead to enhanced general habit propensity. Mixed evidence for habit propensity as a transdiagnostic trait, important in OCD and Tourette’s syndrome. Also important for disorders with compulsivity not as a central characteristic like schizophrenia. Common factors include impaired executive control and stress.

Question 20

How can habits be targeted in therapeutic interventions?

Answer 20

One way is to avoid risk situations and remove trigger stimuli-> habit discontinuity hypothesis. Another is implementation intentions which are if-then plans link a specific context to a desirable instrumental response. Effective due to situation being more highly accessible and the desirable response is triggered when encountered

Question 21

How can maladaptive behaviours be changed through implementation intentions?

Answer 21

They can change unhealthy eating habits, smoking and alcohol consumption and are found to be effective in this. The effectiveness relies on reducing the habit and automaticity of it

Question 22

What has research found about implementation intentions in clinical samples?

Answer 22

Has been found to be effective for symptoms directly related to their disorder, such as in reducing self-harm, increasing attendance in therapy, behavioural activation, and remaining relaxed in stressful circumstances

Question 23

What are some indicators for effectiveness of implementation intentions?

Answer 23

• socially prescribed perfectionism negatively predicts effectiveness (standards set by others)
• urgency in impulsivity which is acting impulsively with negative affect
• those with low executive functioning benefitted from implementation intentions and improving response inhibition

Question 24

How could we incorporate implementation intentions into CBT?

Answer 24

Can support clients in forming if then plans or can be implemented into E-health or self help using a volitional help sheet and link situations to desirable responses. These can be used to reduce rumination as well. Some aspects of II are already embedded in functional analysis and could reduce the need for training of coping skills and could reduce craving and relapse. Better to do so than suppressing the habitual response. But CBT patients are not usually asked to rehearse the if and then structure or imagine the plan. How II can be formulated effectively still needs to be investigated.

Question 25

Which techniques can improve the success of implementation intentions?

Answer 25

• high motivation to obtain goals (can be reinforced by motivational interviewing)
• strategies to increase insight through mental contrasting and a cue monitoring diary
• one II plan at a time rather than formulating multiple plans
• combining II with other treatments like CBM to change automatic biases