Implementation Intentions Facilitate Response Inhibition in Children with ADHD

Psychology of Planning

Planning has been studied in different fields of psychology, including cognitive, developmental, personality, social, and work and organizational research. This article looks at the planning process through the lens of motivation science, and asks the question, What kind of planning can help people reach their goals? We focus on the strategy of making if-then plans (also known as forming implementation intentions). We discuss what kinds of cognitive performance can be enhanced by if-then planning (e.g., attention control, prospective memory, executive functions, and decision making), and whether if-then planning may also benefit people's emotion control, their desired behavior change, and their pending social interactions. We point to the positive impacts of making if-then plans on thinking, feeling, and acting, and we list moderators pertaining to sample characteristics and features of the underlying goals and of the if-then plans themselves. Finally, the underlying processes of if-then planning effects are delineated in the hope of better understanding what kind of if-then planning might work best in promoting flexible but tenacious goal pursuit.

Modal and amodal cognition: an overarching principle in various domains of psychology

Accounting for how the human mind represents the internal and external world is a crucial feature of many theories of human cognition. Central to this question is the distinction between modal as opposed to amodal representational formats. It has often been assumed that one but not both of these two types of representations underlie processing in specific domains of cognition (e.g., perception, mental imagery, and language). However, in this paper, we suggest that both formats play a major role in most cognitive domains. We believe that a comprehensive theory of cognition requires a solid understanding of these representational formats and their functional roles within and across different domains of cognition, the developmental trajectory of these representational formats, and their role in dysfunctional behavior. Here we sketch such an overarching perspective that brings together research from diverse subdisciplines of psychology on modal and amodal representational formats so as to unravel their functional principles and their interactions.

Combatting negative bias: a mental contrasting and implementation intentions online intervention to increase help-seeking among individuals with elevated depressive symptomatology

Background

There are many reasons why individuals with depression may not seek help. Among those with elevated depressive symptomatology, some previous interventions aimed at increasing help-seeking have unintentionally decreased help-seeking intentions. Beck's cognitive theory of depression posits that individuals with elevated depressive symptomatology process information differently from those without depression (i.e., increased cognitive errors, negative bias); potentially explaining the iatrogenic results of previous interventions. Mental contrasting and implementation intentions (MCII; a self-regulatory strategy) interventions have successfully influenced physical and mental health behaviors. However, MCII has not been used specifically for initiating help-seeking for depression. The goal of this research was to ascertain whether an online MCII intervention could increase actual help-seeking or the intention to seek help for depression.

Method

Two online randomized pre-post experiments were conducted to measure the primary outcome measures 2 weeks post-intervention (Study 1 collected Summer 2019: information-only control ["C"], help-seeking MCII intervention ["HS"], and comparison MCII intervention ["E"]; Study 2 collected Winter 2020: "C" and "HS"). At Time 1, adults recruited from MTurk had a minimum Beck Depression Inventory (BDI-II) score of 14 (mild depressive symptoms) and were not seeking professional help.

Results

Study 1 (N = 74) indicated that the intervention was feasible, provided preliminary support, and clarified intervention components for Study 2. Study 2 (N = 224) indicated that the HS group reported greater intentions to seek help and actual help-seeking than the C group. Proportionally, actual help-seeking was more likely among individuals who received the HS intervention and either did not perceive themselves as depressed at Time 2 or had BDI-II scores indicating that their depressive symptomatology decreased from Time 1.

Limitations

Participation was limited to US residents who self-reported data.

Discussion

These studies indicate that a brief online MCII intervention to encourage help-seeking is feasible and preliminarily successful. Future studies should consider using ecological momentary assessment measurements to establish the temporal precedence of intervention effects and whether MCII is effective for encouraging help-seeking among individuals prone to experiencing cognitive errors who may not be experiencing negative bias (e.g., bipolar disorder or anxiety). Clinicians may find this method successful in encouraging ongoing treatment engagement.

Eine Längsschnittstudie zur Vorhersage von ADHS-Symptomen und Schulleistungen in der 1. Klasse durch exekutive Funktionen im Vorschulalter

Zusammenfassung. Theoretischer Hintergrund: Exekutive Funktionen (EF) stehen im Zusammenhang mit ADHS- Symptomen, Vorläuferfertigkeiten und schulischen Leistungen. Fragestellung: Durch Defizite in Inhibition, Arbeitsgedächtnis und Flexibilität im letzten Kindergartenjahr sollen ADHS-Symptome und Schulleistungen am Ende der 1. Klasse vorhergesagt werden. Methode: An einer Längsschnittstudie nahmen 55 Kinder im letzten Kindergartenjahr und am Ende der 1. Klasse teil. Ergebnisse: EF-Defizite im letzten Kindergartenjahr sagen Vorläuferfertigkeiten und ADHS-Symptome zum gleichen Zeitpunkt sowie ADHS-Symptome am Ende der 1. Klasse, nicht aber Schulleistungen vorher. Inhibitionsdefizite hatten einen höheren prädiktiven Wert für ADHS-Symptomen am Ende der 1. Klasse, als Defizite in Arbeitsgedächtnis/Flexibilität. Diskussion und Schlussfolgerung: Ein EF-Defizit Screening könnte deswegen ein wertvoller Ansatzpunkt sein, um Kinder mit einem Risiko für ADHS früh zu identifizieren.

"The Best Laid Plans": Do Individual Differences in Planfulness Moderate Effects of Implementation Intention Interventions?

While there is good evidence supporting the positive effect of planning strategies like implementation intentions on the relationship between intention and behavior, there is less evidence on the moderating role of individual differences in planning capacity on this effect. This study aimed to examine the role of individual differences in planfulness on the effect of planning strategies on the intention-behavior gap. Specifically, this study investigated the influence of planfulness on the effectiveness of implementation intentions on goal-directed behavior using an experimental design. Undergraduate university students (N = 142) with high and low levels of planfulness based on a priori scores on a planfulness measure were randomized to either a planning (implementation intention) or familiarization (control) condition prior to completing a computerized go no-go task. We predicted that individuals reporting low levels of planfulness would be more effective in executing goal-directed behavior when prompted to form an implementation intention compared to individuals who do not receive a prompt. Additionally, we predicted that individuals reporting high planfulness would be equally effective in enacting goal-directed behaviour regardless of whether they formed an implementation intention. The results revealed no main or interaction effects of implementation intention manipulation and planfulness on task reaction times. The current results do not provide support for the moderating effect of planfulness on the implementation effect. The findings of this study were inconsistent with previous literature. This research has implications for the effectiveness of implementation intentions, as well as opportunities for further replication in a novel research area.

The self-regulation of face touching - a preregistered experiment testing if-then plans as a means to promote COVID-19 prevention

Objective: Reducing face touching could help slow COVID-19's spread. We tested whether implementation intentions, a simple-to-use behaviour change intervention, reduce face-touching behaviour effectively.Design: In this pre-registered online study, we utilised a novel way to collect behavioural data during a pandemic. We obtained video recordings of 156 adults while performing three engaging tasks for four minutes each. After the baseline task, participants formed the goal to avoid touching their faces; some participants also formed implementation intentions, targeting either the frequency or duration of face touching.Main Outcome Measures: The 468 videos were rated by two independent raters for face touching frequency and duration.Results: Face touching was widespread. Compared to the baseline, there was a slight reduction in the frequency of face touching after the experimental manipulations. We observed a significant decrease in the length of face touching only for participants with duration-focused implementation intentions.Conclusion: While implementation intentions have effectively downregulated other unwanted behaviours, they did not reduce the frequency of face-touching behaviour. Still, duration-focused implementation intentions appear to be a promising strategy for face-touching behaviour change. This highlights the need for further optimisation and field research to test the effectiveness of implementation intentions in everyday life contexts.

Targeting automatic processes to reduce unhealthy behaviours: a process framework

While previous frameworks to address health behaviours through targeting underlying automatic processes have stimulated an improved understanding of related interventions, deciding between intervention strategies often remains essentially arbitrary and atheoretical. Making considered decisions has likely been hampered by the lack of a framework that guides the selection of different intervention strategies targeting automatic processes to reduce unhealthy behaviours. We propose a process framework to fulfil this need, building upon the process model of emotion regulation. This framework differentiates types of intervention strategies along the timeline of the unfolding automatic response, distinguishing between three broad classes of intervention strategies - direct antecedent, indirect antecedent, and response-focused. Antecedent-focused strategies aim to prevent the exposure to or activation of automatic responses directly through the avoidance of unwanted stimulus-response associations (i.e., situation modification or situation-specific response selection), or indirectly through automatising self-control (i.e., attentional deployment or cognitive change). Response-focused strategies aim to directly downregulate automatic unwanted responses (i.e., response modulation). Three main working hypotheses derived from this process framework provide practical guidance for selecting interventions, but await direct testing in future studies.

How to Remember Something You Didn't Say

When individuals suppress secret information, they should keep this omission in mind to not let this information slip out in future situations. Following recent findings about automatic memory retrieval of outright lies, we hypothesized that suppression tendencies are also automatically retrieved from memory when being confronted with a question to which one has previously omitted secret information. In an online study, participants first had to withhold information about a fictitious love affair during a simulated chat with their relationship partner. To assess automatic suppression tendencies, we developed an indirect response time measure wherein a key that had previously been established to indicate suppression now had to be pressed in response to word stimuli that were presented in a specific color. We found implicit suppression tendencies for words that had been withheld during the interview if they were presented following the prime that involved the question which the secret answer referred to. The question primes or the secret information alone did not elicit a suppression tendency, indicating that suppression responses were automatically retrieved from memory after re-encountering the combination of the question and the critical answer. The results are discussed regarding the theoretical implications for automatic memory processes.

Evidence That Implementation Intentions Enhance Cognitive Training and Reduce Alcohol Consumption in Heavy Drinkers: A Randomized Trial

BACKGROUND

Current training tasks to improve the cognitive deficits thought to be involved in sustained heavy drinking need further investigation to optimize their effectiveness.

PURPOSE

The present study investigated whether combining implementation intention provision with a cognitive training task had a measurable effect on alcohol consumption in heavy drinkers and explored the neural mechanisms underpinning any reductions in subsequent alcohol consumption.

METHODS

Thirty-two heavy-drinking participants completed approach-avoidance and visual probe training tasks preintervention and postintervention during functional Magnetic Resonance Imaging. Participants in the intervention group were randomized to form implementation intentions and participants in the control condition read a goal intention. Alcohol consumption was recorded preintervention and at 1 month follow-up.

RESULTS

Compared to the control group, implementation intention provision significantly improved performance on alcohol-avoidance tasks postintervention, t(30) = -2.315, p = .028, d = .85, and reduced alcohol consumption by 6.9 units/week (1 unit = 10 mL or 8 g ethanol), F(1,30) = 4.263, p = .048 (d = .74), at follow-up. However, the analysis of functional Magnetic Resonance Imaging data revealed no significant differences between groups.

CONCLUSIONS

These findings show for the first time that implementation intentions targeting cognitive processes can significantly reduce alcohol consumption among heavy drinkers. However, there was no evidence that the effects were mediated by changes in neural activity. Further work is required to explore the neural mechanisms underpinning the operation of implementation intentions.

TRIAL REGISTRATION

This trial was registered (ISRCTN:35503634) and is available at https://www.isrctn.com/ISRCTN35503634.

Implementation Intentions Related to Self-Regulatory Processes Do Not Enhance Learning in a Multimedia Environment

Learners face various obstacles during learning from illustrated texts that can be conceptualized against the backdrop of frameworks of self-regulated learning. According to these frameworks, for learning to be successful, students must use appropriate cognitive strategies, hold adequate self-efficacy beliefs, and invest sufficient effort in learning. We investigated whether implementation intentions (if-then-plans) relating to these self-regulatory processes improve learning in a multimedia environment and whether they differ in their effectiveness depending on the self-regulatory process that they address. Learners were either asked to internalize an implementation intention relating to cognitive strategies, self-efficacy beliefs, or effort, or they did not receive any instructional support (control condition). Then, they learned about a mechanical system from a multimedia message and finally were tested on the learned contents. Contrary to expectations, none of the implementation intentions increased learning outcome, compared with the control condition, nor did the conditions differ from each other. However, implementation intentions interacted with the self-efficacy beliefs that learners already held. Higher self-efficacy beliefs were associated with better learning outcome, unless learners received an implementation intention telling them to use a multimedia-specific cognitive strategy. Interfering cognitive processes are discussed as a possible explanation for this interaction. In summary, implementation intentions should be further investigated and optimized before they can be implemented in real-life learning contexts.

Schoolchildren's Compensatory Strategies and Skills in Relation to Attention and Executive Function App Training

BACKGROUND

Given the importance of attention and executive functions (EF) in children's behavior, programs aimed at improving these processes are of special interest. Nexxo-training combines the use of the Nexxo touchscreen application (inhibition and vigilance tasks) with procedural metacognitive strategies (imparted by an instructor) for all the individuals using the app, regardless of their level of ability, plus compensatory strategies based on individual child performance. This study presents an analysis of the compensatory strategies that schoolchildren (aged 6-8 years old) receive when experiencing difficulties with EF tasks, in addition to an analysis of the developmental factors and cognitive skills that may modulate EF task performance.

METHODS

For this study, we use data from a previous randomized active-controlled study (under review), in which forty-six typically developing children aged between 6 and 8 years old (24 girls/22 boys) were enrolled in the training group. The selected children were in the 1st grade (n = 28, x ¯ = 78.32 ± 4.037 months) and 3rd grade of primary education (n = 18, x ¯ = 102.11 ± 3.445). We collected data on EF training performance, compensatory strategies needed and neuropsychological assessments.

RESULTS

A total of 80.43% participants required some form of compensatory strategy during training. Regarding required compensatory strategies, those who had lower scores in EF training needed more compensatory strategies, in particular, instructional comprehension (r = -0.561, p < 0.001 for inhibition-tasks; r = -0.342, p < 0.001 for vigilance-tasks). Concerning developmental factors, age significantly predicted better performance in both EF tasks (β = 0.613, p < 0.001 for inhibition; β = 0.706, p < 0.001 for attention). As regards task performance, those with better performance in inhibition tasks also had better performance in vigilance tasks (r = 0.72, p < 0.001). Finally, regarding cognitive skills, participants with higher performance in fluid intelligence (Q1, n = 12) had higher scores (U = 14.5, p < 0.05) than the group with the lowest performance (Q4, n = 11) in vigilance.

CONCLUSION

As previous literature suggests, inhibition is one of the core processes of EF. Therefore, we should focus training on the core EF processes. Inhibition and vigilance are closely related processes. In terms of the use of compensatory strategies, these are more needed for participants with lower levels of performance in inhibition or vigilance. Regarding strategy analysis, instructional comprehension and self-instruction (goal setting and planning) seem to be the most useful strategies for those with difficulties in inhibitory and vigilance task performance. Regarding development, as expected, age moderates task performance in inhibition and attention. Finally, cognitive skills, such as fluid intelligence and cognitive flexibility, predicted better results in attention. EF training using not only an app, but also compensatory strategies based on user performance, is a new research direction offering more opportunities to generalize EF training in everyday life.

An experimental investigation of breaking learnt habits with verbal implementation intentions

The interplay between inflexible habits and flexible goal-directed control can be modelled in lab-settings using the slips-of-action task. In this task, participants are required to selectively respond to still-valuable outcomes while suppressing responding towards no-longer valuable outcomes, thereby overriding learned stimulus-response associations. Here we examined in the slips-of-action task whether learnt habits can be changed using a planning technique - so-called implementation intentions - whereby people instruct themselves to enact a certain behaviour (or not) in the presence of a specific critical stimulus. Such simple 'if-then' instructions have previously been shown to support behavioural change in real-life settings, possibly because people verbally create new stimulus-response associations. Across four experiments we manipulated the intrinsic value of the stimuli and outcomes in the slips-of-action task: abstract stimuli and outcomes (Experiment 1), snack food stimuli and outcomes (Experiment 2), or a combination of both types (Experiment 3-4). Implementation intentions improved the ability to suppress previously learnt responses towards no-longer-valuable abstract outcomes (Experiment 1 and 3). However, when snacks were used as outcomes (Experiment 2 and 4) no beneficial effect of implementation intentions versus goal intentions was observed. The slips-of-action task is thus sensitive to planning techniques under certain circumstances. Yet, the absence of effects when using snacks as outcomes implies the possible importance of its hedonic outcome value for implementation intentions' effectiveness, which warrants further investigation.

Promoting Mental Health in Unaccompanied Refugee Minors: Recommendations for Primary Support Programs

During the last years, the number of refugees around the world increased to about 22.5 million. The mental health of refugees, especially of unaccompanied minors (70% between the ages of 16 and 18 years) who have been exposed to traumatic events (e.g., war), is generally impaired with symptoms of post-traumatic stress disorder, depression, and anxiety. Several studies revealed (1) a huge variation among the prevalence rates of these mental problems, and (2) that post-migration stressors (e.g., language barriers, cultural differences) might be at least as detrimental to mental health as the traumatic events in pre- and peri-flight. As psychotherapy is a limited resource that should be reserved for severe cases and as language trainings are often publicly offered for refugees, we recommend focusing on intercultural competence, emotion regulation, and goal setting and goal striving in primary support programs: Intercultural competence fosters adaptation by giving knowledge about cultural differences in values and norms. Emotion regulation regarding empathy, positive reappraisal, and cultural differences in emotion expression fosters both adaptation and mental health. Finally, supporting unaccompanied refugee minors in their goal setting and goal striving is necessary, as they carry many unrealistic wishes and unattainable goals, which can be threatening to their mental health. Building on these three psychological processes, we provide recommendations for primary support programs for unaccompanied refugee minors that are aged 16 to 18 years.

Spatiotemporal brain dynamics supporting the immediate automatization of inhibitory control by implementation intentions

While cognitive interventions aiming at reinforcing intentional executive control of unwanted response showed only modest effects on impulse control disorders, the establishment of fast automatic, stimulus-driven inhibition of responses to specific events with implementation intention self-regulation strategies has proven to be an effective remediation approach. However, the neurocognitive mechanisms underlying implementation intentions remain largely unresolved. We addressed this question by comparing electrical neuroimaging analyses of event-related potentials recorded during a Go/NoGo task between groups of healthy participants receiving either standard or implementation intentions instructions on the inhibition stimuli. Inhibition performance improvements with implementation intentions were associated with a Group by Stimulus interaction 200–250 ms post-stimulus onset driven by a selective decrease in response to the inhibition stimuli within the left superior temporal gyrus, the right precuneus and the right temporo-parietal junction. We further observed that the implementation intentions group showed already at the beginning of the task the pattern of task-related functional activity reached after practice in the group having received standard instructions. We interpret our results in terms of an immediate establishment of an automatic, bottom-up form of inhibitory control by implementation intentions, supported by stimulus-driven retrieval of verbally encoded stimulus-response mapping rules, which in turn triggered inhibitory processes.

Health, Dietary Habits, and Achievement Motivation in College Students With Self-Reported ADHD Diagnosis

OBJECTIVE

The present study aimed to investigate aspects of health and motivation in a subpopulation of college students with ADHD.

METHOD

Seventy-seven college students with self-reported ADHD (49 women; M age = 25.82, SD = 4.62) and 120 college students without ADHD (65 women; M age = 25.17, SD = 5.41) participated in an online survey assessing their health, dietary habits, and achievement motivation.

RESULTS

College students with ADHD showed impairment in psychological functioning, impairment in their mental health, and reported more ambition and less self-control. Furthermore, we found gender differences: Women with ADHD reported worse psychological functioning, and the gender differences in obsessive-compulsive behavior and compensatory effort were mediated by the timing of diagnosis.

CONCLUSION

College students, especially women, with ADHD struggle with health-related issues. Some of these gender differences might be due to under diagnosis of girls in childhood. Differences in achievement motivation might indicate compensatory mechanisms.

Self-regulation interventions to reduce consumption of sugar-sweetened beverages in adolescents

This study evaluated the efficacy of self-regulation interventions through the use of drink-specific implementation intentions and drink-specific Go/No-Go training tasks as compensatory strategies to modify inhibitory control to reduce intake of sugar-sweetened beverages (SSB). In a between-subjects randomized manipulation of implementation intentions and Go/No-Go training to learn to inhibit sugary drink consumption, 168 adolescents reporting inhibitory control problems over sugary drinks and foods were recruited from high schools in southern California to participate. Analysis of covariance overall test of effects revealed no significant differences between the groups regarding calories consumed, calories from SSBs, grams of sugar consumed from drinks, or the number of unhealthy drinks chosen. However, subsequent contrasts revealed SSB implementation intentions significantly reduced SSB consumption following intervention while controlling for inhibitory control failure and general SSB consumption during observation in a lab setting that provided SSBs and healthy drinks, as well as healthy and unhealthy snacks. Specifically, during post-intervention observation, participants in the sugar-sweetened beverage implementation intentions (SSB-II) conditions consumed significantly fewer calories overall, fewer calories from drinks, and fewer grams of sugar. No effects were found for the drink-specific Go/No-Go training on SSB or calorie consumption. However, participants in SSB-II with an added SSB Go/No-Go training made fewer unhealthy drink choices than those in the other conditions. Implementation intentions may aid individuals with inhibitory (executive control) difficulties by intervening on pre-potent behavioral tendencies, like SSB consumption.

Physical Activity, Affect, and Cognition in Children With Symptoms of ADHD

OBJECTIVE

To examine the role of physical activity in determining the affect and executive functioning of children with symptoms of ADHD.

METHOD

In Study 1, the association between physical activity and affect in the daily lives of children with varying degrees of hyperactivity was examined. In Study 2, children with ADHD were randomly assigned a physical activity or a sedentary task before working on a task requiring executive control.

RESULTS

Lack of physical activity was shown to relate to depressed affect, more strongly in participants with severe hyperactivity symptoms (Study 1). The physically active participants showed improved executive functioning after only 5 min of vigorous activity; the sedentary control participants showed no improvement (Study 2).

CONCLUSION

These results indicate that interventions to increase the level of physical activity in children with and without ADHD might improve affect and executive functioning.

“Turning Intentions Into Actions”

Contemporary models of attention-deficit/hyperactivity disorder (ADHD) provide frameworks for understanding this condition that move beyond the diagnostic symptom criteria. ADHD is currently viewed as a developmental syndrome of impaired self-regulatory processes that underlie the common symptoms and functional problems. Most clinic-referred adults with ADHD report chronic difficulties executing their intended plans despite recognizing the negative consequences for not doing so. Seeing as the psychosocial treatments for adult ADHD intervene at the level of life impairments and functioning, it is important that interventions directly target these implementation problems. The goal of this article is to discuss the case of a young woman with ADHD who has difficulties engaging in the various tasks she needs to perform to pursue her post-college goals. In particular, a cognitive-behavioral therapy approach that emphasizes implementation strategies designed to help adults with ADHD follow through on their plans is illustrated.

Understanding Activity Limitations in Depression

Behavioral activation plays an important role in the treatment of depression. Although the development of activation treatments has made important progress in the past decades, effects are still low to moderate. This paper illustrates how the understanding and treatment of activity limitations in depression can be improved through the integration of theories from health psychology. One of the leading theories is the health action process approach (HAPA; Schwarzer, Lippke, & Luszczynska, 2011 ). In accordance with the HAPA, we argue that reasons for activity limitations can be divided into problems of intention formation (motivational problems) and problems of intention implementation (volitional problems). To date, depression research has primarily focused on motivational deficits. With regard to the HAPA, we discuss different aspects of motivational deficits by reviewing common constructs such as negative thoughts, learned helplessness, loss of reinforcers, or self-efficacy. In addition, we demonstrate that volitional deficits are also important for explaining activity limitations and should be taken into account more. Volitional deficits in depression are documented by behavior studies focusing on self-regulation and procrastination; additionally, evidence of volitional deficits has been found in research on executive functions and in neurobiology. In conclusion, the HAPA contributes to a better understanding of activity limitations in depression: The reviewed literature demonstrates that depression is associated with motivational and volitional deficits. Each of these two kinds of deficits should be treated with a different intervention technique (e.g., values assessment vs. activity scheduling). Beyond this relevance for clinical psychology, implications for health psychology are discussed.

The Addict in Us all

In this paper, we contend that the psychology of addiction is similar to the psychology of ordinary, non-addictive temptation in important respects, and explore the ways in which these parallels can illuminate both addiction and ordinary action. The incentive salience account of addiction proposed by Robinson and Berridge (1-3) entails that addictive desires are not in their nature different from many of the desires had by non-addicts; what is different is rather the way that addictive desires are acquired, which in turn affects their strength. We examine these "incentive salience" desires, both in addicts and non-addicts, contrasting them with more cognitive desires. On this account, the self-control challenge faced by addicted agents is not different in kind from that faced by non-addicted agents - though the two may, of course, differ greatly in degree of difficulty. We explore a general model of self-control for both the addict and the non-addict, stressing that self-control may be employed at three different stages, and examining the ways in which it might be strengthened. This helps elucidate a general model of intentional action.

The best laid plans: planning skill determines the effectiveness of action plans and implementation intentions

BACKGROUND

Theories of action control emphasise the importance of planning, but plans are not universally beneficial.

PURPOSE

The present study investigates whether the effectiveness of plans depends upon the skill of the planner.

METHODS

Study 1 prospectively predicted changes in unhealthy snacking behaviour over 1 week from intentions, action planning and performance on a standardised cognitive test of planning skill (n = 72). Study 2 experimentally randomised skilled and poor planners to receive (or not) a planning intervention before completing an online food diary (n = 144) RESULTS: Spontaneously generated action plans about snacking explained significantly more variance in subsequent snacking if produced by a skilled rather than a poor planner. The planning intervention (implementation intention) significantly improved goal attainment but only in poor planners.

CONCLUSIONS

Plans are only as good as the people who make them. Poor planners' plans do not help achieve goals. Planning interventions can compensate for a lack of planning skill.

Enhancing inhibition: how impulsivity and emotional activation interact with different implementation intentions

Implementation intentions, a strategy in which a strong link is created between a cue and a to-be-performed action, have been shown to be efficacious in improving self-regulation. The relative efficacy of verbal and visual implementation intentions, however, has yet to be determined. Implementation intentions have also been shown to be inefficacious in participants with high impulsivity, specifically in individuals who reported having a high tendency to commit rash or regrettable actions as a result of intense affect (high urgency). Nevertheless, previous studies did not assess whether the individuals were in an emotional context at the time of the experiment. In the current study, we compared different forms of implementation intentions (verbal/visual/combined verbal-visual) on a computerized inhibition task while assessing impulsivity and emotional activation. The results showed that all types of implementation intentions improved inhibition performances significantly in participants with high urgency, but only when their emotional activation was low. There was no difference between the three types of implementation intentions.

Self-regulation strategies support children with ADHD to overcome symptom-related behavior in the classroom

Children with attention deficit hyperactivity disorder (ADHD) suffer from self-regulation deficits that cause inattention, impulsivity, and hyperactivity. Self-regulation interventions may address these deficits, but to date, only few empirical studies have examined their benefits for children with ADHD in everyday life. The present study investigated three classroom interventions to promote self-regulation and tested their benefit on self-regulatory competencies (assessed with an ADHD questionnaire) in children with ADHD. Students of a special education school for children with ADHD participated in the intervention study that included three sessions (Session 1: Goal Intention or Goal Intention + If-Then Plan; Session 2: Goal Intention + If-Then Plan; Session 3: Goal Intention + If-Then Plan + Self-Monitoring). Teacher-rated self-regulatory competencies were assessed both before and after the intervention sessions. Children with ADHD had better self-regulatory competencies after their first Goal Intention + If-Then Plan Session, but lasting intervention effects were found only when children started with a mere goal intention session.

Furnishing hypnotic instructions with implementation intentions enhances hypnotic responsiveness

Forming implementation intentions has been consistently shown to be a powerful self-regulatory strategy. As the self-regulation of thoughts is important for the experience of involuntariness in the hypnotic context, investigating the effectiveness of implementation intentions on the suppression of thoughts was the focus of the present study. Participants were randomly assigned to one of four conditions (hypnotic instruction plus implementation intention, hypnotic instruction, implementation intention, and control condition). Results showed that participants who received information included in the "Carleton Skill Training Program" and in addition formed implementation intentions improved their hypnotic responsiveness as compared to all of the other three groups on measures of objective responding and involuntary responding. Thus, in line with the nonstate or cognitive social-psychological view of hypnosis stating that an individual's hypnotic suggestibility is not dispositional but modifiable, our results suggest that hypnotic responsiveness can be heightened by furnishing hypnotic instructions with ad hoc implementation intentions.

“Without a Net”

It is currently recognized that attention deficit/hyperactivity disorder (ADHD) persists into adulthood for more than half of affected individuals. ADHD in adulthood is associated with impairments in most adult roles. Medications are considered an effective treatment for the core symptoms of ADHD. Adjunctive psychosocial treatment, primarily cognitive-behavioral therapy (CBT), is efficacious in cases of residual symptoms and impairments. However, a minority of adults with ADHD may not be able to take medications due to medical contraindications, nonresponse, or intolerable side effects. The goal of this article is to discuss the case of an adult with ADHD who is unable to take medications for ADHD due to cardiac risk. The patient sought a course of CBT for adult ADHD to address difficulties he experienced at work and in his home life. His case illustrates the challenges of and opportunities for CBT for adult ADHD without medications.

"Instant success": turning temptations into cues for goal-directed behavior

Contrary to lay intuition, counteractive control theory posits that tempting food cues can help individuals to act in accordance with their long-term dieting goal. However, studies have shown that temptations trigger goal-directed behavior only in successful but not in unsuccessful self-regulators. The aim of the present study was to test whether it is possible to create facilitated temptation-goal associations in unsuccessful dieters using implementation intentions (e.g., "If I see or smell chocolate then I will follow my goal to diet") and whether this indeed stimulates more successful self-regulation. It was found that implementation intentions linking a temptation to a dieting goal lead to self-perceived improved resistance to (Study 1) as well as reduced consumption (Study 2) of tempting snacks compared to a control condition. Moreover, Study 2 revealed that the reduced snack consumption was indeed related to facilitated temptation-goal associations in participants who had formed implementation intentions.

Breaking Habits With Implementation Intentions: A Test of Underlying Processes

Implementation intentions specifying the replacement of a habitual response with an alternative response in a critical situation can overrule habits. In three experiments the cognitive effects of such counterhabitual implementation intentions were investigated. Results showed that implementation intentions eliminated the cognitive advantage of the habitual means in the “horse race” with the alternative response. That is, in the control condition, the habitual means was more accessible than the alternative means on encountering the critical situation, but this was no longer the case when implementation intentions were formulated. However, the cognitive advantage of the habitual means was not immediately replaced by an automatic activation of the alternative means. This suggests that formulating counterhabitual implementation intentions increases individuals’ flexibility to choose which behavior to perform in the critical situation but that actual behavior will depart from their habits only to the extent that individuals have strong alternative goal intentions.

Kognitive Kontrolle und Selbstregulation bei Kindern mit ADHS

Kinder mit ADHS sind unaufmerksam, impulsiv und hyperaktiv, was zu Lern- und Leistungsstörungen sowie zu Schwierigkeiten im Umgang mit Eltern, Lehrern und Gleichaltrigen führt. Aktuell wird ADHS im Zusammenhang mit Selbstregulationsdefiziten diskutiert. Demzufolge gehen die Probleme der von ADHS Betroffenen auf mangelnde Selbstregulationsfähigkeiten sowie defizitäre exekutive Funktionen und dabei vor allem auf mangelnde kognitive Kontrolle zurück. Folglich erscheinen Interventionen, die auf die Förderung der Selbstregulation abzielen (z. B. Wenn-Dann-Pläne) als vielversprechend für die Besserung einer ADHS-Symptomatik.