Weakness of the will: Is a quick fix possible?

WOOP as a Brief Alcohol Intervention Led by Lay Coaches in College Settings

Heavy drinking is a major public health concern, particularly among young adults who often experience fear of being stigmatized when seeking help for alcohol-related problems. To address drinking concerns outside clinical settings, we tested the feasibility of a novel imagery-based behavior change strategy led by student lay interventionists in a college setting. Participants were adults recruited on a college campus and were randomized to either learn the four steps of WOOP (Wish, Outcome, Obstacle, and Plan) or to learn a format-matched Sham WOOP (Wish, Outcome, "Outcome," and Plan). Both WOOP and Sham WOOP interventions were taught by student lay interventionist. We found that the WOOP intervention group reported fewer heavy drinking days (≥ 5 drinks for men or ≥ 4 drinks for women, measured using the Alcohol Timeline Follow-Back Method) compared to the Sham group at the 1-month and 2-month follow-ups. WOOP, when taught by student lay interventionists in a single session, demonstrated the feasibility of reducing heavy drinking. WOOP shows promise as a low-cost and scalable intervention for reducing heavy drinking in nonclinical settings.

Does forming an implementation intention lead individuals to spontaneously use visual mental imagery?

Planning through implementation intention involves forming mental representations of a goal-relevant situation and a goal-directed behavior. The main objective of this study was to determine whether mental representations during conscious planning with if-then plan were spontaneously visualized. The sample included 205 participants, asked to perform an easy vs. difficult pro-environmental behavior. They formed an if-then plan vs. a goal intention and were asked whether they spontaneously used mental imagery. Seven days after, 109 participants reported the number of behaviors they performed. The perceived difficulty of the behavior did not differ significantly, this variable was excluded from analyses. A logistic regression was performed and showed that participants who formed an if-then plan used significantly more spontaneous mental imagery compared to goal intention participants. ANCOVAs also revealed that they reported more behaviors than participants who formed a goal intention. However, participants who spontaneously visualized their if-then plan did not report more goal attainment than other participants. This result, which suggests a distinction between spontaneous and instructed visualization (i.e. explicitly requiring participants to visualize their plan), is discussed.

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.

Leveraging cognitive neuroscience for making and breaking real-world habits

Habits are the behavioral output of two brain systems. A stimulus-response (S-R) system that encourages us to efficiently repeat well-practiced actions in familiar settings, and a goal-directed system concerned with flexibility, prospection, and planning. Getting the balance between these systems right is crucial: an imbalance may leave people vulnerable to action slips, impulsive behaviors, and even compulsive behaviors. In this review we examine how recent advances in our understanding of these competing brain mechanisms can be harnessed to increase the control over both making and breaking habits. We discuss applications in everyday life, as well as validated and emergent interventions for clinical populations affected by the balance between these systems. As research in this area accelerates, we anticipate a rapid influx of new insights into intentional behavioral change and clinical interventions, including new opportunities for personalization of these interventions based on the neurobiology, environmental context, and personal preferences of an individual.

Implemental delay as a mediator of the relationship between depression, anxiety, stress and school burnout

INTRODUCTION

Research following the COVID-19 pandemic points to many problems related to adolescents' mental condition, their coping with the organization of daily life and the implementation of school duties, which can lead to school burnout. It includes absenteeism, decreased motivation and academic performance, and a cynical attitude toward peers and teachers. A significant way to protect adolescents' mental health may be by teaching them to complete their daily duties. Still, an obstacle is the observable post-pandemic, increasing tendency to procrastinate, which can exacerbate the effects of school burnout. The study aimed to establish the impact of depression, anxiety and stress on school burnout mediated by procrastination, understood as implemental procrastination.

METHOD

Three questionnaires were used: Depression, Anxiety and Stress Scale, Implemental Delay Scale, and School burnout scale. The study comprised 344 students (57,6% females) from Polish secondary schools (high schools and technical schools), aged 14-20 years (M = 16.69; SD = 1.74). The analysis of relationships between variables studied was performed with the mediation model.

RESULTS

Analyses confirmed the mediating effect of implemental delay on the relationship between depression, stress and school burnout. Unexpectedly, it turned out that the burnout resulting from parental pressure significantly weakened the value of the mediator (implemental delay). In contrast, the value of the predictors (depression and stress) increased. Anxiety was found to be a nonsignificant predictor of school burnout.

CONCLUSION

The data show that stress, depression and procrastination influence school burnout, which depends mainly on the dimension of burnout. Awareness of these relationships can support the creation of specialized prevention programs, allowing students to overcome their problems. At the same time, parents and teachers may help them understand the nature of observed disorders, which has little to do with laziness often attributed to young people.

Cultural Defaults in the Time of COVID: Lessons for the Future

Five years after the beginning of the COVID pandemic, one thing is clear: The East Asian countries of Japan, Taiwan, and South Korea outperformed the United States in responding to and controlling the outbreak of the deadly virus. Although multiple factors likely contributed to this disparity, we propose that the culturally linked psychological defaults ("cultural defaults") that pervade these contexts also played a role. Cultural defaults are commonsense, rational, taken-for-granted ways of thinking, feeling, and acting. In the United States, these cultural defaults include optimism and uniqueness, single cause, high arousal, influence and control, personal choice and self-regulation, and promotion. In Japan, Taiwan, and South Korea, these defaults include realism and similarity, multiple causes, low arousal, waiting and adjusting, social choice and social regulation, and prevention. In this article, we (a) synthesize decades of empirical research supporting these unmarked defaults; (b) illustrate how they were evident in the announcements and speeches of high-level government and organizational decision makers as they addressed the existential questions posed by the pandemic, including "Will it happen to me/us?" "What is happening?" "What should I/we do?" and "How should I/we live now?"; and (c) show the similarities between these cultural defaults and different national responses to the pandemic. The goal is to integrate some of the voluminous literature in psychology on cultural variation between the United States and East Asia particularly relevant to the pandemic and to emphasize the crucial and practical significance of meaning-making in behavior during this crisis. We provide guidelines for how decision makers might take cultural defaults into account as they design policies to address current and future novel and complex threats, including pandemics, emerging technologies, and climate change.

Creating a psychosocial intervention combining growth mindset and implementation intentions (GMII) to reduce alcohol consumption: A mixed method approach

This work aimed at creating a psychosocial intervention based on growth mindset theory and implementation intention strategies, in order to reduce alcohol consumption among users in the general population, and the clinical population of individuals with alcohol use disorder. A mixed method approach was used, combining qualitative and quantitative research methods among both populations. Four focus groups were first conducted to extract arguments in favor of a malleable view of alcohol consumption (study 1A), situations that trigger the desire to drink alcohol, as well as strategies used by people to counteract this need (study 1B). Data were analyzed using reflective thematic analysis in line with the scientific literature on alcohol consumption. The results were used to create a questionnaire scoring the relevance of each argument, situation and strategy (study 2). The 20 best scored arguments, situations and strategies were selected to create the intervention. The created intervention consisted in a popularized scientific article describing alcohol consumption as malleable, including the selected arguments and followed by two internalization exercises. Then, a volitional help sheet included the selected situations and solutions was presented, allowing forming up to three plans. The discussion focused on the added value of the created material compared to pre-existing tools in the literature, and presents plans to test the intervention in a future study.

Efficacy of a physiotherapy, yoga and patient education programme for patients with breast cancer and hormone therapy-induced pain: a multicentre randomised study protocol (SKYPE 2)

INTRODUCTION

Osteoarticular pain is experienced by approximately 50% of patients with breast cancer under hormone therapy and can increase the risk of therapy discontinuation. Among complementary therapies, yoga has shown efficacy regarding reduction of fatigue, anxiety, pain due to hormone therapy and inflammation. Personalised patient education programmes increase engagement and motivation, and induce effective behavioural changes. The SKYPE programme, an integrated intervention combining physiotherapy, yoga and patient education, showed promising efficacy on hormone therapy-induced pain in a previous pilot study. In this study, we hypothesised that using theory-based patient education favour learning and practising 15 min of at-home yoga every day to decrease hormone therapy-induced pain.

METHODS AND ANALYSIS

This multicentre randomised study will assess the efficacy of the SKYPE programme on pain reduction compared with standard care in patients with breast cancer reporting osteoarticular pain due to hormone therapy. Main secondary objectives will describe pain evolution and characteristics, patient adhesion to yoga sessions and home practice, forward flexibility, quality of life, fatigue, anxiety and compliance to hormone therapy. Patients in the intervention group will participate in 1 weekly educational yoga session of 90 min for 6 weeks, supervised by physiotherapists (period 1). They will also perform daily at-home 15 min yoga sessions for 12 weeks, the total duration of the intervention (periods 1 and 2). Pain will be evaluated during physiotherapy check-ups at baseline (T0), at 6 weeks (T1) and at 12 weeks (T2).

ETHICS AND DISSEMINATION

This study was approved by the ethics committee (CPP Ile de France 8 on 22 June 2020). The results will be disseminated to patients and healthcare professionals, and published in a peer-reviewed journal.

TRIAL REGISTRATION NUMBER

NCT04457895.

Instant habits versus flexible tenacity: Do implementation intentions accelerate habit formation?

Implementation intentions (strategic "if-then" plans) have been shown to support behaviour change. This may be achieved by mentally forming stimulus-response associations, thereby promoting habit formation. Does this deliberate attempt to instal "strategic automaticity" only offer advantages, or does it also come at the cost of reduced flexibility that characterises learnt habits? To investigate this, we tested healthy, young participants on a computerised instrumental learning task. Critically, we introduced implementation intentions ("if I see stimulus X, then I will respond") versus goal intentions ("for outcome Z, I will respond)" during instrumental acquisition, and subsequently assessed behavioural flexibility in an outcome-revaluation test. In Experiment 1, we conducted a between-subjects manipulation of strategic planning, and in Experiment 2, a within-subject manipulation. We hypothesised that implementation intentions would lead to strong stimulus-response associations and consequently impair performance when the signalled outcome value changed and therefore required a different response, while benefitting performance when the outcome value (and required response) remained the same. We found that implementation intentions supported instrumental learning, but impaired test performance overall (most robustly in Experiment 2), irrespective of whether the signalled outcome value had changed. We argue that this general detrimental effect of implementation intentions on test performance is likely a consequence of their negative effect on stimulus-outcome learning. Our findings warrant caution when applying if-then plans to situations where the agent does not already possess perfect knowledge of behavioural contingencies.While implementation intentions may support efficient and fast behavioural execution, this may come at the expense of behavioural flexibility.

Improving goal striving and resilience in older adults through a personalized metacognitive self-help intervention: a protocol paper

BACKGROUND

Successful aging is often linked to individual's ability to demonstrate resilience: the maintenance or quick recovery of functional ability, well-being, and quality of life despite losses or adversity. A crucial element of resilience is behavioral adaptability, which refers to the adaptive changes in behavior in accordance with internal or external demands. Age-related degradation of executive functions can, however, lead to volition problems that compromise flexible adjustment of behavior. In contrast, the reliance on habitual control has been shown to remain relatively intact in later life and may therefore provide an expedient route to goal attainment among older adults. In the current study, we examine whether a metacognitive self-help intervention (MCSI), aimed at facilitating goal striving through the gradual automatization of efficient routines, could effectively support behavioral adaptability in favor of resilience among older adults with and without (sub-clinical) mental health problems.

METHODS

This metacognitive strategy draws on principles from health and social psychology, as well as clinical psychology, and incorporates elements of established behavioral change and activation techniques from both fields. Additionally, the intervention will be tailored to personal needs and challenges, recognizing the significant diversity that exist among aging individuals.

DISCUSSION

Despite some challenges that may limit the generalizability of the results, our MCSI program offers a promising means to empower older adults with tools and strategies to take control of their goals and challenges. This can promote autonomy and independent functioning, and thereby contribute to adaptability and resilience in later life.

TRIAL REGISTRATION

Pre-registered, partly retrospectively. This study was pre-registered before the major part of the data was collected, created, and realized. Only a small part of the data of some participants (comprising the baseline and other pre-intervention measures), and the full dataset of the first few participants, was collected prior to registration, but it was not accessed yet. See: https://osf.io/5b9xz.

Activation Versus Change as a Principle Underlying Intervention Strategies to Promote Health Behaviors

BACKGROUND AND PURPOSE

Interventions are effective in promoting health behavior change to the extent that (a) intervention strategies modify targets (i.e., mechanisms of action), and (b) modifying targets leads to changes in behavior. To complement taxonomies that characterize the variety of strategies used in behavioral interventions, we outline a new principle that specifies how strategies modify targets and thereby promote behavior change. We distinguish two dimensions of targets-value (positive vs. negative) and accessibility (activation level)-and show that intervention strategies operate either by altering the value of what people think, feel, or want (target change) or by heightening the accessibility of behavior-related thoughts, feelings, and goals (target activation).

METHODS AND RESULTS

We review strategies designed to promote target activation and find that nudges, cue-reminders, goal priming, the question-behavior effect, and if-then planning are each effective in generating health behavior change, and that their effectiveness accrues from heightened accessibility of relevant targets. We also identify several other strategies that may operate, at least in part, via target activation (e.g., self-monitoring, message framing, anticipated regret inductions, and habits).

CONCLUSIONS

The Activation Vs. Change Principle (AVCP) offers a theoretically grounded and parsimonious means of distinguishing among intervention strategies. By focusing on how strategies modify targets, the AVCP can aid interventionists in deciding which intervention strategies to deploy and how to combine different strategies in behavioral trials. We outline a research agenda that could serve to further enhance the design and delivery of interventions to promote target activation.

Brief self-affirmation intervention for adults with psoriasis for reducing anxiety and depression and boosting well-being: Evidence from a randomized controlled trial

BACKGROUND

There are relatively few studies to address mental health implications of self-affirming, especially across groups experiencing a chronic health condition. In this study, short- and longer-term effects of a brief self-affirmation intervention framed in terms of implementation intentions (if-then plans with self-affirming cognitions; S-AII) were evaluated against an active control group (non-affirming implementation intentions; N-AII), matched to the target condition, and mere goal intention condition (a non-active control) in adults with psoriasis. The three pre-registered primary outcomes captured depression, anxiety, and well-being.

METHODS

Adults with psoriasis (N = 175; M_age = 36.53, s.d. = 11.52) were randomized into S-AII, N-AII, or control. Participants' mental health outcomes were assessed prior to randomization (at baseline), at week 2 (post-intervention), and at a 1-month follow-up.

RESULTS

Linear mixed models were used and results were reported on the intention-to-treat principle. Analyses revealed that S-AII exerted significantly more improvement in the course of well-being (ds > 0.25), depressive symptoms (ds > -0.40), and anxiety (ds > -0.45) than the N-AII and control group at 2-week post-intervention. Though the differences between groups faded at 1-month follow-up, the within-group changes over time for S-AII in all mental health outcomes remained significant.

CONCLUSIONS

Brief and low-intensity S-AII intervention exerted in the short-term a considerable impact on mental health outcomes. The S-AII shows promising results as a relevant public mental health strategy for enhancing well-being and reducing psychological distress. Future studies could consider whether these effects can be further enhanced with booster interventions.

Unintentional response priming from verbal action-effect instructions

Action-effect learning is based on a theoretical concept that actions are associated with their perceivable consequences through bidirectional associations. Past research has mostly investigated how these bidirectional associations are formed through actual behavior and perception of the consequences. The present research expands this idea by investigating how verbally formulated action-effect instructions contribute to action-effect learning. In two online experiments (Exp. 1, N = 41, student sample; Exp. 2, N = 349, non-student sample), participants memorized a specific action-effect instruction before completing a speeded categorization task. We assessed the consequences of the instructions by presenting the instructed effect as an irrelevant stimulus in the classification task and compared response errors and response times for instruction-compatible and instruction-incompatible responses. Overall, we found evidence that verbal action-effect instructions led to associations between an action and perception (effect) that are automatically activated upon encountering the previously verbally presented effect. In addition, we discuss preliminary evidence suggesting that the order of the action-effect components plays a role; only instructions in a perception-action order showed the expected effect. The present research contributes evidence to the idea that action-effect learning is not exclusively related to actual behavior but also achievable through verbally formulated instructions, thereby providing a flexible learning mechanism that does not rely on specific actual experiences.

How can implementation intentions be used to modify gambling behavior?

Problem gambling can cause significant harm, yet rates of gambling continue to increase. Many individuals have the motivation to stop gambling but are unable to transfer these positive intentions into successful behavior change. Implementation intentions, which are goal-directed plans linking cues to behavioral responses, can help bridge the gap between intention and many health behaviors. However, despite the strategy demonstrating popularity in the field of health psychology, its use in the area of gambling research has been limited. This mini review illustrates how implementation intentions can be used to facilitate change in gambling behavior. Adopting the strategy could help reduce the number of people with gambling problems.

Improving Hand Hygiene Behavior Using a Novel Theory-Based Intervention During the COVID-19 Pandemic

BACKGROUND

Promoting the adoption of personal hygiene behaviors known to reduce the transmission of COVID-19, such as avoiding touching one's face with unwashed hands, is important for limiting the spread of infections.

PURPOSE

We aimed to test the efficacy of a theory-based intervention to promote the avoidance of touching one's face with unwashed hands to reduce the spread of COVID-19.

METHODS

We tested effects of an intervention employing imagery, persuasive communication, and planning techniques in two pre-registered studies adopting randomized controlled designs in samples of Australian (N = 254; Study 1) and US (N = 245; Study 2) residents. Participants were randomly assigned to theory-based intervention or education-only conditions (Study 1), or to theory-based intervention, education-only, and no-intervention control conditions (Study 2). The intervention was delivered online and participants completed measures of behavior and theory-based social cognition constructs pre-intervention and one-week postintervention.

RESULTS

Mixed-model ANOVAs revealed a significant increase in avoidance of touching the face with unwashed hands from pre-intervention to follow-up irrespective of intervention condition in both studies, but no significant condition effects. Exploratory analyses revealed significant effects of the theory-based intervention on behavior at follow-up in individuals with low pre-intervention risk perceptions in Study 2.

CONCLUSIONS

Results indicate high adoption of avoiding touching one's face with unwashed hands, with behavior increasing over time independent of the intervention. Future research should confirm risk perceptions as a moderator of the effect theory-based interventions on infection-prevention behaviors.

Uptake of planning as a self-regulation strategy: Adolescents' reasons for (not) planning physical activity in an intervention trial

OBJECTIVES

Planning is an effective self-regulation strategy. However, little is known why some people take up planning and some do not. Such understanding would help interventions to promote planning. We investigated how adolescents explain their (non) use of planning for physical activity after an intervention.

METHODS

Qualitative content analysis was employed to investigate follow-up interviews (a purposeful sampling; n = 19 low-to-moderately active, vocational school students) of Let's Move It trial participants twice post-intervention: 6-8 weeks and 14 months post-baseline. In the intervention, planning was one of the key techniques used to promote PA.

RESULTS

We identified seven categories linked to reasons for (not) using planning. Most were related to feelings anticipated to result from planning. Action- and identity-related concerns were also raised. The reasons for planning were that the plan (1) helps to clarify what to do and to get things done, (2) strengthens the feeling of autonomy, (3) promotes a sense of progress, ability and control over one's PA. The reasons for not planning were that (having) a plan may (1) feel forced and like an unpleasant duty, (2) take away life's spontaneity and freedom, (3) result in anticipated annoyance and bad mood if one fails to enact the plan, or (4) be an effective strategy for others but not for the interviewee.

CONCLUSIONS

Planning may not only link to behavioural control but also the sense of autonomy, and thus subsequent motivation. We suggest various strategies to promote planning, including challenging non-planner identity and harnessing social dimension of planning.

Using social cognition models to understand why people, such as perfectionists, struggle to respond with self-compassion

Responding with self-compassion to lapses in goal pursuit helps people to achieve their goals, yet evidence suggests that some people struggle to respond with self-compassion. The current research proposes that social cognition models such the Theory of Planned Behaviour and the Prototype Willingness Model could explain why some people, such as those high in perfectionistic concerns, struggle to respond with self-compassion. We therefore conducted a pre-registered prospective study that measured participants' beliefs about self-compassion, difficulties enacting self-compassionate responding, perfectionistic concerns, and then tested their ability to be self-compassionate in response to a recalled and future lapse. The results showed that participants were less likely to respond with self-compassion to lapses if they held negative beliefs about self-compassion and experienced difficulties enacting self-compassion. Participants high in perfectionistic concerns were more likely to have negative beliefs about self-compassion and experience difficulties enacting self-compassion. Together, these findings provide evidence that social cognition models can be used to understand self-compassionate responding and identify why some people struggle to respond with self-compassion to goal lapses.

Getting trapped in a dead end? Trait self-control and boredom are linked to goal adjustment

Disengaging from unattainable goals and reengaging in alternative goals is essential for effective goal pursuit; yet, surprisingly little is known about associated personality factors. Here, we focused on individual differences in self-control (domain-general self-control, if–then planning) and boredom (boredom proneness, boredom avoidance and escape tendencies). Concerning goal adjustment in everyday life (Study 1; N = 323 crowdworkers), if–then planning was associated with worse disengagement and better reengagement. While boredom proneness was associated with poorer reengagement, boredom avoidance and escape tendencies were associated with better reengagement. When goal striving was thwarted during the COVID-19 pandemic (Study 2; N = 97 students), similar associations emerged along with links to anxiety and depression. However, disengagement was no longer associated with if–then planning but instead with better self-control and higher boredom proneness. These results show differential relationships of goal disengagement and reengagement with self-control and boredom, paving the way to a better understanding of who struggles or shines when effective goal adjustment is required.

A single item measure of self-control – validation and location in a nomological network of self-control, boredom, and if-then planning