How to Change Implicit Drug Use-Related Cognitions in Prevention: A Transdisciplinary Integration of Findings from Experimental Psychopathology, Social Cognition, Memory, and Experimental Learning Psychology

Abstract

A recent study from our lab found that an intervention aimed at changing alcohol-related cognitions in heavy drinkers resulted in significant changes in explicit cognitions, in the absence of changes in implicit cognitions. This raised the question how implicit alcohol- and drug-related cognitions could successfully be changed. Here, the literature on changing implicit cognitions from four areas of research is reviewed: 1) memory research (resistance to change of implicit vs. explicit memories); 2) learning psychology (attempts to change learned associations); 3) experimental psychopathology (attempts to change an attentional bias); and 4) social cognition research (attempts to change implicit attitudes). Further, studies directly aimed at changing implicit drug-related cognitions are reviewed. From the integrative review, it is argued that it is important to consider the level of representation (i.e., specific vs. global) when comparing studies aimed at changing implicit cognitions: there is converging evidence that specific implicit cognitions and memories are resistant to change, whereas global implicit cognitions and memories appear to be more malleable. The results are integrated into an overall picture of what it takes to change implicit cognitions in general and what can be expected with respect to the effects of such a change on behavior, and how this could be used in alcohol-use and drug use-related preventive interventions.

• Alcohol
• Attentional bias
• Cognitive change
• “Craving”
• Drugs
• Implicit cognition
• Implicit Memory
• Malleability
• Prevention
• Mental representation

	=	There is growing evidence that implicit and explicit cognitions differentially affect substance use and misuse, and preliminary evidence that interventions may have differential effects on implicit and explicit cognitions. This should have implications for future transdisciplinary research on the prevention of substance use and misuse. (This article)
	=	“And when it came to the sixth or seventh (…), then I began to feel sick. I had like pains all over and felt I could sick up and at the same time not sick up, and I began to feel like in distress, O my brothers, being fixed rigid too on this chair. When this bit of film was over I could slooshy the goloss of this Dr. Brodsky from over by the switchboard saying: “Reaction about twelve point five? Promising, promising.” (Anthony Burgess, A Clockwork Orange, p. 82–83 ()).

	=	There is growing evidence that implicit and explicit cognitions differentially affect substance use and misuse, and preliminary evidence that interventions may have differential effects on implicit and explicit cognitions. This should have implications for future transdisciplinary research on the prevention of substance use and misuse. (This article)
	=	“And when it came to the sixth or seventh (…), then I began to feel sick. I had like pains all over and felt I could sick up and at the same time not sick up, and I began to feel like in distress, O my brothers, being fixed rigid too on this chair. When this bit of film was over I could slooshy the goloss of this Dr. Brodsky from over by the switchboard saying: “Reaction about twelve point five? Promising, promising.” (Anthony Burgess, A Clockwork Orange, p. 82–83 ()).

Notes

¹The journal's style utilizes the category substance abuse as a diagnostic category. Substances are used or misused; living organisms are and can be abused. Editor's note.

²With respect to the second type of individual differences, there is accumulating evidence that individual differences in personality (e.g., “behavioral undercontrol (Sher, 1991) or “a mild deficit in executive functioning” (Pihl and Bruce, 1995; see also Stacy et al., in this issue; Wiers et al., 1998) may place one at increased risk for the development of addiction. This increased susceptibility is not uniquely related to addiction: it can be viewed as a more general tendency to take risks that may have a variety of behavioral outcomes, ranging from an increased risk for accidents to an increased chance of having children at a young age, and can be viewed as an adaptive evolutionary strategy (“live fast, die young”) (Gerald and Higley, 2002).

³Watson and Rayner taught a young boy named Albert to become afraid of a gentle white rat. At the beginning of the study, Albert was unafraid of the white rat and played freely with the animal. While he was playing with the rat, the experimenters frightened the child by making a loud noise behind him. Albert was startled and began to cry. Thereafter, he avoided the rat and would cry whenever it was brought close to him.

⁴Note that these categories are not mutually exclusive: an individual can use or misuse substances for both reasons. Note further that for alcohol use other motives have been found, such as social drinking, and that for alcohol misuse many different taxonomies have been proposed, relating to the perspective of study (e.g., genetic, developmental, treatment, etc.).

Additional information

Notes on contributors

Reinout W. Wiers

Reinout W. Wiers, Ph.D., is associate professor in the Department of Experimental Psychology at the University of Maastricht in The Netherlands. His research interests include implicit cognition, cognitive and biological aspects of addiction, and the prevention and treatment of substance use and misuse. He received his doctorate in 1998 from the University of Amsterdam.

Peter J. de Jong

Peter J. de Jong, Ph.D., is professor of Experimental Psychopathology in the Department of Clinical and Developmental Psychology at the University of Groningen, The Netherlands. His research interests include the role of information processing biases in the development and maintenance of clinical problems. He received his doctorate from the University of Maastricht, The Netherlands, in 1994.

Remco Havermans

Remco Havermans, M.Sc., is finishing his Ph.D., in the Department of Experimental Psychology at the University of Maastricht in The Netherlands. His research interests involve the associative nature of human learning and behavior, and more specifically the role of associative learning in the development, maintenance and relapse of addictive behaviors.

Marko Jelicic

Marko Jelicic, Ph.D., is associate professor in the Department of Experi-mental Psychology at the University of Maastricht in The Netherlands. He is interested in basic and applied memory research, including work on implicit memory. He has published over 20 papers on implicit memory and co-edited a book on the taxonomy of memory. He received his doctorate in psychology from Erasmus University, Rotterdam, The Netherlands, in 1992.