Impulsive versus reflective influences on health behavior: a theoretical framework and empirical review

Abstract

Often, health behavior seems to be governed not only by reasoned attitudes and goal-directed behavior but also by impulsive influences. The notion of a conflict between reflective and impulsive processing which is incorporated in prominent dual-system accounts (e.g., Metcalfe & Mischel, 1999; Strack & Deutsch, 2004) may yield important benefits for the understanding and prediction of health-related behavior. In this article, we suggest a basic framework for the prediction of health-related behavior which combines (a) reflective influences (as measured via self-report), (b) impulsive influences (as measured via implicit measures), and (c) situational or dispositional moderators that shift the weight between reflective and impulsive influences. The practical utility of such a framework is demonstrated by drawing on recent evidence from several areas of health psychology such as eating, drinking, drug abuse, and sexual behavior. Implications for the understanding of health behavior and applied health interventions are discussed.

Keywords:

• impulse
• self-control
• health behavior
• temptation
• restraint
• dual-systems theories

Acknowledgements

We would like to thank Natalie Mallach and Jane Thompson for valuable comments on an earlier version of this article. Please address correspondence to Wilhelm Hofmann, LS Psychologie II, Röntgenring 10, 97070 Würzburg, Germany, Email: [email protected].

Notes

1. Correspondingly, in the heroism scenario, the hedonic component is negative and the activated behavioral tendency is an avoidance reaction.

2. Specifically, in their model of willed and automatic control of behavior, Norman and Shallice (1986) further distinguish between two ways in which a winner may be determined: First, by the mere competition of activation potential among incompatible schemas. This type of conflict resolution may function quite automatically and effortlessly. Second, a (controlled) mechanism of selective attention may be recruited whose function is to “bias” schema selection by inhibiting one of the competing schemas and by providing extra activation for the other. We assume that it is particularly the latter type of mechanism that is in charge of inhibiting and overriding prepotent impulsive action tendencies in the service of self-regulatory goals and that this mechanism can be sapped by a lack of control resources. Also, only the latter mechanisms may be accompanied by a full-fledged conscious experience of internal conflict. Finally, this mechanism also allows for the possibility that, in order to achieve certain goals, control may actually be directed at bolstering the impulsive rather than the reflective response (e.g., when boosting one's aggressive responses in order to win a football match).

3. In most circumstances, the salient features will have to do with the processing of the immediate temptation of interest (resulting in short-sighted, impulsive behavior) rather than to long-term standards, unless these standards are made especially salient (e.g., MacDonald, Fong, Zanna, & Martineau, 2000).

4. We believe that the implicit measures that have been employed in the studies reviewed have encouraging properties that justify their use as proxies of impulse. This does not mean, however, that implicit measures are a silver bullet to impulse assessment, as the degree of internal validity of these measures is still a subject of great debate (e.g., Conrey, Sherman, Gawronski, Hugenberg, & Groom, 2005; Mierke & Klauer, 2003). Nevertheless, the amount of incremental validity provided by these measures is reassuring and their continued application will most likely lead to their further improvement.