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Playing ‘Tetris’ reduces the strength, frequency and vividness of naturally occurring cravings
Abstract
Elaborated Intrusion Theory (EI) postulates that imagery is central to craving, therefore a visually based task should decrease craving and craving imagery. This study provides the first laboratory test of this hypothesis in naturally occurring, rather than artificially induced, cravings. Participants reported if they were experiencing a craving and rated the strength, vividness and intrusiveness of their craving. They then either played ‘Tetris’ or they waited for a computer program to load (they were told it would load, but it was designed not to). Before task completion, craving scores between conditions did not differ; after, however, participants who had played ‘Tetris’ had significantly lower craving and less vivid craving imagery. The findings support EI theory, showing that a visuospatial working memory load reduces naturally occurring cravings, and that Tetris might be a useful task for tackling cravings outside the laboratory. Methodologically, the findings show that craving can be studied in the laboratory without using craving induction procedures.
... The immersive nature of Tetris gameplay, often capturing the player's full attention towards the game, and its imagery-competing (e.g. visuospatial) aspects has recently been harnessed in the development of novel psychological interventions (Singh et al., 2020;Skorka-Brown et al., 2014). In particular, Tetris is being used as one component within psychological interventions to reduce dysfunctional mental imagery. ...
... A novel behavioral intervention, involving Tetris gameplay together with specific instructions to engage in mental rotation (i.e., as part of several intervention components), has shown promise to both prevent the development of intrusive memories (Horsch et al., 2017;Iyadurai et al., 2018;Kanstrup et al., 2021a) and reduce the frequency of long-standing intrusive memories after trauma (Kanstrup et al., 2021b;Kessler et al., 2018). Another procedure involving Tetris gameplay has been shown to reduce the strength, frequency, and vividness of dysfunctional cravings (e.g., alcohol, food, nicotine; Skorka-Brown et al., 2014;Skorka-Brown et al., 2015). Tetris has also been used within a procedure to reduce the emotional intensity and vividness of mental imagery during recall of emotional memories (Engelhard et al., 2010). ...
... For instance, taxing working memory resources with a concurrent visuospatial task reduces the vividness (liveliness and clarity) and emotional impact of mental imagery (Bywaters et al., 2004;Kavanagh et al., 2001). Tetris is hypothesized to act as a cognitive task that competes with mental imagery for working memory resources when, for example, an emotional memory is held in mind (e.g., Engelhard et al., 2010;Lau-Zhu et al., 2017;Skorka-Brown et al., 2014). That is, Tetris is hypothesised to place competition for limited working memory and can therefore act as an imagerycompeting interference task to reduce the frequency or intensity of dysfunctional mental imagery. ...
Tetris is not only a widely used entertaining computer game, but has been used as a component in emerging psychological interventions targeting dysfunctional mental imagery, e.g., intrusive memories and imagery-based cravings. However, little is known about the neurobiological mechanisms underlying these interventions. Tetris gameplay has been hypothesized to disrupt dysfunctional mental imagery (e.g., imagery-based intrusive memories of adverse events) and cravings (e.g., substance use) by taxing visuospatial working memory. In line with this, the present study aimed to characterize brain areas involved in the visuospatial aspects of Tetris gameplay, by controlling for motor activity (button presses) and using gameplay instructions emphasizing mental rotation. Participants ( N = 28) received mental rotation instructions and thereafter either played Tetris, or only pressed buttons as if playing Tetris (motor activity), while undergoing functional magnetic resonance imaging. Tetris gameplay (when using mental rotation instructions and controlling for motor activity) robustly activated brain areas located in the ventral and dorsal stream, with maximum peak activation in the inferior and mid temporal gyrus. To the best of our knowledge, this is the first study to characterize brain areas specifically associated with the visuospatial aspects of Tetris gameplay, by controlling for motor activity and when using mental rotation instructions. Results demonstrate that engaging in Tetris gameplay recruits an extensive brain circuitry previously tied to visuospatial processing. Thus, findings are consistent with the use of Tetris as an imagery-competing task as one of several components of emerging interventions targeting dysfunctional mental imagery.
... It has been used in research to promote cognitive enhancement (e.g. Belchior et al., 2013;Okagaki & Frensch, 1994), treat amblyopia or 'lazy eye' (Li et al., 2013), dampen vividness, and emotionality of autobiographical memories (Engelhard, van Uijen, & van den Hout, 2010), reduce cravings (Skorka-Brown, Andrade, & May, 2014;Skorka-Brown, Andrade, Whalley, & May, 2015), prevent intrusive memories of psychological trauma (Holmes, James, Coode-Bate, & Deeprose, 2009;Iyadurai et al., 2017;James et al., 2015;James, Lau-Zhu, Tickle, Horsch & Holmes, 2016b), and lessen mania-related mental images (Davies, Malik, Pictet, Blackwell, & Holmes, 2012). Little is currently known about the cognitive mechanisms underpinning the benefits of Tetris, but one hypothesis emerging from the clinical psychology literature is that it selectively taxes visuospatial working memory (WM; Holmes et al., 2009;James et al., 2015). ...
... The hypothesis that the beneficial effects of Tetris specifically involve demands on visuospatial WM (Holmes et al., 2009;James et al., 2015) comes from studies proposing that strategic Tetris game play can act as a 'cognitive vaccine' to minimize the development of maladaptive mental images across psychopathological states (James, Lau-Zhu, Clark, et al., 2016a;Ji, Heyes, MacLeod, & Holmes, 2016). These include intrusive visual memories after psychological trauma (James et al., 2015), mania-related visual images (Davies et al., 2012) and craving-induced visual images of desire (Skorka-Brown et al., 2014). Such beneficial effects of Tetris are hypothesised to occur when the visuospatial processing demands of game play compete for the same limited cognitive resources within WM (Baddeley, 2012;Baddeley & Hitch, 1974) that contribute to maintaining visual mental imagery in mind (Pearson, Naselaris, Holmes, & Kosslyn, 2015). ...
... Such beneficial effects of Tetris are hypothesised to occur when the visuospatial processing demands of game play compete for the same limited cognitive resources within WM (Baddeley, 2012;Baddeley & Hitch, 1974) that contribute to maintaining visual mental imagery in mind (Pearson, Naselaris, Holmes, & Kosslyn, 2015). The impact of the concurrent task is initially on weakening the mental imagery as held in WMthat is for brief periods of time (Baddeley & Andrade, 2000;Skorka-Brown et al., 2014). However, this temporary disruption to the intensity of the image by WM interference is then thought to lead to it being permanently stored (Engelhard et al., 2010;Ranganath et al., 2005;van den Hout & Engelhard, 2012) in a weakened form in longterm memory (LTM). ...
Recent experimental and clinical research has suggested that Tetris game play can disrupt maladaptive forms of mental imagery because Tetris competes for limited cognitive resources within visuospatial working memory (WM) that contribute to imagery. Whether or not Tetris performance is selectively associated with visuospatial WM remains to be tested. In this study, young adults (N = 46) completed six standardized measures indexing verbal and non-verbal reasoning, verbal and visuospatial short-term memory, and verbal and visuospatial WM. They also played Tetris. Consistent with the hypothesis that visuospatial WM resources support Tetris game play, there was a significant moderate positive relationship between Tetris scores and visuospatial WM performance but no association with other cognitive ability measures. Findings suggest that Tetris game play involves both storage and processing resources within visuospatial WM. These preliminary results can inform interventions involving computer games to disrupt the development of maladaptive visual imagery, for example, intrusive memories of trauma.Copyright
... Current experimental intervention approaches tackle craving-related mental imagery by blocking craving imagery with distracting attentional interference tasks that tax the visuospatial working memory (Harvey, Kemps, & Tiggemann, 2005;Kemps & Tiggemann, 2014;Kemps, Tiggemann, & Grigg, 2008;Schumacher, Kemps, & Tiggemann, 2018). Based on a cognitive neuroscience account of the sensory nature of mental images, the logic of these approaches presumes that mental imagery is processed in visuospatial working memory, which has limited resources (Harvey et al., 2005;Schumacher et al., 2018;Skorka-Brown, Andrade, & May 2014). Hence, using a task that competes for those working memory capacities (i.e. ...
... By inducing neutral mental imagery in this condition less visuospatial resources were available to produce or sustain food/craving-related mental imagery, resulting in overall decreases in craving and thus also motivation to eat healthily. In general, this result is in line with previous studies demonstrating the visuospatial interference effect of mental imagery for (unhealthy) craving (Kemps & Tiggemann, 2007Skorka-Brown et al., 2014). Interestingly, our exploratory analysis of changes in unhealthy craving yielded nonsignificant results. ...
Craving for high-calorie foods predicts consumption of high-calorie foods thereby contributing to unhealthy eating habits and, potentially in the long term, to the development of overweight, obesity, and eating disorder pathology. Thus, effective interventions tackling craving for unhealthy foods and motivating healthy eating behavior are needed. This initial study tested if an experimental mental imagery procedure could induce craving for healthy foods and increase the motivation to eat healthily. Participants (N = 82) were randomized to either a healthy craving mental imagery condition or to a neutral mental imagery control condition. Craving for healthy foods and motivation to eat healthily was assessed before and after the experimental manipulation via self-report. A (disguised) food choice for healthy versus unhealthy food was added as a behavioural measure at the end of the experiment. Repeated measures of variance analyses with time (pre vs. post experimental manipulation) and condition (healthy craving mental imagery versus neutral mental imagery) yielded significant interactions for healthy craving and motivation to eat healthily: Post-hoc tests showed that craving for healthy foods and motivation to eat healthily increased significantly after the experimental manipulation in the healthy craving mental imagery condition, but not in the neutral mental imagery condition. Results of this initial study suggest that an experimental mental imagery induction of craving for healthy food leads to an increase in healthy craving and motivation to eat healthily. Further experimental research is needed to rule out priming effects, to test the underlying mechanisms of this effect, and evaluate the potential of this mental imagery procedure in a clinical context.
... Guided imagery has been used to combat experimentally-induced cravings for breakfast and snack foods in a series of laboratory-based studies (Hamilton, Fawson, May, Andrade, & Kavanagh, 2013;May, Andrade, Batey, Berry, & Kavanagh, 2010). Other imagery-based tasks (e.g., imagining alternative imagery, playing Tetris or watching dynamic visual noise) have been shown to reduce naturally occurring cravings for a range of substances, including food in the field (Kemps & Tiggemann, 2013;Knäuper, Pillay, Lacaille, McCollam, & Kelso, 2011;Skorka-Brown, Andrade, & May 2014;Skorka-Brown, Andrade, Whalley, & May 2015). While Kemps and Tiggemann (2013) found that dynamic visual noise reduced consumption, Skorka-Brown et al. (2015) and Knäuper et al. (2011) did not find effects of other imagery-based techniques on consumption. ...
... The observed craving reduction following guided imagery is in line with studies that have used other imagery-based techniques for reducing naturalistic cravings (Kemps & Tiggemann, 2013;Knäuper et al., 2011;Skorka-Brown et al., 2014. In comparing the relative efficacy of cognitive defusion and guided imagery, the present study found that there was no difference between the techniques in their ability to reduce craving frequency, nor intensity. ...
The present study investigated the effect of two craving reduction techniques, namely, cognitive defusion and guided imagery, on naturalistic food cravings. These techniques targeted the intrusion and elaboration stages of the craving process, respectively (Kavanagh, Andrade, & May, 2005). Participants underwent a seven-day baseline period followed by a seven-day intervention period, during which they recorded their food cravings as they occurred using online diaries accessed via smartphone. In the intervention period, participants were randomly assigned to one of cognitive defusion, guided imagery or control conditions. Participants in the cognitive defusion and guided imagery conditions listened to three-minute audio clips containing their respective instructions every time they experienced a food craving, and rated their craving intensity before and after the intervention, while the control participants recorded their cravings as they did in the baseline week. Results showed that both cognitive defusion and guided imagery techniques reduced craving frequency, intensity, the likelihood of consumption following cravings, and craving-related calorie intake, consistent with predictions. These findings show that cognitive defusion and guided imagery are useful for dealing with naturally occurring cravings across a range of foods, and can reduce craving-related consumption in everyday life.
... Sensorimotor and cognitive stimulation-similar to animal models described above-with computer games and/or task are used in stroke rehabilitation (e.g., Janssen et al. 2012;Anåker et al. 2017;McDonald et al. 2018). Some studies have shown that videogame exercises improve intervention programs for opioid dependence (Cutter et al. 2014;Abroms et al. 2015) or affect brain correlates of addictive behaviors (Cole et al. 2012;Skorka-Brown et al. 2014, but these computer-aided interventions do not mimic the complexity of EE conditions. Virtual reality (VR), a technology that creates a state of immersion closer to the real situation and allows for controlled assessment of neuropsychological and behavioral responses, is a promising methodological approach in addictive behaviors (Hone-Blanchet et al. 2014). ...
Rationale
Environmental enrichment (EE) is a non-pharmacological approach that has been shown to be effective in reducing food-taking in rats. Studies in human volunteers are still in their infancy, given the difficulty to translate the complexity of EE in clinical practice. Virtual reality (VR) is a promising methodological approach, but no study has yet applied it to model and test EE in humans.
Objectives
The present study is the first to assess the effects of virtual EE on craving for palatable food.
Methods
Eighty-one healthy volunteers (43 women) were divided into three groups: (i) exposure to a virtual EE (VR-EE), (ii) exposure to a virtual neutral environment (VR-NoEE), and (iii) without exposure to VR (No VR). Craving for palatable food at basal level and evoked by neutral and palatable food images was assessed before and after the VR simulation. Behavior during VR exposure and subjective measures related to the experience were also collected.
Results
VR-EE group showed a significantly greater decrease in pre-post craving difference compared to No VR for all assessments and at basal level compared to VR-NoEE. Interestingly, an inverse correlation between craving and deambulation in the VR simulation emerged in VR-EE group only.
Conclusions
The study highlighted the feasibility of exposing human subjects to an EE as a virtual simulation. Virtual EE induced effects on basal craving for food that suggest the potential for further improvements of the protocol to extend its efficacy to palatable food cues.
... Interventions that aim to interfere the consolidation of traumatic memories have used video game playing as a visuo-spatial task. Studies have found that playing video games can, under specific circumstances, hinder the formation of imagery related to traumatic events and cravings ( [52,54]. ...
During the COVID-19 pandemic, video game playing increased exponentially. The question if playing could offer benefits to cope with the pandemic stressors emerged. This study compares how non-players and players who may or may not re-experience (e.g., seeing, hearing) game content after playing [i.e., Game Transfer Phenomena (GTP)] cope with the pandemic stressors, emotion regulation and resilience. It also examines the impact of GTP on the perception of self and the world. A total of 567 completed a survey (59.6% male, MeanAge = 28.55). The measures include emotional regulation (ERC), resilience to stress (BRCS) and fear of contamination (PI). No differences between players and non-players on ERC, BRCS and PI were found. Players with moderate GTP levels were more likely to report contamination fears and show preventive COVID coping behaviours. The positive impact of GTP was associated with high resilience and cognitive reappraisal as an emotion regulation strategy. The results suggest that attention should be paid to players who experience GTP more frequently and with a negative impact. Maladaptive coping styles can exacerbate distress from GTP and situational stressors. Identifying methods of protecting vulnerable individuals from these psychological burdens can guide interventions and mitigate consequences in similar situations.
... Second, these intrusions may be further elaborated, if for example they elicit a powerful affective reaction or a sense of deficit (Tapper, 2018), with vivid mental imagery (Schumacher et al., 2018), so that this cognitive elaboration is then experienced as craving. Therefore, the EI theory considers that craving is mainly a working memory process in which affective-laden sensory images are the object of further elaboration using internal or external information (Skorka-Brown et al., 2014). Elaboration fosters the growth of craving and the development of negative affective states that further fuel intrusions, giving rise to a cycle of intrusions and elaborations that are usually alleviated by eating the craved food (Schumacher et al., 2018). ...
The elaborated intrusion theory of desire proposes that craving is a cognitive motivational process involving intrusive thoughts. Changing the way we react to them, cognitive defusion (CD), should limit thought elaboration and craving. We induced chocolate craving in female chocolate cravers before CD (Study 1). A decrease in craving measured by a single-item scale, Visual Analogical Scale (VAS; p < .001, η p ² = .449) and as a state, State Food Craving Questionnaire (FCQ-S; p = .029, η p ² = .106) were found in the experimental group, while similar results were also found in group control. The reduction in craving (VAS) in group CD correlated negatively with chocolate consumption on a bogus taste test ( r = –.439, p = .036), while the correlation was positive in the case of group control ( r = .429, p = .047). Food craving as a trait, measured by the Trait Food Craving Questionnaire (FCQ-T), showed negative correlations with measures of CD and mindfulness skills (lowest r = –.313, p = .018). In Study 2 participants made use of a smartphone application implementing the CD procedure in real contexts whenever they experienced food craving. A corresponding decline in self-reported craving was found, as well as in consumption of the craved food (indulgence) compared with the control condition. Our findings indicate that CD may be a promising intervention for tackling the elaboration of intrusive thoughts and eating behavior in young female food cravers, both in a controlled laboratory environment after a cue-food exposure craving induction procedure, as well as responding to naturally occurring food cravings in real-life settings.
... However, it should be noted that in this study, there was no significant difference in self-reported arousal between VR and RL conditions. In contrast, there is also some evidence that playing games may decrease food cravings [29], possibly because playing games distracts from feelings of hunger and craving. Given the unexpected nature of this finding, it is important that this be replicated. ...
Background:
Virtual reality (VR) has gained popularity in daily life, and VR food cues seem to elicit food cravings, similar to real food cues. However, little is known about the impact of VR food cues on actual food intake.
Objective:
In real life (RL), exposure to food cues in a situation in which the desire to eat food interferes with the completion of a food-related task reduces the subsequent food intake (ie, the pre-exposure effect). In this study, we examine, on the one hand, whether the pre-exposure effect could be replicated in RL and, on the other hand, whether this effect could be extended to VR contexts.
Methods:
The study used a 2 (stimulus type: food vs nonfood) × 2 (mode: VR vs RL) between-subject design (n=175). Participants were randomly assigned to 1 of the 4 conditions.
Results:
We found the main effect of mode on food intake, with a higher food intake after both VR conditions than after RL conditions (P=.02). In addition, among female participants, we found that exposure to both food cues (ie, VR and RL) resulted in lower food intake than exposure to both nonfood cues (P=.05). In contrast, this effect was not observed among male participants (P=.34). Additionally, VR and RL cues generated similar emotional and behavioral responses (eg, arousal and game difficulty).
Conclusions:
We were unable to replicate the exposure effect in our complete sample. Subgroup analyses, however, showed that for women, exposure to food cues (either in VR or in RL) reduces food intake, indicating that a VR pre-exposure procedure may effectively be applied exclusively for women.
Trial Registration:
ClinicalTrials.gov NCT05169996; https://clinicaltrials.gov/ct2/show/NCT05169996
... Second, these intrusions may be further elaborated, if for example they elicit a powerful affective reaction or a sense of deficit (Tapper, 2018), with vivid mental imagery (Schumacher et al., 2018), so that this cognitive elaboration is then experienced as craving. Therefore, the EI theory considers that craving is mainly a working memory process in which affective-laden sensory images are the object of further elaboration using internal or external information (Skorka-Brown et al., 2014). Elaboration fosters the growth of craving and the development of negative affective states that further fuel intrusions, giving rise to a cycle of intrusions and elaborations that are usually alleviated by eating the craved food (Schumacher et al., 2018). ...
... In Experiment 2, we tested another type of interference-based method, which consists in playing the video game Tetris. This choice was based on recent studies suggesting that this video game, which has a heavy load on visuospatial working memory interferes with visual imagery involved in the elaboration of craving, can be successfully used to mitigate substance cravings (see Table 1 for more detail; Skorka-Brown et al., 2014, Skorka-Brown et al., 2015. ...
Craving is central in the prognosis of gambling disorder. The elaborated intrusion theory (EIT) provides a sound framework to account for craving in addictive disorders, and interference methods inspired from the EIT have substantiated their effectiveness in mitigating substance and food-related cravings. The principle of these methods is to recruit the cognitive resources underlying craving (e.g., visuospatial skills, mental imagery) for another competitive and cognitively demanding task, thus reducing the vividness and overwhelming nature of craving. Here we conducted two experiments employing a between-subjects design to test the efficacy of interference methods for reducing laboratory-induced craving. In these experiments, gamblers (n = 38 for both experiments) first followed a craving induction procedure. They then performed either a visuospatial interference task (making a mental and vivid image of a bunch of keys [experiment 1] or playing the video game Tetris [experiment 2]; experimental conditions) or another task supposed not to recruit visuospatial skills and mental imagery (exploding bubble pack [experiment 1] or counting backwards [experiment 2]; control conditions). Results show that all methods successively mitigated induced craving. Although previous research evidenced the superiority of visuospatial tasks to reduce substance-related craving, our findings question their superiority in the context of gambling craving.
Abbreviations EIT: Elaborated intrusion theory of desire; GD: Gambling disorder; CEQ: Craving Experience Questionnaire; g-CEQ: gambling Craving Experience Questionnaire; g-CEQ-F: Gambling Craving Experience Questionnaire – Frequency form; g-CEQ-S: Gambling Craving Experience Questionnaire – Strength form; Psi-Q: Plymouth Sensory Imagery Questionnaire; PGSI: Problem Gambling Severity Index; S-UPPS-P: Short UPPS-P Impulsive Behavior Scale; DASS-21: Depression, Anxiety and Stress Scales; ANCOVA: Analysis of covariance.
... Our data are in line with previous use of dual-tasking on successfully modulating various forms of memory/imagery during their retrieval Engelhard, Van Uijen, et al., 2010;Leer et al., 2017;Skorka-Brown et al., 2014van den Hout et al., 2013). ...
Background and Objectives:
Media trauma in civilians is linked to intrusive imagery-based memory symptoms. We investigated whether mental imagery of the 9/11 terrorist attacks following media exposure is dampened by taxing working memory (WM).
Methods:
Forty-five young adult UK residents, who were exposed to the 9/11 terrorist attacks as children via the media, identified a personally-relevant mental image of the attacks. They were then randomly allocated to: (1) recall + Tetris, (2) recall + eye movements (EMs), or (3) recall-only. Ratings on imagery vividness and emotionality were provided at three time points: pre-, post-manipulations, and at 24-hr follow-up.
Results:
Repeated measures ANOVAs revealed that recall + Tetris and recall + EMs (relative to recall-only) significantly reduced imagery vividness and emotionality from pre- to post-manipulations, but not to follow-up.
Limitations:
A passive control group is needed to fully rule out the role of natural memory decay; the follow-up was exploratory and took place outside the laboratory with reduced experimental control.
Conclusions:
Aversive memory imagery from media trauma in civilians can be dampened by taxing WM, at least temporarily, which could be therapeutically useful. The use of such cognitive techniques may also hold relevance for public health approaches to address the impact of collective trauma.
... Results on the cognitive/behavioral domain of the outcome measures showed that visuospatial skill measures are associated with a significant moderate effect size (0.44). This is in accordance with previous research indicating that visualspatial abilities are enhanced by video-and computer-game playing (James et al., 2015;Lau-Zhu, Holmes, Butterfield, & Holmes, 2017;Skorka-Brown, Andrade, & May, 2014). However substantial level of unexplained heterogeneity remained for all other subgroups, undermining any interpretation of the magnitude of their estimates. ...
Computerized cognitive training programs (CCTP) are based on the assumption that cognitive abilities may be boosted by repetitively performing challenging tasks. The integration of game-like features in these programs, associated with the goal of amusing or rewarding participants,may contribute to generate cognitive benefits. Indeed, reinforcement contingencies have been reported to produce positive effects on performance and motivation, especially in children. This meta-analysis was aimed at providing a quantitative summary of the effectiveness of CCTP with game-like features in school-aged childrenwith typical and atypical development. A total of 24 studies, with the cognitive and behavioral outcome data of 1547 participants, were selected for inclusion in the meta-analysis. Subgroup analyses were performed to identify the sources of the observed methodological heterogeneity. Arobust variance estimationmodel, after removal of study outliers, yielded a small-to-moderate significant effect size. Final results pointed out smaller but more precise estimate effect sizes according to methodological aspects related to cognitive domain of outcomes, standardization of measures and type of control applied. Alongside supporting the use of CCTP for rehabilitating cognitive functions, the present results shed light on how different methodological choices are able to shape research findings in the field of children’s cognitive rehabilitation.
... Indeed, the five proposed games, albeit focusing on different cognitive domains, relied on visual-spatial competence as they required participants to: i) detect the orientation of a stimulus in space (Disillusion, Lost in Migration), ii) match together (Disillusion) or recognize (Tidal Treasure, Speed Match) visually presented figures that could differ in shape and color, iii) solve arithmetic operations contained in drops that moved vertically on the computer screen and were distributed in space (Raindrops), and iv) maintain in working memory the shapes and colors of visual stimuli (Tidal Treasure, Speed Match). This hypothesis is in line with the notion that computer games heavily tax visual-spatial working-memory [49][50][51] and that the benefits of games like Tetris on mental health are likely proxied by occupying visual-spatial working memory [64][65][66][67] . In keeping with it, previous research showed that visual-spatial abilities are enhanced by video-and computer-game playing, even after a few months of training 50 . ...
Cognitive rehabilitation may compensate for cognitive deficits of children with acquired brain injury (ABI), capitalizing on the use-dependent plasticity of a developing brain. Remote computerized cognitive training (CCT) may be delivered to patients in ecological settings, ensuring rehabilitation continuity. This work evaluated cognitive and psychological adjustment outcomes of an 8-week multi-domain, home-based CCT (Lumosity Cognitive Training) in a sample of patients with ABI aged 11–16 years. Two groups of patients were engaged in five CCT sessions per week for eight weeks (40 sessions). According to a stepped-wedge research design, one group (Training-first Group) started the CCT immediately, whereas the other group (Waiting-first Group) started the CCT after a comparable time of waiting list. Changes after the training and after the waiting period were compared in the two groups. Both groups improved in visual-spatial working memory more after the training than after the waiting-list period. The Training-first group improved also in arithmetic calculation speed. Findings indicate that a multi-domain CCT can produce benefits in visual-spatial working memory, probably because, in accordance with previous research, computer games heavily tax visuo-spatial abilities. This suggests that the prolonged stimulation of the same cognitive ability may generate the greatest benefits in children with ABI.
... Theory and research suggest craving processing occupies capacity-limited cognitive resources, [10][11][12][13] and that occupa-tion of such resources by nondrug processing (particularly by tasks with a visual component 14 ; e.g., the game tetris 15,16 ) may reduce craving processing and levels. [17][18][19] Thus, in theory, games should interfere with the cognitive processing underlying craving. ...
Objective:
Strong cravings to smoke are an obstacle to cessation success. Unfortunately, cessation medication and counseling only modestly quell craving. This pilot study was designed to examine the feasibility of mobile games as a response strategy to craving and whether a fully powered trial is warranted.
Materials and Methods:
Smokers interested in quitting (N = 30) were offered 4 weeks of nicotine patch plus counseling and randomized to quit with (games-on) versus without (games-off) access to 11 commercial mobile games. Outcomes included post-target quit day (TQD) game play, craving, smoking, and quitting. Almost all P's were >0.05; outcomes should be interpreted with caution due to the small N.
Results:
Of games-on participants (n = 16), one played games ≥80% of days post-TQD (22/28 days); 38% played >1/3 of days; 25% did not play. Games-on participants reported games moderately helped them cope with cravings; M = 3.22 on a scale from 1 (not at all) to 5 (very much). Also, games-on participants showed a slight decrease in craving from baseline to 1-week post-TQD (2.35-2.25 on a 0-5 point-scale), whereas games-off participants showed an increase (2.01-2.53). Games-on participants showed greater decreases in craving after playing a game than after the passage of time (when an app imposed a 2-minute wait period following their game request), but there was little evidence games-on versus games-off participants differed in mean post-TQD cigarettes/day. Games-on participants reported modestly but not significantly higher continuous abstinence through day 28 (31.3% vs. 21.4%).
Conclusion:
Feasibility results encourage a fully powered trial of this easily disseminable intervention. Clinical Trial Registration: ClinicalTrials.gov NCT02164383.
... Therefore, the addition of features that increase the engagement to the games but not to the application itself may not support the users during their quitting attempts. Games must be kept simple, but they should also be attractive enough to be able to distract the user during the craving [37] . Thus, adding extra features, as suggested by several experts, may not be a good idea and is a topic that requires further study. ...
Background:
Mobile apps have a great potential to support patients in healthcare, and to encourage healthy behavioral changes such as smoking cessation. Nevertheless, the user rejection levels are still high. A set of factors that has impact on the app effectiveness is related to the quality of those features that lead to positive user experiences when using the app. This work aims to evaluate the user experience, and more specifically the usability and the user satisfaction with a mobile application for smoking cessation. This will also provide a basis for future improvements.
Methods:
We provided a smoking cessation mobile Android app to two different user cohorts, the smokers as valid users and the experts, for three weeks. The app featured usual functionalities to help quit smoking, including an achieved benefits section, mini-games to distract during cravings, and supportive motivational messages. We collected information about user experience, through game playability and message satisfaction questionnaires, and the experts' opinions. We also considered usage of app sections, the duration of the mini-game sessions, and the user ratings for motivational messages.
Results:
We included 45 valid users and 25 experts in this study. The questionnaire indicated 80% satisfaction rate for the motivational messages. According to game questionnaires, over 69% of the participants agreed that the games have good usability features, however, for questions related to mobility and gameplay heuristics, agreements were below 67%. The most accessed app sections were achieved benefits and the one with motivational messages. The experts described issues that could help to improve the application.
Conclusions:
The combination of questionnaires with expert reports allowed to identify several problems and possible corrections. Our study showed that motivational messages have a good satisfaction rate, although it is necessary to consider technical features of some mobile devices that may hinder message reception. Games have good usability and it's expected that the addition of difficulty levels and a better accessibility to the game menu could make them more attractive and increase its usage. Future development of mHealth apps based on gamification and motivational messages need to consider these factors for better user satisfaction and usability.
... However, it is also possible that the control condition was an active training. Recent research proved that playing Tetris may reduce craving strength and attentional bias (Skorka-Brown, Andrade, & May, 2014). This research was built on the elaborated intrusion theory (Kavanagh, Andrade, & May, 2005), implying that craving arises from visual images stored in the visuospatial sketchpad of working memory. ...
Childhood obesity treatment programs only result in moderate outcomes in the short term and do not reduce risk for future weight gain. Therefore, in the current study, Approach Avoidance Training (AAT) with motivational game elements will be added to an inpatient childhood obesity program with the aim of improving outcomes. Forty-one children (10-15 years) in the final months of an inpatient treatment program were randomised to either the AAT plus care-as-usual condition group or to a care-as-usual-only control group. During the 10 sessions, the children were trained to approach healthy food stimuli and to avoid unhealthy food stimuli. Treatment outcomes were child performances on tasks of AAT, implicit attitudes and attentional bias, self-report ratings on craving symptoms, and weight loss maintenance after leaving the clinic (12-week follow-up). Changes over time were not significantly different between conditions for the measures of automatic processes, craving, and weight loss maintenance. Possible accounts for the null findings , including sample size, influence of game elements, point of time in therapeutic process, limitations of the setting, and the control group are discussed. More research is needed before firm conclusions can be drawn about the clinical usefulness of CBM for weight control in childhood obesity.
... (Color figure online) Vidne, & Cohen, 2013), and, more broadly, to the notion that emotion is strongly embedded in cognition (Kavanagh et al., 2005;Pessoa, 2013). Our results also revealed a possible neural mechanism that might underlie recent behavioral findings showing that blocking people's mental resources while they are exposed to attractive food cues can reduce cravings in response to these cues (Kemps et al., 2008;Skorka-Brown et al., 2014), as well as subsequent craving-induced consumption choices (Van Dillen & Andrade, 2016;Van Dillen et al., 2013). ...
The present research examined whether cognitive load modulates the neural processing of appetitive, high-calorie food stimuli. In a functional magnetic resonance imaging (fMRI) study, participants quickly categorized high-calorie and low-calorie food pictures versus object pictures as edible or inedible while they concurrently performed a digit-span task that varied between low and high cognitive load (memorizing six digits vs. one digit). In line with predictions, the digit-span task engaged the dorsolateral prefrontal cortex (DLPFC) when cognitive load was high compared to low. Moreover, exposure to high-calorie compared to low-calorie food pictures led to increased activation in the nucleus accumbens (NAcc), but only when cognitive load was low and not when it was high. In addition, connectivity analyses showed that load altered the functional coupling between NAcc and right DLPFC during presentation of the high-calorie versus low-calorie food pictures. Together, these findings indicate that loading the cognitive system moderates hedonic brain responses to high-calorie food pictures via interactions between NAcc and DLPFC. Our findings are consistent with the putative cognitive nature of food motivation. Implications for future research are discussed.
Electronic supplementary material
The online version of this article (10.3758/s13415-018-0579-3) contains supplementary material, which is available to authorized users.
... Participants then played the video game Tetris for three minutes as a distraction task. Tetris has been shown to cognitively distract from cravings, in addition to activating visuospatial processing centers of the brain, thereby increasing visual memory loss, making it a sufficient distractor task for the purpose of this study (Price, Paul, Schneider, & Siegle, 2013;Skorka-Brown, Andrade, & May, 2014;van Dillen, 2016;van Dillen, Papies, & Hofmann, 2013). Following this, participants were presented with a tray containing a serving dish filled with real pasta with tomato sauce, made to be visually identical to the virtual pasta (see Fig. 1). ...
Assessment of parents' child feeding behavior is challenging, and there is need for additional methodological approaches. Virtual reality technology allows for the creation of behavioral measures, and its implementation overcomes several limitations of existing methods. This report evaluates the validity and usability of the Virtual Reality (VR) Buffet among a sample of 52 parents of children aged 3-7. Participants served a meal of pasta and apple juice in both a virtual setting and real-world setting (counterbalanced and separated by a distractor task). They then created another meal for their child, this time choosing from the full set of food options in the VR Buffet. Finally, participants completed a food estimation task followed by a questionnaire, which assessed their perceptions of the VR Buffet. Results revealed that the amount of virtual pasta served by parents correlated significantly with the amount of real pasta they served, rs = 0.613, p < .0001, as did served amounts of virtual and real apple juice, rs = 0.822, p < .0001. Furthermore, parents' perceptions of the calorie content of chosen foods was significantly correlated with observed calorie content (rs = 0.438, p = .002), and parents agreed that they would feed the meal they created to their child (M = 4.43, SD = 0.82 on a 1-5 scale). The data presented here demonstrate that parent behavior in the VR Buffet is highly related to real-world behavior, and that the tool is well-rated by parents. Given the data presented and the potential benefits of the abundant behavioral data the VR Buffet can provide, we conclude that it is a valid and needed addition to the array of tools for assessing feeding behavior.
... attentional processes, visuospatial sketchpad of the working memory) allocated to the elaboration of desire thoughts to another competing task that recruits the same type of resources (May, Andrade, Kavanagh, & Penfound, 2008;May, Andrade, Panabokke, & Kavanagh, 2010;Steel, Kemps, & Tiggemann, 2006). Growing evidence supports the usefulness of interference-based interventions (e.g. as diverse as clay modelling, playing the video game Tetris, guided imagery) to interfere with psychoactive substance-related craving (May et al., 2010;Skorka-Brown, Andrade, & May, 2014;Skorka-Brown, Andrade, Whalley, & May, 2015) or food-related craving (Andrade, Pears, May, & Kavanagh, 2012;Hamilton, Fawson, May, Andrade, & Kavanagh, 2013). However, to date, interference-based techniques have not been tested in relation to gambling craving, implying that further research on this very topic is warranted. ...
Gambling disorder is a well-established behavioural addiction, which was classified with substance-related disorders in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders. Although craving was introduced as a new diagnostic criterion for substance-related disorders, it was not included for gambling disorder. This study aimed to explore the experience of gambling craving and to evaluate whether the elaborated intrusion theory of desire (EIT), a cognitive model of craving, fits gambling craving. A mixed methods study was conducted among 31 non-clinical gamblers. The qualitative part consisted of open-ended questions targeting the components of the EIT. The quantitative part consisted of a questionnaire designed to assess triggers and descriptions of gambling craving. Qualitative analysis revealed six distinct conceptual categories related to gambling craving: positive and negative affect, external cues, mental imageries, thoughts and physiological sensations. The quantitative analysis highlighted the most relevant triggers (e.g., spontaneous thoughts) and experiential characteristics (e.g., visual imagery) of gambling craving. The present study allowed us to support the relevance of the EIT as it applies to gambling craving by disentangling its core features. Findings from this study suggest that the use of interventions derived from the EIT may be relevant for problem gambling treatment.
... These may include images of non-food related (E. Kemps & Tiggemann, 2007), modeling clay (Andrade et al., 2012), playing a video game (Skorka-Brown et al., 2014), or engaging in hand or eye movements (Kemps & Tiggemann, 2007;McClelland et al., 2006). ...
The purpose of this randomized wait-list controlled trial was to test the feasibility and preliminary efficacy of a guided imagery based multi-behavior intervention intended to address psychological stress, food cravings, and physical activity. Personalized guided imagery scripts were created and participants were instructed to practice guided imagery every day for 35 consecutive days. Of 48 women who enrolled, we report comparisons between 16 randomized to treatment with 19 who were wait-listed (overall Mage = 45.50; Mbodymassindex = 31.43). Study completers reported 89% compliance with practicing guided imagery during the intervention. A significant time-by-group interaction was observed with reductions in food cravings and increases in physical activity compared with wait-list controls. Telephone-based multi-behavior interventions that utilize guided imagery to address food cravings and exercise behavior appear to be acceptable for overweight and obese women. Future phone-based guided imagery research testing this skill to address multiple health behaviors is justified.
... Tetris has been found useful in helping patients with retrograde amnesia ( Stickgold et al., 2000). It has also been proven to reduce cravings in addicts, as it (hypothetically) uses up the visuo- spatial part of the working memory and creates a load on it, such that at the time the brain cannot produce images of the addictive substance, thus decreasing cravings (Skorka-Brown, Andrade & May, 2014). But most relevant to this present study is the work done on the use of Tetris in people with post- traumatic stress disorder or PTSD, wherein gameplay helped restrict the intrusion of traumatic images in to the conscious mind. ...
This study was intended to test the effect of Tetris as an intervention for severe but sub-clinical life stress in young adults. Tetris has been indicated to be useful in many clinical populations, particularly having potential in reducing the occurrence of intrusive recollections in PTSD; and the mechanism it has been hypothesised to work on has cognitive and neurological connections to the experience of stress. Method: Tetris was administered as an intervention on a young adult population (30 males, 30 females between 18-20 years) in India, who had a minimum score of 16 as measured by the Perceived Stress Scale. The design used was a single group pre-test post-test method, where PSS scores were compared. Results: There was a significant reduction in the mean perceived stress levels of the group post-intervention, and a significantly greater reduction in perceived stress among women as compared to men, respectively. The effect size score computed (0.759) for reduction in stress levels indicated that the use of Tetris has a high practical significance. Conclusion: Tetris was found useful in controlling perceived stress; and can be a highly relevant intervention for the tech-savvy generation of young adults who spend a considerable amount of their time on their smart-gadgets. Its implications are that any comparable visuo-spatially oriented task could potentially be useful in controlling stress, and that technology can potentially be the next step in administering clinical interventions.
... The most commonly craved foods are those high in fat, salt and sugar, with chocolate being the most highly craved food in Western society (Hill & Heaton-Brown, 1994;Weingarten & Elston, 1990. Cravings are thought to be cognitive in nature, and have been described as a subjective motivational state (Shiffman, 2000;White, Whisenhunt, Williamson, Greenway, & Netemeyer, 2002). Although food cravings are not necessarily pathological, they can be maladaptive for some people. ...
The elaborated-intrusion theory of desire proposes that craving is a two-stage process whereby initial intrusions about a desired target are subsequently elaborated with mental imagery. The present study tested whether the craving reduction strategies of cognitive defusion and guided imagery could differentially target the intrusion and elaboration stages, respectively, and thus differentially impact the craving process. Participants were randomly assigned to a cognitive defusion, a guided imagery or a mind-wandering control condition. Pre- and post-intervention chocolate-related thoughts, intrusiveness of thoughts, vividness of imagery, craving intensity, and chocolate consumption were compared. Experiment 1 recruited a general sample of young women (n = 94), whereas Experiment 2 recruited a sample of chocolate cravers who wanted to reduce their chocolate consumption (n = 97). Across both experiments, cognitive defusion lowered intrusiveness of thoughts, vividness of imagery and craving intensity. Guided imagery reduced chocolate-related thoughts, intrusiveness, vividness and craving intensity for chocolate cravers (Experiment 2), but not for the general sample (Experiment 1). There were no group differences in chocolate consumption in either experiment. Results add to existing evidence supporting the elaborated-intrusion theory of desire in the food domain, and suggest that acceptance- and imagery-based techniques have potential for use in combatting problematic cravings.
... EI theory aligns with treatment approaches such as motivational enhancement, mindfulness, acceptance-based therapies, and retraining attentional biases (May et al., 2014b;Witkiewitz et al., 2013Witkiewitz et al., , 2014. Recent research has directly employed EI theory in the development of promising new craving management strategies and novel treatment approaches (Hsu et al., 2014;Tiggemann, 2007, 2013;Kn€ auper et al., 2011;Littel et al., 2016;Skorka-Brown et al., 2014). These approaches employ nonsubstance imagery and sensory tasks designed to compete with cravingbased imagery within the limited capacity of working memory. ...
Background:
Standardized alcohol craving scales are rarely used outside of research environments despite recognized clinical utility. Scale length is a key barrier to more widespread application. A brief measure of alcohol craving is needed to improve research and treatment of alcohol use disorders (AUDs). Grounded in the Elaborated Intrusion Theory of Desire, the Alcohol Craving Experience (ACE) Questionnaire comprises two 11-item self-report scales that assess past-week frequency and maximum strength of alcohol craving. This study aimed to create a brief version of the ACE while maintaining psychometric integrity and clinical utility.
Methods:
Patients attending a university hospital alcohol and drug outpatient service for the treatment of AUD completed the ACE as part of a questionnaire battery. Three patient samples were utilized: 519 patients with pretreatment and outcome data, 228 patients with pretreatment data, and 66 patients who completed the ACE at treatment sessions 1 and 2.
Results:
The Frequency scale of the ACE possessed greater clinical utility and predictive validity than the Strength scale. Revision of the Frequency measure produced a 5-item "Mini Alcohol Craving Experience" (MACE) Questionnaire. Satisfactory validity (construct, predictive, concurrent, convergent, and incremental) and reliability (internal and test-retest) were maintained. A 1 standard deviation increase in pretreatment MACE score was associated with a 54 percentage increase in the odds of patient lapse or dropout.
Conclusions:
The MACE provides a brief, theoretically, and psychometrically robust measure of alcohol craving suitable for use with AUD populations in time-limited clinical and research settings.
... Performing a task between a food advergame and eating opportunity may decrease the influence of the advergame on intake (cf. Skorka-Brown, Andrade, & May, 2014). However, compared with previous studies (Folkvord et al., 2013Folkvord et al., , 2014), a slightly different and shorter version of the advertisement was used. ...
Objective:
Implicit approach reactions to energy-dense snack food can facilitate unhealthy eating in children. Therefore, an experiment was conducted to test whether modifying implicit reactions to snack food by means of a go/no-go task can reduce consumption of this food. The effectiveness of this intervention on actual snack intake after exposure to a food or a control advertisement was tested.
Method:
Children (133; age range = 7-10 years) played an advergame promoting either energy-dense food or nonfood products. Subsequently, children conducted either a go/no-go food task in which the advertised food was consistently associated with no-go cues, or a go/no-go control task in which colored circles were consistently associated with no-go cues. Afterward, they could eat the advertised food and a new food. Candy intake was weighed and caloric intake was determined.
Results:
Results show that children who performed the go/no-go food task consumed significantly and considerably fewer calories (34%) than the children who carried out the control task. No main effect of type of advertisement was found. Furthermore, the effect of the go/no-go food task was similar after each type of advertisement, similar for advertised and new foods, and was significant for both girls and boys.
Conclusion:
Targeting implicit reactions to high-energy snacks proved effective in decreasing intake of snacks in children. Furthermore, the previously reported stimulating effect of food promoting advergames on intake may disappear when a short cognitive task is presented directly after the game. Future work should evaluate the clinical implications of these findings. (PsycINFO Database Record
... Performing a task between a food advergame and eating opportunity may decrease the influence of the advergame on intake (cf. Skorka-Brown, Andrade, & May, 2014). However, compared with previous studies (Folkvord et al., 2013Folkvord et al., , 2014), a slightly different and shorter version of the advertisement was used. ...
... Indeed, lab-studies suggest that visuospatial load reduces cigarette (May, Andrade, Panabokke, & Kavanagh, 2010) and food cravings (e.g. (Kemps & Tiggemann, 2013) using tasks such as dynamic visual noise (May et al., 2010), playing Tetris ® (Skorka-Brown, Andrade, & May, 2014), spatial tapping, or visual tracking of a moving stimulus (McClelland, Kemps, & Tiggemann, 2006). Although promising, it is unclear whether this approach is viable in clinical samples experiencing frequent and intense cravings. ...
... Playing Tetris consumes heavy visuospatial working memory resources that potentially compete with cognitive resources required for elaboration of visual imagery. Since Holmes et al.'s (2009) study, other studies have used Tetris to inhibit intrusive imagery (Holmes et al., 2010;Skorka-Brown et al., 2014James et al., 2015a,b). However, these have not assessed the role of videogame content after playing in relation to Game Transfer Phenomena (GTP) Griffiths, 2014a,b,c, 2015a,b). ...
... Playing Tetris consumes heavy visuospatial working Q8 memory resources that potentially compete with cognitive resources required for elaboration of visual imagery. Since Holmes et al.'s (2009) study, other studies have used Tetris to inhibit intrusive imagery (Holmes et al., 2010;Skorka-Brown et al., 2014James et al., 2015a,b). However, these have not assessed the role of videogame content after playing in relation to Game Transfer Phenomena (GTP) (Ortiz de Griffiths, 2014a,b,c, 2015a,b). ...
Unwanted visual intrusions are characteristic of Post-Traumatic Stress Disorder (American Psychiatric Association, 2013). One innovative intervention for inhibiting unwanted intrusions is playing the Tetris videogame, described as a “cognitive vaccine” in preventing intrusions after traumatic events (Holmes et al., 2009). Playing Tetris consumes heavy visuospatial working memory resources that potentially compete with cognitive resources required for elaboration of visual imagery. Since Holmes et al.'s (2009) study, other studies have used Tetris to inhibit intrusive imagery (Holmes et al., 2010; Skorka-Brown et al., 2014, 2015; James et al., 2015a,b). However, these have not assessed the role of videogame content after playing in relation to Game Transfer Phenomena (GTP) (Ortiz de Gortari and Griffiths, 2014a,b,c, 2015a,b).
GTP research has investigated non-volitional experiences (e.g., altered sensorial perceptions and automatic mental processes/behaviors) mostly experienced after gaming. Gamers often report sensorial (visual/auditory) intrusions after playing (e.g., visual and auditory imagery, hallucinations) (Ortiz de Gortari et al., 2011; Ortiz de Gortari and Griffiths, 2014a,b). In a survey of 2362 gamers, most (77%) had visualized images from a variety of videogames (including tile-puzzle games) with closed-eyes, and one-third (31%) had visualized images with open-eyes (Ortiz de Gortari and Griffiths, 2015b). Other studies have experimentally induced videogame-related visualizations at sleep onset (Stickgold et al., 2000; Wamsley et al., 2010; Kusse et al., 2012).
James et al. (2015a,b) study was the first to make explicit reference to GTP (referred to as the “Tetris effect” [TE]). Ortiz de Gortari and Griffiths (2012) argued the TE term is misleading as it suggests repetition is the core of transfer effects. However, other factors are involved. Research concerning GTP makes the distinction between sensorial modalities facilitating the assessment of non-volitional phenomena with videogame content that occur along the continuum from mild to severe (Ortiz de Gortari and Griffiths, under review). Moreover, the descriptive constructs of GTP are empirically based on analysis of 3500 + gamers and have been examined via confirmatory factor analysis demonstrating good reliability and validity (Ortiz de Gortari et al., 2015).
James et al. (2015a,b) tested if playing Tetris offered a protective mechanism against re-experiencing traumatic events. Healthy participants (n = 56) were randomly assigned to either playing Tetris for 11 min, or doing nothing before exposure to a 12-min traumatic film. Image-base memories about the film were then registered in a 1-week dairy. However, playing Tetris as a proactive interference task before watching the film did not show significant results. James and colleagues offered different explanations including: (i) duration of the task in relation to film length, (ii) temporal contingencies between the tasks, (iii) differences between the task types, (iv) videogame types used, and (v) reactivation of gameplay during the film for aided interference. These explanations are discussed in relation to GTP literature.
... However, it is also possible that the control condition was an active training. Recent research proved that playing Tetris may reduce craving strength and attentional bias (Skorka-Brown, Andrade, & May, 2014). This research was built on the elaborated intrusion theory (Kavanagh, Andrade, & May, 2005), implying that craving arises from visual images stored in the visuospatial sketchpad of working memory. ...
Childhood obesity treatment programs only result in moderate outcomes in the short term and do not reduce risk for future weight gain. Therefore, in the current study, Approach Avoidance Training (AAT) with motivational game elements will be added to an inpatient childhood obesity program with the aim of improving outcomes. Forty-one children (10–15 years) in the final months of an inpatient treatment program were randomised to either the AAT plus care-as-usual condition group or to a care-as-usual-only control group. During the 10 sessions, the children were trained to approach healthy food stimuli and to avoid unhealthy food stimuli. Treatment outcomes were child performances on tasks of AAT, implicit attitudes and attentional bias, self-report ratings on craving symptoms, and weight loss maintenance after leaving the clinic (12-week follow-up). Changes over time were not significantly different between conditions for the measures of automatic processes, craving, and weight loss maintenance. Possible accounts for the null findings, including sample size, influence of game elements, point of time in therapeutic process, limitations of the setting, and the control group are discussed. More research is needed before firm conclusions can be drawn about the clinical usefulness of CBM for weight control in childhood obesity.
Purpose
The purpose of this study is to conceptually integrate business to consumer (B2C) into business to business (B2B), with a holistic consumer-centric, technology-reinforced, long-term vision for tourism industries and companies to survive and succeed in the era of new technologies 4.0. The research suggests that the tourism-marketing-new technologies decision-making involves customers as the center of the design and decision process.
Design/methodology/approach
The research design includes a qualitative study with 94 in-depth interviews, a literature analysis and a conceptual proposition. The qualitative study follows the tourism consumer desire data analysis, from categorization to integration. The literature analysis applies a systematic literature review approach based on the 29 most up-to-date new-tech papers from peer-reviewed journals. The analysis compares qualitative research findings and literature analysis results and matches the new technology applications with consumer desire understanding. The conceptual framework of tourism marketing/advertising is proposed based on qualitative research and literature analysis.
Findings
The qualitative research deciphers that consumers, based on their imagination and memorization, desire therapy and sceneries and connect such desires to the empathetic and resonating advertising messages. The literature analysis synthesizes the new tech applications in tourism and matches the qualitative research findings with the deciphered desires in tourism. The conceptual model proposes that B2C should be integrated into B2B to provide value for both consumers and businesses and opens avenues of research on this topic.
Research limitations/implications
This research has made the following theoretical contributions: it offers an in-depth understanding of consumer desire, often hidden or subconscious, in the field of tourism. Consumer desires regarding tourism are mostly subconscious and exist long before consumers are exposed to advertising messages. These desires reflect the search for therapy and sceneries and become “embodied” – they exist on multisensorial levels and become part of the body and life and will lead consumers into positive perceptions when marketing communications/advertisements resonate with them. In the latter case, they will subjectively judge advertising as “good,” regardless of the advertising design quality. The research also connects consumer research with a new technologies research review and proposes a conceptual framework to integrate business to consumer (B2C) with business to business (B2B). As such, the research makes theoretical contributions to the integration or the “boundary blurring” between B2C and B2B research and practical suggestions that involved industries and consumers may all benefit from such integration. Conceptually, there is a lack of discussions of the pitfalls of new technologies, a dearth of empirical verification of the applications of new technologies in the proposed fields and a shortage of discussions about ethical issues. Qualitative methods, offering an efficient tool for understanding consumer desires in the tourism industry, have their own limits, as discussed in previous research. The sample is limited to the state of New York population and may be influenced by geographic, demographic and psychological characteristics related to the region.
Practical implications
This research provides advertising practitioners, new technology innovators and tourism industries with a framework to face the combined challenges of understanding hidden consumer desires and applying adequate technologies that resonate with consumer desires to tackle relevant issues. The conceptual proposition of this research fills the gap between qualitative consumer research without concrete practical resolution and new technologies applications without in-depth consumer understanding. Through the conceptual framework, the author provides insights into how industries may benefit from consumer understanding. The business relationships among the industries of marketing, tourism and new technologies should be centered around consumers. Thus, B2C and B2B should be naturally integrated into business practices.
Social implications
Social implications of this research include three major points: first, the understanding of consumer desire for therapeutic power in tourism, which invites more attention to tourism as part of social well-being design instead of a purely for-profit business. Second, a profound comprehension of what consumers need and desire, without which the applications of new technologies may cause severe societal problems. Third, a way to tailor to consumers’ individuality and desires for advertising/marketing that may be considered abusive, stressful and socially destructive if applied in a nonpersonal manner.
Originality/value
Conceptually, this research adds consumer desire, an originally B2C concept, to the B2B context regarding the new technology applications in tourism marketing/advertising. It contributes to the B2B literature by proposing a strong consumer-centric approach, especially the consumer desire understanding, that is not yet investigated in the B2B literature; and a combination of empirical study and literature analysis and the matching of the two for better practice of advertising/marketing, tourism and new technologies applications.
Introduction:
Hospital is a stressful place of employment, and a high proportion of healthcare workers, especially the ICU (Intensive Care Unit) nurses were found to be at risk of PTSD. Previous studies showed that taxing working memory through visuospatial tasks during the reconsolidation process of aversive memories can reduce the number of intrusions afterwards. However, the finds could not be replicated by some researches, indicating there may be some boundary conditions that are subtle and complex.
Methods:
We performed a randomized controlled trial (ChiCTR2200055921; URL: www.chictr.org.cn). In our study, a series of ICU nurses or probationers who performed a cardiopulmonary resuscitation (CPR) were enrolled and instructed to play a visuospatial music tapping game ("Ceaseless Music Note", CMN; Beijing Muyuan Technology Co., Ltd., Beijing, China) at the fourth day after CPR. The numbers of intrusions each day were recorded from the first to the seventh days (24 h×6 day), and the vividness and emotionality of CPR memories were rated at the 4th and 7th days. These parameters were compared between different groups (game with background sound; game with sound off; sound only; none).
Results:
The game-matching background music can have an add-on effect for single tapping game with no sound in reducing the emotionality of previous aversive memories.
Discussion:
We proposed that flow experience (the subjective experience of effortless attention, reduced self-awareness, and enjoyment, and may be induced by optimal skill-demands compatibility in challenging tasks) as a key boundary condition for successful reconsolidation intervention.
Clinical trial registration:
www.chictr.org.cn, identifier: ChiCTR2200055921.
Obesity is a substantial problem in the U.S., with growing rates particularly at early developmental stages (e.g., childhood, adolescents). Several factors may contribute to the development of overeating and obesity, including elevated craving in response to food-related cues, individual susceptibility to food-related cues, and neural changes associated with behavioral phenotypes implicated in obesity. The current dissertation aims to shed light on these contributing factors, in an effort to better understand obesity risk and contribute to the development of effective interventions. Study 1 aimed to test the incentive-sensitization theory of addiction by examining food motivation, hunger, and consumption in a cue-rich compared to neutral environment. Participants (n = 126) were randomized to either a naturalistic fast-food laboratory or a neutral laboratory, where they provided self-reported ratings of “wanting,” “liking,” and hunger, and engaged in a task assessing food motivation and food consumption. Study 1 found that “wanting,” hunger, and consumption were greater in the cue-rich compared to neutral laboratory, while “liking” did not differ between conditions. This study provides support for the incentive-sensitization theory as applied to eating behavior. Study 2 developed and tested a novel paradigm for identifying two phenotypes of cue-responsivity, sign-tracking and goal-tracking. Children aged 5-7 (n = 64) engaged in a Pavlovian conditioning task designed to assess propensity to engage with a cue (sign-tracking) versus the location of a reward (goal-tracking). Children then engaged in tasks assessing food motivation and inhibitory control. Contrary to hypotheses, Study 1 did not find a distinct goal-tracking phenotype, and did not find sign-tracking behavior to be associated with either food motivation or inhibitory control. Considerations for how to examine these phenotypes in future research are discussed. Study 3 examined how resting state functional connectivity (rsFC) relates to obesity, food consumption, food motivation, and inhibitory control in adolescents (n = 164) aged 13-16 who ranged from lean to obese. Participants completed tasks assessing food motivation and inhibitory control, then on a second visit underwent a resting-state scan and then completed a food consumption task in a cue-rich environment. Obesity and elevated food motivation were found to be marked by altered connectivity in areas in the salience network (e.g., caudate, NAcc, OFC) and the default mode network (e.g., PCC, hippocampus). However, obesity was not found to be associated with behavioral outcomes, thus these behaviors were not found to mediate associations between obesity and rsFC patterns. These findings provide suggestions as to effective prevention and intervention targets. The current dissertation provides evidence for a strong role of elevated food motivation (especially in the context of food cues) in the overconsumption of palatable foods. Clinical implications and suggestions for intervention are discussed.
According to the elaborated intrusion (EI) theory of desire, loading visual working memory should help prevent and reduce cravings because cravings occur when intrusive thoughts are elaborated upon in working memory, often as vivid mental images. Mindfulness-based decentering strategies may also help prevent and reduce cravings since they may divert attention away from craving-related thoughts and mental imagery. To compare the effects of visualisation versus decentering on cravings, participants (N = 108) were randomly assigned to one of three conditions: (a) decentering, (b) visualisation, (c) mind-wandering control. Participants in each condition received two audio exercises: (1) a 2-minute exercise, preceding a craving induction but after initial deprivation and cue exposure, (2) a 4-minute exercise, following a craving induction. The audios instructed participants to look at a plate of chocolate that was in front of them whilst either (a) decentering from their thoughts and feelings, (b) engaging in visualisation or (c) letting their mind wander. Participants were asked to rate the strength of their cravings at four time points (Time 1, baseline; Time 2, after the 2-minute audio; Time 3, post-craving induction; Time 4, post-4 minute audio). Frequency of craving-related thoughts was also measured at Time 4. Compared to the control condition, results showed a significant reduction in strength of cravings for the decentering condition after both the 2-minute audio and the 4-minute audio. Decentering was superior to visualisation only after the 2-minute audio. Participants in both the visualisation and decentering conditions also had significantly lower frequencies of craving-related thoughts compared to control participants. The findings support EI theory and suggest that mindfulness-based decentering strategies may be useful for both the prevention and reduction of cravings. Pre-registration: https://osf.io/jv3pq.
Intrusive thoughts about food can trigger cravings and result in unhealthy eating behaviour. Here we tested whether Load Theory of attention can be applied to the eating behaviour literature and reduce intrusive appetitive-related thoughts. Load Theory predicts that high levels of perceptual load in a task exhaust attentional capacity and so reduces interference from a range of stimuli, including intrusive thoughts. Therefore, this study aimed to test whether perceptual load reduced appetitive-related intrusive thoughts about chocolate. Sixty female participants were first given a chocolate bar to interact with for 2 min, before rating their levels of hunger, craving and liking for chocolate. They were then asked to avoid thinking about chocolate and instead focus attention on a visual search task. Perceptual load was manipulated within-subjects by varying the search set size. Appetitive-related thoughts were measured using both self-caught and probe-caught measures, allowing us to index load effects at varying levels of meta-awareness. Across subjects, the level of appetitive-related thoughts seen in the high load condition was significantly reduced, to less than half the level seen in the low load condition, on both probe and self-caught measures. Furthermore, self-reported hunger, craving and liking for the chocolate were positively correlated with appetitive-related thoughts under low load, but high perceptual load eliminated these state individual differences. Therefore, engaging in perceptually demanding tasks may be a worthwhile strategy for those wanting to disrupt the cycle of craving at the earliest stage.
Vivid and emotionally laden imagery is a symptom across a wide range of psychiatric disorders. Flash-forwards describe the mental simulation of anticipated future events which might also be relevant in the context of gaming disorder. The aim of this laboratory study was to investigate flash-forwards and the experience of desires and craving in gamers, and to examine the effect of eye movements on their vividness and related desires. A sample of 77 gamers formed a mental picture of themselves gaming in the future and rated the vividness and emotionality of this imagination, and their current desire and craving for gaming. Thereafter, one half of the gamers conducted a dual task (i.e., horizontal eye movements while retrieving the picture), whereas the other half let their eyes rest on the middle of the computer screen while retrieving the picture (non-dual task). Vividness of the flash-forward and intensity of desire and craving were again measured after the dual or non-dual task. In the overall sample, more imagery-related desire correlated positively with associated positive affect and vividness of flash-forwards. However, in a subsample of problematic gamers, flash-forwards are experienced less vivid and less pleasurable with increasing symptom severity. Eye movements while retrieving the flash-forwards led to significantly decreased ratings of imagery-related desire intensity, which was not the case for the non-dual condition. Results suggest different properties of flash-forwards between recreational and problematic gamers. Moreover, an attention-demanding task taxing the working memory seems beneficial for reducing desires related to imagery-induced flash-forwards.
Background: We present two studies (hereafter Study 1 and Study 2), aimed to evaluate Bach Flower Remedies (BFR) effectiveness in controlling food cravings (FC), with assessment at three different stages: baseline, 1 month after baseline and 3 months after baseline.
Methods: Study 1 consisted in a double-blind placebo-controlled trial aimed to assess the specific effects of a BFR-formula and the overall effectiveness of the placebo-control on FC (n=173). Participants were assigned to BFR (n=65), Placebo (n=55) and Control group (n=53). On the other hand, Study 2 did not involve deception, and combined an implementation intention instruction with the BFR-formula, all aimed to reduce FC in overweight and obese adults while at home (n=74). Every participant received an implementation intention instruction to sip a glass of water whenever experiencing FC at home. BFR group (n=37) was instructed to sip water with BFR solution diluted in it, whereas Water group just sipped plain water (n=37).
Results: Study 1 did not support specific effects for BFR; placebo seemed to be effective in controlling FC. Moreover, findings from Study 2 suggest that BFR, used at least once a day, in conjunction with implementation intention intervention, may be helpful in reducing FC in overweight and obese adults while at home.
Conclusions: Results of both Studies helped us evaluate the ‘power of the placebo’ in helping individuals overcome FC in their everyday life.
There is a long history of using videogames in a therapeutic capacity including rehabilitation for stroke patients, people with traumatic brain injuries, burns victims, wheelchair users, Erb's palsy sufferers, children undergoing chemotherapy, children with muscular dystrophy, autistic children and individuals looking to overcome real-life challenges (including symptoms of depression) and boost their wellbeing (including boosting life satisfaction, self-efficacy and social support). This paper briefly and selectively examines a number of areas including: (1) videogames as physiotherapy and occupational therapy, (2) videogames as distractors in the role of pain management, (3) videogames and cognitive rehabilitation, (4) videogames and the development of social and communication skills among the learning disabled, (5) videogames and impulsivity/attention deficit disorders, (6) videogames and therapeutic benefits in the elderly, (7) videogames in psychotherapeutic settings, (8) videogames and health care, (9) videogames and anxiety disorders, and (10) videogames and psychological wellbeing. It is concluded that there has been considerable success when games are specifically designed to address a specific problem or to teach a certain skill. However, generalizability outside the game-playing situation remains an important consideration.
Elaborated Intrusion (EI) theory posits a key role for visuospatial working memory (WM) in craving. In line with the predictions of EI theory, several studies have found that WM and craving show mutually interfering effects - for example, performance of visuospatial WM tasks has been found to attenuate naturally occurring cravings. However, the extent to which these effects are driven specifically by visuospatial processing remains unclear. We conducted two experiments to investigate the effects of WM on naturally occurring cravings in more detail. In experiment 1, we examined whether such effects are driven specifically by visuospatial WM processes or can also be induced by a verbal WM task. Subjective craving ratings were attenuated equally by performance of visuospatial and verbal WM tasks, suggesting that craving is not dependent specifically on visuospatial processing. In experiment 2, we examined whether effects of visuospatial WM on craving could be driven by simple distraction. Naturally occurring cravings were attenuated in a control condition with minimal WM demands (watching a video). However, the magnitude of attenuation was significantly greater in a visuospatial WM condition. Taken together, these findings highlight a key role for WM in the attenuation of naturally occurring craving, but do not support the hypothesis that such effects are dependent specifically on visuospatial processing.
According to the elaborated-intrusion theory of desire, strategies that load visual working memory will reduce cravings. According to the grounded cognition theory of desire, cravings will be reduced with mindfulness-based decentering strategies that encourage individuals to see their thoughts as thoughts. However, decentering strategies also tend to load visual working memory making it difficult to test the latter prediction. This study addressed this issue by matching visualization across decentering and guided imagery tasks. Male and female participants (n = 101) underwent a chocolate craving induction before listening to a 4-min audio recording that guided them to (a) decentering from their thoughts and feelings, (b) engage in visualization, or (c) let their mind wander. Participants reported on chocolate craving before and after the craving induction and following the 4-min recording. They also provided retrospective reports of craving during the recording, reported on the extent to which they had adhered to the audio instructions and briefly indicated what they had been thinking about during the recording. Results showed a significant reduction in cravings to baseline following the recording across all three conditions (p < .001), but no significant differences between conditions or in the retrospective reports of craving. There was some evidence to suggest that participants in the mind wandering condition had been thinking about alternate goals, which may have inhibited thoughts about chocolate and been just as effective at reducing craving as the imagery and decentering strategies. Exploratory analyses showed a trend toward decentering being more effective than imagery where participants reported higher task adherence throughout the 4 min (p = .067). This raises the possibility that decentering effects may be improved with better strategy adherence, which might be achieved through practice or increased motivation.
How can vibrotactile stimuli be used to create a technology-mediated somatic learning experience? This question motivates this practice-based research, which explores how the Feldenkrais Method and cognate neuroscience research can be applied to technology design. Supported by somaesthetic philosophy, soma-based design theories, and a critical acknowledgement of the socially-inflected body, the research develops a systematic method grounded in first- and third-person accounts of embodied experience to inform the creation and evaluation of design of Haplós, a wearable, user-customisable, remote-controlled technology that plays methodically composed vibrotactile patterns on the skin in order to facilitate body awareness—the major outcome of this research and a significant contribution to soma-based creative work. The research also contributes to design theory and somatic practice by developing the notion of a somatic learning affordance, which emerged during course of the research and which describes the capacity of a material object to facilitate somatic learning. Two interdisciplinary collaborations involving Haplós contribute to additional fields and disciplines. In partnership with experimental psychologists, Haplós was used in a randomised controlled study that contributes to cognitive psychology by showing that vibrotactile compositions can reduce, with statistical significance, intrusive food-related thoughts. Haplós was also used in Bisensorial, an award-winning, collaboratively developed proof-of-concept of a neuroadaptive vibroacoustic therapeutic device that uses music and vibrotactile stimuli to induce desired mental states. Finally, this research contributes to cognitive science and embodied philosophy by advancing a neuroscientific understanding of vibrotactile somaesthetics, a novel extension of somaesthetic philosophy.
The incentive-sensitization (IS) theory proposes that “wanting” (strong motivation), more so than “liking” (hedonic pleasure), drives compulsive consumption in both substance use and overeating. Importantly, “wanting” and “liking” are only distinct in the presence of relevant cues. Cues may also contribute to overeating by increasing feelings of hunger. We employed a simulated fast-food laboratory to test IS theory by examining the effect of environmental cues on eating behavior. We tested the following hypotheses: In a cue-rich compared to neutral environment, (a) wanting would be greater whereas liking would remain the same, (b) feelings of hunger would be greater, and (c) food consumption would be greater, a relationship mediated by elevated wanting and hunger. These hypotheses were supported in the current study. Thus, contextual cues may contribute to overconsumption through increased wanting and hunger. These findings have public health implications for overeating and obesity.
There is a long history of using videogames in a therapeutic capacity including rehabilitation for
stroke patients, people with traumatic brain injuries, burns victims, wheelchair users, Erb’s palsy
sufferers, children undergoing chemotherapy, children with muscular dystrophy, autistic children and
individuals looking to overcome real-life challenges (including symptoms of depression) and boost
their wellbeing (including boosting life satisfaction, self-efficacy and social support). This paper
briefly and selectively examines a number of areas including: (1) videogames as physiotherapy and
occupational therapy, (2) videogames as distractors in the role of pain management, (3) videogames
and cognitive rehabilitation, (4) videogames and the development of social and communication
skills among the learning disabled, (5) videogames and impulsivity/attention deficit disorders, (6)
videogames and therapeutic benefits in the elderly, (7) videogames in psychotherapeutic settings,
(8) videogames and health care, (9) videogames and anxiety disorders, and (10) videogames and
psychological wellbeing. It is concluded that there has been considerable success when games are
specifically designed to address a specific problem or to teach a certain skill. However, generalizability
outside the game-playing situation remains an important consideration.
Food cravings are common experiences that precede dysfunctional eating behaviors, such as overeating and binge eating. These cravings are often related to negative affect, especially in emotional eaters. Recent studies have revived interest in a theory on the implicit modulation of affect: the facial feedback-hypothesis. This theory claims that mimic expressions influence affective experiences. Given the association between negative affect and food craving, facial feedback could provide a means to reduce or prevent food cravings. In an experimental study, using a read aloud task, we examined, whether an implicit modulation of facial muscle activity - zygomatic muscle (smiling: FF+) and corrugator muscle (frowning: FF-) - would alter food cue-induced cravings in healthy young women (n = 60). We further examined, if traits in emotional eating influence the facial feedback-effect. The activation of the zygomatic muscle prevented the occurrence of food cravings after exposure with palatable food cues. Food craving only increased in the FF- group (p = 0.029). The facial feedback effect was especially pronounced in emotional eaters, indicated by a significant moderation (p = 0.041). In participants with high degrees of emotional eating, food craving was reduced in the FF + group and amplified in the FF- group. The results indicate that mimic expressions might influence food cravings on implicit pathways. Existing approaches that target implicit behavior modification via facial feedback may be transferable to eating behavior. These methods could potentially help in altering dysfunctional eating associated with food craving, especially in individuals prone to emotional eating.
Mindfulness is increasingly being used for weight management. However, the strength of the evidence for such an approach is unclear; although mindfulness-based weight management programs have had some success, it is difficult to conclude that the mindfulness components were responsible. Research in this area is further complicated by the fact that the term ‘mindfulness’ is used to refer to a range of different practices. Additionally, we have little understanding of the mechanisms by which mindfulness might exert its effects. This review addresses these issues by examining research that has looked at the independent effects of mindfulness and mindfulness-related strategies on weight loss and weight management related eating behaviors. As well as looking at evidence for effects, the review also considers whether effects may vary with different types of strategy, and the kinds of mechanisms that may be responsible for any change. It is concluded that there is some evidence to support the effects of (a) present moment awareness, when applied to the sensory properties of food, and (b) decentering. However, research in these areas has yet to be examined in a controlled manner in relation to weight management.
People who are sensitive to food temptations are prone to weight gain and obesity in food-rich environments. Understanding the factors that drive their desire to eat is key to limiting their reactions to available food. This study tested whether individual differences in sensitivity to hedonic food cues are cognitively based and, accordingly, can be regulated by blocking cognitive resources. To this end, one lab study (study 1; N=91) and one field study (study 2; N=63) measured sensitivity to hedonic food cues using the Power of Food Scale (PFS; Lowe et al., 2009) and assessed participants' appetitive responses to high-calorie food options. To test the role of cognitive elaboration of food cues, participants completed a menu-selection task to induce food cravings and then were free to elaborate those cravings (control group) or were blocked from doing so by cognitive distraction (playing Tetris, solving puzzles; experimental group). Compared to non-sensitive participants, sensitive participants displayed a greater attentional bias to high-calorie food (Study 1), reported stronger cravings (Study 2), and more often chose an unhealthy snack (Studies 1 & 2), but only when they had not been distracted. When distracted, all participants were similarly unresponsive to high-calorie food. This finding suggests that temptation can be effectively controlled by blocking people's cognitive resources, even for people highly sensitive to hedonic food cues.
A clear understanding of the cognitive-emotional processes underpinning desires to over- consume foods and adopt sedentary lifestyles can inform the development of more effective interventions to promote healthy eating and physical activity. The Elaborated Intrusion Theory of Desires offers a framework that can help in this endeavour through its emphases on the roles of intrusive thoughts and elaboration of multi-sensory imagery. There is now substantial evidence that tasks that compete for limited working memory resources with food-related imagery can reduce desires to eat that food, and that positive imagery can promote functional behaviour. Meditation mindfulness can also short-circuit elaboration of dysfunctional cognition. Functional Decision Making is an approach that applies laboratory- based research on desire, to provide a motivational intervention to establish and entrench behavior changes, so healthy eating and physical activity become everyday habits.
ensory imagery is a powerful tool for inducing craving because it is a key component of the cognitive system that underpins human motivation. The role of sensory imagery in motivation is explained by Elaborated Intrusion (EI) theory. Imagery plays an important role in motivation because it conveys the emotional qualities of the desired event, mimicking anticipated pleasure or relief, and continual elaboration of the imagery ensures that the target stays in mind. We argue that craving is a conscious state, intervening between unconscious triggers and consumption, and summarise evidence that interfering with sensory imagery can weaken cravings. We argue that treatments for addiction can be enhanced by the application of EI theory to maintain motivation, and assist in the management of craving in high-risk situations.
This study examined the comparative impact of three types of imagery interventions (olfactory, visual, and olfactory-plus-visual imagery) and a distracting cognitive task (serial sevens) on self-reported craving for cigarettes by 54 university students who had been smoking at least a pack of cigarettes per day for the past 3 to 6 months. Using the 10-item, self-report questionnaire of smoking urges, we assessed participants’ experience of craving prior to cue exposure, following 2 min of lab-based cue-exposure, during a 2 min imagery or distraction intervention, and immediately following the intervention. Reported craving during intervention was significantly lower in all three imagery conditions compared to the distracting cognitive task condition, but there was not a significant difference in craving among the imagery conditions. Despite explicit instructions to focus on the designated form(s) of imagery, a majority of participants in each of the imagery conditions also reported experiencing other forms of sensory imagery. Brief imagery interventions hold promise to interrupt, at least temporarily, cue-induced craving in daily smokers.
Desire thinking is a voluntary cognitive process involving verbal and imaginal elaboration of a desired target. Recent research has revealed that desire thinking and craving are distinct constructs and that desire thinking may play a significant role in the escalation of craving. The goal of this study was to explore the effect of desire thinking induction on craving in a nonclinical sample. Forty-five volunteers with no current diagnosis of psychological disorders chose a desired activity and were randomly allocated to three thinking manipulation tasks: distraction, verbal reasoning, and desire thinking. Craving was measured before and after manipulation and during a 3-day period of abstinence from the desired activity. Findings showed that desire thinking had a significant effect on craving after manipulation. This effect appeared to be independent of baseline levels of craving and desire thinking as well as perceived stress changes during the manipulation. Both distraction and verbal reasoning inductions did not lead to a significant change in craving. Desire thinking impacts craving and is a risk factor for craving-related problems. (PsycINFO Database Record (c) 2012 APA, all rights reserved).
How often and how strongly do people experience desires, to what extent do their desires conflict with other goals, and how often and successfully do people exercise self-control to resist their desires? To investigate desire and attempts to control desire in everyday life, we conducted a large-scale experience sampling study based on a conceptual framework integrating desire strength, conflict, resistance (use of self-control), and behavior enactment. A sample of 205 adults wore beepers for a week. They furnished 7,827 reports of desire episodes and completed personality measures of behavioral inhibition system/behavior activation system (BIS/BAS) sensitivity, trait self-control, perfectionism, and narcissistic entitlement. Results suggest that desires are frequent, variable in intensity, and largely unproblematic. Those urges that do conflict with other goals tend to elicit resistance, with uneven success. Desire strength, conflict, resistance, and self-regulatory success were moderated in multiple ways by personality variables as well as by situational and interpersonal factors such as alcohol consumption, the mere presence of others, and the presence of others who already had enacted the desire in question. Whereas personality generally had a stronger impact on the dimensions of desire that emerged early in its course (desire strength and conflict), situational factors showed relatively more influence on components later in the process (resistance and behavior enactment). In total, these findings offer a novel and detailed perspective on the nature of everyday desires and associated self-regulatory successes and failures.
Background:
Flashbacks are the hallmark symptom of Posttraumatic Stress Disorder (PTSD). Although we have successful treatments for full-blown PTSD, early interventions are lacking. We propose the utility of developing a 'cognitive vaccine' to prevent PTSD flashback development following exposure to trauma. Our theory is based on two key findings: 1) Cognitive science suggests that the brain has selective resources with limited capacity; 2) The neurobiology of memory suggests a 6-hr window to disrupt memory consolidation. The rationale for a 'cognitive vaccine' approach is as follows: Trauma flashbacks are sensory-perceptual, visuospatial mental images. Visuospatial cognitive tasks selectively compete for resources required to generate mental images. Thus, a visuospatial computer game (e.g. "Tetris") will interfere with flashbacks. Visuospatial tasks post-trauma, performed within the time window for memory consolidation, will reduce subsequent flashbacks. We predicted that playing "Tetris" half an hour after viewing trauma would reduce flashback frequency over 1-week.
Methodology/principal findings:
The Trauma Film paradigm was used as a well-established experimental analog for Post-traumatic Stress. All participants viewed a traumatic film consisting of scenes of real injury and death followed by a 30-min structured break. Participants were then randomly allocated to either a no-task or visuospatial ("Tetris") condition which they undertook for 10-min. Flashbacks were monitored for 1-week. Results indicated that compared to the no-task condition, the "Tetris" condition produced a significant reduction in flashback frequency over 1-week. Convergent results were found on a clinical measure of PTSD symptomatology at 1-week. Recognition memory between groups did not differ significantly.
Conclusions/significance:
Playing "Tetris" after viewing traumatic material reduces unwanted, involuntary memory flashbacks to that traumatic film, leaving deliberate memory recall of the event intact. Pathological aspects of human memory in the aftermath of trauma may be malleable using non-invasive, cognitive interventions. This has implications for a novel avenue of preventative treatment development, much-needed as a crisis intervention for the aftermath of traumatic events.
The working memory framework was used to investigate the factors determining the phenomenological vividness of images. Participants rated the vividness of visual or auditory images under control conditions or while performing tasks that differentially disrupted the visuospatial sketchpad and phonological loop subsystems of working memory. In Experiments 1, 2, and 6, participants imaged recently presented novel visual patterns and sequences of tones; ratings of vividness showed the predicted interaction between stimulus modality and concurrent task. The images in experiments 3, 4, 5, and 6 were based on long-term memory (LTM). They also showed an image modality by task interaction, with a clear effect of LTM variables (meaningfulness, activity, bizarreness, and stimulus familiarity), implicating both working memory and LTM in the experience of vividness.
Cognitive modelling of phenomena in clinical practice allows the operationalization of otherwise diffuse descriptive terms such as craving or flashbacks. This supports the empirical investigation of the clinical phenomena and the development of targeted treatment interventions. This paper focuses on the cognitive processes underpinning craving, which is recognised as a motivating experience in substance dependence. We use a high-level cognitive architecture, Interacting Cognitive Subsystems (ICS), to compare two theories of craving: Tiffany's theory, centred on the control of automated action schemata, and our own Elaborated Intrusion theory of craving. Data from a questionnaire study of the subjective aspects of everyday desires experienced by a large non-clinical population are presented. Both the data and the high-level modelling support the central claim of the Elaborated Intrusion theory that imagery is a key element of craving, providing the subjective experience and mediating much of the associated disruption of concurrent cognition.
The authors argue that human desire involves conscious cognition that has strong affective connotation and is potentially involved in the determination of appetitive behavior rather than being epiphenomenal to it. Intrusive thoughts about appetitive targets are triggered automatically by external or physiological cues and by cognitive associates. When intrusions elicit significant pleasure or relief, cognitive elaboration usually ensues. Elaboration competes with concurrent cognitive tasks through retrieval of target-related information and its retention in working memory. Sensory images are especially important products of intrusion and elaboration because they simulate the sensory and emotional qualities of target acquisition. Desire images are momentarily rewarding but amplify awareness of somatic and emotional deficits. Effects of desires on behavior are moderated by competing incentives, target availability, and skills. The theory provides a coherent account of existing data and suggests new directions for research and treatment.
Based on converging evidence that visual and olfactory images are key components of food cravings, the authors tested a central prediction of the elaborated intrusion theory of desire, that mutual competition between modality-specific tasks and desire-related imagery can suppress such cravings. In each of Experiments 1 and 2, 90 undergraduate women underwent an imaginal food craving induction protocol and then completed either a visual, auditory, or olfactory imagery task. As predicted, the visual and olfactory imagery tasks were superior to the auditory imagery task in reducing participants' craving for food in general (Experiment 1) and for chocolate in particular (Experiment 2). Experiment 3 replicated these findings in a sample of 96 women using a nonimagery craving induction procedure involving a combination of chocolate deprivation and exposure to chocolate cues. Thus, imagery techniques in the visual or olfactory domain hold promise for treating problematic cravings in disordered eating populations.
People who are sensitive to food temptations are prone to weight gain and obesity in food-rich environments. Understanding the factors that drive their desire to eat is key to limiting their reactions to available food. This study tested whether individual differences in sensitivity to hedonic food cues are cognitively based and, accordingly, can be regulated by blocking cognitive resources. To this end, one lab study (study 1; N=91) and one field study (study 2; N=63) measured sensitivity to hedonic food cues using the Power of Food Scale (PFS; Lowe et al., 2009) and assessed participants' appetitive responses to high-calorie food options. To test the role of cognitive elaboration of food cues, participants completed a menu-selection task to induce food cravings and then were free to elaborate those cravings (control group) or were blocked from doing so by cognitive distraction (playing Tetris, solving puzzles; experimental group). Compared to non-sensitive participants, sensitive participants displayed a greater attentional bias to high-calorie food (Study 1), reported stronger cravings (Study 2), and more often chose an unhealthy snack (Studies 1 & 2), but only when they had not been distracted. When distracted, all participants were similarly unresponsive to high-calorie food. This finding suggests that temptation can be effectively controlled by blocking people's cognitive resources, even for people highly sensitive to hedonic food cues.
Research into craving is hampered by lack of theoretical specification and a plethora of substance-specific measures. This study aimed to develop a generic measure of craving based on Elaborated Intrusion (EI) Theory. Confirmatory Factor Analysis (CFA) examined whether a generic measure replicated the 3-factor structure of the Alcohol Craving Experience (ACE) scale over different consummatory targets and timeframes.
Twelve studies were pooled for CFA. Targets included alcohol, cigarettes, chocolate and food. Focal periods varied from the present moment to the previous week. Separate analyses were conducted for Strength and Frequency forms.
Nine studies included university students, with single studies drawn from an Internet survey, a community sample of smokers, and alcohol-dependent outpatients.
A heterogeneous sample of 1230 participants.
Adaptations of the Alcohol Craving Experience (ACE) questionnaire.
Both craving Strength (CFI .974; RMSEA .039, 95%CI .035-.044) and Frequency (CFI .971, RMSEA .049, 95%CI .044-.055) gave an acceptable three-factor solution across desired targets that mapped onto the structure of the original ACE (Intensity, Imagery, Intrusiveness), after removing an item, reallocating another and taking intercorrelated error terms into account. Similar structures were obtained across timeframes and targets. Preliminary validity data on the resulting 10-item Craving Experience Questionnaire (CEQ) for cigarettes and alcohol were strong.
The Craving Experience Questionnaire (CEQ) is a brief, conceptually grounded and psychometrically sound measure of desires. It demonstrates a consistent factor structure across a range of consummatory targets in both laboratory and clinical contexts.
This study demonstrated the applicability of the well-established laboratory task, dynamic visual noise, as a technique for reducing naturally occurring food cravings and subsequent food intake. Dynamic visual noise was delivered on a hand-held computer device. Its effects were assessed within the context of a diary study. Over a 4-week period, 48 undergraduate women recorded their food cravings and consumption. Following a 2-week baseline, half the participants watched the dynamic visual noise display whenever they experienced a food craving. Compared to a control group, these participants reported less intense cravings. They were also less likely to eat following a craving and consequently consumed fewer total calories following craving. These findings hold promise for curbing unwanted food cravings and craving-driven consumption in real-world settings.
This study compared 40 female participants in a behavioral weight loss program who frequently reported cravings sweets to 40 who rarely reported craving sweets using 2-week behavioral eating diaries. The two groups were compared on physiological, demographic, and questionnaire measures and no significant differences were found. There were no significant differences in macronutrient intake either overall or in wide range of specific situations. The relative proportions of carbohydrate, protein, and fat consumed in association with craving sweets differed only slightly from the composition of other meals and snacks. Carbohydrate and protein intake when craving sweets was similar to breakfasts while the relative amount of fat consumed when craving sweets comparable to episodes of overeating. The two groups differed in their reporting of moods with the high-craving group reporting more boredom and less stress than the low-craving group. The relationship between situational andmood variables and reports of craving sweets did not differ between the two groups. Craving sweets was negatively associated with hunger and was not associated with meal skipping. A sequential analysis demonstrated that eating in response to craving sweets triggers an abstinence violation effect. These data are not consistent with the hypothesis that sweet craver's consume high-carbohydrate, low- protein meals and snacks in order to self-medicate depression caused by serotonin depletion. Instead, the data suggests that we should further explore the role of food palatability and food- related cognitions in order to understand cravings sweets.
Elaborated Intrusion theory (EI theory; Kavanagh, Andrade, & May, 2005) posits two main cognitive components in craving: associative processes that lead to intrusive thoughts about the craved substance or activity, and elaborative processes supporting mental imagery of the substance or activity. We used a novel visuospatial task to test the hypothesis that visual imagery plays a key role in craving. Experiment 1 showed that spending 10 min constructing shapes from modeling clay (plasticine) reduced participants' craving for chocolate compared with spending 10 min 'letting your mind wander'. Increasing the load on verbal working memory using a mental arithmetic task (counting backwards by threes) did not reduce craving further. Experiment 2 compared effects on craving of a simpler verbal task (counting by ones) and clay modeling. Clay modeling reduced overall craving strength and strength of craving imagery, and reduced the frequency of thoughts about chocolate. The results are consistent with EI theory, showing that craving is reduced by loading the visuospatial sketchpad of working memory but not by loading the phonological loop. Clay modeling might be a useful self-help tool to help manage craving for chocolate, snacks and other foods.
Laboratory studies have shown that asking people to engage in imagery reduces the intensity of laboratory-induced food cravings. This study examined whether the intensity of naturally occurring cravings can be reduced by replacing the craving-related imagery with alternative, pleasant imagery. Participants were instructed to vividly imagine engaging in their favorite activity. They had to apply this imagery technique over a period of four days whenever they felt a craving arising and were asked to keep applying this technique until the craving passed. Compared to baseline, craving intensity and vividness of craving-related imagery were both significantly reduced. Vividness of craving-related imagery fully mediated the effect of the alternative imagery on craving intensity. No effects were found for control conditions in which participants (1) just formed the goal intention to reduce their cravings, (2) formed implementation intentions to reduce their cravings, and (3) engaged in a cognitive task (reciting the alphabet backwards). The findings suggest that vividly imagining a pleasant element can be an effective technique to curb cravings in everyday life.
To develop a measure of craving based on the Elaborated Intrusion (EI) theory of desire and to examine the construct, concurrent and discriminant validity of the instrument.
Cross-sectional.
Patients from a hospital alcohol and drug out-patient service (n = 230), participants in a randomized controlled trial (n = 219) and students in a university-based study of alcohol craving (n = 202) were recruited.
The Alcohol Craving Experience questionnaire (ACE) was developed to measure sensory aspects of craving (imagining taste, smell or sensations of drinking and intrusive cognitions associated with craving) when craving was maximal during the previous week (ACE-S: strength), and to assess frequency of desire-related thoughts in the past week (ACE-F: frequency). All participants completed the ACE and the Alcohol Use Disorders Identification Test (AUDIT). The Obsessive Compulsive Drinking Scale (OCDS) and the Depression Anxiety and Stress Scale (DASS) were completed by hospital patients and randomized control trial participants.
Exploratory factor analysis on the ACE-S and ACE-F resulted in a three-factor structure representing imagery, intensity and intrusion. An attempt to confirm this factor structure required a reduction in items (two from ACE-S, five from ACE-F) before a good fit to the three-factor model was obtained. Concurrent validity with the OCDS, with severity of alcohol dependence and with depression, anxiety and stress, was demonstrated. The ACE discriminated between clinical and non-clinical populations and between those at higher risk of alcohol dependence and those at lower risk.
A new scale, the Alcohol Craving Experience questionnaire, based on the Elaborated Intrusion theory of desire appears to capture key constructs of the theory and correlate with indices of alcohol dependence.
The Elaborated Intrusion (EI) theory of desire posits that visual imagery plays a key role in craving. We report a series of experiments testing this hypothesis in a drug addiction context. Experiment 1 showed that a mental visual imagery task with neutral content reduced cigarette craving in abstaining smokers, but that an equivalent auditory task did not. The effect of visual imagery was replicated in Experiment 2, which also showed comparable effects of non-imagery visual working memory interference. Experiment 3 showed that the benefit of visual over auditory interference was not dependent upon imagery being used to induce craving. Experiment 4 compared a visuomotor task, making shapes from modeling clay, with a verbal task (counting back from 100), and again showed a benefit of the visual over the non-visual task. We conclude that visual imagery supports craving for cigarettes. Competing imagery or visual working memory tasks may help tackle craving in smokers trying to quit.
Although dengue is a common disease in South-East Asia, there is a marked absence of virological data from the Malaysian state of Sarawak located on the island of Borneo. From 1997 to 2002 we noted the co-circulation of DENV-2, DENV-3 and DENV-4 in Sarawak. To determine the origins of these Sarawak viruses we obtained the complete E gene sequences of 21 isolates. A phylogenetic analysis revealed multiple entries of DENV-2 and DENV-4 into Sarawak, such that multiple lineages co-circulate, yet with little exportation from Sarawak. Notably, all viral isolates were most closely related to those circulating in different localities in South-East Asia. In sum, our analysis reveals a frequent traffic of DENV in South-East Asia, with Sarawak representing a local sink population.
We tested predictions from the elaborated intrusion (EI) theory of desire, which distinguishes intrusive thoughts and elaborations, and emphasizes the importance of imagery. Secondarily, we undertook preliminary evaluations of the Alcohol Craving Experience (ACE) questionnaire, a new measure based on EI Theory.
Participants (N = 232) were in correspondence-based treatment trials for alcohol abuse or dependence. The study used retrospective reports obtained early in treatment using the ACE, and daily self-monitoring of urges, craving, mood and alcohol consumption.
The ACE displayed high internal consistency and test - retest reliability and sound relationships with self-monitored craving, and was related to Baseline alcohol dependence, but not to consumption. Imagery during craving was experienced by 81%, with 2.3 senses involved on average. More frequent imagery was associated with longer episode durations and stronger craving. Transient intrusive thoughts were reported by 87% of respondents, and were more common if they frequently attempted to stop alcohol cognitions. Associations between average daily craving and weekly consumption were seen. Depression and negative mood were associated with more frequent, stronger and longer lasting desires for alcohol.
Results supported the distinction of automatic and controlled processes in craving, together with the importance of craving imagery. They were also consistent with prediction of consumption from cross-situational averages of craving, and with positive associations between craving and negative mood. However, this study's retrospective reporting and correlational design require that its results be interpreted cautiously. Research using ecological momentary measures and laboratory manipulations is needed before confident inferences about causality can be made.
Pretreatment measures of craving for carbohydrates were related to higher dropout rates during the first month of a protein-sparing fast. 97 patients in a medically supervised weight-loss program, who were at least 50 pounds overweight, completed the Beck Depression Inventory, the Eating Inventory, and a questionnaire about their food habits before beginning a supplemented fast. While self-reported cravers of carbohydrates were significantly more likely to drop out during the first month of treatment than noncravers, this result does not appear to be related to differences in depression, disinhibition, or cognitive restraint.
A common assumption is that dieting causes food cravings, probably as a result of food energy deprivation. This issue was investigated in a two-phase study. In phase one, 206 women completed the Dutch Eating Behaviour Questionnaire, the Three-Factor Eating Questionnaire and a food craving scale. A correlational analysis showed food craving to be only weakly related to dietary restraint, but highly and significantly correlated with external eating, emotional eating and susceptibility to hunger. In phase two, ten women who regularly experienced food cravings and ten who rarely craved food kept prospective records of their food intake, daily mood and food craving episodes. There were few differences in eating behaviour, although the cravers tended to consume slightly more daily energy than the non-cravers. The cravers had higher ratings of boredom and anxiety during the day, and dysphoric mood was prominent prior to the cravings themselves. Food deprivation does not appear to be a necessary condition for food cravings to occur. Rather, food cravings are closely associated with mood, in particular as an antecedent to craving and also as a consequence of craving.
This research investigated the effect of alcohol consumption on smokers' general levels of craving for cigarettes and their reactivity to smoking-related cues. Cue reactivity was evaluated across multiple trials of exposure to both imaginal and in vivo presentations of smoking and non-smoking stimuli. On imagery trials, subjects imagined either smoking and non-smoking scenarios; during in vivo trials subjects watched an experimenter either smoke a cigarette or drink water. Measures included self-reported craving to smoke and selected somatovisceral responses. Subjects (n = 60) completed two sessions, the first examined cue reactivity in the absence of alcohol. In Session 2 subjects were told they were consuming alcohol; half received placebo and the other half were given ethanol (0.75 ml/kg). Following beverage consumption, subjects were exposed to the cue manipulation. In both sessions, exposure to smoking stimuli enhanced craving in each presentation mode and increased skin conductance levels in the in vivo mode. Alcohol intoxication produced a generalized increase in craving but did not selectively enhance craving or physiological reactivity to smoking stimuli. The results are discussed in terms of models of craving and processes through which alcohol may influence craving to smoke.
Fifty young-adult and 48 elderly Ss participated in a structured interview study on food cravings (defined as an intense desire or longing to eat a particular food). Elderly Ss were less likely than young Ss to report cravings and reported craving a smaller number of different foods. In contrast to a number of other researchers, we found a relationship between dietary restrictions and cravings. Types of food craved differed by gender and age. Women reported significantly more cravings for chocolate and for sweets than did men. However, craving for sweets declined with age among women. Cravings were not evenly distributed throughout the day, but tended to occur in the late afternoon and early evening.
Food cravings are a frequently described antecedent to binge eating, yet not all of those who report food cravings also binge eat. The present study sought to determine the factors that distinguish cravers who binge versus those whose cravings are satisfied by a relatively "normal" amount of food.
A food craving questionnaire, a psychiatric diagnostic interview containing questions on binge eating, and a self-report booklet were completed by a group of cravers recruited by advertisement and a group of cravers from a randomly selected sample.
In both groups, the cravers who binged were differentiated from those who did not binge by higher measures of body mass index (BMI), more frequent diagnoses of bulimia nervosa, a higher level of dietary restraint, and a by a temperament characterized by low self-directedness. In the recruited cravers, those who binged were also more likely to have had an episode of major depression, social phobia, to be cognitively controlled and harm avoidant. A comparison of recruited cravers with randomly selected cravers and control women suggests that greater rates of psychopathology and eating-related disturbances and lower levels of parental care may be found in recruited samples.
In addition to elucidating factors associated with binge eating in cravers, this study highlights important differences between recruited and random samples.
Two studies are presented, which examine cue reactivity in dieting.
Experiment 1 investigated whether the presence of a preferred food affected dieters' performance on measures of attention, reaction time, and motor speed. The manipulation did not affect the performance. Experiment 2 investigated the performance of dieters (N = 19), highly restrained non-dieters (N = 18) and low-to-medium restrained eaters (N = 34) on two simple reaction time tasks. Subjects were either required to imagine their favorite food or to imagine their favorite holiday while completing a reaction time task.
In the food condition, both dieters and restrained nondieters displayed significantly slower reaction times during the first three of five blocks of the task than the low-to-medium restrained eaters.
The results are discussed in terms of Tiffany's (Psychological Review 97:147-168, 1990) model of cue reactivity in that different abstinent states produce comparable effects upon performance.
The aim of this survey was to study food cravings and its indulgence in community adults (538 women and 506 men) and to compare nutritional parameters, weight preoccupations, and weight history between cravers and noncravers.
Cravers experienced a strong urge to eat specific foods more than once a week during the past 6 months. Food intake was estimated by a 3-day food record.
28% of women and 13% of men were food cravers. Cravers, especially women, were more frequently concerned about their weight than noncravers. Energy intake during snacks was higher in cravers. Less than 40% of cravers reported being hungry when they experienced cravings. Women cravers indulged their cravings as often as men. They reported more frequently negative feelings, whereas men reported more frequently positive feelings.
This study shows that food craving episodes are strongly associated with mood but in a different way in women and men.
Several authors have hypothesized that visuo-spatial working memory is functionally analogous to verbal working memory. Irrelevant background speech impairs verbal short-term memory. We investigated whether irrelevant visual information has an analogous effect on visual short-term memory, using a dynamic visual noise (DVN) technique known to disrupt visual imagery (Quinn & McConnell, 1996b). Experiment I replicated the effect of DVN on pegword imagery. Experiments 2 and 3 showed no effect of DVN on recall of static matrix patterns, despite a significant effect of a concurrent spatial tapping task. Experiment 4 showed no effect of DVN on encoding or maintenance of arrays of matrix patterns, despite testing memory by a recognition procedure to encourage visual rather than spatial processing. Serial position curves showed a one-item recency effect typical of visual short-term memory. Experiment 5 showed no effect of DVN on short-term recognition of Chinese characters, despite effects of visual similarity and a concurrent colour memory task that confirmed visual processing of the characters. We conclude that irrelevant visual noise does not impair visual short-term memory. Visual working memory may not be functionally analogous to verbal working memory, and different cognitive processes may underlie visual short-term memory and visual imagery.
Two experiments adopted a working memory approach to evaluate the effectiveness of visuospatial tasks as a technique for reducing food cravings.
Dieting and non-dieting women were asked to form images of both food-related and nonfood items, induced by either pictures (Experiment 1) or verbal cues (Experiment 2). They were required to concurrently perform one of three tasks that load on the visuospatial sketch pad of working memory: saccadic eye movements, dynamic visual noise, or spatial tapping.
In support of the working memory model of limited visuospatial capacity, concurrent visuospatial activity reduced the vividness of food-related images which, in turn, reduced the intensity of the associated craving. The same pattern of results was observed across dieters and non-dieters and for all stimulus types.
Visuospatial tasks may provide a useful technique for the treatment of food craving episodes in both nonclinical and clinical populations.
The study investigated the specificity of visuo-spatial working memory-based techniques as a means to reduce chocolate cravings. Twenty-four self-identified chocolate cravers and 24 non-cravers formed and maintained images of chocolate-containing foods elicited by pictures, while performing a visuo-spatial task (loading the visuo-spatial sketch pad) or an auditory task (loading the phonological loop). Vividness and craving intensity were rated for each image. Concurrent visuo-spatial processing was found to render chocolate images significantly less vivid and cravings less intense compared to concurrent verbal processing, for both cravers and non-cravers. Chocolate cravers did, however, report higher levels of chocolate craving and intake than non-cravers. It was concluded that visuo-spatial tasks provide an effective craving reduction mechanism for the management of chocolate cravings. Such techniques may be particularly useful in populations for whom eating problems are triggered by chocolate craving.
The study used a working memory approach to examine the nature of the imagery processes underlying food cravings.
A sample of 60 dieters and 60 non-dieters were asked to imagine either a food induction or a holiday induction scenario. Participants then performed 18 trials of either a visual imagery task (loading the visuo-spatial sketch pad) or auditory imagery task (loading the phonological loop). Food craving was measured before and after the induction scenario, and then after every 6 trials of the imagery task.
Craving intensity increased following instructions to imagine the food (but not holiday) induction scenario, especially for dieters. As predicted, the visual imagery task was superior to the auditory imagery task in reducing the level of food craving.
The results confirmed the imaginal basis of food cravings. Specifically, they demonstrated that the imagery processes involved in food cravings are predominantly visual in nature. Hence concurrent tasks that load the visuospatial sketch pad of working memory can be used to reduce food cravings. The findings have potential application in the treatment of craving episodes in clinical populations.
Nonclinical participants watched a trauma film under two processing conditions. During part of the film participants carried out a concurrent visuospatial grounding task consisting of the construction of shapes out of plasticine (modelling clay), while the rest of the film constituted a control, no task condition. The visuospatial task was predicted to selectively compete for processing resources required for intrusive image formation. As predicted, spontaneous intrusive images during the succeeding week were significantly less common from those parts of the film that coincided with the concurrent task. The task had no effect on levels of distress or peritraumatic dissociation, consistent with the hypothesis that intrusions were reduced because the task competed for resources necessary for encoding into an image-based memory system.
This study aimed to extend recent experimental work on the efficacy of visuo-spatial working memory-based techniques for reducing food cravings by adopting a more naturalistic methodology. Fifty undergraduate women formed images of their favorite foods while performing a visuo-spatial task across six successive trials. Vividness and craving intensity were rated for each food image. Concurrent visuo-spatial processing reduced the vividness of, and craving reactivity to, personally relevant food images. Forehead tracking, a novel self-administered task, proved to be as effective in reducing vividness and craving ratings as the established visuo-spatial working memory laboratory tasks of eye movements, dynamic visual noise, and spatial tapping, and thus presents a simple, accessible technique potentially applicable in the home environment. All four tasks maintained their reducing effect over multiple trials. Individual differences in imaging ability and habitual food craving did not impact upon their effectiveness, indicating that visuo-spatial tasks can be successfully used to reduce food cravings across a range of people.
The present study investigated the effects of hunger and visuo-spatial interference on imagery-induced food cravings. Forty-two women were randomly assigned to a hungry (no food for prior 4h) or not hungry condition. Participants were asked to form and maintain images of desired foods while looking at a blank computer screen (control condition) or performing a task designed to load the visuo-spatial sketchpad of working memory (dynamic visual noise). They then rated the vividness of their images and their craving intensity. Although hungry participants reported stronger food cravings, dynamic visual noise made images less vivid and cravings less intense, irrespective of participant hunger status. Thus concurrent visuo-spatial processing may offer a useful technique for treating problematic food cravings that are predominantly psychological in origin, as well as those that are hunger-driven.
The study investigated the relative effectiveness of thought suppression and the working memory-based method of dynamic visual noise as techniques for reducing food cravings. Twenty dieting women on the weight-loss programme prescribed by weight watchers and 20 non-dieting controls formed images of their most craved food and then suppressed thoughts of the food or watched a flickering pattern of black and white dots (dynamic visual noise). Both thought suppression and dynamic visual noise reduced cravings for weight watchers and non-dieters. However, their relative effectiveness varied according to participant dieting status. Specifically, while both techniques reduced cravings equally well for non-dieters, dynamic visual noise was clearly the more effective technique for weight watchers. Thus, dynamic visual noise may provide a useful tool for controlling problematic cravings in clinically overweight or obese individuals who are actively trying to lose weight.
One hundred and thirty-four non-dieting participants spent 5 min thinking aloud under three different conditions. Participants either suppressed or expressed thoughts of eating chocolate, or verbalised with no further instructions. After thinking aloud, all participants took part in a taste preference task where they tried two brands of chocolate and answered questions about their preference. Unbeknownst to participants the variable of interest was the amount of chocolate eaten, not their preference. Results indicated an interaction between condition (suppression vs. expression vs. control) and gender. Both male and female participants showed a behavioural rebound effect, consuming significantly more chocolate after suppression than participants in the verbalise only control group. However, in the expression group, a clear difference between males and females was manifested, while females ate a similar amount of chocolate in the expression and verbalise only control groups, males ate the most chocolate in the expression group and this was significantly greater than the amount eaten after suppression or the verbalise only control group.