Metacognition in addictive behaviors

doi:10.1016/j.addbeh.2014.08.002

Addictive Behaviors

Volume 44, May 2015, Pages 9-15

https://doi.org/10.1016/j.addbeh.2014.08.002 Get rights and content

Highlights

•
An overview of the metacognitive model of psychopathology.
•
An examination of its relevance to addictive behaviours.
•
A discussion of the application of metacognitive therapy to addictive behaviors.

Abstract

Background

Over the last twenty years metacognitive theory has provided a novel framework, in the form of the Self-Regulatory Executive Function (S-REF) model, for conceptualizing psychological distress (Wells & Matthews, 1994, 1996). The S-REF model proposes that psychological distress persists because of unhelpful coping styles (e.g. extended thinking and thought suppression) which are activated and maintained as a result of metacognitive beliefs.

Objective

This paper describes the S-REF model and its application to addictive behaviors using a triphasic metacognitive formulation.

Discussion

Evidence on the components of the triphasic metacognitive formulation is reviewed and the clinical implications for applying metacognitive therapy to addictive behaviors outlined.

Section snippets

Metacognition in psychopathology: the Self-Regulatory Executive Function model

The term ‘metacognition’, which is most often associated with the work of John Flavell, 1979, Flavell, 1987, can be broadly defined as knowledge and cognitive processes that are involved in the appraisal, control, or monitoring of thinking. Theory and research in metacognition emerged in developmental psychology and has, over the last forty years, been applied across various domains including aging, education, forensic psychology, memory, and neuropsychology (Dunlosky and Metcalfe, 2009, Nelson

Applying the S-REF model to addictive behaviors

Spada and Wells (2009) and Spada, Caselli, and Wells (2013) have applied the S-REF model to addictive behaviors (see Fig. 2). In their formulation the CAS and metacognitive beliefs are conceptualized across three temporal phases of the addictive behavior episode: pre-engagement, engagement, and post engagement. What follows is an exposition of these different phases in nicotine use.

In the pre-engagement phase triggers in the form of urges, images, memories or thoughts activate the S-REF and

A review of research evidence on the components of the triphasic metacognitive formulation of addictive behaviors

The triphasic metacognitive formulation of addictive behaviors proposes that aspects of the CAS such as attentional bias, extended thinking (e.g. desire thinking, rumination and worry), disruption in metacognitive monitoring and thought suppression should be associated with addictive behaviors and lead to maladaptive consequences including increased levels of craving and engagement. The formulation also proposes that metacognitive beliefs should be associated with aspects of the CAS and

Clinical implications of a triphasic metacognitive formulation of addictive behaviors

The triphasic metacognitive formulation of addictive behaviors presented implies that MCT (Wells, 2000, Wells, 2009) may be applied to addictive behaviors. For example, in the pre-engagement phase the primary therapeutic target would be interrupting extended thinking and modifying associated metacognitive beliefs. In this phase Detached Mindfulness, which involves encouraging the patient to observe their urge, images, memories and thoughts without trying to control or change them, would feature

Conclusions

The S-REF model provides a conceptual framework for expressing how stored knowledge and beliefs about thinking processes influence the choice of plans and regulation of coping. A review of the research evidence indicates that the central features of the S-REF model; CAS configurations and metacognitive beliefs, are present in addictive behavior. These processes can be interpreted within a triphasic metacognitive formulation that has implications for adapting and targeting MCT for addictive

Role of funding sources

The study was completely self-funded.

Contributors

The manuscript was co-written by all four authors.

Conflict of interest

There are no conflicts of interest to declare.

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Metacognition in addictive behaviors

Highlights

Abstract

Background

Objective

Discussion

Section snippets

Metacognition in psychopathology: the Self-Regulatory Executive Function model

Applying the S-REF model to addictive behaviors

A review of research evidence on the components of the triphasic metacognitive formulation of addictive behaviors

Clinical implications of a triphasic metacognitive formulation of addictive behaviors

Conclusions

Role of funding sources

Contributors

Conflict of interest

Addictive Behaviors

Addictive Behaviors

Addictive Behaviors

Addictive Behaviors

Drug and Alcohol Dependence

Addictive Behaviors

Drug and Alcohol Dependence

Drug and Alcohol Dependence

Biological Psychology

Addictive Behaviors

Addictive Behaviors

Behaviour Research and Therapy

Behaviour Research and Therapy

Behaviour Therapy and Experimental Psychiatry

Addictive Behaviors

Behaviour Research and Therapy

Computers in Human Behavior

Addictive Behaviors

Addictive Behaviors

Personality and Individual Differences

Behaviour Research and Therapy

Behaviour Research and Therapy

The nature, functions and origins of worry

Rumination in problem drinkers

Addiction Research & Theory

Desire thinking across the continuum of drinking behaviour

European Addiction Research

Rumination as a predictor of drinking behaviour: A prospective study

Addiction

Desire thinking across the continuum of nicotine dependence

Addiction Research & Theory

The effect of desire thinking on craving: An experimental investigation

Psychology of Addictive Behaviors

Metacognitions in desire thinking: A preliminary investigation

Behavioural and Cognitive Psychotherapy

The metacognitions about Desire Thinking Questionnaire: Development and psychometric properties

Journal of Clinical Psychology

A cognitive model of social phobia

Metacognition

I suppress, therefore I smoke: Effects of thought suppression on smoking behavior

Psychological Sciences

Effect of thought suppression on desire to smoke and tobacco withdrawal symptoms

Psychopharmacology

Attentional biases for alcohol cues in heavy and light social drinkers: The roles of initial orienting and maintained attention

Psychopharmacology