learning objectives Flashcards
(70 cards)
define compulsivity?
behavior that is continued despite explicit knowledge of devastating negative consequences in various disorders
what’s the transdiagnostic approach and why it may be useful?
- transdiagnostic approach focuses of common psych/neurobio mechanisms that underly behavior -> goes away from labels and caategorization
- transdiagnostic perspective on compulsivity can open up new ways of exploring not only their development and commorbidity but also new targets for prevention and treatment
definition of ‘endophenotype’?
measurable trait or characteristic that links genetic factors to complex psychopathology
Explain what the RDoC initiative of the NIMH entails?
- research domain categoria
- transdiagnostic framework
- considers major domains instead of categories
what are the self-report measures (and their differences) for measuring real-world habits?
- SRHI (Self Report Habit Index): asking people about their subjective experiences of doing something out of habit -> measures repetition, automaticity, identity
- SRBAI (Self report behavioral automaticity): only the automaticity items from the SRHI
Describe what implementation intentions (II’s) are and explain two working mechanisms?
IIs are specific if-then action plans that tie the intended behavior to a concrete cue or situation. help bypass the need for motivation in the moment.
working mechanisms: 1. ‘If’ – Heightened cue accessibility
2. ‘If–then’ – Strong stimulus-response link.
Describe how II’s can be used to form new habits and break existing ones
Forming habits: IIs link a cue to a specific action; with repetition in a stable context, this builds automaticity (Verhoeven & de Wit, 2018).
Mechanisms: “If” boosts cue awareness, “then” triggers the action, and repetition cements the habit.
Breaking habits: Substitution-based IIs (e.g., “If I crave sugar, then I’ll drink tea”) are more effective than negation; they rewire the cue–response link and avoid ironic rebound effects.
Explain the relevance of the difference between instigation and execution habits for habit-based interventions
Instigation vs. execution: Instigation = starting a behavior (e.g., feeling you’re smelly and grabbing towel); execution = doing it (e.g. the steps of showering).
Intervention focus: IIs primarily target instigation, helping people start behaviors by tying them to cues (Gardner et al., 2024).
Why it matters: Instigation is the usual failure point; execution often follows naturally once initiated and improves through repetition.
Describe and explain different components of habit-based interventions, their theoretical basis, and how they can support behavior change
step 1: choose behavior highly motivated to change (motivation is key -> MI).
step 2: determine critical cue (if) -> importance of personal cue (cue monitoring diary and mental contrasting).
step 3: habit discontinuity hypothesis ( changing context creates window of opportunity to create new habit).
step 4: then component (habit substitution instead of negation due to ironic process theory)
step 5: monitor and adjust.
step 6: sequential (small steps)
step 7: celebrate and reward.
Be able to predict the main driver of behavior (habits or intentions or both) depending on the level of self-control
- when habits override intentions depend on the availability of self-control resources.
- high self-control: (1) intentions are the sole determinant of behavior in the absence of habits (2) habit can support intentions (when habit for intended behavior is strong) and this frees up cognitive resources (3) conflicting habits can compete with intentions (who wins depends on many factors and strength)
- low self-control (fatigue, distraction or stress): habits are the main determinant of behavior.
Name factors contributing to the effectiveness of II’s and habit-based interventions
Formulation quality matters: Specific, action-based IIs (e.g., “If I feel stressed, I’ll go for a walk”) are more effective than vague or negation-based ones (e.g., “I won’t smoke”), especially when tied to personal cues.
Context, repetition, and timing: IIs work best when repeated in stable environments and during life changes (Habit Discontinuity); chaotic routines reduce success.
Individual differences: Effectiveness decreases with strong habits, low motivation, or rigid thinking (e.g., OCD), but increases in those with low executive functioning (e.g., ADHD, schizophrenia) who benefit from reduced reliance on conscious control.
Advise on how effective II’s should be formulated based on a case study
Key Principles from Verhoeven & de Wit (2018):
Be specific: IIs should link a cue to a clear, action-based response — not vague goals.
Use substitution: Replace unwanted behavior with a positive alternative (e.g., “order a soft drink” instead of “don’t drink”).
Support with strategy: Mental contrasting and cue monitoring help identify effective triggers.
Keep it simple: Use only one II per behavior at a time to avoid interference.
Go step-by-step: Implement IIs sequentially — this mirrors CBT techniques like ERP.
Provide logical/evidence-based arguments as to whether II’s can be succesfully applied to compulsive behavior in mental disorders
Compulsive behaviors stem from strong, cue-driven habits that persist despite consequences.
IIs can help by automating alternative responses, aligning with CBT methods like habit reversal.
Evidence supports use in clinical groups (e.g., self-harm, OCD, ADHD), improving outcomes like reduced avoidance and better impulse control.
Limitations: Less effective for deeply entrenched habits (e.g., long-term addiction), and depend on factors like motivation, cue insight, and cognitive flexibility.
What are the DSM criteria of gambling disorder?
persistent recurrent problematic gambling behaviour leading to clinically significant impairment or distress, meet min 4 out of these in 1y
1. Need to gamble w increasing amount of money to achieve the desired excitement (tolerance)
2. Restless or irritable when trying to cut down or stop gambling (withdrawal)
3. Repeated unsuccessful efforts to control, cut back on or stop gambling
4. Frequent thoughts about gambling (such as reliving past gambling experiences, planning the next gambling venture, thinking of ways to get money to gamble) (craving)
5. Often gambling when feeling distressed
6. After losing money gambling, often returning to get even (referred to as “chasing” one’s losses) -> chasing losses
7. Lying to conceal gambling activity
8. Jeopardizing or losing a significant relationship, job or educational/career opportunity because of gambling
9. Relying on others to help with money problems caused by gambling
Describe how problematic gambling can be measured
questionnaries:
- problem gambling severity index (9 items based on DSM criteria, often used for general pop)
- south oaks gambling screen (16 items, often used for clinical pop)
Be able to name and explain psychological factors that contribute to the addictive potential of gambling
- machine features
- human design features
what are the machine feature that contribute to the addictive potential of gambling?
- unfrequent reinforcement chedule (interacts with the gambler’s fallacy)
- shortime between bet and outcome & higher stake bets (both regulated)
- near misses: triggers brain regions (namely the insula) even tho is not an actual win -> influenced by severity of symptoms
- audiovisual stimuli
- losses disguised as wins
what are the human design feature that contribute to the addictive potential of gambling?
- executive functions (response inhibition, delay discounting, decision making)
- reduced cognitive flexibility (stroop task)
- gambler’s fallacy: expecting outcomes to balance out despite randomness (justifies chasing of losses and continued gambling)
- illusion of control: perceiving skill development in games of chance (gives feeling of confidence to do risky behaviors and chase losses)
- cue reactivity (attention bias to gambling cues)
- abnormal reward antecipation (high in gambling contexts, low in neutral ones) and processing (decreased striatal response for both wins and losses)
explain what neurobiological processes are disrupted in the onset and the course of gambling disorder
- diminished physiological responses before risky choices -> might explain continue gambling despite loses
- changes in the brain’s mesolimbic reward circuitry, leading to heightened attention to gambling cues and increased motivation to gamble
- heightened ventral straitum response to anticipation of reward, even if it’s a loss -> in gambling context!!
- diminished prefrontal activation during loss avoidance (less cognitive control)
- activation of sympathetic NS and cortisol release
- abnormalities in amygdala and anterior insula region (correlates to near misses preception)
Explain the utility of gambling disorder as a model of addiction
- Gambling doesn’t cause neurotoxic damage, making it a good model to study addiction without drug-induced brain changes
- helps us understand how natural rewards influence addiction mechanisms
- opens door to consider other types of addiction (e.g. internet addiction)
describe the three pathways of the three-pathway model of the development of addiction
- biopsychosocial model
- identifies 3 three distinct routes through which pathological gambling can develop
- Behaviorally conditioned gamblers with no major biological issues, but who gamble due to early exposure and environmental factors
- Emotionally vulnerable gamblers, who have traits like anxiety, depression, or risk-taking, often with underlying neurobiological susceptibilities
- Antisocial-impulsivist gamblers, who also show impulsivity, ADHD traits, and antisocial behaviors
take a critical stance regarding the existence of behavioral addictions in general: can any behavior be addictive? Where do we draw the line?
(roos answered) gambling is in DSM cause of similarities to other SUDs in symptoms, comorbidities etc.
other behaviour addicitons (foodn, sex, shopping etc) are under consideration but data & research still inconclusive
most important components of CBT for GD?
- focus of request for help and motivation (MI to increase it)
- psychoeduction
- Functional analysis to identify both the triggering and sustaining factors
- ‘stimulus control’ to stop gambling and regain control over the behaviour in the short term
- Challenging “gambling illusions” or irrational thoughts
- Relapse prevention
similarities GD and SUD?
- high commorbidity
- similar risk factors
- same effective treatments (CBT)
- similar neuropsychological mechanisms
- both explanatory models highlight conditioning and impulsivity, and both link biased evaluation to abnormal reward processing
