The Experimental Manipulation of Desire Thinking in Alcohol use Disorder

Group based metacognitive therapy for alcohol use disorder: a pilot study

Introduction

Alcohol use disorder (AUD) is a severe clinical disorder, which has been associated with 5.3% of death worldwide. Although several treatments have been developed to improve AUD symptomatology, treatment effects were moderate, with a certain amount of patients displaying symptom deterioration after treatment termination. Moreover, outpatient treatment placements become increasingly scarce, thus necessitating more efficient treatment options. Therefore, the aim of the present study was to investigate the efficacy, feasibility, and acceptability of a newly invented, short, group based metacognitive therapy (MCT) for patients diagnosed with AUD.

Method

Seven patients were treated with eight sessions of group based MCT using a single case series design with an A-B replication across patients. Patients were assessed one month and one week before treatment, as well as one week and three months after treatment termination.

Results

Patients improved significantly and with large effect sizes regarding dysfunctional metacognitive beliefs, desire thinking/craving and depressive symptoms up to three months after treatment termination. AUD symptomatology as well as positive and negative metacognitive beliefs improved at post-treatment, but improvements could not be maintained at follow-up. All included patients completed the treatment and were highly satisfied.

Conclusion

The presented findings show preliminary evidence for the efficacy, feasibility, and acceptability of the implemented group based MCT treatment. Large scale randomized controlled trials (RCTs) are needed to confirm the effectiveness of the developed program for patients diagnosed with AUD.

Psychometric validation of the Chinese version of the desire thinking questionnaire in adolescent mobile phone users

BACKGROUND

Desire thinking is a conscious and voluntary cognitive process that is closely linked to levels of craving and addictive behaviors. The Desire Thinking Questionnaire (DTQ) can be used to measure desire thinking in all age groups as well as in addicts. This measurement has also been translated into several languages. This study aimed to test the psychometric properties of the Chinese version of the DTQ (DTQ-C) among adolescent mobile phone users.

METHODS

One thousand and ninety-seven adolescents who own a mobile phone and are younger than 18 years old completed the DTQ-C and a battery of questionnaires assessing the big five personality traits, negative affect, brooding, self-control, craving, and problematic mobile phone use (PMPU). The psychometric analyses of the DTQ-C were conducted, including exploratory factor analysis (EFA), confirmatory factor analysis (CFA), reliability, and validity analysis.

RESULTS

The EFA revealed a 10-item two-factor structure (i.e., verbal perseveration and imaginal prefiguration) that was confirmed by the CFA. The results of CFA showed fit indexes of χ²/df = 4.83, CFI = 0.967, TLI = 0.954, RMSEA = 0.059, SRMR = 0.032. The total scale had internal consistency reliabilities of 0.93, which demonstrated that DTQ-C presented good reliability. The two dimensions were correlated with PMPU (r_{verbal perseveration} = 0.54; r_{imaginal prefiguration} = 0.45), neuroticism (r_{verbal perseveration} = 0.18; r_{imaginal prefiguration} = 0.14), conscientiousness (r_{verbal perseveration} = -0.19; r_{imaginal prefiguration} = -0.18), depression (r_{verbal perseveration} = 0.22; r_{imaginal prefiguration} = 0.16), anxiety (r_{verbal perseveration} = 0.26; r_{imaginal prefiguration} = 0.22), stress (r_{verbal perseveration} = 0.15; r_{imaginal prefiguration} = 0.10) and self-control (r_{verbal perseveration} = -0.29; r_{imaginal prefiguration} = -0.26), which demonstrated that DTQ-C presented good concurrent validity. The two factors of DTQ-C correlated weakly with brooding (ranging from 0.08 to 0.10). The principal component factor analysis of the two dimensions of desire thinking and craving showed that craving and desire thinking belonged to different dimensions. Both of which showed good divergent validity of desire thinking. Additionally, an examination of incremental validity revealed that two factors were both positively associated with PMPU beyond demographic characteristics, big five personality traits, negative affect, and self-control (B_{verbal perseveration} = 0.49 and B_{imaginal prefiguration} = 0.13).

CONCLUSIONS

It has been found that the 10-item DTQ-C is a reliable and valid measure of desire thinking in Chinese adolescent mobile phone users.

License to look? The role of permissive beliefs, desire thinking, and self-control in predicting the use of social networking sites

Permissive beliefs are considered the most proximal predictor of actual behavior. Whereas they have frequently been researched in substance-use disorders, the field of social networking sites (SNS) use is missing the investigation as to how relevant permissive beliefs might be in this context, what might be causal precursors of permissive beliefs (i.e., desire thinking), and which processes might influence the effect that permissive beliefs have on actual behavior (i.e., self-control). To answer these questions, 116 people who use SNS participated in an online survey that contained an experimental manipulation of desire thinking and questionnaires measuring permissive beliefs, self-control, and severity of problematic SNS use. In a one-week follow-up, 85 participants reported their SNS usage times. Results showed that the association between permissive beliefs and tendencies to use SNS problematically was not significant. The experimental manipulation led to a decrease in permissive beliefs in the control condition, but did not increase permissive beliefs in the desire thinking condition. Permissive beliefs predicted SNS use in the follow-up assessment, which was not moderated by self-control. The results suggest that permissive beliefs seem to be unrelated to addictive tendencies of SNS use, but are nevertheless associated with daily use. Desire thinking does not appear to activate permissive beliefs in this study, possibly because the use of social networks is less often experienced as conflicting. Due to its ubiquitous availability, the use of social networks itself might quickly resolve the conflict between desires and possible regulatory attempts, making good reasons for use unnecessary.

Desire thinking as an underlying mechanism in alcohol use disorder and nicotine dependence

Desire thinking is an emerging construct in the addictive behaviours literature. No research, to date, has investigated its contribution to problematic alcohol use and nicotine dependence in patient samples when accounting for established predictors of addictive behaviours. The present study sought to clarify, in patient samples, the relative contribution of desire thinking in the associations between negative affect, impulsivity and thought suppression on the one hand and craving, problematic alcohol use and nicotine dependence on the other. To achieve this goal, two groups of individuals with alcohol use disorder (AUD) (n = 370; age range = 15-67 years) and nicotine dependence (n = 365; age range = 17-75 years) were selected, and measures of negative affect, impulsivity, thought suppression, craving, desire thinking, problematic alcohol use and nicotine dependence were completed by both groups. Results showed that in both groups, negative affect and thought suppression indirectly affected alcohol and nicotine craving, problematic alcohol use and nicotine dependence through the mediating role of desire thinking. The present study shows the independent role of desire thinking in predicting problematic alcohol use and nicotine dependence in patient samples, indicating its potential relevance for treatment.

The independent contribution of desire thinking to problematic social media use

In the present study, we investigated the role of desire thinking in problematic social media use (PSMU) whilst accounting for negative affect, impulsivity, and thought suppression. A sample of individuals with PSMU (n = 350) who used social media at least 8 h daily was recruited. Participants completed measures of negative affect, impulsivity, thought suppression, craving, desire thinking, and PSMU. Results indicated that negative affect, impulsivity, and thought suppression had significant indirect effects on craving and PSMU through the significant mediating role of desire thinking. The present study shows that desire thinking is an underlying mechanism linking established variables associated with PSMU (negative affect, impulsivity, and thought suppression) to craving and PSMU. Focusing efforts on the interruption of desire thinking may be beneficial to support individuals in disengaging from PSMU.

Psychometric validation of the desire thinking questionnaire in a Turkish adolescent sample: Associations with internet gaming disorder

BACKGROUND

Desire thinking is a conscious and voluntary cognitive process that consists of perseverative focus on information, memories, and prefiguration of images related to a desired target. The Desire Thinking Questionnaire (DTQ) is acknowledged as a reliable and valid tool to measure desire thinking in both adults and adolescents. The aim of the present study was to examine the psychometric properties of the DTQ in Turkish adolescent sample.

METHODS

A convenience sample of 200 adolescents completed the Turkish version of the DTQ (DTQ-T) and an Exploratory Factor Analysis (EFA) was performed. Subsequently, a convenience sample of 701 adolescents completed the DTQ-T and a battery of questionnaires assessing personality traits, affect, boredom, impulsivity, and Internet Gaming Disorder (IGD). A Confirmatory Factor Analysis (CFA) was performed on the DTQ-T and validity was determined by examining correlations with other measures.

RESULTS

A 9-item two-factor structure was observed in the EFA. An 8-item two-factor structure was established in the CFA. Results demonstrated that the DTQ-T yields adequate levels of reliability and concurrent validity. Additionally, an examination of incremental validity showed that DTQ-T significantly predicted IGD when controlling for personality traits, affect, boredom, and impulsivity.

CONCLUSIONS

The 8-item DTQ-T was found to be a reliable and valid measure of desire thinking among Turkish adolescents. Desire thinking may be a feasible target for mental health workers to alleviate the symptoms of IGD.

The desire thinking questionnaire-Persian version (DTQ-P) and its association with addictive behaviors in individuals with alcohol use disorder, nicotine dependence, and problematic social media use

Desire thinking is an emerging construct which has been shown to play a role in addictive behaviors. The present study sought to validate a translated Persian version of the Desire Thinking Questionnaire (DTQ) in three groups of individuals with Alcohol Use Disorder (AUD; n = 300), nicotine dependence (n = 300), and problematic social media use (n = 300). All three groups completed the translated Persian version of the DTQ, the Barratt Impulsiveness Scale-15 (BIS-15), the White Bear Suppression Inventory (WBSI), and the Depression Anxiety and Stress Scale-21 (DASS-21). Measures of alcohol use, nicotine dependence and problematic social media use were also collected. The results confirmed a two-factor structure of the Persian version of the DTQ with good reliability and validity in all three groups. Furthermore, both the verbal perseveration and imaginal prefiguration components of the Persian version of the DTQ were found to predict addictive behaviors beyond demographic and clinical characteristics, negative affect, impulsiveness, and thought suppression. The study confirms the psychometric properties of the Persian version of the DTQ and the role of desire thinking as an independent predictor of AUD, nicotine dependence, and the problematic use of social media.

Integrating Desire Thinking into the I-PACE Model: a Special Focus on Internet-Use Disorders

Purpose of Review

This manuscript aims to propose an integration of desire thinking into the Interaction of Person-Affect-Cognition-Execution (I-PACE) model based on theoretical considerations within the Elaborated Intrusion Theory of Desire and Self-Regulatory Execution Function model and empirical evidence from the field of internet-use disorders.

Recent Findings

Theory and research on desire thinking in the context of internet-use disorders suggest considerable relations to craving, metacognitive beliefs, and emphasizes its nature when initiated as a reaction towards unpleasant triggers. Accordingly, we postulate that desire thinking may be located at the position for affective and cognitive reactions towards triggers within the I-PACE model.

Summary

The suggested integration of desire thinking into the I-PACE model specifically implies the assumption of a relief-oriented and pleasure-oriented entry pathway into desire thinking and a feedback loop between desire thinking and the experience of gratification and compensation. The model pathways proposed here may serve as a theoretical basis for future research and need further empirical verification.

Fleeing through the mind's eye: Desire thinking as a maladaptive coping mechanism among specific online activities

INTRODUCTION

Desire thinking is defined as a voluntary cognitive activity aimed at imaginatively and verbally elaborating a future scenario of performing a desired behavior. Although not problematic per se, desire thinking can become dysfunctional if it is used to regulate negative mood states and due to its ability to induce craving. This study tests a mediation model where desire thinking is hypothesized to mediate the association between emotional reactivity and craving among specific online activities.

METHODS

The study comprised an online survey that was completed by 925 participants who indicated that their first-choice online activity was one out of social-networks use, shopping, gaming, gambling, or pornography viewing. In this sample, a structural equation model was tested where negative emotional reactivity, desire thinking, and craving were latently modelled in this serial order.

RESULTS

Results indicated that higher levels in negative emotional reactivity significantly predicted higher desire thinking tendencies, which in turn significantly predicted higher cravings for online activities. The direct path between negative reactivity and craving was not significant. Further, our results support the two-factorial structure of a German version of the Desire Thinking Questionnaire (Caselli & Spada, 2011).

DISCUSSION

The findings show that desire thinking might be initiated as an attempt to regulate negative affective states. This highlights its possible role as a maladaptive coping mechanism in the context of specific online activities due to the resulting craving responses, which in turn could promote the emergence of unwanted behaviors.

Does alcohol-related desire thinking predict in-the-moment drinking behaviours?

Desire thinking (voluntary thinking involving a perseverative focusing on desired target-related memories, images, and information), is an important factor in the experience of drinking urges and cravings. Research has not examined the relationship between desire thinking, behavioural intention and the implementation of that behaviour into action, nor how one's past repeated behaviour in situ (expressed as habit) may moderate these relationships. We employed an ad libitum drinking paradigm to provide indirect measures of in-the-moment drinking behaviours (amount poured [mls] and amount consumed [mls]) in a group of eighty-eight self-defined social drinkers immediately after measuring self-reported drinking habit, drinking-related desire thinking, and general drinking behaviour. Results confirmed the predicted positive relationship between desire thinking and in-the-moment drinking behaviour with the effects increasing as a function of rising drinking habit strength. We also observed a dissociation between desire thinking components (verbal perseveration and imaginal prefiguration) in the moderating effects of habit strength on drinking behaviour. For imaginal prefiguration (thoughts related to construction of mental images of a desired target or of its context for consumption) a direct effect on drinking behaviours was shown. In comparison, the effect for verbal perseveration (repetitive self-talk regarding the need to achieve a desired target) was not shown to independently predict drinking-related behaviour but was significantly moderated by increasing drinking-related habit strength. Future work should formulate the nature of this moderating influence on perseverative goal-directed thinking.

Psychometric properties of the Polish version of the desire thinking questionnaire in a sample of Internet game players

The Desire Thinking Questionnaire (DTQ) is the main instrument used to measure desire thinking, which is the voluntary cognitive elaboration of a desired target on a verbal or imaginal level. Research has shown that this pattern of thinking occurs in different addictive behaviors. This study aimed to adapt the DTQ for use in research on gaming behavior (DTQ-G) and to validate the Polish version of the DTQ-G in a sample of Internet game players. A sample of 635 gamers were examined via the internet. The psychometric analyses of the DTQ-G yielded good results. The questionnaire proved to be a reliable tool for measuring desire thinking related to gaming. Confirmatory factor analysis provided support for the two-factor solution, with both factors (imaginal prefiguration and verbal perseveration) achieving good internal consistency. The Polish version of the DTQ-G has good psychometric properties and can be considered comparable to the original version.

Validity of a Norwegian version of the Desire Thinking Questionnaire (DTQ): Associations with problem drinking, nicotine dependence and problematic social media use

The aim of the current study was to test the validity of the Norwegian version of the Desire Thinking Questionnaire (DTQ). Three cross-sectional surveys were conducted investigating the psychometric properties of the DTQ in alcohol use (N = 588), nicotine use (N = 446) and social media use (N = 359). Principal components and confirmatory factor analyses supported the original two-factor solution consisting of verbal perseveration (VP) and imaginal prefiguration (IP); however, one item was removed to obtain good fit. Internal consistency was acceptable. Both IP and VP showed significant correlations with problem drinking, nicotine dependence and problematic social media use. Regression analyses, controlling for demographics and negative affect, found IP and VP to be significantly associated with all dependent variables. The results confirm that desire thinking is an important construct across different addictive behaviours.

Desire thinking as a predictor of compulsive sexual behaviour in adolescents: Evidence from a cross-cultural validation of the Hebrew version of the Desire Thinking Questionnaire

BACKGROUND

Desire thinking is a voluntary cognitive process that involves the perseverative focus on memories, images and information related to a desired target. The aim of the present study was to validate the Hebrew version of the Desire Thinking Questionnaire (DTQ; Caselli & Spada, 2011) in a sample of adolescents and to investigate its relationship with measures of thought suppression, impulsivity and individual-based compulsive sexual behaviour.

METHODS

In Study 1, a convenience sample of 718 adolescents completed the newly translated Desire Thinking Questionnaire in Hebrew (DTQ-H) and results were subjected to an Exploratory Factor Analysis (EFA). In Study 2, a convenience sample of 379 adolescents completed a battery of questionnaires including the DTQ-H. A Confirmatory Factors Analysis was performed on the DTQ-H and validity was ascertained by correlating with other measures.

RESULTS

In Study 1, a 9-item two-factor structure was identified. A 6-item two-factor structure was confirmed in Study 2. Results also indicated that the DTQ-H has acceptable levels of reliability, and good concurrent and incremental validity in predicting compulsive sexual behaviour.

CONCLUSIONS

The 6-item DTQ-H appears to be a reliable and valid measure of desire thinking and may be used also on adolescents - an understudied population.

The Effect of State and Trait Self-Critical Rumination on Acute Distress: An Exploratory Experimental Investigation

Self-critical rumination is a process whereby individuals focus attention on past failures and inadequacies without consideration for improvement or problem-solving. Past research has demonstrated that self-critical rumination is a separate process from the experience of having intrusive self-critical thoughts and that engaging in self-critical rumination is strongly correlated with beliefs that it is uncontrollable or represents a weakness of character. What is less clear at this time, however, is the impact that self-critical rumination has on levels of distress when faced with failure. Thirty volunteers who were not experiencing significant levels of depression were randomly assigned across three groups: one rumination and two controls. Acute distress was measured prior to and immediately following a task, as well as upon debrief. Individuals expected to complete an impossible task, who experienced simulated self-critical rumination experienced greater levels of acute distress than controls immediately following the task. There was also a significant correlation between reported levels of trait self-critical rumination, negative metacognitive beliefs and self-esteem with levels of distress following debrief when controlling for initial levels of distress and group membership. The use of subjective self-reports and small sample size limits the findings of this exploratory study. Engaging in self-critical rumination, and associated negative metacognitive beliefs, may have a significant impact on levels of acute distress following a recent failure.

The effect of desire thinking on facilitating beliefs in alcohol use disorder: An experimental investigation

Permissive beliefs relate to the acceptability of engaging in alcohol use in spite of obvious potential negative consequences. They are considered the most proximal and precipitating cognitive factor in the decision to use alcohol and/or the activation of strategies to obtain it. Recent research suggested that 'desire thinking' may be involved in the escalation of craving and addictive behaviours and can play a role in strengthening permissive beliefs. The current study tested whether the induction of desire thinking would have a stronger effect on rate of conviction in permissive beliefs compared to a control cognitive response in the form of neutral thinking and whether this effect would be specific for patients with alcohol use disorder (AUD). Thirty AUD patients and 30 social drinkers (SD) were randomly allocated to two thinking manipulation tasks (desire thinking and neutral thinking). Current permissive beliefs were measured before and after manipulation and after a resting phase. Findings showed that desire thinking increased the level of current permissive beliefs after manipulation relative to the neutral thinking condition for the AUD group but not for the SD group. This effect was not purely dependent on the concurrent level of perceived craving. This study supports a causal relationship between the induction of desire thinking and rate of conviction in permissive beliefs and highlights the relevance of targeting desire thinking in the treatment for AUD patients.

Psychometric Validation of the Dutch Version of the Desire Thinking Questionnaire (DTQ-D)

Abstract. Desire thinking refers to verbal and imaginal elaboration of a desired target. It predicts escalations in craving intensity and subsequent alcohol use. This article aimed to determine the psychometric properties of the Dutch version of the Desire Thinking Questionnaire (DTQ-D). In Study 1, a confirmatory factor analysis provided support for the original two-factor solution, achieved with adequate internal consistency. The DTQ-D demonstrated partial invariance over time. In Study 2, convergent validity with measures of craving was demonstrated. Discriminant validity with measures of severity of alcohol use and perseverative thinking was satisfactory. Concurrent validity was established by comparing three distinctive groups of alcohol users with increasing levels of drinking: a normative and an out- and in-patient sample. The normative group scored significantly lower on the DTQ-D than the clinical groups. Within the normative sample a low and higher at-risk drinking group could be distinguished. Overall, the DTQ-D possesses reasonable psychometric properties for use with alcohol-drinking samples. However, additional psychometric evaluation in larger clinical samples as well as in other addictions is warranted.

The effects of food craving and desire thinking on states of motivational challenge and threat and their physiological indices

PURPOSE

Food craving has been shown to induce states of psychological challenge, indexed by increases in adrenaline but not cortisol production. The study aimed to test the relationship between challenge and (1) desire thinking (the active processing of the pleasant consequences of achieving a desired target and planning how to do so) and (2) craving.

METHODS

Participants (N = 61) self-reported their levels of craving and desire thinking. They were then presented with situations in which their craving would be fulfilled or not via a false feedback practice task (a wordsearch task). During this period psycho-physiological measures of challenge and threat were taken.

RESULTS

Higher levels of craving were linked to challenge only when the craved object was likely to be obtained. Whilst anticipating reward fulfillment, higher levels of craving were linked to higher levels of desire thinking. In turn, higher levels of desire thinking were related to lower levels of challenge. In contrast, during the processes of reward fulfillment, desire thinking was linked to increased challenge (i.e., a positive indirect effect).

CONCLUSIONS

Craving is linked to increased levels of psychological challenge when the object of the craving can be obtained, but it is unrelated to craving when it is not. The research also highlights the importance of desire thinking as an important, but complex, mediator in the relationship between craving and motivational states: desire thinking inhibited challenge when anticipating craving fulfillment, but encouraging it during the process of fulfillment itself.

LEVEL OF EVIDENCE

I: Evidence obtained from at least one properly designed randomized controlled trial.

Metacognitive Therapy for Alcohol Use Disorder: A Systematic Case Series

Alcohol Use Disorder (AUD) is a debilitating condition with serious adverse effects on health and psycho-social functioning. The most effective psychological treatments for AUD show moderate efficacy and return to dysregulated alcohol use after treatment is still common. The aim of the present study was to evaluate Metacognitive Therapy (MCT) as applied to AUD. Five patients were treated using a non-concurrent multiple baseline design with follow-up at 3- and 6-months time points. Each patient received 12 one-hour sessions of MCT. Following MCT all patients demonstrated large and clinically meaningful reductions in weekly alcohol use and number of binge drinking episodes that were upheld at follow-up in almost all cases. Metacognitive beliefs, as secondary outcome, also changed substantially. The findings from this study offer preliminary evidence of positive effects associated with MCT in AUD and support the need for a definitive trial of MCT in addictive behaviors.

Desire thinking as a confounder in the relationship between mindfulness and craving: Evidence from a cross-cultural validation of the Desire Thinking Questionnaire

Desire thinking and mindfulness have been associated with craving. The aim of the present study was to validate the French version of the Desire Thinking Questionnaire (DTQ) and to investigate the relationship between mindfulness, desire thinking and craving among a sample of university students. Four hundred and ninety six university students completed the DTQ and measures of mindfulness, craving and alcohol use. Results from confirmatory factor analyses showed that the two-factor structure proposed in the original DTQ exhibited suitable goodness-of-fit statistics. The DTQ also demonstrated good internal reliability, temporal stability and predictive validity. A set of linear regressions revealed that desire thinking had a confounding effect in the relationship between mindfulness and craving. The confounding role of desire thinking in the relationship between mindfulness and craving suggests that interrupting desire thinking may be a viable clinical option aimed at reducing craving.