The Metacognitions About Desire Thinking Questionnaire: Development and Psychometric Properties

Does desire thinking mediate the influence of in-group identity as an Instagram user on components of problematic Instagram use?

Desire-based thinking is associated with the magnitude and severity of problematic social media use. One's ingroup identity has also been shown to be related to problematic behaviour including excessive social media use. Recent work showed that different factors predicted either compulsivity or withdrawal-based aspects of problematic Instagram. For compulsivity symptoms, negative metacognitions and the verbal perseveration component of desire thinking (i.e., persistent repetition of self-talk about the need to achieve a desired goal) were essential. In contrast, for withdrawal symptoms identity centrality (and no other dimensions of identity) and imaginal prefiguration (i.e., thoughts related to the mental images of a desired target or of its context for consumption) were the only predictors. The current study extended this work by testing whether the direct effects of components of ingroup identity as an Instagram user (N = 200) on increasing problematic use was also accounted for indirectly as a function of increasing desire-based thoughts as an active mediator, and whether these effects differed as a function of desire thinking component (i.e., imaginal prefiguration and verbal perseveration). Results showed that for overall problematic Instagram use desire thinking and the imaginal prefiguration component were found to fully mediate the influence of one ingroup self-investment aspect of identity, namely centrality i.e., chronicity of being an Instagram ingroup member for one's experienced identity. Total desire thinking was also shown to fully mediate the effects of identity centrality only for that component of problematic Instagram use that reflected compulsivity-type symptoms and to be a partial mediator for withdrawal-type symptoms. Imaginal prefiguration and verbal perseveration desire thinking components were both shown to partially mediate the effect of identity centrality on withdrawal symptoms but not show any mediating influence for compulsivity. These results reemphasise the primary significance of identity centrality (and ingroup self-investment processes) in accounting for variability in problematic Instagram use but also detail the importance of desire thinking factors as mediating its expression.

Distinct roles of specific metacognitive beliefs in adolescent problematic mobile phone use: A Cross-Lagged panel network analysis

Problematic mobile phone use (PMPU) among adolescents is increasingly recognized as a significant behavioral health concern. Previous studies have found general metacognitive beliefs can positively predict PMPU. However, the longitudinal relationship between specific metacognitive beliefs and addictive behaviors has not been fully explored. This study aimed to explore the longitudinal relationship between metacognitions about mobile phone use, metacognitions about desire thinking, and PMPU among adolescents using cross-lagged panel network analysis. A sample of 993 adolescents were surveyed at two points over six months. Findings indicated that negative metacognitions about mobile phone use and positive metacognitions about desire thinking emerged as two prominent bridge nodes. Negative metacognitions about mobile phone use were strongly associated with withdrawal and relapse symptoms, while positive metacognitions about desire thinking correlated with tolerance and relapse. These results suggest that interventions aimed at addressing PMPU should consider the distinct impacts of different metacognitive beliefs and tailor their approaches accordingly.

Metacognitive beliefs and desire thinking as potential maintenance factors of compulsive sexual behavior

Using the Elaborated Intrusion Theory of Desire and the Self-Regulatory Executive Function model of psychopathology as bases, this study explored whether metacognitive beliefs and desire thinking (DT) are associated with higher levels of Compulsive Sexual Behavior (CSB). A total of 1185 participants from the general population were included in the study (mean ± SD age = 25.32 years ± 5.58; age range = 18-19 years; females = 76.7 %). Metacognitive beliefs, DT, CSB, anxiety and depressive symptoms were assessed. Correlation analyses and path analyses were run. Results of the path analysis showed that positive metacognitive beliefs about DT were associated with DT-Imaginal Prefiguration (DT-IP), which in turn was positively associated with DT-Verbal Perseveration (DT-VP). The latter was strongly and positively associated with negative metacognitive beliefs about DT, which in turn was linked to CSB. Moreover, DT-VP was also found to be directly linked to the outcome variable and positive metacognitive beliefs about DT were also directly linked to DT-VP and negative metacognitive beliefs about DT. The total Coefficient of Determination (0.45) indicated a good fit to the observed data. Metacognitive beliefs and DT may be potential maintenance factors in CSB. Metacognitive beliefs and DT could also be considered as potential therapeutic targets in clinical interventions aimed at reducing the severity of CSB.

Related metacognitions, desire thinking and identity differentially predict compulsion and withdrawal symptoms in problematic Instagram use

Work has identified that metacognitive thought results in desire-based thinking and perpetuates the magnitude and severity of maladaptive behaviour including problematic social media use, and also that one's ingroup identity is related to increasing problematic behaviour. No evidence has ascertained the relative contribution of these as related differential factors in the experience of problematic social media use. The current study explored the comparative importance of components of desire thinking, positive and negative metacognitions and dimensions of ingroup identity on degree of problematic use among 147 current Instagram users. Results showed that for predicting general problematic Instagram use negative metacognitive beliefs and the verbal perseverance component of desire-based thinking were significant. Importantly, however, different factors appeared to be important for predicting distinct aspects of problematic Instagram. For compulsivity indicators, negative metacognitions and verbal perseveration were essential, whereas for the withdrawal component identity centrality (and no other dimensions of identity) and imaginal prefiguration emerge as the sole independent predictors.

The Application of the Metacognitive Model of Desire Thinking and Craving in Problematic Social Networking Sites Use

Cognitive models of addictive behaviours have highlighted the central role of Desire Thinking (DT) - a conscious and voluntary cognitive process orienting to prefigure images and information about a positive target-related experience - in increasing craving and maintaining addictive behaviors. The metacognitive model of DT and craving posits that metacognition plays a central role in understanding dysregulation in DT. The current study aims to test the role of metacognitions about DT, DT, and craving in the relationship between Fear of Missing Out (FoMo), boredom proneness, negative emotional reactivity and Problematic Social Network Sites Use (PSNSU). A sample of 529 participants (Mage= 32.45 ± 13.33; F = 62.9%) completed an online survey. The hypothesised model produced an adequate fit to the data and accounted for 86% of PSNSU variance. FoMO predicted positive metacognitions about DT (PMDT), which predicted DT that, in association with craving, predicted PSNSU. Boredom proneness positively predicted PSNSU directly and indirectly through the serial mediation of PMDT, DT, and craving. A direct path between negative emotional reactivity and PSNSU was found. The current findings provide preliminary evidence for applying the metacognitive model of DT and craving in PSNSU. PMDT and DT may be central cognitive processes in craving and PSNSU for individuals who experience boredom proneness and FoMo.

Initial Validation of a Behavioral Phenotyping Model for Substance Use Disorder

Standard nosological systems, such as DSM-5 or ICD-10, are relied upon as the diagnostic basis when developing treatments for individuals with substance use disorder (SUD). Unfortunately, the vast heterogeneity of individuals within a given SUD diagnosis results in a variable treatment response and/or difficulties ascertaining the efficacy signal in clinical trials of drug development. Emerging precision medicine methods focusing on targeted treatments based on phenotypic subtypes rather than diagnosis are being explored as alternatives. The goal of the present study was to provide initial validation of emergent subtypes identified by an addiction-focused phenotyping battery. Secondary data collected as part of a feasibility study of the NIDA phenotyping battery were utilized. Participants completed self-report measures and behavioral tasks across six neurofunctional domains. Exploratory and confirmatory factor analysis (EFA/CFA) were conducted. A three-factor model consisting of negative emotionality, attention/concentration, and interoception and mindfulness, as well as a four-factor model adding a second negative emotion domain, emerged from the EFA as candidate models. The CFA of these models did not result in a good fit, possibly resulting from small sample sizes that hindered statistical power.

Desire thinking and craving as predictors of problematic Internet pornography use in women and men

INTRODUCTION

According to the recent adaptation of the I-PACE model, desire thinking and craving might be closely related to problematic Internet pornography use. The overall aim of the present study was to investigate the role of two components of desire thinking (imaginal prefiguration and verbal perseveration) and craving in problematic Internet pornography use. Furthermore, we examined gender differences in the underlying mechanism linking desire thinking to problematic Internet pornography use.

METHOD

A total of 414 Italian adults (mean age = 27.55 years, SD = 6.13; age range = 18-58; 53.6 % men) participated in this study. Participants completed an online survey to assess problematic Internet pornography use, pornography craving, desire thinking and problematic Internet use. Path analyses and a multi-group approach were used to test the relationships among variables and to explore gender differences.

RESULTS

Imaginal prefiguration was associated to pornography craving which, in turn, was associated to verbal perseveration as proximal antecedent of problematic Internet pornography use, above and beyond the effect of age, relationship status, and problematic Internet use. Two paths significantly differed between men and women: the path between verbal perseveration and problematic Internet pornography, which for women was weaker and did not reach significance; and the path between problematic Internet use and problematic Internet pornography use that was not significant for women.

CONCLUSIONS

In line with the I-PACE model, the present study provided support for the potential role of desire thinking in problematic Internet pornography use as a specific Internet-use disorder and expanded the literature in the field by testing unexplored gender differences. Preventive and clinical implications are discussed.

The role of desire thinking in the problematic use of social networking sites among adults

The problematic use of social networking sites (SNS) is associated with several psychiatric disorders. This behavior closely resembles addiction in terms of neurological basis and behavioral patterns. Nevertheless, successful intervention strategies and the etiology of problematic SNS use are not yet thoroughly investigated. We aimed to study whether desire thinking is associated with problematic SNS use among adults when controlling for some confounders, including boredom, affect, and impulsivity. With the help of convenience sampling, we enrolled 546 Turkish adults in this study to whom we administered a sociodemographic form, the Social Media Addiction Scale (SMAS), the Leisure Boredom Scale (LBS), the Positive and Negative Affect Schedule (PANAS), the Barratt Impulsiveness Scale (BIS-11), and the Desire Thinking Questionnaire (DTQ). To explore the association between the variables, we performed Pearson correlational and hierarchical regression analyses. The results showed that higher scores on two sub-dimensions of desire thinking, namely verbal perseveration and imaginal prefiguration, were associated with higher scores on problematic SNS use after we controlled for boredom, affect, and impulsivity. This study demonstrates that desire thinking may play a role in problematic SNS use among adults. We recommend targeting desire thinking as a potential area in treatments which may help alleviate problematic SNS use.

Metacognition, Desire Thinking and Craving in Problematic Video Game Use

Gaming addiction is now a prevalent and persistent phenomenon in modern society. This study aimed to assess the metacognitive model of desire thinking and craving in explaining problematic video game use and to examine the role that specific motives for gaming have towards positive metacognitions about desire thinking. A sample of participants (N = 186) aged between 18 and 58 years old, who were primarily male (81.8%), played online games and met the inclusion criteria for Internet gaming disorder, completed an online survey, and the data were cross-sectionally analysed. Specifically, path analysis confirmed that the metacognitive model of desire thinking and craving was predictive of gaming-related cognitions and cravings. Furthermore, an expanded model, which included measures of psychopathology, suggested that anger and anxiety may magnify the driving metacognitive and cognitive processes underlying cravings. Finally, a multiple regression revealed that gaming for escapism, coping and skill development associated with stronger positive metacognitions about desire thinking. The findings of this study reinforced the importance of understanding motive when exploring problematic gaming and provided support for the role of metacognitions about desire thinking in shaping video game use cravings. Such findings could benefit both research and practice in their approach to understanding and intervening on problematic gaming behaviours.

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.

Self-critical Rumination and Associated Metacognitions as Mediators of the Relationship Between Perfectionism and Self-esteem

Past research has shown that perfectionism, can negatively impact self-esteem. However, the mediating factors that explain this relationship remain unclear. The current study aimed to investigate whether specific cognitive processes, namely, self-critical rumination and associated metacognitions, mediate this relationship. An opportunity sample of 347 participants completed a battery of online questionnaires measuring clinical perfectionism, self-critical rumination, metacognitions about self-critical rumination, self-esteem, and levels of psychological distress. Several hypotheses were tested to examine the associations between the study variables. Following this, a path analysis was used to determine whether the influence of perfectionistic concerns and perfectionistic striving on self-esteem is mediated by positive metacognitions about self-critical rumination, self-critical rumination, and negative metacognitions about self-critical rumination, serially. Positive metacognitions about self-critical rumination, self-critical rumination, and negative metacognitions about self-critical rumination partially mediated the relationship between perfectionistic concerns and self-esteem and fully mediated the relationship between perfectionistic striving and self-esteem. These results point towards possible interventions for those who struggle with low self-esteem due to their perfectionistic tendencies. Further investigations should explore additional factors that help to explain why perfectionism impacts self-esteem levels, whilst also addressing the limitations of this current research.

Relationships between Attentional Bias and craving in Alcohol Use Disorder: Role of metacognitions

Researchers have claimed that craving and Attentional Bias (AB) towards alcohol-related cues can be explained by a common incentive-salience mechanism. However, the exact relationship between AB and craving is a matter of debate. The aim of this study was to show that metacognitions moderate the effect of AB on craving. A sample of 38 alcohol abusers undergoing post-withdrawal treating in a hospital setting completed the visual Dot Probe Detection Task (DPDT), while both pre- and post-task measures of craving were recorded. Our results confirmed significant effects of both exposure to pictures of alcohol, and metacognitions, on craving; in particular, the interaction Metacognition * DPDT was significant. Although we initially confirmed a significant main effect of AB on craving, it became non-significant when adjusted for inter-subject variance, and metacognitions. The effect of the interaction AB * Metacognition on craving was not significant. Our findings support the hypothesis that craving and AB share variance, but the relationship appears to be spurious, and caused by confounding factors. We discuss these results with reference to the metacognitive model of addiction.

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.

Metacognitions in heterosexual, bisexual, and homosexual men: with or without premature ejaculation and erectile dysfunction

BACKGROUND

Premature ejaculation (PE) and erectile dysfunction (ED) are prevalent sexual problems, with evidence to suggest variation across sexual orientation. Contributing factors have traditionally been divided into organic and psychological categories. While limited research has found support for the influence of metacognitive beliefs, these studies did not investigate potential differences in sexual orientation.

AIM

The current study aimed to investigate the differences in metacognitive beliefs in men with or without PE and/or ED and whether these varied according to sexual orientation.

METHOD

A sample of 531 men was recruited (65 met criteria for PE only, 147 for ED, 83 with PE and ED, and 236 healthy controls). Within this sample, 188 men identified as heterosexual, 144 as bisexual, and 199 as homosexual. Participants completed a cross-sectional online survey consisting of psychometric measures.

RESULTS

Participants with PE and ED were significantly higher in cognitive confidence, thoughts concerning uncontrollability and danger, and need to control thoughts than PE only, ED only, and healthy controls. Furthermore, the PE only group was significantly higher than healthy controls for cognitive confidence, with the ED significantly higher for thoughts concerning uncontrollability and danger. There were no significant differences between differing sexual orientations for men with/or without PE and/or ED.

CONCLUSIONS

Congruent with previous research, metacognitive beliefs play a role in PE and/or ED, although this is not exclusive to sexual orientation. The findings highlight that assessment and intervention regarding metacognitive beliefs may be beneficial for men of all sexual orientations with PE and/or ED.

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.

A metacognitive model of self-esteem

BACKGROUND

In the current study, we aimed to test a metacognitive model of self-esteem grounded in the Self-Regulatory Executive Function model of psychopathology.

METHOD

A convenience sample of 346 community participants were recruited and completed a battery of online questionnaires that measured self-esteem, self-criticism, self-critical rumination, metacognitions about self-critical rumination, generic metacognitions and negative affect. Initially, we tested a series of hypotheses to establish the relationships between the study variables. We then conducted a path analysis to test a metacognitive model of self-esteem, where the process of self-critical rumination and its associated metacognitive beliefs was hypothesized to mediate the relationship between affect and self-esteem.

RESULTS

Self-critical rumination and its associated negative metacognitions, levels of depression and self-criticism independently predicted self-esteem. However, the multicollinearity between rumination and metacognitions suggests that one might not exist without the other. Additionally, a path analysis revealed that the study data was a very good fit to the proposed metacognitive model of self-esteem.

CONCLUSION

The metacognitive model of self-esteem presented in this paper may be used to generate novel interventions to improve self-esteem and decrease self-critical rumination.

Desire thinking as a predictor of drinking status following treatment for alcohol use disorder: A prospective study

Research has indicated that craving is one of the strongest predictors of treatment outcome and relapse in Alcohol Use Disorders (AUD) but there is little consensus on the factors that may influence its activation and escalation. Research has also shown that desire thinking is an important cognitive process which may exacerbate craving in problem drinkers. The aim of present study was to explore, for the first time, the role of desire thinking in prospectively predicting relapse, craving and binge drinking in patients receiving treatment for AUD. One hundred and thirty-five patients admitted to two rehabilitation centres and two outpatient services for addiction and mental health problems were administered baseline, treatment completion and three months follow-up measures of anxiety and depression, AUD severity, binge drinking frequency, craving and desire thinking. Results indicated that the verbal perseveration component of desire thinking at treatment completion was the only significant predictor of relapse at follow-up over and above baseline AUD severity and binge drinking frequency. Furthermore, the imaginal prefiguration component of desire thinking and craving levels at treatment completion were found to predict craving levels at follow-up independently of AUD severity and binge drinking frequency at baseline. Finally, both the imaginal prefiguration and verbal perseveration components of desire thinking at treatment completion were found to be the only predictors of binge drinking frequency at follow-up independently of AUD severity and binge drinking frequency at baseline. Treatments for AUD should aim to reduce desire thinking in people to enhance clinical outcomes and reduce relapse risk.

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 beliefs in addictive behaviours: A systematic review

A wide research base has shown the link between metacognitive beliefs and psychopathology and there is currently evidence that elevated levels of maladaptive metacognitive beliefs are present in the majority of psychological disorders. An increasing body of evidence also suggests that metacognitive beliefs may play a role in alcohol use, nicotine use, gambling, online gaming and problematic internet use. This article provides a systematic review of empirical studies that have examined metacognitive beliefs and addictive behaviours. Thirty-eight studies were included, with results showing a significant positive association between metacognitive beliefs and addictive behaviours. These results are consistent with the metacognitive model of addictive behaviour that supports the central role of metacognitive beliefs in the development and maintenance of addictive behaviours. However, our review highlights the paucity of longitudinal and experimental studies, preventing the determination of the causal status of metacognitive beliefs in addictive behaviours. Despite this limitation, the current evidence has important treatment implications because it suggests that interventions that target metacognitive beliefs could be beneficial for people presenting with addictive behaviours.

The metacognitions about self-critical rumination questionnaire

BACKGROUND

Self-criticism refers to a series of persistent and negative self-judgements, often involuntary, that an individual makes about themselves. Recent research has explored the possibility that self-criticism can lead to a more perseverative style of thinking called self-critical rumination. There is evidence that self-critical rumination may be a separate construct from other forms of rumination, such as depressive rumination and post-event processing. Research has indicated that metacognitions, beliefs that individuals have about their internal experiences and how to control them, may play a role in self-critical rumination. The aim of our work was to develop a measure to assess metacognitions related to self-critical rumination.

METHOD

In Study 1, a community sample of 178 participants completed the newly developed Metacognitions about Self-Critical Rumination Questionnaire (MSCRQ) and results were subjected to a Principal Components Analysis. In Study 2, a community sample of 247 participants completed a battery of questionnaires including the MSCRQ. A Confirmatory Factors Analysis was performed on the MSCRQ and validity was ascertained by correlating with other measures.

RESULTS

In Study 1, a 15-item two-factor structure was identified. A 10-item two-factor structure was confirmed in Study 2. Results also indicated that the MSCRQ has acceptable levels of reliability, and good concurrent and incremental validity.

CONCLUSIONS

The MSCRQ appears to be a reliable and valid measure of metacognitions about self-critical rumination whilst the MCQ-30 is a better predictor of general emotional distress.

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.

Predicting drinking outcomes: Evidence from the United Kingdom Alcohol Treatment Trial (UKATT)

AIMS

To explore client characteristics that predict drinking outcomes using data from the UK Alcohol Treatment Trial (UKATT).

METHODS

Multiple linear regression was used to determine if there were any characteristics, measured before the start of treatment, that could predict drinking outcomes at three and 12months, as measured by percent day abstinent (PDA) and drinks per drinking day (DDD) over the preceding 90days.

RESULTS

Lower baseline DDD score and greater confidence to resist drinking predicted lower DDD at both three and twelve months following entry to treatment. In addition to baseline PDA and having greater confidence to resist heavy drinking, female gender, aiming for abstinence, more satisfaction with family life and a social network that included less support for drinking were predictors of percent days abstinent.

CONCLUSIONS

Overall the strongest and most consistent predictors of outcome were confidence to avoid heavy drinking and social support for drinking. More predictors were identified for percent of days abstinent than for drinks per drinking day. For percent of days abstinent, a number of client characteristics at baseline consistently predicted outcome at both month three and month twelve.

Problematic internet pornography use: The role of craving, desire thinking, and metacognition

Defined as sexually explicit material that elicits erotic thoughts, feelings, and behaviours, internet pornography is a prevalent form of media that may facilitate problematic use and craving for engagement. Research suggests that superordinate cognitions and information processing, such as desire thinking and metacognition, are central to the activation and escalation of craving in addictive behaviours. The current study aimed to contribute to the literature by testing the proposed metacognitive model of desire thinking and craving in a sample of problematic pornography users, while revising the model by incorporating negative affect. From a theoretical perspective, environmental cues trigger positive metacognitions about desire thinking that directly influence desire thinking, resulting in the escalation of craving, negative metacognitions, and negative affect. Participants were recruited via an online survey and screened for problematic internet pornography use. Path analyses were used to investigate relationships among the aforementioned constructs in a final sample of 191 participants. Consistent with previous research, results of this study validated the existence of metacognitive processes in the activation of desire thinking and escalation of craving, while indicating that desire thinking has the potential to influence negative affect. Additionally, results supported the role of significant indirect relationships between constructs within the revised model of metacognition, desire thinking, and psychopathology. Collectively, the findings demonstrate the clinical value of a metacognitive conceptualisation of problematic pornography use. Exploring the metacognitive mechanisms that underpin problematic internet pornography use may give rise to the development of new treatment and relapse prevention strategies.

Desire thinking as a predictor of craving and binge drinking: A longitudinal study

Desire thinking is a conscious and voluntary cognitive process orienting to prefigure images, information and memories about positive target-related experience. Desire thinking has been found to be associated with both craving and alcohol use in clinical and non-clinical populations, however its role in predicting craving and problematic drinking patterns has never been investigated using a longitudinal design. The central aim of the present study was to explore the role of desire thinking at Time 2 (3months post-baseline) in predicting craving and binge drinking and Time 3 (6months post-baseline), controlling for levels of both these constructs and Time 1 (baseline). One hundred and thirty three non-hazardous drinkers were assessed on craving and binge drinking at Times 1 and 3, and on desire thinking at Time 2. Findings showed that desire thinking at Time 2 predicted craving and binge drinking at Time 3, controlling for craving and binge drinking at Time 1. Furthermore, the imaginal prefiguration component of desire thinking at Time 2 was found to mediate the relationship between craving at Times 1 and 3; conversely the verbal perseveration component of desire thinking at Time 2 was found to mediate the relationship between binge drinking at Times 1 and 3. The implications of these findings are discussed.

Experimental modification of perspective on thoughts and metacognitive beliefs in alcohol use disorder

Metacognitive therapy is designed to impact directly on cognitive monitoring and control processes such that individuals can develop alternative ways of experiencing and regulating thoughts. One technique used for this purpose is 'detached mindfulness' which promotes a decentred perspective to thoughts and decouples repetitive thinking and coping from their occurrence. This study set out to test the effects of detached mindfulness against a control condition, a brief exposure to alcohol-related thoughts. Eight patients diagnosed with alcohol use disorder in an abstinence regime were exposed to detached mindfulness versus brief exposure in a counterbalanced repeated-measures design. Results showed that detached mindfulness led to significantly greater decreases in meta-appraisal and metacognitive beliefs about alcohol-related thoughts compared to a brief exposure. Significantly greater decreases in distress and urge to use alcohol were also observed in detached mindfulness. The clinical implications are discussed.

Metacognitions about desire thinking predict the severity of binge eating in a sample of Italian women

In this study, our principal aim was to investigate whether metacognitions about desire thinking predict the severity of binge eating in women and, if so, whether this relationship is independent of age, self-reported body mass index (BMI), negative affect, irrational food beliefs and craving. One hundred and four women, consisting of 32 consecutive patients with binge eating disorder undergoing initial assessment for cognitive therapy for eating disorders, 39 moderate binge eaters, and 33 non-binge eaters (both from the general population), completed the following measures: Self-reported BMI, Hospital Anxiety and Depression Scale, Irrational Food Beliefs Scale, General Craving Scale, Metacognitions about Desire Thinking Questionnaire, and Binge Eating Scale. A series of Spearman's rho correlation analyses revealed that self-reported BMI, anxiety, depression, irrational food beliefs, craving, and all three factors of the metacognitions about desire thinking questionnaire were significantly associated with the severity of binge eating. A stepwise regression analysis identified self-reported BMI, craving, and negative metacognitions about desire thinking as significant predictors of the severity of binge eating. These results, taken together, highlight the possible role of metacognitions about desire thinking in predicting the severity of binge eating. The clinical implications of these findings are discussed.

Desire thinking: A risk factor for binge eating?

In the current study we explored the role of desire thinking in predicting binge eating independently of Body Mass Index, negative affect and irrational food beliefs. A sample of binge eaters (n=77) and a sample of non-binge eaters (n=185) completed the following self-report instruments: Hospital Anxiety and Depression Scale, Irrational Food Beliefs Scale, Desire Thinking Questionnaire, and Binge Eating Scale. Mann-Whitney U tests revealed that all variable scores were significantly higher for binge eaters than non-binge eaters. A logistic regression analysis indicated that verbal perseveration was a predictor of classification as a binge eater over and above Body Mass Index, negative affect and irrational food beliefs. A hierarchical regression analysis, on the combined sample, indicated that verbal perseveration predicted levels of binge eating independently of Body Mass Index, negative affect and irrational food beliefs. These results highlight the possible role of desire thinking as a risk factor for binge eating.

Desire thinking: what is it and what drives it?

INTRODUCTION

The aim of this study was to provide an overview of the construct of desire thinking and test a metacognitive model of desire thinking and craving, based on the work of Spada, Caselli and Wells (2012; 2013), which aims to explain the perseveration of desire thinking.

METHOD

We conducted two studies involving four clinical samples (total N = 493) and a community sample (N = 494) presenting with different addictive behaviors. The relationships among variables were examined by testing the fit of path models within each sample.

RESULTS

In the model presented it was proposed that positive metacognitions about desire thinking are associated with, in turn, imaginal prefiguration and verbal perseveration, marking the activation of desire thinking. Verbal perseveration is then associated to negative metacognitions about desire thinking and craving denoting the pathological escalation of desire thinking. Finally, a direct association between positive metacognitions about desire thinking and negative metacognitions about desire thinking would mark those occasions where target-achieving behaviour runs as an automatized schemata without the experience of craving. Results indicated a good model fit in the clinical sample and a variation in the model structure in the community sample.

CONCLUSION

These findings provide further support for the application of metacognitive theory to desire thinking and craving in addictive behaviors.

The Elaborated Intrusion Theory of desire: a 10-year retrospective and implications for addiction treatments

INTRODUCTION

Ten years after the publication of Elaborated Intrusion (EI) Theory, there is now substantial research into its key predictions. The distinction between intrusive thoughts, which are driven by automatic processes, and their elaboration, involving controlled processing, is well established. Desires for both addictive substances and other desired targets are typically marked by imagery, especially when they are intense. Attention training strategies such as body scanning reduce intrusive thoughts, while concurrent tasks that introduce competing sensory information interfere with elaboration, especially if they compete for the same limited-capacity working memory resources.

CONCLUSION

EI Theory has spawned new assessment instruments that are performing strongly and offer the ability to more clearly delineate craving from correlated processes. It has also inspired new approaches to treatment. In particular, training people to use vivid sensory imagery for functional goals holds promise as an intervention for substance misuse, since it is likely to both sustain motivation and moderate craving.

Metacognition in addictive behaviors

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.