Unconscious thought reduces intrusion development: a replication and extension

A systematic review and meta-analysis of experimental methods for modulating intrusive memories following lab-analogue trauma exposure in non-clinical populations

Experiencing trauma leads to intrusive memories (IMs), a hallmark symptom of post-traumatic stress disorder (PTSD), which also occurs transdiagnostically. Understanding why IMs increase or decrease is pivotal in developing interventions to support mental health. In this preregistered meta-analysis (PROSPERO: CRD42021224835), we included 134 articles (131 techniques, 606 effect sizes and 12,074 non-clinical participants) to investigate how experimental techniques alter IM frequency, intrusion-related distress and symptoms arising from lab-analogue trauma exposure. Eligible articles were identified by searching eight databases until 12 December 2023. To test potential publication biases, we employed methods including Egger's test and three-parameter selection models. We employed three-level multilevel modelling and meta-regressions to examine whether and how experimental techniques would modulate IM frequency and associated outcomes. Results showed that techniques (behavioural, pharmacological, neuromodulation) significantly reduced intrusion frequency (g = 0.16, 95% confidence interval [0.09, 0.23]). Notably, techniques aimed to reduce IMs also ameliorated intrusion-related distress and symptoms, while techniques that increased IMs exacerbated these related outcomes, thus highlighting IM's centrality in PTSD-like symptoms. Techniques tapping into mental imagery processing (for example, trauma reminder followed by playing Tetris) reduced intrusions when administered immediately after, or at a delayed time after trauma. Although our meta-analysis is limited to symptoms induced by lab-analogue trauma exposure, some lab-based results have now generalized to real-world trauma and IMs, highlighting the promising utility of lab-analogue trauma paradigms for intervention development.

Unconscious versus conscious thought in creative science problem finding: Unconscious thought showed no advantage!

Unconscious thought theory (UTT) suggests that creativity benefits more from unconscious thought than conscious thought. However, previous studies have only focused on creative problem solving. This study aims to explore the effect of unconscious thought and conscious thought in creative science problem finding (CSPF). The ability of CSPF was measured by fluency, flexibility and originality. Participants accomplished the CSPF task after 3 min of distraction, during which unconscious thought was supposed to take place, or after 3 min of conscious thought. Results showed that unconscious thought had no advantage over conscious thought on CSPF. For the CSPF task with open instructions, conscious thought was comparable to unconscious thought in fluency, flexibility and originality. What's more, for the CSPF task with closed instructions, unconscious thought was even overtaken by conscious thought in fluency, flexibility and originality. These findings extend the unconscious thought theory and provide practical guidance on how to propose a creative science problem.

A Case for Thinking Without Consciousness

People can engage in prolonged thought processes, such as when they are facing an important decision or when they are working on a scientific discovery. Such thought processes can take months or even years. We argue that while people engage in such thinking, they make progress not only when they consciously think but also sometimes when they are consciously thinking about something else-that is, while they think unconsciously. We review the literature on unconscious thought (UT) processes and conclude that there is indeed quite some evidence for UT. Conceptualized as a form of unconscious goal pursuit, UT is likely to be especially fruitful for thought processes that are complex, important, or interesting to the thinker. In addition, we discuss other characteristics of the UT process. We end with proposing Type 3 processes, in addition to Type 1 and Type 2 (or Systems 1 and 2) processes, to accommodate prolonged thought processes in models on thought.

Assessment of unconscious decision aids applied to complex patient-centered medical decisions

Background

To improve patient health, recent research urges for medical decision aids that are designed to enhance the effectiveness of specific medically related decisions. Many such decisions involve complex information, and decision aids that independently use deliberative (analytical and slower) or intuitive (more affective and automatic) cognitive processes for such decisions result in suboptimal decisions. Unconscious thought can arguably use both intuitive and deliberative (slow and analytic) processes, and this combination may further benefit complex patient (or practitioner) decisions as medical decision aids. Indeed, mounting research demonstrates that individuals render better decisions generally if they are distracted from thinking consciously about complex information after it is presented (but can think unconsciously), relative to thinking about that information consciously or not at all.

Objective

The current research tested whether the benefits of unconscious thought processes can be replicated using an Internet platform for a patient medical decision involving complex information. This research also explored the possibility that judgments reported after a period of unconscious thought are actually the result of a short period of conscious deliberation occurring during the decision report phase.

Methods

A total of 173 participants in a Web-based experiment received information about four medical treatments, the best (worst) associated with mostly positive (negative) side-effects/attributes and the others with equal positive-negative ratios. Next, participants were either distracted for 3 minutes (unconscious thought), instructed to think about the information for 3 minutes (conscious thought), or moved directly to the decision task (immediate decision). Finally, participants reported their choice of, and attitudes toward, the treatments while experiencing high, low, or no cognitive load, which varied their ability to think consciously while reporting judgments. Cognitive load was manipulated by having participants memorize semi-random (high), line structured (low), or no dot patterns and recall these intermittently with their decision reports. Overall then, participants were randomly assigned to the conditions of a 3 (thought condition) by 3 (cognitive-load level) between-subjects design.

Results

A logistic regression analysis indicated that the odds of participants choosing the best treatment were 2.25 times higher in the unconscious-thought condition compared to the immediate-decision condition (b=.81, Wald=4.32, P=.04, 95% CI 1.048-4.836), and 2.39 times greater compared to the conscious-thought condition (b=.87, Wald=4.87, P=.027, 95% CI 1.103-5.186). No difference was observed between the conscious-thought condition compared to the immediate-decision condition, and cognitive load manipulations did not affect choices or alter the above finding.

Conclusions

This research demonstrates a plausible benefit of unconscious thinking as a decision aid for complex medical decisions, and represents the first use of unconscious thought processes as a patient-centered medical decision aid. Further, the quality of decisions reached unconsciously does not appear to be affected by the amount of cognitive load participants experienced.

On making the right choice: A meta-analysis and large-scale replication attempt of the unconscious thought advantage

Are difficult decisions best made after a momentary diversion of thought? Previous research addressing this important question has yielded dozens of experiments in which participants were asked to choose the best of several options (e.g., cars or apartments) either after conscious deliberation, or after a momentary diversion of thought induced by an unrelated task. The results of these studies were mixed. Some found that participants who had first performed the unrelated task were more likely to choose the best option, whereas others found no evidence for this so-called unconscious thought advantage (UTA). The current study examined two accounts of this inconsistency in previous findings. According to the reliability account, the UTA does not exist and previous reports of this effect concern nothing but spurious effects obtained with an unreliable paradigm. In contrast, the moderator account proposes that the UTA is a real effect that occurs only when certain conditions are met in the choice task. To test these accounts, we conducted a meta-analysis and a large-scale replication study (N = 399) that met the conditions deemed optimal for replicating the UTA. Consistent with the reliability account, the large-scale replication study yielded no evidence for the UTA, and the meta-analysis showed that previous reports of the UTA were confined to underpowered studies that used relatively small sample sizes. Furthermore, the results of the large-scale study also dispelled the recent suggestion that the UTA might be gender-specific. Accordingly, we conclude that there exists no reliable support for the claim that a momentary diversion of thought leads to better decision making than a period of deliberation.