Mental Contrasting With Implementation Intentions Reduces Drinking When Drinking Is Hazardous: An Online Self-Regulation Intervention

Abstract

Introduction. Drinking alcohol has detrimental health consequences, and effective interventions to reduce hazardous drinking are needed. The self-regulation intervention of Mental Contrasting with Implementation Intentions (MCII) promotes behavior change across a variety of health behaviors. In this study, we tested if online delivery of MCII reduced hazardous drinking in people who were worried about their drinking. Method. Participants ( N = 200, female = 107) were recruited online. They were randomized to learn MCII or solve simple math problems (control). Results. Immediately after the intervention, participants in the MCII condition (vs. control) reported an increased commitment to reduce drinking. After 1 month, they reported having taken action measured by the Readiness to Change drinking scale. When drinking was hazardous (Alcohol Use Disorders Identification Test ≥ 8, n = 85), participants in the MCII condition indicated a decreased number of drinking days, exp(β) = 0.47, CI (confidence interval) [−1.322, −.207], p = .02, and drinks per week, exp(β) = 0.57, CI [0.94, 5.514], p = .007, compared with the control condition. Discussion. These findings demonstrate that a brief, self-guided online intervention ( Mdn = 28 minutes) can reduce drinking in people who worry about their drinking. Our findings show a higher impact in people at risk for hazardous drinking. Conclusion. MCII is scalable as an online intervention. Future studies should test the cost-effectiveness of the intervention in real-world settings.

Comparing mental contrasting with implementation intentions against solution-focused and autonomous planning

“…When expectancy and desirability are high, MCII should enhance commitment, which should in turn lead to greater goal progress. This mediational hypothesis (MCII → enhanced commitment → greater goal progress) has been supported empirically (Wittleder et al., 2019). MCII can be effective even as a brief single-session intervention (Kizilcec & Cohen, 2017).…”

“…The present study of course has limitations. Goal progress was assessed using a self-report measure, as was the case in other studies of IIs/MCII (Adriaanse et al., 2010; Koestner et al., 2006; Wittleder et al., 2019). Future studies may wish to include additional measures of progress such as teacher reports.…”

“…Research suggests that MCII leads to goal progress by enhancing individuals’ commitment (Wittleder et al., 2019). In the present study, therefore, goal commitment was hypothesised to mediate the positive effect of MCII on goal progress.…”

The Self-Regulation of Conformity: Mental Contrasting With Implementation Intentions (MCII)

“…Specifically, the tendency to conform should increase when a person identifies with the group. And because MCII has been shown to be particularly effective when challenges are high (Wittleder et al, 2019;Mutter et al, 2020), we would expect MCII to be more effective the stronger people identify with their ingroup.…”

A Meta-Analysis of the Effects of Mental Contrasting With Implementation Intentions on Goal Attainment

“…Sailer et al ( 2015 ) found that MCII improved patient' exercise in autonomy-focused settings, but not in a highly structured setting, compared to control condition. Wittleder et al ( 2019 ) found that MCII decreased the number of drinking days for people with hazardous drinking behavior, but not for people with non-hazardous drinking behavior, compared to the control group. Thus, a meta-analysis is needed to assess the effect of MCII on goal achievement beyond the scope of health behavior and explore potential moderators.…”