206 MOTIVATION AND BEHAVIOUR
Participants engaging in health-risk alcohol consumption who had been affirmed in
this way reported greater ease of imagining developing breast cancer and higher
perceptions of personal risk, suggesting that self-affirmation facilitated acceptance of
personal risk (by reducing defensive processing). These high-risk, self-affirmed
participants were found to have greater intentions to reduce their alcohol consumption
at the 4-week follow up, compared to controls. Thus self-affirmation can change the
way in which people process threat messages (Good and Abraham, 2011). In a very
similar way, it appears that by enhancing self-efficacy before presenting threat
information can also facilitate acceptance of threatening messages (Floyd et al., 2000).
Two points emerge from our consideration of fear appeals. First, one cannot assume
that raising people’s awareness of a health threat will promote protective motivation.
There may be more important determinants of the targeted behavioural change.
Second, and more generally, messages based on particular mechanisms of change (such
as those specified by PMT) need to be carefully designed to correspond to what is
known about these change processes. Poorly designed fear appeals or other messages
are likely to be ineffective or even counterproductive. Use of the intervention
mapping framework and IMB can help optimize intervention design.
CHANGING IMPULSIVE PROCESSES
Fear appeals may elicit impulsive regulation through automatic activation of emotional
responses, such as fear and disgust but the intervention techniques we have considered
so far are hypothesized to work mainly by developing new reflective processing such
as reasoning that, ‘If I do X it will be bad for me’. Can we instead work directly on the
impulsive system to change unwanted behaviour patterns? Yes, psychologists have been
doing so for decades.
Building on Pavlov’s (1927) work, Skinner’s (1938) Behavior of Organismssystem -
atically explained how the environment shapes behaviour. For example, we perceive
Smoking cessation also illustrates the biopsychosocial nature of health-related
behaviour. Evidence suggests that participation in smoking cessation groups, which
employ verbal persuasion as well as teaching self-regulatory skills, increases the
chances of successful quitting and abstinence over six months. Moreover, because
of the nicotine-based dependency helping maintain smoking, use of nicotine
replacement therapy Zyban (Bupropion hydrochloride, which dampens appetite) is
also effective. However, the most effective treatment is the combination of
behaviour cessation groups and either nicotine replacement therapy or Zyban.
This combination increases successful 6-month abstinence rates fourfold over that
observed without help (West, McNeill and Raw, 2000). Thus by taking account of
a variety of key cognitive determinants, important self-regulatory and social skills
and critical biochemical processes a package of intervention components can be
combined to tackle even complex and difficult-to-change behaviours.