Health Psychology, 2nd Edition

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aspects of the environment that, in the past, have been associated with rewarding
experiences and we respond to repeat those experiences. Over time this process of
conditioning establishes automatic responses to particular environmental stimuli, or
cues, which, through sequencing, can be built up into complex impulsively regulated
behaviour patterns. We can, for example, repeatedly pair a new cue with one that has
been previously conditioned to elicit a particular response. Over time, perception of
the new cue will elicit the conditioned response because of its association with the
previously conditioned cue. This is Pavlov’s (1927) classical conditioning often
exemplified by the pairing of a sound with the presentation of food. Alternatively, we
can alter the environmental consequences of a response. For example, by repeatedly
pairing a rewarding consequence with a behaviour we can increase the frequency of
that behaviour, especially in the environment in which the reward is presented. This
is Skinner’s (1938) operant conditioning as exemplified by a rat learning to press a lever
to receive food. Pavlov and Skinner developed and researched the effectiveness of a
sophisticated series of change techniques that can be used to recondition the impulsive
system. For example, in classical conditioning the new cue may be presented
simultaneously with, or just after, the conditioned stimulus, referred to as delay (where
the conditioning stimulus and new cue are overlapping) and trace conditioning. Use
of these different classical conditioning techniques can have different effects on
emotional and behavioural responding (e.g. Burman and Gewirtz, 2004). The new
consequence introduced in operant conditioning may be a reward or a punishment
and both may have positive or negative effects on behaviour. For example, negative
reinforcement can include the removal of an unpleasant experience in order to
increase the frequency of the targeted escape behaviour. Repeated escapes reinforce
avoidant responding including avoidance of classically conditioned emotional response,
as when we avoid a cue that is associated with stress or fear (e.g. Delgadoet al., 2009).
Substantial research effort has been devoted to identifying and cataloguing such
reconditioning techniques but further research is needed to better understand how they
can be applied (singly and collectively) to help people alter unwanted everyday
behaviour patterns, especially habitual or mindless behaviour patterns initiated with
little reflective control.
Research has been conducted into pairing a desired object that is usually approached
with a stop signal so that rather than approaching the object the recipient ignores or
rejects the object. If this is done repeatedly then the established (conditioned) impulse
to approach may be inhibited because the object becomes associated with non-response
or rejection. For example, in the ‘go-no-go’ paradigm pictures of food may be paired
with cues that the recipient is asked to respond to, for example, by touching a screen,
or refrain from responding to, for example, by not touching a screen. Two different
tones can be used to signal whether the recipient should touch, or not touch, the image.
If recipients are conditioned not to touch desirable food images over many pairings this
may strengthen inhibitory control and, thereby, help people inhibit automatic approach
responses in the real world (Lawrence et al., 2015; Veling, Aarts and Stroebe, 2013).
For example, if one is trained not to respond to pictures of doughnuts or chocolate this
may make it easier to ignore or refuse these foods subsequently. A meta-analysis of 19
experimental studies, conducted mainly with undergraduates, suggested that inhibition
training of this kind may be effective in changing health behaviour patterns (Allom,
Mullen and Hagger, 2015). The analyses generated a small dvalue of 0.38 (see Focus 8.1)


CHANGING BEHAVIOUR 207
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