Imagine you are on a diet, and you are painfully aware that another piece of that delicious chocolate cake is waiting for you in the refrigerator. Do you go and get it, or not? Although our environment is full of temptations, we have mechanisms for resisting them. To reach your long-term goal of losing weight, you may be able to resist that mouth-watering temptation and keep from opening the refrigerator. The ability to postpone immediate gratification – also known as self-control, inhibition, self-regulation, or willpower – is extremely valuable. It is important in the context of addiction (e.g. to alcohol or nicotine), impaired emotion regulation (e.g. borderline personality disorder), and eating disorders (e.g. obesity), where the ability to control impulses is oftentimes disturbed. These disorders, which are highly debilitating for the individual, also impose considerable social and economic costs.
Research has shown that the prefrontal cortex, in particular the right inferior frontal gyrus, of the brain is the key to self-control. Later in life, the ability to inhibit responses wanes, accompanied by a natural decrease in the volume of the prefrontal cortex. The present research aims to show that there are ways to strengthen this part of the brain and therewith enhance the ability to resist the urge to go the refrigerator, light a cigarette, or open a bottle of whiskey.
In a first study on older adults we were able to demonstrate that a custom-made video game played on a day-to-day basis over a period of two months can increase self-control. We were able to show that the training that we developed increases the thickness of right inferior frontal gyrus, a subpart of the prefrontal cortex, and train the ability to inhibit prepotent responses in an untrained task. This finding is remarkable in two ways, first that we find brain structural growth in a population above the age of 60 years, where neural plasticity has often been called into question and second that self-control can actually be trained, since this has frequently been doubted in the scientific community.
The overall goal of this ERC starting grant was to develop and optimize this promising self-control training and investigate its effectiveness in real-life self-regulation problems in the healthy population (dieting and quitting to smoke) as well as in patients suffering from alcohol addiction. We evaluated other training approaches that have been proven successful in addiction such as trainings using the so-called approach-avoidance task (AAT). In this task addicted individuals have been shown to be faster in pulling pictures to themselves that relate to their addiction and slower in pushing them away. We have developed a so called “in sensu” AAT (imaginal retraining), a variant of the AAT where the approach and avoidance is accomplished mentally by means of imagination. In the studies that we performed this imaginal approach has proved to be successful in terms of reducing alcohol consumption and craving for alcohol. Moreover, we demonstrated positive effects on craving for high-caloric foods in obese women and in smokers. The effects in smokers were demonstrated to persist in a 1 year follow up. In order to communicate this new “in sensu” AAT we created a video instruction:
https://clinical-neuropsychology.de/retraining_download/(s’ouvre dans une nouvelle fenêtre).
Furthermore, we developed a virtual reality(VR)-based AAT training that we are currently still gathering evidence with.
Our hope is that these digital training interventions, which are relatively easy to implement, might be used to augment common psychotherapeutic approaches to addiction. But most importantly, these self-control training approaches can enable everyone to improve their capacity for self-regulation.
