ATTUD Journal Club Postings

Building the Self‐Control Muscle

An earlier blog (Self‐Control as a Finite Resource, discussed research that found practicing self‐control on Task A makes it harder to exert self‐control on Task B (Psychol Bulletin 136:495, 2010). In that blog I suggested this results implies that when trying to stop smoking, you should not try to also diet, exercise more, etc.

However, other research presents a slightly different picture (Psychol Addict Behav 24:446, 2010). This study had smokers either repeatedly practice small acts of self‐control (avoiding sweets, holding handgrip as long as possible) or non‐self‐control tasks (math problems, keeping a diary) for 2 weeks prior to trying to quit. Sure enough, the self‐control practicing group had higher rates of short‐term abstinence: 27% vs 12% (OR = 1.6) at 1 month. Although I cannot find a replication test of this, three studies have shown that practicing self‐control on an unrelated task improves self‐control; however, these examined relatively trivial self‐control tasks.

So how do we integrate these two findings? I think we use the analogy of a muscle. If you are trying to lift a heavy rock this afternoon, best not to be lifting weights in the gym in the morning. But if you know you are going to have to lift a rock two months from now, then going to the gym beforehand is probably helpful.

The above would suggest that “practice quit attempts” before trying to quit should be helpful. Unfortunately I could not find a direct experimental test of this, although one abstract at the upcoming SRNT by Hall et al may be relevant. I doubt we would want a smoker who wants to quit right now to put off a quit attempt, but in many instances, smokers want to quit sometime soon but have no first quit date. In this case 24 hr abstinence (e.g. like the Great American Smokeout) might be helpful. Especially, if they day after they could have a discussion with a counselor about what they learned or what problems they have identified. Thoughts? The other implication is that if done sequentially exerting self‐control on one behavior (e.g. smoking) should help with self‐control on another behavior (e.g. eating). The next blog will discuss experimental studies of this; i.e., if a patient smokes, is overweight, does not take his/her meds, does not exercise and chooses bad food, is it best to focus on these one at a time or all together, or just some together and others not. And if one at a time, best to start with the most important or the one in which the patient is most likely to succeed to build self‐efficacy?