The UK Chief Medical Officer has recently released an update on guidelines for safe drinking levels, reporting that there is no safe level of alcohol consumption. This report triggered national conversations about individual choices on alcohol intake. While it remains difficult to determine the line between safe and dangerous drinking levels on an individual basis, it is clear that excessive drinking is strongly linked with global disease burden. The same applies to smoking tobacco, which has been recorded as a primary cause of mortality globally. Even with the knowledge of the negative health consequences of smoking and drinking, these behaviours are notoriously difficult to modify and effective interventions for improving health-related behaviours remain elusive.
A novel and potentially effective route to improving health-related behaviours is via targeting of non-conscious processes, as these appear to be crucial in determining behaviour. A report published last week by a team spanning the Department of Psychiatry and the Behaviour and Research Health Unit at the University of Cambridge aimed to lay down a conceptual framework for the development and implementation of interventions targeting non-conscious processes.
A central premise of the paper is that behaviour can be understood in terms of whether it is activated through conscious or non-conscious means. We can then examine the degree of conscious awareness of, for example, an external triggering stimulus, an ensuing behaviour, or the link between the two. A prerequisite for awareness of the link between stimulus and behaviour would be conscious awareness of both individually, and awareness of all three would suggest conscious activation of behaviour. An example of this would be awareness that a free bar at a wedding (external stimulus) influenced higher than usual alcohol consumption (behaviour).
Unlike awareness of a stimulus, a problem with determining conscious awareness of the behaviour itself is that behaviour exists as a composite of more basic actions, such that even the most deliberative behaviours will involve some non-conscious acts. The authors outline that the level of analysis should coincide with the level of behaviour the individual aims to elicit, whether that is a higher level such as which wine to consume or a lower level such as taking a large or small sip. Subsequently, conscious awareness can be considered to exist (or not exist), at a certain level and intended interventions can be catered to this level.
Ultimately the authors provide a template for others who want to test and develop interventions targeting non-conscious processing. Within this framework, the effects of the specific intervention can be assessed when the level of consciousness matches the aim of that intervention. With the notion that interventions that modify non-conscious processing may be more effective than those targeting conscious processing, this report provides an important step forward for the operationalisation of behavioural interventions on the basis of non-conscious processes.
One of the authors, Theresa Marteau, will discuss this work at the Chaucer Club on 4 February, at 3.30pm in the Lecture Theatre at the MRC Brain Sciences Unit.
Written by Laurel Morris.