Implication des croyances métacognitives dans les conduites addictives : point sur les connaissances

The results showed that general metacognitive beliefs are elevated across addictive behaviors and that beliefs about the need to control thoughts appear to positively predict addictive behaviors (Spada et al., 2014). In addition, a series of interviews identified specific metacognitive beliefs about engaging in addictive behaviors. There are two kinds of specific beliefs. Positive metacognitive beliefs about use refer to beliefs about the effect of addictive behaviors as a means to control and regulate cognition and emotion. Negative metacognitive beliefs about use focus on the perception of lack of executive control over the engagement in the addictive behaviors, uncontrollability of thoughts related to addictive behaviors, and the negative impact of engagement in addictive behaviors on cognitive functioning. These specific beliefs have been identified in nicotine dependence, gambling disorders and problem drinking. Several scales have been developed to assess these specific beliefs in nicotine, alcohol dependence, and in problematic online gaming. Studies showed that these specific beliefs were positively associated with the severity of use and were a predictor of use beyond outcome expectancies. For example, metacognitive beliefs about alcohol use predicted drinking behavior in clinical and non-clinical sample (Spada and Wells, 2009, 2010) or beliefs about cigarette use were positively associated with cigarette use and mediated the relation between anxiety and smoking behavior (Nikčević et al., 2017). With regard to these results, Spada et al. (2014) proposed an application of Wells's metacognitive model to addictive behaviors. In their formulation, addictive behaviors were considered as a “cognitive self-regulatory strategy” that failed due to the activation of cognitive and metacognitive processes (metacognitive beliefs, negative repetitive thinking, attentional bias, poor metacognitive monitoring). The model was composed of three phases : pre-engagement, engagement and post-engagement phase, which describe how cognitive and metacognitive processes operate and lead to addictive behavior. This triphasic formulation suggested that metacognitive therapy (MCT) may be an effective treatment for addictive behavior (Spada et al., 2013). MCT consists of different techniques aiming to reduce dysfunctional cognitive and metacognitive processes through attention modification, challenging metacognitive beliefs and develop new response to mental events (Fisher and Wells, 2009). However, at this time, data about the efficacy of MCT in the field of addictive behavior remains limited and further research is needed (Caselli et al., 2016).