The Elaborated Intrusion Theory of desire: A 10-year retrospective and implications for addiction treatments

•Both addictive and other cravings involve intrusive thoughts and elaboration.•Multisensory images typically occur in intense craving.•Mindfulness strategies can reduce intrusive thoughts and lower desire.•Competing tasks interfere with elaboration, reducing craving intensity.•Imagery for abstinence benefits has potential to promote control of substance use.

Introduction: Ten years after the publication of Elaborated Intrusion (EI) Theory, there is now substantial research into its key predictions. The distinction between intrusive thoughts, which are driven by automatic processes, and their elaboration, involving controlled processing, is well established. Desires for both addictive substances and other desired targets are typically marked by imagery, especially when they are intense. Attention training strategies such as body scanning reduce intrusive thoughts, while concurrent tasks that introduce competing sensory information interfere with elaboration, especially if they compete for the same limited-capacity working memory resources. Conclusion: EI Theory has spawned new assessment instruments that are performing strongly and offer the ability to more clearly delineate craving from correlated processes. It has also inspired new approaches to treatment. In particular, training people to use vivid sensory imagery for functional goals holds promise as an intervention for substance misuse, since it is likely to both sustain motivation and moderate craving.