Impulsive versus reflective influences on health behavior: A theoretical framework and empirical review

Often, health behavior seems to be governed not only by reasoned attitudes and goal-directed behavior but also by impulsive influences. The notion of a conflict between reflective and impulsive processing which is incorporated in prominent dual-system accounts (e.g., Metcalfe & Mischel, 1999; Strack & Deutsch, 2004) may yield important benefits for the understanding and prediction of health-related behavior. In this article, we suggest a basic framework for the prediction of health-related behavior which combines (a) reflective influences (as measured via self-report), (b) impulsive influences (as measured via implicit measures), and (c) situational or dispositional moderators that shift the weight between reflective and impulsive influences. The practical utility of such a framework is demonstrated by drawing on recent evidence from several areas of health psychology such as eating, drinking, drug abuse, and sexual behavior. Implications for the understanding of health behavior and applied health interventions are discussed.