Scientific research in psychology is intrinsically bound to the measurement of variables that are per nature highly complex, changeable, and most often unobservable. The design of measurement methods is mostly focused on the attempt to capture the main features of the psychological attribute of interest. The last fifteen years have seen a massive development and use of a new set of measurement instruments that go under the name of implicit measures, which accomplishes the primary goal of indexing psychological attributes interchangeably defined as automatic, uncontrollable, unconscious, impulsive, or implicit. The primary goal of the present work was to explore the implicitness feature of implicit measures and their functioning. The research covered the experimentation of several implicit measures in two different contexts within the broader domain of mental health: the automatic components of stigmatizing attitudes and behaviours towards people affected by a mental disease (Part 1) and the impulsive, automatic processes implied within people affected by a mental disease, more specifically, by an alcohol addiction disorder (Part 2).
Part 1 of this dissertation is concerned with the design of two Implicit Association Tests targeting two aspects of mental illness stigma, namely, aetiological beliefs and prejudicial attitudes. The main objectives were to verify whether these two measures could be used as assessment techniques in this particular framework and to explore the plausible existence of implicit complements of mental illness stigma.
Part 2 doubled the perspective of this research by experimenting implicit measurement techniques as means for change by adapting them to retrain the implicit processes they were initially designed to assess. The study took the form of a Randomised Clinical Trial with alcohol addict outpatients in which the combination of two training paradigms targeting maladaptive impulsive processes towards alcohol (i.e., attentional bias and approach bias) is examined.
In both studies, the measurement properties of the implicit measures developed and their meaning in relation to the theoretical to-be-measured psychological attributes have been explored within a Rasch modelling perspective, through the application of the Many-Facet Rasch Measurement (MFRM) model.
In Part 1, the MFRM model allowed disentangling the different ‘ingredients’ contributing to the emergence of the IATs effect and highlighting how implicit aetiological beliefs and evaluative associations with mental illness are multifaceted aspects. Semantic and evaluative implicit associations with mental illness resulted to be dependent on diagnostic categories and differently determined by biologic semantic associations and by a positive association primacy, respectively. Further, the MFRM evidenced the functioning of the IAT at the microscopic level.
In Part 2, analysis of data of a group of participants at pre- and post-intervention assessment sessions evidenced the first promising results of the RCT: although participants did not show a substantial change in their alcohol attentional and approach bias measures, the MFRM showed a changing process in action. Experimental conditions showed to have a differential effect in bringing in a decrease and/or a reversal of the two cognitive biases. The MFRM contributed to the exploration of the dimensional and theoretical status of the two cognitive bias implicit measures and provided informative clues about their general and domain- specific features. Further, the MFRM retrieved first evidence about a differential effect of the stimuli used in improving control processes over the impulsive reactions towards alcohol.
The intertwined elements of this work, namely, implicit measurement, mental health, and Rasch modelling, have been combined in the attempt not only to clarify the benefits of implicit methods in psychology, but also to unravel what it actually means to use implicit measures. The combination with a rigorous modelling approach indeed demonstrated both the limitations and the strength of this new family of instruments
