Before rock bottom? Disrupting 'valid denial' amongst harmful drinkers with continuum beliefs
Harmful drinkers represent a significant public health burden in the UK, yet are largely unreached by alcohol interventions or policy measures. A low degree of self-appraised problem recognition may be an important barrier to opportunities for self-change or help-seeking. Little is known about how the beliefs harmful drinkers hold about the nature and aetiology of alcohol problems affect problem recognition and subsequent behaviour change processes.
In study 1, participants (n=579) were invited to take part in an online study and were randomised to a condition designed to promote beliefs either according to (a) a continuum model of alcohol problems, (b) a binary disease model, or (c) a control condition. Participants completed measures including alcohol problem beliefs, problem recognition and other related indices. Harmful drinkers without addiction experience exposed to the continuum condition had significantly higher problem recognition than those in binary condition.
Continuum beliefs appear to offer self-evaluative benefits for harmful drinkers with low alcohol problem recognition. Further research to understand the mechanisms by which continuum beliefs may promote more accurate drinking self-appraisal and its potential for behaviour change is warranted. The role of continuum beliefs may have important consequences for alcohol-related messaging and interventions seeking to promote self-change or help-seeking.
Study 2 (currently underway) seeks to examine the role of stigma in mediating the results on study 1. That is, do continuum beliefs increase problem recognition by decreasing self-stigma? Study 3 (also underway) also seeks to develop understanding as to whether continuum or binary beliefs amongst the general population influence stigma-related attitudes and behaviours towards persons with perceived alcohol problems.