TY - JOUR
T1 - The "alcoholic other"
T2 - Harmful drinkers resist problem recognition to manage identity threat
AU - Morris, James
AU - Moss, A. C.
AU - Albery, I. P.
AU - Heather, N.
N1 - Funding Information:
The design and data collection for this study was undertaken as part of the lead author’s PhD studies funded by Alcohol Change UK (grant number RE 16-03) and London South Bank University.
PY - 2022/1/1
Y1 - 2022/1/1
N2 - Harmful drinkers represent an important Alcohol Use Disorder (AUD) group in public health terms, accounting for significant health and social costs. However, harmful drinkers are characterized by low problem recognition; they tend to construct their drinking identity as positive and problem-free, actively setting themselves apart from the stigmatised 'alcoholic other'. As such, harmful drinkers rarely engage in treatment and represent an important opportunity for lower threshold interventions and self-change. The present study sought to explore AUD problem framing and stigma effects on problem recognition. Harmful drinkers without perceived addiction experience recruited online (n = 244, 54% male, 46% female, 96% British) were randomised to one of six conditions comprising beliefs about alcohol problems (control, continuum, binary disease model) and stigma (stigma, non-stigma), and completed measures relating to problem recognition. As predicted, results found that harmful drinkers exposed to binary disease model beliefs and stigmatising language had significantly lower problem recognition than those in other conditions. However, no support was found for the prediction that continuum beliefs would be associated with higher problem recognition. Results suggest that the interaction of binary disease model beliefs and stigma prompted alcoholic label avoidance. These findings suggest that problem framing has important consequences for harmful drinkers. Implications for behaviour change amongst harmful drinkers through mechanisms of problem framing and identity are discussed.
AB - Harmful drinkers represent an important Alcohol Use Disorder (AUD) group in public health terms, accounting for significant health and social costs. However, harmful drinkers are characterized by low problem recognition; they tend to construct their drinking identity as positive and problem-free, actively setting themselves apart from the stigmatised 'alcoholic other'. As such, harmful drinkers rarely engage in treatment and represent an important opportunity for lower threshold interventions and self-change. The present study sought to explore AUD problem framing and stigma effects on problem recognition. Harmful drinkers without perceived addiction experience recruited online (n = 244, 54% male, 46% female, 96% British) were randomised to one of six conditions comprising beliefs about alcohol problems (control, continuum, binary disease model) and stigma (stigma, non-stigma), and completed measures relating to problem recognition. As predicted, results found that harmful drinkers exposed to binary disease model beliefs and stigmatising language had significantly lower problem recognition than those in other conditions. However, no support was found for the prediction that continuum beliefs would be associated with higher problem recognition. Results suggest that the interaction of binary disease model beliefs and stigma prompted alcoholic label avoidance. These findings suggest that problem framing has important consequences for harmful drinkers. Implications for behaviour change amongst harmful drinkers through mechanisms of problem framing and identity are discussed.
KW - Stigma
KW - Addiction
KW - Problem recognition
KW - Framing
KW - Alcohol
UR - http://www.scopus.com/inward/record.url?scp=85114344166&partnerID=8YFLogxK
U2 - 10.1016/j.addbeh.2021.107093
DO - 10.1016/j.addbeh.2021.107093
M3 - Article
C2 - 34500234
VL - 124
SP - 1
EP - 7
JO - Addictive Behaviors
JF - Addictive Behaviors
SN - 0306-4603
M1 - 107093
ER -