A metacognitive model of problem drinking

Clin Psychol Psychother. 2009 Sep-Oct;16(5):383-93. doi: 10.1002/cpp.620.

Abstract

Previous research has demonstrated significant relationships between metacognition and problem drinking. In this study, we aimed to investigate further these relationships by testing the fit of a metacognitive model of problem drinking in a sample of 174 problem drinkers from a university student population. In the model presented, it is proposed that positive metacognitive beliefs about alcohol use and negative affect lead to alcohol use as a means of affect regulation. Positive metacognitive beliefs about alcohol use are also associated with a reduction in metacognitive monitoring which further contributes to alcohol use. Once alcohol use is initiated it brings a disruption in metacognitive monitoring leading to a continuation in drinking. Following a drinking episode, alcohol use is appraised as both uncontrollable and dangerous, which in turn strengthens negative metacognitive beliefs about alcohol use. These beliefs are associated with an escalation of negative affect, which acts as a trigger for further drinking. The specified relationships among these variables were examined by testing the fit of a path model. Results of this analysis indicated a good model fit consistent with predictions. The conceptual and clinical implications of these data are discussed.

Key practitioner message: *A cognitive-attentional model that may aid assessment, conceptualization and treatment for moderate or at risk problem drinkers.

MeSH terms

  • Adult
  • Affect
  • Alcoholism / epidemiology*
  • Alcoholism / psychology*
  • Anxiety Disorders / epidemiology
  • Anxiety Disorders / psychology
  • Attitude to Health*
  • Cognition*
  • Comoros
  • Depressive Disorder / epidemiology
  • Depressive Disorder / psychology
  • Female
  • Humans
  • Male
  • Models, Psychological*
  • Psychiatric Status Rating Scales / statistics & numerical data
  • Students / psychology
  • Young Adult