| dc.description.abstract | The current PhD thesis tested the hypothesis that scientifically generated narratives which frame addiction as a compulsive brain disease may inadvertently harm problem drinkers’ perception of capacity to reduce substance use. Eight framing studies were undertaken to test this hypothesis, utilising different narrative framing methods and different measures of capacity to reduce substance use to try and reveal the necessary conditions for detecting the predicted effect. Two initial pilot studies conducted for masters and MPhil projects were promising. Hazardous drinkers who were randomly assigned to read and listen to audios of academic quotes describing addiction as a compulsive brain disease versus a value-based choice reported a small but significant reduction in readiness to change their drinking behaviour in the lab and online, respectively. Study 3 used a mono-media framing manipulation in which academic quotes were simply read and found that compulsion framing statements did not reduce RTC (failing to replicate Study 1 and Study 2) but did increase substance use intentions (represented by intended substance use time allocation). Unfortunately, this latter effect did not replicate in Study 4, which could be due to the compulsion framing statements only motivating substance use intentions in individuals who find the frame unpleasant (a moderation effect), the between-subjects design having low power to detect an effect, the narrative/language of the framing text being too complex/scientific to convey a clear message, or the mono-media framing method attracting little engagement to affect outcome measures. Each of these four possibilities was addressed in turn in Study 5 through Study 8. Study 5 used the same textual framing manipulation and asked participants to reflect on their perceived unpleasantness after reading the framing statements to test for a moderation effect. However, there was no evidence that compulsion framing statements preferentially increased substance use intentions in those who found the frame unpleasant. Study 6 manipulated the same textual frames between subjects as before but measured substance use intentions before and after (the within-subjects component) to determine the change. However, no significant effects were observed. Study 7 utilised the same textual framing manipulation but with simpler experimenter-generated language focussing on the controllable versus uncontrollable nature of addiction, with outcome measures again collected between subjects post-manipulation. However, no significant effects were observed. The final Study 8 utilised a more compelling multi-media video-based framing manipulation in which scientists explained addiction as a compulsive brain disease versus value-based choice, clipped from public lectures, to eliminate the task of reading and hopefully promote more engagement. Analysis of the data demonstrated a small but significant decrease in confidence to reduce substance use in hazardous and potentially dependent drinkers, but not low-risk drinkers, who were exposed to the compulsion compared to the choice-framing video. Multiple regression analysis suggested that the lower confidence in hazardous and dependent drinkers exposed to the compulsion versus choice framing video was independently predicted by greater perceived unpleasantness and endorsement of disease beliefs following the compulsion video but not by agreement with the video’s narrative. The final study provided the most compelling support for the hypothesis that scientifically generated narratives framing addiction as a compulsive brain disease can adversely affect confidence to reduce substance use in hazardous and dependent drinkers. Furthermore, the collected experiments provide insight into the challenges and necessary conditions, using multi-media framing, for demonstrating this effect and have implications for how addiction discourse should be framed in clinical settings to promote recovery outcomes. | en_GB |
