(PS1-5) Alcohol-related Shame and Internal Motivation for Drinking Behavior Change: The Moderating Effects of Self-efficacy and Growth Mindset

Abstract Text: While excessive alcohol use (EAU) remains a top public health concern in the United States, treatment utilization rates for EAU remain low (CDC, 2022). Improving internal motivation for drinking behavior change (IM) may be helpful for improving these treatment utilization rates (Ryan & Deci, 2017; Wild et al., 2006). One potential target for improving IM is drinking-related shame, a commonly endorsed emotion by those with EAU. While the relationship between shame and IM has not yet been specifically examined, shame has been associated with both increases (Lickel et al., 2014; Sawer et al., 2020) and decreases (Jakobsson et al., 2008; Walhed Finn et al., 2014) in motivation to change behavior more broadly. These mixed findings may suggest the presence of moderating variables such that shame sometimes fosters but sometimes inhibits motivation. Furthermore, research suggests that motivation may be higher among individuals with high self-efficacy for reducing drinking behavior (Demmel et al., 2004; Baldwin et al., 2006) and a growth mindset regarding alcohol use (Burnette et al., 2019). Shame may foster IM when self-efficacy and growth mindset are present and inhibit IM when these variables are not present. However, no study to our knowledge has examined shame in relation to these variables. To this end, this study tested whether IM is higher among individuals with higher levels of shame and whether the relationship between shame and IM is moderated by self-efficacy and growth mindset. We predicted that IM would be higher among individuals with higher levels of shame compared to individuals with lower levels of shame and that this relationship would be stronger among individuals with high self-efficacy and high growth-mindset. Adults who endorsed EAU (N=143) completed a one-time survey on the research platform Prolific regarding their shame about alcohol use (PODS), their motivation to change their alcohol use (HBMS), their confidence in their ability to change (CDSES), and their beliefs about mindset for alcohol use disorder (AMS). In addition, the survey included questions about neuroticism (NEO-N) and level of alcohol use (AUDIT). Set-wise regression models were conducted to determine whether shame predicts IM and whether this relationship is stronger in the presence of high self-efficacy and a high growth mindset, controlling for neuroticism and level of alcohol use. Results supported our hypotheses that IM is higher among individuals with higher levels of shame (β = .665, t(139) = 3.39, p < .001) and that this relationship is stronger among individuals with high self-efficacy (β = .016, t(137) = 2.59, p = .011). In contrast to our hypothesis, there was a marginally significant effect of mindset such that the relationship between shame and IM is stronger among individuals with a fixed mindset (β = -.277, t(137) = -1.91, p = .058). IM may be especially low among individuals with the combination of low levels of shame and low self-efficacy, and as a result, these individuals may be more at risk for harmful outcomes of EAU. Developing interventions that highlight drinking-related shame while also boosting self-efficacy for reducing drinking may be helpful for improving IM and subsequently improving treatment seeking rates for this subset of the population.