Metacognitions about alcohol use in problem drinkers

In this study 10 patients with problem drinking behaviour were assessed using a semi-structured interview to investigate (a) whether they held positive and/or negative metacognitive beliefs about alcohol use, (b) whether alcohol use was perceived to have an impact on negative emotions, (c) whether alcohol was used as a coping strategy, and if so what its main goal was, (d) how individuals knew whether they had achieved their goal and what signalled the cessation of using and (e) how alcohol use impacted on self-consciousness. All patients endorsed positive metacognitive beliefs and six endorsed negative metacognitive beliefs about alcohol use. Positive metacognitive beliefs concerned the usefulness of alcohol as an emotional, cognitive and image self-regulation tool. Negative metacognitive beliefs concerned uncontrollability and harm. Seven patients indicated that during a drinking episode negative emotions subsided. Nine out of ten patients stated that alcohol was used as a coping strategy and that its main goal was to reduce negative emotions and/or improve mood. However, nine out of ten patients also reported that they did not know how to determine whether they had achieved their goals. Instead the signal for stopping use came from being sick and/or blacking out. All patients reported that alcohol use helped to reduce self-consciousness. The results support a metacognitive conceptualization in which problem drinking is supported by disruptions of metacognitive monitoring and control. The conceptual implications for understanding problem drinking from a metacognitive perspective are discussed. Copyright © 2006 John Wiley & Sons, Ltd.