Framing addiction as a compulsive brain disease lowers readiness to change addictive behavior in alcohol consumers, in two exploratory experiments

Background It has been argued that framing addiction as a compulsive brain disease rather than a value-based choice might harm substance users’ motivation and beliefs concerning their capacity to modify their behavior (so called psychological recovery capital, e.g. readiness to change) but few experiments have tested this proposal. Methods In study 1, students who drink hazardously (N = 63) were randomized to read and hear quotes from scientific publications describing addiction as a compulsive brain disease versus a value-based choice (between-subjects, in-laboratory), before reporting readiness to change their drinking behavior, alcohol choice, craving and self-efficacy. In study 2, students who drink weekly (N = 155) were randomized to receive the same framing manipulation (online), before reporting readiness to change their unwanted habits, self-control and self-regulation. Results In both studies, participants reported lower readiness to change following exposure to scientific quotes that framed addiction as a compulsive brain disease versus a value based choice (study 1: M = 2.95 vs. M = 3.32, p = 0.025, d = 0.58; study 2: M = 3.18 vs. M = 3.40, p < 0.04, d = 0.33). There were no significant framing effects on other outcome measures. Conclusions These findings provide preliminary evidence that scientific discourse describing addiction as a compulsive brain disease rather than a value-based choice is iatrogenic (in the sense of being a harmful diagnosis) in reducing readiness to change drinking behavior and unwanted habits in students who consume alcohol hazardously or weekly. These findings provide a foundation for further research into the downstream epistemic consequences of scientific addiction narratives on psychological recovery capital.