Alcohol-Related Shame and Internal Motivation for Drinking Behavior Change: The Moderating Effects of Self-Efficacy and Growth Mindset

While excessive alcohol use remains a top public health concern in the United States, treatment engagement remains low. Understanding the factors associated with higher internal motivation to reduce drinking may help increase treatment engagement in this population. Given that many individuals with excessive alcohol use endorse feelings of shame related to their drinking, this study sought to better understand whether shame is associated with internal motivation. In addition, I examine whether this relationship between shame and internal motivation is stronger when individuals have higher levels of self-efficacy to reduce their drinking and higher levels of growth mindset. Adults who endorsed excessive alcohol use (N=143) completed a one-time survey on the research platform Prolific regarding their alcohol use, their feelings about drinking, and their motivation to change. Shame was positively associated with internal motivation, and this relationship was stronger when individuals had higher levels of self-efficacy to reduce their drinking, but not when individuals had higher levels of growth mindset. Exploratory analyses suggest that these findings are not specific to shame and internal motivation and may also extend to guilt and motivation more broadly. In addition, exploratory analyses suggest that increases in shame beyond low levels are not associated with further increases in internal motivation. Future studies should examine whether increases in shame lead to increases in internal motivation and ultimately improve treatment attendance.