The impoverished self and alcoholism: Content and structure of self -cognitions in alcohol dependence and recovery.

Alcoholism is a leading cause of preventable mortality. The self-concept has been implicated as an important factor in the development and progression of alcoholism and as a motivator of recovery. However, methodological weaknesses including the failure to address alcoholism subtype and stage of progression of the disorder, and the lack of a theoretical model of the self-concept compromise the validity of existing studies and compromise their utility as a foundation for nursing practice. In this study, the schema model was used to examine differences in the number, valence, content, and organization of self-schemas that comprise the self-concept in antisocial type alcoholism (Zucker, Ellis, & Fitzgerald, 1994). In this model, the self-concept is defined as a complex memory structure that is comprised of a diverse collection of highly organized units of knowledge about the self in specific content areas that are referred to as self-schemas (Markus, 1977). Using this theoretical model, the role of an impoverished self-concept as a cognitive vulnerability to the disorder, the role of an alcohol-related self-schema in the persistence of symptoms, and the role of the self-concept in recovery was investigated by examining self-concept properties in young adults at two stages of the disorder: alcohol dependence (n = 24) and sustained recovery (n = 18), and in controls (n = 23). Zajonc' cardsorting task (1960) with Markus' (1977) methodology was used to measure the number, valence, content, and organization of self-schemas. Results provide evidence that antisocial alcohol dependence (AAD) is associated with an elaborated drinking-related self-schema and an impoverished self-concept---one comprised of few positive and many negative and highly interrelated self-schemas, and that recovery from AAD is associated with a more well-developed self-concept---one comprised of many positive, few negative, and independent self-schemas---and an elaborated recovery-related self-schema. Furthermore, results showed that an impoverished self-concept contributes to negative affect and high levels of alcohol use and this effect is partially mediated through a drinking-related self-schema. Findings from this study suggest that nursing interventions to promote recovery from AAD should focus on deconstruction of negative self-schemas, construction of new and independent positive domains of self-definition, and fostering the development of a recovery-related self-schema.Ph.D.Health and Environmental SciencesNursingPsychologyPublic healthSocial psychologyUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/131688/2/3057933.pd