Gender role conflict and alcohol metacognitions : implications for the Marlatt Model of Relapse Prevention

Cook, Nicholas (2016) Gender role conflict and alcohol metacognitions : implications for the Marlatt Model of Relapse Prevention. Doctoral thesis, London Metropolitan University.


The Marlatt model of alcohol treatment (Marlatt & Gordon, 1986) is widespread. A key component of that model is alcohol expectancies. Alcohol expectancies refer to the effects of alcohol use anticipated by individuals. Metacognitive beliefs about alcohol are considered to be a specific form of alcohol expectancy (Spada, Moneta, & Wells). The present study argues that development of a triphasic metacognitive formulation for problematic drinking (Spada, Caselli, & Wells, 2012) represents the single most important advance in alcohol treatment since the advent of the Marlatt model. The formulation postulates that a reduction in positive and negative alcohol metacognitive beliefs leads to a reduction in alcohol use. A crucial element of the metacognitive formulation is attention allocation (Steele & Josephs, 1990). Internally generated conflict, such as gender role conflict (O’Neil, 1981), it is hypothesised, can disrupt attention allocation thereby reducing efficacy of metacognitive treatment.

A clinical sample of 102 (male, 74; female, 28) completed the Positive Alcohol Metacognitions Scale (PAM), Negative Alcohol Metacognitions Scale (NAM), Gender Role Conflict Scale (GRCS) and the Alcohol Use Disorders Identification Test (AUDIT).

Regression analysis indicated that gender role conflict moderated the relationship between positive alcohol metacognitions and alcohol use in men but not in women. Similar results were obtained for the GRCS subscale ‘Restricted Emotionality’.

Findings have implications for gender sensitive interventions in both the Marlatt model generally and metacognitive therapy specifically.

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