Psychosocial determinants of perceived vulnerability to harm among adult drinkers

Perceived vulnerability to harm is widely acknowledged as a determinant of behavior change, but little is known about why some drinkers believe that they are personally "at risk" for problems while others do not. This study examined perceived vulnerability to alcohol-related harm in relation to epidemiological risk status on a standardized problem-drinking measure and two psychosocial measures of drinking context: (1) typical reasons for drinking and cutting down and (2) social network influences related to alcohol use. We evaluated the general hypothesis that these psychosocial variables would independently affect perceived vulnerability to alcohol-related harm, over and above epidemiological risk status.

Adults between the ages of 18 and 79 (N = 430; 249 women, 173 men, 8 gender unknown) completed a questionnaire about drinking behavior and drinking-related social and motivational context.

There was a positive relationship between problem-drinking status and perceived risk of experiencing harm, and no support for the idea that objectively "at-risk" drinkers believe that they are less likely to personally experience harm than comparable peers. Drinking motives and social network variables each significantly improved the prediction of perceived vulnerability when epidemiological risk status was controlled.

Interventions designed to alter drinkers' risk perceptions should take into account the reasons that people have for drinking and the social network context of alcohol use, in addition to whether or not individuals are "problem drinkers."