2 - (SYM 73) Implications of and Perceptions of Genetic Attributions for Addiction Among Individuals with Gambling Disorder and Alcohol Use Disorder

Background. Genes’ role in addiction is increasingly emphasized. Per conventional wisdom, genetic explanations should reduce stigma by portraying addictive disorders as blameless diseases. Yet such explanations can yield essentialism—e.g., the notion that genetically influenced disorders represent permanent, deep-seated aspects of the self—which could potentially exacerbate so-called “characterological self-blame” (a construct involving attributions to immutable, internal causes, associated with belief in deserving negative outcomes), decrease feelings of self-efficacy and symptom controllability, and lead to preferences for biomedical (vs. psychosocial) treatments.

Method. Sixty individuals seeking treatment for gambling disorder (GD) and 53 seeking to participate in treatment or research studies focused on alcohol use disorder (AUD) rated their genetic attributions for their symptoms and completed quantitative measures of characterological self-blame for their addictions, beliefs about medication and psychotherapy effectiveness, and self-efficacy and locus-of-control beliefs related to their disorders. A subset of participants (n=20) completed qualitative interviews focused on their opinions about the relevance of genetics in addiction and their views about the use of genetic testing to someday explain or predict addiction.

Results. In the GD sample, but not in the AUD sample, genetic attributions were positively associated with characterological self-blame. No other outcome measures were significantly associated with genetic attributions. Qualitative analyses revealed that most participants would be interested in taking a genetic test that could indicate whether their addiction was caused by their genes, as a way of explaining their behavior, informing treatment and prevention efforts, and reducing stigma and blame. Those who were not interested in genetic testing tended not to view genes as a primary factor in the etiology of addiction and not to view genetic information as having clinical utility. Some participants expressed concern that genetic information about addiction susceptibility could be used in discriminatory or harmful ways.

Conclusion. Among people with addictive disorders, the relationship of genetic explanations for addiction to stigma and blame is likely complex. Also, while participants highlighted potential benefits to be reaped by incorporating genetic information into clinical care for people with addictive disorders, concerns about negative consequences also emerged.