Problem recognition as a discrete concept for change processes in problematic alcohol use

Purpose of review: Alcohol problem recognition reflects the extent to which a person with any level of problematic alcohol use (PAU), including hazardous alcohol use, acknowledges the associated risks/harms as potentially/actually problematic with a relative degree of objectivity. Notably, alcohol problem recognition is typically low amongst people with PAU not engaged in treatment or support. This review evaluates existing PAU problem recognition measures and related concepts such as ambivalence, readiness to change, motivation, cognitive biases and other self-evaluative appraisal processes. Recent findings: Alcohol problem recognition has been operationalised via various measures but is often conflated with other related but theoretically distinct concepts. Limited conceptual work examines the nature of problem recognition as a discrete concept and its function in relation to behaviour change outcomes and key variables. Summary: Problem recognition is proposed as an important theoretically distinct process that warrants further conceptual development and testing for advancing understanding of change processes across the PAU spectrum.