SSStttooonnnyyy BBBrrrooooookkk UUUnnniiivvveeerrrsssiiitttyyy The official electronic file of this thesis or dissertation is maintained by the University Libraries on behalf of The Graduate School at Stony Brook University. ©©© AAAllllll RRRiiiggghhhtttsss RRReeessseeerrrvvveeeddd bbbyyy AAAuuuttthhhooorrr... From Sin to Sickness: A Qualitative Content Analysis of Four Major American Newspapers’ Representations of Alcoholism A Dissertation Presented By Amy Platt to The Graduate School in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy in Social Welfare Stony Brook University December 2010 Copyright by Amy Platt 2010 Stony Brook University The Graduate School Amy Platt We, the dissertation committee for the above candidate for the Doctor of Philosophy degree, hereby recommend acceptance of this dissertation. Richard Morgan, Ph.D., Dissertation Advisor Clinical Assistant Professor Stony Brook University School of Social Welfare Joel Blau, D.S.W., Chairperson of Defense Professor and Director of the Ph.D. program Stony Brook University School of Social Welfare Harvey A. Farberman, Ph.D. Professor Stony Brook University School of Social Welfare Lisa Diedrich, Ph.D., Outside member Associate Professor Stony Brook University School of Women’s Studies This dissertation is accepted by the Graduate School. Lawrence Martin Dean of the Graduate School ii Abstract of the Dissertation From Sin to Sickness: A Qualitative Content Analysis of Four Major American Newspapers’ Representation of Alcoholism By Amy Platt Doctor of Philosophy In Social Welfare Stony Brook University 2010 The purpose of this study is to explore how four major American newspapers represent alcoholism. These newspapers are: The New York Times, Los Angeles Times, Chicago Tribune, and the Wall Street Journal. Articles were collected over a five year period (2004-2008) using a constructed, random sample. The principal research questions are: (1) How do different newspapers portray alcoholism?, (2) How much emphasis do the articles place on the moral model of addiction? (3) How much emphasis do the articles place on the disease model of addiction? (4) What, other models, if any, are presented in the articles? A qualitative content analysis was used to analyze the data. Through coding, pattern-coding matrices, and a thematic meta-matrix, overall themes were constructed. Findings suggest that the disease model of alcoholism is underrepresented in the data, whereas the public health and the moral models of addiction are prevalent. “Socio-moral continuity” is the overarching theoretical construct developed to explain why the disease model of addiction dominates the scientific, medical, and therapeutic communities yet scarcely appears in major print media. The persistence of the moral model of alcoholism in major American print media, and its impact on public opinion, promotes punishment initiatives and hinders policy and program developments that might support prevention and treatment initiatives. iii Table of Contents List of Figures ……………………………………………………………………….p.vi Chapter I : Introduction.......………………………………………………………… p.1 Chapter II : Review of the Literature ………………………………………………..p.10 A Brief History of Alcoholism…………………….………………………………….p.10 Traditions of Alcoholics Anonymous……………...………………………………….p.15 Current Views of Alcoholism…………………………………………………………p.18 Social Work and Alcoholism………………………………………………………….p.20 Views in the Newspaper………………………………………………………………p.27 Theoretical Framework………………………………………………………………..p.30 Literature Review……………………………………………………………………..p.33 Statement of Research Questions……………………………………………………..p.37 Chapter III : Methodology……………………………………………………………p.39 Description of Study and Methodology…..……..…………………………………….p.39 Researcher Bias………………………………………………………………………..p.40 Samples, Data Collection, and Sources……...………………………………………...p.41 Sampling…………………………………………………………………………….…p.44 Data Management……………………………………………………………………...p.46 Data Analysis…………………………………………………………………………..p.48 Validity of Qualitative Research……………………………………………………….p.52 Limitations of the Study………………………………………………………………..p.53 Chapter IV : The New York Times ……………….……...………………..…………...p.55 Religious Beliefs towards Alcohol Consumption………………………………….p.55 Crimes Subsequent to Alcohol Consumption……………………………………...p.57 The Use of Labeling………………………………………………………………..p.59 Consequences from Drunk Driving………………………………………………..p.62 Pregnancy and Alcohol Consumption……………………………………………..p.64 Social Responsibility……………………………………………………………....p.66 Treatment Services………………………………………………………………....p.68 Alcohol-related Health Concerns…………………………………………………..p.70 Drink Responsibly………………………………………………………………....p.72 Lack of Coping Skills…………………………………………………………...…p.74 Analyst-constructed Typologies….………………………………………………..p.76 Acceptable Drinking………………………...…………………………………p.77 Alcohol: A Double-Edged Sword…..…………………………………………p.78 Criminal Consequences of Alcohol Consumption…………………………….p.79 Stigmatized Identity……………………………………………………………p.79 Summary and Conclusion………………………………………………………….p.80 Chapter V : The Wall Street Journal ..…..……………………………………………..p.82 Cultural Aspects towards Alcohol Consumption………………………………….p.82 iv Underage Drinking………………………………………………………………...p.84 Alcohol Abuse……………………………………………………………………..p.88 Alcohol as an Industry………………………………………………………..……p.90 Social Responsibility…………………………………………………………..…..p.92 Health………………………………………………………………………..……..p.94 Labeling Alcoholism…….……………………………………………………........p.96 Alcohol Advertisements………………………………………………………...….p.98 Analyst-constructed Typologies…….………………………………….……...…p.100 System of Shared Beliefs and Values………………………………………...p.101 Business Aspects of Alcohol Industry………………………………………..p.101 Negative Consequences from Alcohol Consumption………………………...p.102 Social Responsibility for Improving Health………………………………….p.103 Summary and Conclusion…………………………………………………….p.104 Chapter VI : The Los Angeles Times ………..…………..……………………………p.106 Labeling Alcoholism……………………………………………………………..p.106 Drunk Driving……………………………………………………………………p.107 Military Reactions to Alcohol Consumption…………………………………….p.109 Morality and Alcoholism………………………………………………………...p.113 Mental Illness and Alcoholism…………………………………………………..p.117 Binge Drinking…………………………………………………………………..p.122 Underage Drinking………………………………………………………………p.126 Treatment for Alcoholism………………………………………………………..p.128 Analyst-constructed Typologies…………….…………………………………...p.130 Legal Consequences of Alcohol Consumption……………………………….p.131 Unacceptable Drinking Practices……………………………………………..p.131 Language Related to Alcohol Consumptions……………………………...…p.132 Factors Used for Understanding Alcoholism…………………………………p.133 Summary and Conclusion……………………………………………...………..p. 133 Chapter VII : The Chicago Tribune …………………………………………………p.135 Labeling Alcoholism…………………………………………………………….p.135 Consequences from Drinking and Driving………………………………………p.137 Binge Drinking…………………………………………………………………..p.140 Effects on Health from Alcohol Consumption…………………………………..p.141 Religious Beliefs towards Alcohol Consumption……………………………….p.144 Treatment for Alcoholism……………………………………………………….p.146 Underage Alcohol Consumption………………………………………………...p.148 Analyst-constructed Typologies ………………………………………………...p.150 Negative Outcomes of Drunk Driving………………………………………..p.151 Unacceptable Drinking Practices……………………………………………..p.151 Physical and Emotional Results of Alcohol Consumption…………………...p.152 Cultural Perceptions of Alcoholism…………………………………………..p.153 Summary and Conclusion………………………………………………………..p.154 Chapter VIII …………..……………………………………………………………..p.155 v Cross-Regional Analysis……………………………………………………………...p.155 The Disease Model, the Moral Model, and the Public Health Model.…...…………..p.155 Themes’ Relationships to Different Models……………………………………….…p.156 Discussion…………………………………………………………………………….p.162 Theoretical Construct…………………………………………………………………p.167 Implications for Social Policy………………………………………………………...p.171 Media Reports………………………………………………………………………...p.171 Policy Development…………………………………………………………………..p.172 Implications for Social Work Practice………………………………………………..p.174 New Model of Alcoholism……………………………………………………………p.175 Limitations of Study………………………………………………………………….p.176 Future Research Recommendations…………………………………………………..p.177 Conclusion………….………………………………………………………...………p.178 References……………………………………………………………………………p.180 Appendices …………………………………………………………………………...p.196 Appendix A……………………………………………………………………...p.196 Appendix B……………………………………………………………………...p.202 Appendix C……………………………………………………………………...p.203 Appendix D……………………………………………………………………...p.204 vi List of Figures Figure 1. (Appendix B) Stratified Random Sample of Nine. Constructed…………...p.202 Figure 2. Example of One Constructed Week…………………………………………p.46 Figure 3. Example of Pattern-Coding Matrix………………………………………….p.51 Figure 4. (Appendix C) Frequency of the Public Health Model/Moral Model vs. the Disease Model in Four Major American Newspapers………………………. p.203 Figure 5. Frequency of the Public Health Model/Moral Model vs. the Disease Model in The New York Times …………………………………………………………..p.55 Figure 6. Frequency of the Public Health Model/Moral Model vs. the Disease Model in The Wall Street Journal ………………………………………………………..p.82 Figure 7. Frequency of the Public Health Model/Moral Model vs. the Disease Model in The Los Angeles Times ……………………….…………………………...…..p.106 Figure 8. Frequency of the Public Health Model/Moral Model vs. the Disease Model in The Chicago Tribune …………………………………………………………p.135 Figure 9. Thematic Meta-Matrix…………………………………………………...…p.161 vii Acknowledgements I would like to thank