Contemplating readiness to change: Relationship to underreporting and defensiveness

Date of Award


Degree Type


Degree Name

Doctor of Philosophy (PhD)




Kate B. Carey


Alcohol abuse, Self-report, Readiness to change, Defensiveness

Subject Categories

Clinical Psychology | Military and Veterans Studies | Psychoanalysis and Psychotherapy | Substance Abuse and Addiction


Recent research has established that readiness to change and acknowledgement of alcohol-related problems are positively associated. Some researchers have speculated that problem drinkers exhibiting low readiness to change underreport alcohol-related problems. Furthermore, some researchers have speculated that this underreporting is due to defensiveness. Thus, this study evaluated whether readiness is related to underreporting, whether readiness and defensiveness are related, whether defensiveness is related to underreporting, and whether defensiveness leads to underreporting. Participants were 97 male veterans attending a Substance Abuse Day Program at the Newington Veterans Administration Medical Center. The previously observed positive association between readiness and acknowledgement of alcohol-related problems was replicated. Underreporting was operationalized as differences between therapist and patient evaluations of alcohol-related problems, problem severity, and dependence symptoms categorized into underreporting and not underreporting. Readiness was negatively associated with underreporting. Specifically, lower readiness was associated with an increased likelihood of underreporting categorization. In contrast with expectations, defensiveness was not related to readiness and was not related to underreporting categorization. This suggests that low readiness to change individuals do indeed underreport; however, this phenomenon is not attributable to defensiveness.