"How many alcoholics, chronic gamblers, and so on, are really incapable of helping themselves, as opposed to just being people who enjoy drinking or gambling and claim to be unable to help themselves to diminish social disapproval?"

But by self-diagnosing as an alcoholic, a person would thereby be much more likely to become the focus of deliberate social interventions, like being taken to Alcoholics Anonymous (a shining example, by the way, of well-rganied and effective social treatment of a disease) or some such. This sort of focused attention, essentially being treated as if one had a disease, I would think would be the opposite of what a hedonistic boozer would want. Would they really consider possible medical intervention a fair price to pay for slightly less disapproval from friends?