Social anxiety and alcohol

Introduction and Aims: The comorbidity of social anxiety disorder (SAD) and alcohol use disorders (AUD) is prevalent and linked to negative health consequences. The underlying mechanisms of this relationship are poorly understood and have therefore been identified as an important area of research attention. The present study investigated impulsivity, specifically, reward drive and rash impulsivity in this relationship in an effort to better understand this co-occurrence.

Design and Methods: Participants included alcohol-dependent drinkers (n = 26), alcohol-dependent drinkers with social phobia (n = 11), non-dependent drinkers with social phobia (n = 18) and non-dependent drinkers (n = 33).Trait measures of reward drive and rash impulsivity and a behavioural measure of rash impulsivity, the Iowa Gambling task were administered. A cue-reactivity paradigm was employed to examined the impact of neutral and alcohol cues on
self-reported craving, mood and physiological responding (heart-rate, skin conductance).

Results: Dependent drinkers scored higher on trait measures of impulsivity and showed greater increases in self-reported craving, skin conductance and heart-rate when exposed to alcohol cues than non-dependent drinkers. Dependent drinkers performed worse on the Iowa Gambling task compared to chose with comorbid SAD-AUD. Individuals with comorbid SAD-AUD reported significant increases in negative affect when exposed to the alcohol cue compared to the neutral cue.

Discussion and Conclusions: Trait and behavioural measures of impulsivity may characterise alcohol use motivation in dependent drinkers. Social anxiety disorder may promote the development of alcohol dependence via a mechanism involving negative affect regulation and may offer some protective effects from cognitive impairments.