Social anxiety and problematic alcohol use among college students: a longitudinal study.

Abstract

Social anxiety disorder (SAD) and alcohol use disorders (AUDs; i.e., alcohol dependence, alcohol abuse) are highly prevalent and potentially debilitating. They also commonly co-occur, and when they do, their combined effect may be even more devastating. The onset of SAD most commonly precedes the onset of AUDs, suggesting that SAD may be a marker or risk factor for the onset of these other disorders. Previous research has not sufficiently examined the mechanisms involved in the development of AUDs, and longitudinal research is lacking. The current study examined mechanisms related to the development of AUDs among incoming college freshman students at two large universities in the United States. Incoming freshmen are at higher risk for developing symptoms consistent with SAD, particularly during their first semester, and they may be more likely to cope with their symptoms of anxiety by drinking alcohol. The current study aimed to explicate the relationship between social anxiety and alcohol consumption in college freshmen. Baseline data collection occurred late in the summer after registration for the Fall semester or early in the Fall semester. Follow-up data collection occurred later in the Fall semester. It was expected that social anxiety, the quantity and frequency of drinking alcohol (including frequency of intoxication), and alcohol-related problems would increase among the freshmen over the course of the fall semester. Additionally, several relationships among the variables being examined were hypothesized. Drinking motives, symptoms of depression, and quality of life were expected to mediate the relationship between social anxiety and the drinking outcome variables. In addition, expectancies about alcohol consumption were expected to moderate the mediated relationship. However, there were no increases in social anxiety, alcohol consumption, or alcohol-related problems between baseline and follow-up. There were few hypothesized relationships found, although there was a positive relationship between social anxiety and negative alcohol expectancies and a negative relationship between social anxiety and quality of life. Model testing generated one promising model in which the relationship of positive expectancies regarding alcohol use to alcohol use and problems was mediated by coping with anxiety drinking motives. In particular, the main effect of positive expectancies of alcohol and coping with anxiety drinking motives generated a medium effect whereas the other relationships generated small to medium effects. Clinical implications and limitations of the current study are discussed.