Alcohol and anxiety: Postdrink-performance feedback alters affective and self-evaluative responses to a subsequent social stressor

Several models of alcohol use and abuse implicate self-evaluation as a variable that mediates alcohol's anxiolytic effects. Self-evaluation when drinking, in turn, is affected by people's causal attributions for their behavior and alcohol expectancies. Accordingly, postdrink performance feedback was manipulated by having 20 subjects engage in a set of tasks before and after a moderate dose of alcohol. Half of the subjects received feedback that alcohol impaired their task performance whereas the other half received feedback that alcohol did not impair their performance. All subjects then participated in a stressful social interaction. As expected, subjects in the high behavioral impairment condition made more external performance attributions during the social stressor and reported less negative self-evaluation and subjective anxiety than subjects in the low behavioral impairment condition. Alcohol expectancies appeared to account partially for the data. The results indicate that information concerning alcohol-induced behavioral impairment moderates alcohol's effects on self-evaluation and subjective anxiety.     

Alcohol expectancies and social anxiety in male and female undergraduates

Recent studies have demonstrated that alcohol expectancies co-vary with some measures of trait anxiety. As part of a college drinking survey with 606 respondents (75.8%) evenly distributed by sex, this study tests further whether social anxiety predicts the expectancies of tension reduction, increased social assertiveness, and social/physical pleasure. In addition, the study examines whether sex, social anxiety, and alcohol consumption interact to predict alcohol expectancies. MANOVA analysis demonstrated that social anxiety significantly predicts the expectancies of tension reduction and increased social assertiveness but not the expectancy of social/physical pleasure. No interaction effects were found among sex, social anxiety, and consumption to predict expectancy levels. However, previous evidence that consumption levels (but not sex) predict expectancies was cross-validated. Findings are discussed within the context of a broader social learning model of alcohol use.     

The effects of alcohol and anxiousness on physiological and subjective responses to a social stressor in women

Several studies have examined the validity of the tension reduction hypothesis as an explanatory model for the development of alcohol problems, but support has been inconsistent. In recent years, researchers have begun to examine how various individual differences variables moderate the relationship between alcohol consumption and reduction of anxiety. The present study examined how 40 women, either moderate or low in anxiety sensitivity (AS), responded to a social stressor (giving a body image speech) after consuming either a low dose of alcohol (0.4 ml/kg of body weight) or a placebo. Results indicated that of the participants reporting moderate AS, participants consuming alcohol reported more stress dampening as measured by heart rate in anticipation to the stressor than participants not consuming alcohol. Furthermore, of the participants consuming alcohol, those reporting high social anxiety reported more of an increase in heart rate than participants not consuming alcohol. Findings are discussed in terms of considering individual differences factors when examining predictions made from the tension reduction hypothesis.     

Polysubstance Use,Social Anxiety,and Length of Treatment for Alcohol Use Disorders

Objective: The purpose of the present study was to examine the interactive effects of social anxiety and psychosocial factors (i.e., group attendance, polysubstance use) on substance use treatment for men with a primary diagnosis of alcohol use disorder. Social anxiety and alcohol use disorders often co-occur, but it is currently unclear how having high social anxiety might affect aspects of substance use treatment, such as group participation and length of stay. Methods: This study compared men with alcohol use disorder only versus those with alcohol plus other drug disorders in a residential treatment facility. Measures included demographics, self-reported social anxiety, self-reported drug history, attendance at treatment groups, and total number of days in treatment. Results: Of 128 participants, 39 (30.5%) used only alcohol, while 89 (69.5%) used alcohol and other substances. Hierarchical linear regression showed only one significant interaction with social anxiety and length of treatment: people who used alcohol only or alcohol in addition to other substances (p < .05). Simple effects analyses revealed a positive relationship between social anxiety and length of stay among men who used only alcohol, but not among men who used more than one substance. Conclusions: Currently, the distinction between those who use only alcohol and those who use other substances as well is not often examined in the literature. However, the present study shows that this assumption of homogeneity may be inaccurate, given the differential relationships that these groups may have with factors such as social anxiety.     

Effects of alcohol on group formation among male social drinkers

OBJECTIVE: Social factors affect alcohol use and misuse, yet researchers rarely study the acute effects of alcohol in groups. This study used systematic observation techniques to measure the effects of alcohol on behavioral responses during an initial group interaction. METHOD: Fifty-four male social drinkers were assembled into three-person groups of strangers, and all members of each group were administered either a 0.82 g/kg dose of alcohol or a placebo to be consumed during a 30-minute period. This social interaction was video recorded, and the duration and sequence of selected smiling and speech behaviors were coded on a 1-second time base. RESULTS: Alcohol consumption increased individual- and group-level coordination of smiling and speech behaviors over time and improved self-reported bonding. CONCLUSIONS: These data suggest that alcohol may facilitate social bonding during initial group formation. Measuring behavioral responses in a social context provides new directions for studying the acute effects of alcohol.     

Age, drinking habits and the effects of alcohol

Some explanations for the common observation that older persons drink less alcohol than younger persons were tested in a sample of 41 men social drinkers aged 19-63. Subjects reported their drinking habits and performed balance beam and bead-stringing tasks under a moderate dose of alcohol (.72 ml absolute alcohol/kg). Self-reports of dose (ml absolute alcohol/kg) on a typical social occasion, and hourly dose (which controlled for individual differences in the duration of these occasions) were found to decline linearly with age. Alcohol absorption and elimination rates in the sample were not significantly related to age. The Ponderal Index (an estimate of percentage of body water in body weight) was negatively correlated with age and with peak blood alcohol levels (BALs). Older subjects had proportionately less body water (i.e., a smaller volume for distribution of alcohol) and obtained higher BALs. When individual differences in BAL were controlled for, the amount of alcohol-induced impairment in task performance was still found to increase significantly with age. This evidence was considered to suggest that a reduction in the volume of distribution for alcohol and an intensified behavioral effect of alcohol may operate jointly to cause older persons to reduce their dose of alcohol on social drinking occasions.     

The separate and interactive effects of drinking motives and social anxiety symptoms in predicting drinking outcomes

Purpose

Our goal was to test the separate and interactive effects of drinking motives and social anxiety symptoms in predicting drinking-related consumption and problems.

Methods

Participants (N = 730; 59.7% female) were undergraduate college students who completed measures of social anxiety symptoms, drinking motives, alcohol consumption, and drinking problems.

Results

Greater social anxiety symptoms were significantly associated with less alcohol consumption, and there was some evidence that greater social anxiety symptoms were also associated with greater alcohol-relevant problems. Significant interactions between social anxiety and motives indicated that a) alcohol use was most pronounced for individuals high in enhancement motives and low in social anxiety symptoms; and b) among participants low in coping motives, drinking problems were greater for individuals high (vs. low) in social anxiety symptoms.

Conclusions

More fully identifying the individual difference factors that link social anxiety symptoms with drinking outcomes is important for informing prevention and intervention approaches.     

Incorporating social anxiety into a model of college student problematic drinking

College problem drinking and social anxiety are significant public health concerns with highly negative consequences. College students are faced with a variety of novel social situations and situations encouraging alcohol consumption. The current study involved developing a path model of college problem drinking, including social anxiety, in 316 college students referred to an alcohol intervention due to a campus alcohol violation. Contrary to hypotheses, social anxiety generally had an inverse relationship with problem drinking. As expected, perceived drinking norms had important positive, direct effects on drinking variables. However, the results generally did not support the hypotheses regarding the mediating or moderating function of the valuations of expected effects and provided little support for the mediating function of alcohol expectancies in the relations among social anxiety and alcohol variables. Therefore, it seems that the influence of peers may be more important for college students than alcohol expectancies and valuations of alcohol's effects are. College students appear to be a unique population in respect to social anxiety and problem drinking. The implications of these results for college prevention and intervention programs were discussed.     

Effects of alcohol on psychomotor performance and perceived impairment in heavy binge social drinkers

Alcohol intoxication often results in negative consequences; however, specific behavioral and subjective effects vary as a function of individual differences. The present study utilized an alcohol challenge paradigm to examine whether heavy binge social drinkers (HD; n=77), compared to light social drinkers (LD; n=55), exhibit: (1) greater tolerance in psychomotor task performance under the influence of alcohol, and (2) differential perceptions of the impairing effects of alcohol. The study included three test sessions in which participants consumed either a low (0.4 g/kg) or a high (0.8 g/kg) dose of ethanol or a placebo beverage administered in random order and counterbalanced within group. Participants completed the Digit-Symbol Substitution Task (DSST) and the Grooved Pegboard at pre-drink baseline and at multiple time points after beverage consumption. They also completed a scale of perceived impairment at several intervals after beverage consumption. Ethanol impaired performance at the high dose, but not at the low dose (ps<.001). The groups exhibited similar alcohol-induced impairment. However, HD reported lower self-perceived impairment compared to LD, particularly during the early portion of the blood alcohol curve when actual impairment was most pronounced (p<.001). Thus, this study extends prior research in that habitual binge social drinking does not appear to be associated with tolerance to alcohol's impairing effects on select psychomotor skills. Further, results may have implications for alcohol-related harm as binge social drinkers regularly consume intoxicating doses of alcohol but may not be aware of the physical and cognitive impairments produced by alcohol.     

Social anxiety and alcohol use: The role of alcohol expectancies about social outcomes

Though social anxiety disorder and alcohol use disorders commonly co-occur, the mechanisms involved in social anxiety and hazardous drinking among college students are not well understood. The current study contributes to the emerging literature on social anxiety and college drinking as the first known study to test how positive (e.g. “I would feel at ease in social situations”) and negative (e.g. “I would make a fool out of myself”) alcohol outcome expectancies (AOE) specific to social situations (social AOE) impact the association between social anxiety and hazardous alcohol use among 718 undergraduates (61% women; M_age?=?19.50, SD?=?1.45; 85% White). Results supported the mediation, but not the moderation models. There were positive indirect effects of social anxiety through positive social AOE and negative indirect effects of social anxiety through negative social AOE on both hazardous drinking outcomes (i.e. alcohol consumption and alcohol problems). Findings suggest that there could be competing pathways for increasing (positive social AOE) and decreasing (negative AOE) risk for hazardous alcohol use in socially anxious college students.     

Acute alcohol intoxication and vicarious emotional responsiveness

The effects of acute alcohol intoxication on vicarious emotional responsiveness were investigated using 30 young male social drinkers who were randomly assigned to one of three alcohol administration conditions. Dose levels were selected to approximate the following blood alcohol concentrations: (1) placebo-0.00%; (2) low alcohol dose-0.05%; or (3) high alcohol dose-0.10%. The vicarious conditioning paradigm required participants to observe another individual (videotaped model) receive an electric shock subsequent to auditory presentation of a numbered stimulus in a series from 1 to 7. Electrodermal activity and heart rate were monitored. Resting levels of autonomic functioning were minimally influenced by alcohol intoxication, although the high alcohol dose significantly reduced variability in nonspecific electrodermal responses. Magnitude of electrodermal response to the stimulus immediately paired with shock did not differ as a function of alcohol dose, but alcohol had a dose-related effect on vicariously instigated anticipatory electrodermal responses occurring prior to the stimulus associated with shock.     

Low but not high doses of buspirone reduce the anxiogenic effects of diazepam withdrawal

After 21 days of treatment with diazepam (2 mg/kg/day IP) rats were tested 24 h after the last injection in the social interaction and elevated plus-maze tests of anxiety. Compared with control-treated rats, they showed significant decreases in social interaction, in the % numbers of entries onto open arms of the plus-maze and in the % of time spent on the open arms, indicating an anxiogenic response on withdrawal from diazepam. Buspirone (200 µg/kg SC) significantly increased social interaction in diazepam withdrawn rats and in the plus-maze also this dose significantly reversed the anxiogenic effects of diazepam withdrawal. Buspirone (400 µg/kg SC) was without effect in the plus-maze, but buspirone (800 µg/kg SC) significantly decreased the % of time spent on open arms in control-treated rats, indicating an anxiogenic effect. In the social interaction test buspirone (800 µg/kg SC) was without significant effect. The contrasting effects of the 200 and 800 µg/kg doses are discussed in terms of the pre- and post-synaptic actions of buspirone. The findings are consistent with earlier proposals that the increased anxiety during benzodiazepine withdrawal is at least partly caused by an increased release of hippocampal 5-HT.     

Substance Use in Young Swiss Men: The Interplay of Perceived Social Support and Dispositional Characteristics

Background: Social environment plays a central role in substance use behaviors. However, it is not clear whether its role varies as a function of individual dispositional characteristics. Objectives: To investigate the interaction between dispositional characteristics (i.e. sensation seeking, anxiety/neuroticism) and social environment (i.e. perceived social support [PSS]) in association with substance use. Methods: A representative sample of 5,377 young Swiss males completed a questionnaire assessing substance use, sensation seeking, anxiety/neuroticism, and PSS from friends and from a significant other. Results: Sensation seeking and anxiety/neuroticism were positively related to most substance use outcomes. PSS from friends was significantly and positively related to most alcohol and cannabis use outcomes, and significantly and negatively associated with the use of hard drugs. PSS from a significant other was significantly and negatively associated with most alcohol and cannabis use outcomes. The associations of sensation seeking with drinking volume, alcohol use disorder and the use of illicit drugs other than cannabis were stronger in individuals reporting high levels of PSS from friends than those with low levels. The associations of sensation seeking with risky single-occasion drinking and the use of hard drugs were weaker in participants reporting high levels of PSS from a significant other than in those with low levels. Conclusions: Sensation seeking and anxiety/neuroticism may constitute risk factors for substance use and misuse. PSS from friends may amplify the risk for alcohol and illicit drug use (other than cannabis) associated with high sensation seeking, whereas the PSS from a significant other may reduce it.     

Stress response dampening: effects of gender and family history of alcoholism and anxiety disorders

One hundred and fifteen non-alcoholic social drinkers, ages 21–30 years, were selected on the basis of parental history of alcoholism and/or anxiety disorders to participate in a laboratory study of stress response dampening (SRD) effects of alcohol. The following four risk groups were identified based on the diagnoses of both parents: 1) alcoholism (ALC+), (2) alcoholism and anxiety disorder (ALCANX+), (3) anxiety (ANX+), and (4) no psychiatric diagnoses (FH–). Subjects were randomly assigned to receive a placebo or alcohol (0.85 g/kg) beverage, following which cardiovascular measures and self-reports of anxiety were monitored prior to, during and after a speech stressor. Women with a family history of alcoholism and women with a family history of anxiety disorders showed strong SRD effects of alcohol on heart rate and pulse transit time. Men with a family history of anxiety disorders showed evidence of increased subjective response to stress during the alcohol beverage condition. Finally, SRD effects of alcohol were not found for male subjects, and this was attributed to their heavier drinking histories and lower breath alcohol levels as compared to women. Implications of the SRD effects in women are discussed in the context of the comorbid association between alcoholism and anxiety disorders. Received: 16 October 1996/Final version: 14 November 1997     

Understanding the relationship between social anxiety and alcohol use in college students: A meta-analysis

Many college students use alcohol, and most of these students experience problems related to their use. Emerging research indicates that socially anxious students face heightened risk of experiencing alcohol-related problems, although the extant research on alcohol use and social anxiety in this population has yielded inconsistent findings. This meta-analysis was conducted to examine the relationship between social anxiety and alcohol variables in college students. A literature search was used to identify studies on college students that included measures of social anxiety and at least one of the alcohol variables of interest. All analyses were conducted using random effects models. We found that social anxiety was negatively correlated with alcohol use variables (e.g., typical quantity and typical frequency), but significantly positively correlated with alcohol-related problems, coping, conformity, and social motives for alcohol use, and positive and negative alcohol outcome expectancies. Several moderators of effect sizes were found to be significant, including methodological factors such as sample ascertainment approach. Given that social anxiety was negatively related to alcohol use but positively related to alcohol-related problems, research is needed to address why individuals high in social anxiety experience more problems as a result of their alcohol use. Avoidance of social situations among socially anxious students should also be taken into account when measuring alcohol use. The primary limitation of this study is the small number of studies available for inclusion in some of the analyses.     

Recognizing the patient with social anxiety disorder

Social anxiety disorder is a prevalent and highly disabling condition, affecting 7-13% of the population at some point in their lives. Most sufferers are not diagnosed however, even after visiting a healthcare professional. Social anxiety disorder need not be a difficult condition to diagnose. Characteristic features of the disorder include blushing as the principal symptom and an early age of onset. Social anxiety disorder is also easily distinguished from other anxiety disorders by the situations in which patients experience fear and avoidance; for the patient with social anxiety disorder, these situations always involve social interaction or scrutiny by other people. The consequences of untreated social anxiety disorder include social isolation, impaired educational attainment and career progression, depression, and alcohol abuse. Rating scales such as the Liebowitz Social Anxiety Scale (LSAS) give a consistent measure of severity of social anxiety disorder and so help physicians assess their patients' need for treatment and their improvement. Social anxiety disorder is an eminently treatable condition, as demonstrated by treatment-induced reduction in LSAS scores in clinical trials and by individual case histories. Appropriate therapy can give patients relief from their distressing and disabling symptoms and allows them to make substantial improvements to their quality of life.     

Tobacco chippers show robust increases in smoking urge after alcohol consumption

Objective and rationale Heavy social drinkers often engage in occasional cigarette smoking, especially in the context of consuming large quantities of alcohol. The current study assessed alcohol’s effects on smoking urge as a function of alcohol dose and time course in tobacco chippers with heavy social drinking patterns. Method The study assessed 39 chippers who underwent three separate evening sessions. Each subject received a placebo (1% volume alcohol as a taste mask), a low alcohol dose (two to three drinks equivalent), and a high alcohol dose (four to five drinks equivalent) in random order. No smoking was permitted during the sessions and the participants were abstinent from smoking for at least 3 h before arrival. Throughout the session, cigarette craving was assessed by the Brief Questionnaire of Smoking Urges and alcohol response was assessed by the Biphasic Alcohol Effects Scale (BAES). Results The results showed that alcohol significantly increased cigarette craving in a dose-dependent manner (p<0.001). At the high alcohol dose, craving was heightened during the rising portion of the blood alcohol curve (BAC). There was a strong relationship between BAC and craving for positive reinforcement and this relationship was partially mediated by BAES stimulation, but not sedation. Conclusions The findings show that alcohol directly increases smoking urge in chipper smokers. Tobacco chippers may crave cigarettes more during heavier than during lighter drinking bouts, and this effect appears to be driven by heightened stimulation levels rather than as a means to offset alcohol’s sedative effects.     

Effects of alcohol on aggressive behavior in squirrel monkeys: influence of testosterone and social context

Social status and reproductive cycle determine the effects of acute, low doses of alcohol on the social behavior of squirrel monkeys. Alcohol produces biphasic effects on the behavior of dominant but not subordinate monkeys, and only during the mating season. The change in alcohol sensitivity measured in dominant monkeys coincides with changes in plasma testosterone levels. In order to directly study the interaction between alcohol, testosterone and aggressive behavior, testosterone propionate (TP, 25 mg/kg/day, SC) was administered to either dominant or subordinate male monkeys belonging to four separate groups, resulting in significantly elevated plasma levels of testosterone (i.e., 905±43 ng/ml in subordinates; 171±19 ng/ml in dominants). Two to three weeks after the beginning of testosterone treatment, the monkeys were administered doses of alcohol (0.1–1.0 g/kg). The behavior of subordinate monkeys was unaffected by TP treatment (even after the dominant monkey from each colony was removed and housed separately for 6 weeks). Testosterone treatment altered the sensitivity of subordinate monkeys to alcohol. Low doses of alcohol increased the frequency of threats, grasps, and displacements exhibited by subordinate monkeys with exogenously elevated testosterone. Daily administration of TP to dominant monkeys during the non-mating season did not affect the behavior of the treated animals in the group, although the body weight of TP-treated monkeys was similar to that measured during the mating season. Low doses of alcohol increased the frequency of threats, grasps, and displacements in dominant monkeys maintained on TP.We also tested the role of social context in maintaining high levels of plasma testosterone, and alcohol sensitivity in dominant monkeys. While living in their social groups, dominants exhibited a similar pattern of alcohol enhancement of aggressive behavior in dyadic confrontations compared to effects measured during the mating season in an undisturbed group. After 2 weeks of individual housing, both plasma testosterone values and sensitivity to alcohol's effects were significantly reduced.These findings strengthen previous correlative studies indicating a relationship between plasma testosterone levels and the effects of alcohol on the aggressive behavior of squirrel monkeys. High levels of testosterone may activate alcohol-sensitive brain substrates of aggressive behavior.     

Chronic fluoxetine treatment partly attenuates the long-term anxiety and depressive symptoms induced by MDMA ('Ecstasy') in rats.

Use of the drug 3,4-methylenedioxymethamphetamine (MDMA, 'Ecstasy') can have long-term adverse effects on emotion in both humans and laboratory animals. The present study examined whether chronic treatment with the antidepressant drug fluoxetine could reverse such effects. Male Wistar rats were briefly exposed to MDMA (4 x 5 mg/kg over 4 h) or vehicle on 2 consecutive days. Approximately 9-12 weeks later, half of the rats received a dose of approximately 6 mg/kg/day fluoxetine in their drinking water for a 5-week period. Fluoxetine administration reduced fluid intake and body weight in MDMA and vehicle pretreated rats. After several weeks of fluoxetine treatment, rats were assessed on the social interaction test, the emergence test of anxiety and the forced swim model of depression. MDMA pretreated rats showed reduced social interaction, increased anxiety on the emergence test, and increased immobility and decreased active responses in the forced swim test. Fluoxetine treatment reversed MDMA-induced anxiety in the emergence test and depressive-like effects in the forced swim test, yet exhibited no effects on the social interaction test. MDMA pretreated rats had decreased 5-HT and 5-HIAA levels in limbic and cortical regions, and decreased density of serotonin transporter sites in the cortex. Fluoxetine treatment did not greatly affect 5-HT levels in MDMA pretreated rats, but significantly decreased 5-HIAA levels in all brain sites examined. Postmortem blood serum levels of fluoxetine and norfluoxetine did not differ in MDMA and vehicle pretreated rats. These results indicate that fluoxetine may provide a treatment option for some of the deleterious long-term effects resulting from MDMA exposure.     

The use of flumazenil in prevention of Diazepam dependence in the rat

Rats were treated with diazepam (4 mg/kg per day) or its vehicle for 21 days. Twenty-four hours after their last dose they were tested in the social interaction test of anxiety. Diazepam withdrawal significantly reduced the time spent in social interaction compared with controls, indicating an anxiogenic withdrawal response. The administration of a single dose of flumazenil (4 mg/kg) during chronic diazepam treatment, 7 or 14 days before testing, prevented the development of this withdrawal response. The clinical implications of these findings are discussed.