Motives and Consequences of Alcohol Use in People With Social Anxiety Disorder: A Daily Diary Study

Using substances to cope with social anxiety: Associations with use and consequences in daily life.

“…However, social anxiety coping motives uniquely explained heavy drinking in certain social contexts, such that undergraduates with higher levels of social avoidance reported higher drinking to cope with social anxiety motives, which was associated with drinking more heavily in personal/intimate contexts (e.g., before sexual intercourse) and more negative drinking consequences. At the daily level, higher social anxiety coping motives, but not general anxiety coping motives or depression coping motives, were uniquely associated with a greater likelihood of experiencing some positive social consequences on drinking days (e.g., feeling more sociable), but not others (e.g., strengthening and/or forming new relationships; Goodman et al, 2022). Among a sample of undergraduates reporting cannabis use, general positive and negative affect were not related to cannabis-related consequences; instead, using cannabis to decrease negative affect and increase positive affect specifically in social situations were positively associated with more frequent cannabis use and more cannabis-related negative consequences (Walukevich-Dienst et al, 2020).…”

“…Significantly, less work has examined whether elevated social anxiety symptoms are associated with a greater likelihood of experiencing subjective positive consequences (e.g., increased sociability) at the daily level. Preliminary evidence is mixed, with one study finding that individuals with clinically elevated social anxiety symptoms do not differ significantly from those with lower social anxiety in attaining positive consequences related to their use (Goodman et al, 2022), whereas another study found that young adults with higher baseline internalizing symptoms appear to experience greater mood benefit when drinking to cope with anxiety than those with low baseline internalizing symptoms (Gorka et al, 2017). Thus, socially anxious individuals who use substances to cope with their social anxiety may not have a greater likelihood of actually experiencing the positive social consequences they seek (like feeling more sociable).…”

“…Using substances to cope with social anxiety is endorsed by many young adults, not just young adults who have clinically elevated social anxiety symptoms (Buckner & Heimberg, 2010; Buckner & Zvolensky, 2014). Social anxiety coping motives are typically conceptualized as using substances to cope with symptoms of social anxiety, including drinking “to feel less concerned about what others think” (Goodman et al, 2022) and using cannabis “because it makes you more comfortable in an unfamiliar situation” (Lee et al, 2009). In a cross-sectional sample of undergraduates, both depression coping motives and social anxiety coping motives mediated the link between social avoidance and negative drinking consequences (Collins et al, 2021).…”

“…Thus, young adults who use substances to cope with social anxiety may expect or report experiencing specific positive consequences related to these areas (e.g., decreased social avoidance, having an easier time socializing with others) while being vulnerable to also experiencing negative consequences as a result of the type of substance they use (e.g., increased anxiety with cannabis, saying or doing something embarrassing with alcohol or cannabis). Importantly, using substances to cope with social anxiety has been shown to be negatively reinforcing (e.g., reduced anxiety) and positively reinforcing (e.g., increased sociability; Goodman et al, 2022; Villarosa-Hurlocker et al, 2018). More daily-level research is needed in this area to further characterize associations between social anxiety coping motives and alcohol outcomes, including drinking quantity and negative consequences.…”

Common and Uncommon Risky Drinking Patterns in Young Adulthood Uncovered by Person-Specific Computational Modeling

“…Because of this aspect of multilevel models, researchers must decide which of the many constructs involved in drinking are the most important to consider. Studies have examined associations between affect and drinking (20), affect and motives (21,22), motives and drinking (23,24), motives and consequences (22,(25)(26)(27), expectancies and drinking (28)(29)(30)(31)(32)(33), expectancies and consequences (29,30,34,35), and consequences and drinking (34,(36)(37)(38)-but inconsistent with self-regulatory theories that incorporate all of these variables, none have examined all in a single model. This has resulted in a fragmented literature (Figure 1 depicts this visually), with each study testing a narrow subset of processes assumed to be important, yet because other key variables are unaccounted for, it is unclear which of these paths are relevant for alcohol use for most people.…”