Co-Morbidity of Social Phobia and Alcohol Use Disorders: A Review of Psychopathology Research Findings

Abstract

This chapter review focuses on psychopathology research findings for the co-morbidity of SP and AUD, with the goal of using the existing literature to build a conceptual framework to delineate the SPAUD specific association that may also be useful in guiding the next generation of research on SP and other SUD. In this chapter we review the literature on a spectrum of current biological and psychosocial explanations for the co-occurrence between SP and AUD. Our literature review places primacy on investigations conducted with clinical/ diagnosed and subclinical samples of SP and AUD to reduce redundancy with a recent comprehensive review of this topic (Morris, Stewart, & Ham, 2005) and to avoid possible distraction by results that may not be specific to our population of interest. To provide a context for our review, we begin with an overview of the literature on SP-AUD co-morbidity rates, highlighting the effects of symptom severity on the relationship between SP and AUD. We review empirical studies testing directly and indirectly the following hypotheses on the mechanisms linking SP to AUD: (1) Individuals with SP and AUD are genetically predisposed to both disorders, (2) Neurochemical disturbances are related to the occurrence of co-morbid SP and AUD, (3) Individuals with SP use alcohol because it has anxiolytic properties, and (4) Individuals with SP consume alcohol because they expect that alcohol use will reduce social anxiety and/or lack confidence in their ability to abstain or moderate their drinking in stressful social situations. The initial results in these research areas suggest that both biological and cognitive factors can account for the co-morbid relationship of SP and AUD. Our chapter concludes with a preliminary model of how genetics, neurobiology, cognitive, and social learning experiences might be considered jointly to provide an integrative and more complete understanding of SP-AUD causal mechanisms than can be achieved by focusing on any single causal pathway alone. (PsycINFO Database Record (c) 2019 APA, all rights reserved)