Social Anxiety Disorder and Alcohol Use

Social anxiety disorder—an excessive fear of social situations, such as eating or speaking in public—affects 2 to 13 percent of the U.S. population. About one-fifth of patients with social anxiety disorder also suffer from an alcohol use disorder (AUD) (i.e., alcohol abuse or dependence). One theory to explain the comorbidity between social anxiety disorder and AUDs is the tension reduction theory, which posits that people with social anxiety use alcohol to alleviate their fears. This expectation that alcohol reduces anxiety may motivate alcohol consumption even if pharmacological studies do not support that assumption. Social anxiety disorder is treatable with both pharmacotherapy and psychotherapy, and some of those treatments also would be expected to be effective for patients with comorbid AUDs. Evaluation of patients seeking alcoholism treatment for coexisting social anxiety disorder is important for improving treatment outcome. KEY WORDS: comorbidity; anxiety; social phobia; AODU (alcohol and other drug use); alcoholic beverage; tension reduction theory of AODU; diagnostic criteria; prevalence; positive AOD (alcohol and other drug) expectancies; drug therapy; psychotherapy; monoamine oxidase; benzodiazepines; serotonin uptake inhibitors; literature review Many people experience social anxiety—that is, they feel uncomfortable or even anxious related problems than does the general population. This article explores the diagnosis and prevalence of social anxi- tions can vary from interpersonal social interactions in small groups to talking to strangers. Performance fears, such as